Sample records for clinical biochemistry laboratory

  1. Error tracking in a clinical biochemistry laboratory

    DEFF Research Database (Denmark)

    Szecsi, Pal Bela; Ødum, Lars


    BACKGROUND: We report our results for the systematic recording of all errors in a standard clinical laboratory over a 1-year period. METHODS: Recording was performed using a commercial database program. All individuals in the laboratory were allowed to report errors. The testing processes were cl...

  2. National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines for use of tumor markers in clinical practice

    DEFF Research Database (Denmark)

    Sturgeon, Catharine M; Hoffman, Barry R; Chan, Daniel W


    BACKGROUND: This report presents updated National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines summarizing quality requirements for the use of tumor markers. METHODS: One subcommittee developed guidelines for analytical quality relevant to serum and tissue-based tumor...

  3. Clinical biochemistry (United States)

    Alexander, W. C.; Leach, C. S.; Fischer, C. L.


    The objectives of the biochemical studies conducted for the Apollo program were (1) to provide routine laboratory data for assessment of preflight crew physical status and for postflight comparisons; (2) to detect clinical or pathological abnormalities which might have required remedial action preflight; (3) to discover as early as possible any infectious disease process during the postflight quarantine periods following certain missions; and (4) to obtain fundamental medical knowledge relative to man's adjustment to and return from the space flight environment. The accumulated data presented suggest that these requirements were met by the program described. All changes ascribed to the space flight environment were subtle, whereas clinically significant changes were consistent with infrequent illnesses unrelated to the space flight exposure.

  4. Application of indices Cp and Cpk to improve quality control capability in clinical biochemistry laboratories. (United States)

    Chen, Ming-Shu; Wu, Ming-Hsun; Lin, Chih-Ming


    The traditional criteria for acceptability of analytic quality may not be objective in clinical laboratories. To establish quality control procedures intended to enhance Westgard multi-rules for improving the quality of clinical biochemistry tests, we applied the Cp and Cpk quality-control indices to monitor tolerance fitting and systematic variation of clinical biochemistry test results. Daily quality-control data of a large Taiwanese hospital in 2009 were analyzed. The test items were selected based on an Olympus biochemistry machine and included serum albumin, aspartate aminotransferase, cholesterol, glucose and potassium levels. Cp and Cpk values were calculated for normal and abnormal levels, respectively. The tolerance range was estimated with data from 50 laboratories using the same instruments and reagents. The results showed a monthly trend of variation for the five items under investigation. The index values of glucose were lower than those of the other items, and their values were usually <2. In contrast to the Cp value for cholesterol, Cpk of cholesterol was lower than 2, indicating a systematic error that should be further investigated. This finding suggests a degree of variation or failure to meet specifications that should be corrected. The study indicated that Cp and Cpk could be applied not only for monitoring variations in quality control, but also for revealing inter-laboratory qualitycontrol capability differences.

  5. [External quality assessment in clinical biochemistry laboratories: pilot study in 11 laboratories of Lomé (Togo)]. (United States)

    Kouassi, Kafui; Fétéké, Lochina; Assignon, Selom; Dorkenoo, Ameyo; Napo-Koura, Gado


    This study aims to evaluate the performance of a few biochemistry analysis and make recommendations to the place of the stakeholders. It is a cross-sectional study conducted between the October 1(st), 2012 and the July 31, 2013 bearing on the results of 5 common examinations of clinical biochemistry, provided by 11 laboratories volunteers opening in the public and private sectors. These laboratories have analysed during the 3 cycles, 2 levels (medium and high) of serum concentration of urea, glucose, creatinine and serum aminotransferases. The performance of laboratories have been determined from the acceptable limits corresponding to the limits of total errors, defined by the French Society of Clinical Biology (SFBC). A system of internal quality control is implemented by all laboratories and 45% of them participated in international programs of external quality assessment (EQA). The rate of acceptable results for the entire study was of 69%. There was a significant difference (p<0.002) between the performance of the group of laboratories engaged in a quality approach and the group with default implementation of the quality approach. Also a significant difference was observed between the laboratories of the central level and those of the peripheral level of our health system (p<0.047). The performance of the results provided by the laboratories remains relatively unsatisfactory. It is important that the Ministry of Health put in place a national program of EQA with mandatory participation.

  6. Biochemistry: from supermarket to laboratory


    F. R. Freitas-Rego; Pereira, M. G.; S. O. Loureiro; M. T. de Santana; R. G. Garrido; F. de S.R.G Garrido


    After new campi as Instituto Multidisciplinar em Saúde (IMS/UFBA) startedworking, it was necessary to develop practical classes using domestic reagents atBiochemistry to Pharmacy (IMS078). Firstly, students visited a supermarket to readnutritional information at label and select possible products to be used in class. Moreover,chemical processes and fermentation were discussed as different foods and drinks wereanalysed. Some food were token to laboratories so that biomole cules qualitative ana...

  7. National Academy of Clinical Biochemistry laboratory medicine practice guidelines for use of tumor markers in testicular, prostate, colorectal, breast, and ovarian cancers

    DEFF Research Database (Denmark)

    Sturgeon, Catharine M; Duffy, Michael J; Stenman, Ulf-Håkan


    BACKGROUND: Updated National Academy of Clinical Biochemistry (NACB) Laboratory Medicine Practice Guidelines for the use of tumor markers in the clinic have been developed. METHODS: Published reports relevant to use of tumor markers for 5 cancer sites--testicular, prostate, colorectal, breast...

  8. [Research activity in clinical biochemistry

    DEFF Research Database (Denmark)

    Jorgensen, H.L.; Larsen, B.; Ingwersen, P.


    BACKGROUND: Quantitative bibliometric measurements of research activity are frequently used, e.g. for evaluating applicants for academic positions. The purpose of this investigation is to assess research activity within the medical speciality of Clinical Biochemistry by comparing it with a matched...... Clinical Biochemistry, 57 fulfilled the inclusion criteria. Each of these 57 was matched according to medical title with two randomly chosen specialists from other specialities, totaling 114. Using Medline and the Web of Science, the number of publications and the number of citations were then ascertained....... RESULTS: 25% of the 11,691 specialists held a PhD degree or doctoral degree, DMSci, (Clinical Biochemistry: 61%). The 171 specialists included in the study had 9,823 papers in Medline and 10,140 papers in the Web of Science. The number of Medline papers per specialist was 71 for Clinical Biochemistry...

  9. Biochemistry: from supermarket to laboratory

    Directory of Open Access Journals (Sweden)

    F. R. Freitas-Rego


    Full Text Available After new campi as Instituto Multidisciplinar em Saúde (IMS/UFBA startedworking, it was necessary to develop practical classes using domestic reagents atBiochemistry to Pharmacy (IMS078. Firstly, students visited a supermarket to readnutritional information at label and select possible products to be used in class. Moreover,chemical processes and fermentation were discussed as different foods and drinks wereanalysed. Some food were token to laboratories so that biomole cules qualitative analysiswere carried on. Domestic use reagents as pharmaceutical iodine solutions, commercialNaOH and vegetable pigments were used. The substances identified were reductant glycid,starch, fatty acid, triacylglycerol and protein. Reactions allowed to identify fungi andvegetable tissues. Moreover, invertase and alfa-amilase activities were determined. Afterdiscussions in class, students could improve biochemical knowledge as well as distinguishbetween milk or lactic drink, animal fat or vegetable hydrogenated fat, honey or glucose.After that, students produced kits and wrote laboratorial notes for use in classes with therest of the group.

  10. Immobilized Lactase in the Biochemistry Laboratory (United States)

    Allison, Matthew J.; Bering, C. Larry


    Immobilized enzymes have many practical applications. They may be used in clinical, industrial, and biotechnological laboratories and in many clinical diagnostic kits. For educational purposes, use of immobilized enzymes can easily be taught at the undergraduate or even secondary level. We have developed an immobilized enzyme experiment that combines many practical techniques used in the biochemistry laboratory and fits within a three-hour time frame. In this experiment, lactase from over-the-counter tablets for patients with lactose intolerance is immobilized in polyacrylamide, which is then milled into small beads and placed into a chromatography column. A lactose solution is added to the column and the eluant is assayed using the glucose oxidase assay, available as a kit. We have determined the optimal conditions to give the greatest turnover of lactose while allowing the immobilized enzymes to be active for long periods at room temperature.

  11. Clinical biochemistry of aluminum

    Energy Technology Data Exchange (ETDEWEB)

    King, S.W.; Savory, J.; Wills, M.R.


    Aluminum toxicity has been implicated in the pathogenesis of a number of clinical disorders in patients with chronic renal failure on long-term intermittent hemodialysis treatment. The predominant disorders have been those involving either bone (osteomalacic dialysis osteodystrophy) or brain (dialysis encephalopathy). In nonuremic patients, an increased brain aluminum concentration has been implicated as a neurotoxic agent in the pathogenesis of Alzheimer's disease and was associated with experimental neurofibrillary degeneration in animals. The brain aluminum concentrations of patients dying with the syndrome of dialysis encephalopathy (dialysis dementia) are significantly higher than in dialyzed patients without the syndrome and in nondialyzed patients. Two potential sources for the increased tissue content of aluminum in patients on hemodialysis have been proposed: (1) intestinal absorption from aluminum containing phosphate-binding gels, and (2) transfer across the dialysis membrane from aluminum in the water used to prepare the dialysate. These findings, coupled with our everyday exposure to the ubiquitous occurrence of aluminum in nature, have created concerns over the potential toxicity of this metal.

  12. Application of sigma metrics for the assessment of quality assurance in clinical biochemistry laboratory in India: a pilot study. (United States)

    Singh, Bhawna; Goswami, Binita; Gupta, Vinod Kumar; Chawla, Ranjna; Mallika, Venkatesan


    Ensuring quality of laboratory services is the need of the hour in the field of health care. Keeping in mind the revolution ushered by six sigma concept in corporate world, health care sector may reap the benefits of the same. Six sigma provides a general methodology to describe performance on sigma scale. We aimed to gauge our laboratory performance by sigma metrics. Internal quality control (QC) data was analyzed retrospectively over a period of 6 months from July 2009 to December 2009. Laboratory mean, standard deviation and coefficient of variation were calculated for all the parameters. Sigma was calculated for both the levels of internal QC. Satisfactory sigma values (>6) were elicited for creatinine, triglycerides, SGOT, CPK-Total and Amylase. Blood urea performed poorly on the sigma scale with sigma six sigma standards for all the analytical processes.

  13. An Integrated Biochemistry Laboratory, Including Molecular Modeling (United States)

    Hall, Adele J. Wolfson Mona L.; Branham, Thomas R.


    The dilemma of designing an advanced undergraduate laboratory lies in the desire to teach and reinforce basic principles and techniques while at the same time exposing students to the excitement of research. We report here on a one-semester, project-based biochemistry laboratory that combines the best features of a cookbook approach (high success rate, achievement of defined goals) with those of an investigative, discovery-based approach (student involvement in the experimental design, excitement of real research). Individual modules may be selected and combined to meet the needs of different courses and different institutions. The central theme of this lab is protein purification and design. This laboratory accompanies the first semester of biochemistry (Structure and Function of Macromolecules, a course taken mainly by junior and senior chemistry and biological chemistry majors). The protein chosen as the object of study is the enzyme lysozyme, which is utilized in all projects. It is suitable for a student lab because it is easily and inexpensively obtained from egg white and is extremely stable, and its high isoelectric point (pI = 11) allows for efficient separation from other proteins by ion-exchange chromatography. Furthermore, a literature search conducted by the resourceful student reveals a wealth of information, since lysozyme has been the subject of numerous studies. It was the first enzyme whose structure was determined by crystallography (1). Hendrickson et al. (2) have previously described an intensive one-month laboratory course centered around lysozyme, although their emphasis is on protein stability rather than purification and engineering. Lysozyme continues to be the focus of much exciting new work on protein folding and dynamics, structure and activity (3 - 5). This lab course includes the following features: (i) reinforcement of basic techniques, such as preparation of buffers, simple enzyme kinetics, and absorption spectroscopy; (ii

  14. An "in Silico" DNA Cloning Experiment for the Biochemistry Laboratory (United States)

    Elkins, Kelly M.


    This laboratory exercise introduces students to concepts in recombinant DNA technology while accommodating a major semester project in protein purification, structure, and function in a biochemistry laboratory for junior- and senior-level undergraduate students. It is also suitable for forensic science courses focused in DNA biology and advanced…

  15. Re-Attitude of Biochemistry Laboratory Course Contents in Medical, Dentistry and Para-Medical Faculties

    Directory of Open Access Journals (Sweden)

    Durdi Qujeq


    Full Text Available Regarding to development of basic science and new methods in biochemistry in recent years, practical biochemistry contents should be optimized (1. Therefore, re-attitude biochemistry course contents in medical schools has paralleled worldwide trends a moved from current status is needed (2, 3. As reported by investi-gators many medical schools around the world have reformed their medical curriculum in recent years (2. Many authors are convinced that students learn more effectively if the knowledge and skills they acquire are inserted and contextualized in relevant real-life, problem based situations (3. Previous studies demonstrated that biochemistry course content is now incorporated into the clinical beneficial, therefore the evolution of students in many countries has occurred (4. In this respect, the purpose of the current study was to evaluate biochemistry laboratory course contents in medical, dentistry and Para-medicine faculties from view points of the students. This descriptive study was per-formed in years 2010-2013. Questionnaire contained items about appropriateness of biochemistry laboratory contents for students. The first section of questionnaire determines the effectiveness of bioche¬mistry laboratory contents and the factors influence on it. The second section indicates the application of biochemistry laboratory contents, and the third parts of questi¬onnaire demonstrate the laboratory time spent of biochemistry laboratory course contents. For this purpose three faculties were selected. First, Faculty of Medicine (50 medical students, second Faculty of Dentistry (50 dentistry students and third Faculty of Para-medicine (50 laboratory science students were selected. At least 50 students were selected from each faculty and they received a questionnaire. All students were randomly selected to receive a standard questionnaire designed to evaluate their opinions about biochemistry laboratory course contents. The students were asked

  16. Raising environmental awareness through applied biochemistry laboratory experiments. (United States)

    Salman Ashraf, S


    Our environment is under constant pressure and threat from various sources of pollution. Science students, in particular chemistry students, must not only be made aware of these issues, but also be taught that chemistry (and science) can provide solutions to such real-life issues. To this end, a newly developed biochemistry laboratory experiment is described that guides students to learn about the applicability of peroxidase enzymes to degrade organic dyes (as model pollutants) in simulated waste water. In addition to showing how enzymes can potentially be used for waste water remediation, various factors than can affect enzyme-based reactions such as pH, temperature, concentration of substrates/enzymes, and denaturants can also be tested. This "applied biotechnology" experiment was successfully implemented in an undergraduate biochemistry laboratory course to enhance students' learning of environmental issues as well important biochemistry concepts. Student survey confirmed that this laboratory experiment was successful in achieving the objectives of raising environmental awareness in students and illustrating the usefulness of chemistry in solving real-life problems. This experiment can be easily adopted in an introductory biochemistry laboratory course and taught as an inquiry-guided exercise.

  17. Ribose 5-Phosphate Isomerase Investigations for the Undergraduate Biochemistry Laboratory (United States)

    Jewett, Kathy; Sandwick, Roger K.


    The enzyme ribose 5-phosphate isomerase (RpiA) has many features that make it attractive as a focal point of a semester-long, advanced biochemistry laboratory for undergraduate students. The protein can easily and inexpensively be isolated from spinach using traditional purification techniques. Characterization of RpiA enzyme activity can be…

  18. Differentiating Biochemistry Course Laboratories Based on Student Experience (United States)

    Jakubowski, Henry V.


    Content and emphases in undergraduate biochemistry courses can be readily tailored to accommodate the standards of the department in which they are housed, as well as the backgrounds of the students in the courses. A more challenging issue is how to construct laboratory experiences for a class with both chemistry majors, who usually have little or…

  19. Raising Environmental Awareness through Applied Biochemistry Laboratory Experiments (United States)

    Salman Ashraf, S.


    Our environment is under constant pressure and threat from various sources of pollution. Science students, in particular chemistry students, must not only be made aware of these issues, but also be taught that chemistry (and science) can provide solutions to such real-life issues. To this end, a newly developed biochemistry laboratory experiment…

  20. Virtual Laboratories in Chemistry, Biochemistry, & Molecular Biology

    DEFF Research Database (Denmark)

    May, Michael; Achiam, Marianne


    Report (state-of-the-art review) from a research and development project on virtual laboratories supported by Markedmodningsfonden (tidl. "Fornyelsesfonden")(2012-2014).

  1. A biochemistry laboratory course designed to enhance students autonomy

    Directory of Open Access Journals (Sweden)

    T. Silva


    Full Text Available INTRODUCTION: Laboratory sessions are responsible for promoting instrumentation skills desirable in biochemistry and biochemistry related careers. They are traditionally based on experimental protocols that lead to the expected results, and students usually have not autonomy to plan and execute their experiments. GOALS: This work aimed to enhance a traditional biochemistry lab course, applying pre-lab quizzes on protein biochemistry and lab techniques in order to have students better prepared to plan, execute and interpret experiments. This approach also aims to bring the laboratory sessions into an inquiry-based environment capable to improve students’ independent capabilities in 2 autonomy domains: learning and communication. MATERIAL AND METHODS: Online quizzes are delivered one week before each laboratory session, containing questions regarding the experimental techniques and theoretical basis related to them. Laboratory activities are presented in an inquiry-based approach where the first class of each activity is dedicated to plan experiments in order to answer the research questions presented by instructors. Activities are also organized in order to enhance students’ autonomy. The first activity is the simplest and more instructor-controlled and the last one is the most complex and less driven, transferring gradually to students the responsibility for their decisions in laboratory, supporting students’ autonomy. RESULTS: Online quizzes allowed instructors to identify students’ difficulties and to timely intervene. Scientific reports presented by students at the end of each activity showed that they performed better on less driven activities in which autonomy support were more complex than in the instructor controlled activities. CONCLUSIONS: Scientific reports analysis reveals students capabilities related to different scopes of autonomy, such as: discuss different strategies; find multiple solutions to solve problems; make their

  2. 78 FR 4170 - License Amendment Request for Analytical Bio-Chemistry Laboratories, Inc., Columbia, MO (United States)


    ... COMMISSION License Amendment Request for Analytical Bio-Chemistry Laboratories, Inc., Columbia, MO AGENCY... issuance of a license amendment to Materials License No. 24-13365-01 issued to Analytical Bio-Chemistry... accession numbers are: 1. Analytical Bio-Chemistry Laboratories, Inc., Licensee amendment request...

  3. Myoglobin structure and function: A multiweek biochemistry laboratory project. (United States)

    Silverstein, Todd P; Kirk, Sarah R; Meyer, Scott C; Holman, Karen L McFarlane


    We have developed a multiweek laboratory project in which students isolate myoglobin and characterize its structure, function, and redox state. The important laboratory techniques covered in this project include size-exclusion chromatography, electrophoresis, spectrophotometric titration, and FTIR spectroscopy. Regarding protein structure, students work with computer modeling and visualization of myoglobin and its homologues, after which they spectroscopically characterize its thermal denaturation. Students also study protein function (ligand binding equilibrium) and are instructed on topics in data analysis (calibration curves, nonlinear vs. linear regression). This upper division biochemistry laboratory project is a challenging and rewarding one that not only exposes students to a wide variety of important biochemical laboratory techniques but also ties those techniques together to work with a single readily available and easily characterized protein, myoglobin.

  4. Collective Construction of Knowledge in Clinical Biochemistry

    Directory of Open Access Journals (Sweden)

    S.B. Barreto


    Full Text Available The collective construction of knowledge occurs by the convergence of ideas and semantic. This paper was made for a graduation discipline, in 2009-2, with 240students who were separated into 4 groups: morning period (M1,M2 and night period (N1,N2. This study aims the collective construction of a abstract-manual of clinical biochemistry tests, due the difficulty in comprehension of certain concepts by the students; it intends to help them in the process of knowledge acquirement. The constructivist approach was adopted and the matters of the discipline were available in a “Student Group e-mail account”, a functional communication tool. The instructions were reachable on the web. M1,M2 and N1 made one part of the study at the first period. N2 did not conclude the study at the same time period of the other groups; therefore they received a new responsibility: they were supposed to conclude and correct the manual and its application which included 90 different kinds of labor exams. A textbook has been defined containing illustrative pictures of blood collection and biosecurity. Three banners were exposed inside the hall of the institution. Collective work is important for the effective arrangement in health area. In the process of teaching/learning, the teacher must proceed on practices and methodologies aiming the development of the student competences and skills which represent its professional identity.

  5. An in silico DNA cloning experiment for the biochemistry laboratory. (United States)

    Elkins, Kelly M


    This laboratory exercise introduces students to concepts in recombinant DNA technology while accommodating a major semester project in protein purification, structure, and function in a biochemistry laboratory for junior- and senior-level undergraduate students. It is also suitable for forensic science courses focused in DNA biology and advanced high school biology classes. Students begin by examining a plasmid map with the goal of identifying which restriction enzymes may be used to clone a piece of foreign DNA containing a gene of interest into the vector. From the National Center for Biotechnology Initiative website, students are instructed to retrieve a protein sequence and use Expasy's Reverse Translate program to reverse translate the protein to cDNA. Students then use Integrated DNA Technologies' OligoAnalyzer to predict the complementary DNA strand and obtain DNA recognition sequences for the desired restriction enzymes from New England Biolabs' website. Students add the appropriate DNA restriction sequences to the double-stranded foreign DNA for cloning into the plasmid and infecting Escherichia coli cells. Students are introduced to computational biology tools, molecular biology terminology and the process of DNA cloning in this valuable single session, in silico experiment. This project develops students' understanding of the cloning process as a whole and contrasts with other laboratory and internship experiences in which the students may be involved in only a piece of the cloning process/techniques. Students interested in pursuing postgraduate study and research or employment in an academic biochemistry or molecular biology laboratory or industry will benefit most from this experience.

  6. 临床生物化学室间质评回报结果分析%External Quality Assessment of Clinical Biochemistry Laboratories

    Institute of Scientific and Technical Information of China (English)

    魏琦; 常中宝; 黎春宝; 张明亮; 王春亮; 袁征; 申梦来


    Objective:To analyze the results of clinical laboratorycs external quality assessment by using the Industry Standard WS/T403-2012 and six sigma quality management criterion.Methods:Data were collected from routine internal quality control and external quality assess-ment in clinical chemistry laboratory in 2014.Allowable analytical error was defined according to the Industry Standard WS/T403-2012.Inde-xes such asσlevel, quality goal index(QGI),priority improvement measure and performance evaluation were calculated in projects of external quality assessment launched in this department.Results:In 22 routine tests,8 analytes were reached more than 6 Sigma Quality Level,5 analytes were reached more than 3 Sigma Quality Level ,the other 9 analytes were less than 3 Sigma metrics.Conclusion:Application of industry standard WS/T403-2012 and 6 Sigma methodology can improve the level of quality management in clinical chemistry laboratory.%目的:根据行业标准WS/T403-2012和6σ标准分析临床生物化学室间质评回报数据。方法:收集2014年度临床生化检验项目室内质量控制及室间质量评价数据;按照行业标准WS/T403-2012中允许总误差( TEa )标准,计算该室已开展的室间质评项目进行σ水平、质量目标指数( QGI)、优先改进措施及性能评定等指标。结果:全部22个常规生化检测项目,其中8个项目的σ水平>6σ,5个项目的σ水平>3σ,其余9个项目均<3σ。结论:应用行业标准WS/T403-2012和6σ标准分析室间质评数据,有助于了解和提高临床生化检验质量水平。

  7. Comprehensive Experiment--Clinical Biochemistry: Determination of Blood Glucose and Triglycerides in Normal and Diabetic Rats (United States)

    Jiao, Li; Xiujuan, Shi; Juan, Wang; Song, Jia; Lei, Xu; Guotong, Xu; Lixia, Lu


    For second year medical students, we redesigned an original laboratory experiment and developed a combined research-teaching clinical biochemistry experiment. Using an established diabetic rat model to detect blood glucose and triglycerides, the students participate in the entire experimental process, which is not normally experienced during a…

  8. CYP17A1: a biochemistry, chemistry, and clinical review. (United States)

    Porubek, David


    Cytochrome P450 17A1 (CYP17A1; also P450c17and P450sccII) is a critically important enzyme in humans that catalyzes the formation of all endogenous androgens. It is an atypical cytochrome P450 enzyme in that it catalyzes two distinct types of substrate oxidation. Through its hydroxylase activity, it catalyzes the 17α-hydroxylation of pregnenolone to 17α-OH pregnenolone. Subsequently, through its C17,20lyase activity, it can further convert 17α-OH pregnenolone to the androgen dehydroepiandrosterone, which is a precursor to androstenedione, testosterone, and dihydrotestosterone. The importance of androgens in diseases such as prostate cancer has been appreciated for decades and the discovery of extra-testicular formation of androgens has helped clarify the pathology of the disease, especially the castrate- resistant disease. Therefore, specific inhibition of CYP17A1 by therapeutic intervention has been an area of considerable effort in several research laboratories. This basic research has led to the discovery of several promising drug candidates followed by the conduct of several clinical trials. Recently, all these efforts have culminated in the first approval by FDA of an inhibitor of CYP17A1 for the treatment of castrate-resistant prostate cancer. Ongoing clinical trials are now evaluating the agent in earlier stages of prostate cancer and even rare forms of androgen-dependent breast cancer. Accordingly, this review focuses on the biochemistry, chemistry, and clinical inhibitors of CYP17A1.


    Directory of Open Access Journals (Sweden)

    J.M. Martins


    Full Text Available The cybernetic spaces simulate the real world with interactive multimedia. This work  has been applied since January, 2007 on the curricular student’s apprenticeship at high school and graduation, in the site “”. It has been developed to provide continuity to the technical-scientific learning of students and professionals, and also to improve their human social relations on the  labour  environment.  It’s comprises a virtual space, destined to communication and collective building of knowledge on the clinical biochemistry.   It’s about an interactive environment which allows the users registered as coordinator professor (professional  or the scientist student (trainee,  unlimited access to  posting contents (classes, texts, presentations, animations, consultations, non-synchronic discussions (on orkut, forums, e-mail and synchronic discussions (on chats, videoconferences. After a few live tutorials  about new  input in this environment, and the use of the new learning tool,  the collective building of knowledge on cyberspace begins. As a trainee’s program task, the scientist student would have to build a space of his own, under guidance and supervision of the coordinator teachers.  The cyberspace efficiency was evaluated from reports collected in February, 2008: the adherence to this  work was satisfactory, regarding this period, with 68 registered users, 870 accesses and 52 contents available on the several sections of the virtual laboratory. Our work is still being applied, and new adhesions are  happening everyday. We intend to amplify this cyber environment in order to make it a  permanent  continued education site on the health area.  From interest contracts and common knowledge,  the technological interfaces constitute an interaction, in which everyone is a potential author.  Keywords: Cyberspace, online biochemistry education, continued education.

  10. Comprehensive experiment-clinical biochemistry: determination of blood glucose and triglycerides in normal and diabetic rats. (United States)

    Jiao, Li; Xiujuan, Shi; Juan, Wang; Song, Jia; Lei, Xu; Guotong, Xu; Lixia, Lu


    For second year medical students, we redesigned an original laboratory experiment and developed a combined research-teaching clinical biochemistry experiment. Using an established diabetic rat model to detect blood glucose and triglycerides, the students participate in the entire experimental process, which is not normally experienced during a standard clinical biochemistry exercise. The students are not only exposed to techniques and equipment but are also inspired to think more about the biochemical mechanisms of diseases. When linked with lecture topics about the metabolism of carbohydrates and lipids, the students obtain a better understanding of the relevance of abnormal metabolism in relation to diseases. Such understanding provides a solid foundation for the medical students' future research and for other clinical applications.

  11. Human RAG mutations: biochemistry and clinical implications. (United States)

    Notarangelo, Luigi D; Kim, Min-Sung; Walter, Jolan E; Lee, Yu Nee


    The recombination-activating gene 1 (RAG1) and RAG2 proteins initiate the V(D)J recombination process, which ultimately enables the generation of T cells and B cells with a diversified repertoire of antigen-specific receptors. Mutations of the RAG genes in humans are associated with a broad spectrum of clinical phenotypes, ranging from severe combined immunodeficiency to autoimmunity. Recently, novel insights into the phenotypic diversity of this disease have been provided by resolving the crystal structure of the RAG complex, by developing novel assays to test recombination activity of the mutant RAG proteins and by characterizing the molecular and cellular basis of immune dysregulation in patients with RAG deficiency.

  12. Known Structure, Unknown Function: An Inquiry-Based Undergraduate Biochemistry Laboratory Course (United States)

    Gray, Cynthia; Price, Carol W.; Lee, Christopher T.; Dewald, Alison H.; Cline, Matthew A.; McAnany, Charles E.; Columbus, Linda; Mura, Cameron


    Undergraduate biochemistry laboratory courses often do not provide students with an authentic research experience, particularly when the express purpose of the laboratory is purely instructional. However, an instructional laboratory course that is inquiry- and research-based could simultaneously impart scientific knowledge and foster a student's…

  13. Guided Inquiry in a Biochemistry Laboratory Course Improves Experimental Design Ability (United States)

    Goodey, Nina M.; Talgar, Cigdem P.


    Many biochemistry laboratory courses expose students to laboratory techniques through pre-determined experiments in which students follow stepwise protocols provided by the instructor. This approach fails to provide students with sufficient opportunities to practice experimental design and critical thinking. Ten inquiry modules were created for a…

  14. A Semester-Long Project-Oriented Biochemistry Laboratory Based on "Helicobacter pylori" Urease (United States)

    Farnham, Kate R.; Dube, Danielle H.


    Here we present the development of a 13 week project-oriented biochemistry laboratory designed to introduce students to foundational biochemical techniques and then enable students to perform original research projects once they have mastered these techniques. In particular, we describe a semester-long laboratory that focuses on a biomedically…

  15. Clinical Laboratory Fee Schedule (United States)

    U.S. Department of Health & Human Services — Outpatient clinical laboratory services are paid based on a fee schedule in accordance with Section 1833(h) of the Social Security Act. The clinical laboratory fee...

  16. Haematology and Clinical Biochemistry Findings Associated with Equine Diseases - a Review

    Directory of Open Access Journals (Sweden)

    Onyinyechukwu A. AGINA


    Full Text Available The course and outcome of a disease process is dependent upon factors such as the disease-causing agent and its cell tropism, defense mechanisms of the host, genetic resistance of the species or breed affected, as well as the age, nutritional status and hormonal levels of the affected animal. When haematology, clinical biochemistry and cytology test results are combined with other laboratory procedures, complete physical examination and also with the history of the patient, a veterinarian is well armed to arrive at a definitive diagnosis, make a certain prognosis (good, poor or guarded and can also make a concluding statement on the efficacy of the instituted therapy. In clinical biochemistry, demonstration of specific enzyme activity and concentration of analytes in serum/plasma facilitates the disease diagnosis. Also, evaluation of haematology, clinical biochemistry and diagnostic cytology tests can help establish the presence or absence of diseases of internal organs, and by serial performance of these tests, may help to determine whether a disease process remains static, progressive or regressive. This review therefore provides the haematological, serum biochemical and cytological characteristics of diseases caused by the main bacteria, viruses, fungi, protozoa, helminths, arthropods, nutritional deficiencies, endocrine disturbances, neoplasm, allergy, toxins (phytoxins and zootoxins and inorganic poisons in horses.

  17. Costing clinical biochemistry services as part of an operational management budgeting system. (United States)

    Tarbit, I F


    The process of costing clinical biochemistry tests as a component of the commissioning of a unit management budgeting system based on an International Computers Limited (ICL) minicomputer system was examined. Methods of apportioning consumable and labour costs under direct and indirect cost headings and as test and request charges were investigated, and in this currently operational system it was found that 38% of consumable costs and 57% of labour costs were not a direct component of the routine analysis function. Means of assigning test costs to a given request source and the incorporation of such charges into clinical budget statements were looked at. A reduction in laboratory workload did not produce a comparable reduction in laboratory costs. For a theoretical reduction in workload of 20% only a 3.8% laboratory saving in recoverable costs could be expected.

  18. Thermodynamic Exploration of Eosin-Lysozyme Binding: A Physical Chemistry and Biochemistry Laboratory Experiment (United States)

    Huisman, Andrew J.; Hartsell, Lydia R.; Krueger, Brent P.; Pikaart, Michael J.


    We developed a modular pair of experiments for use in the undergraduate physical chemistry and biochemistry laboratories. Both experiments examine the thermodynamics of the binding of a small molecule, eosin Y, to the protein lysozyme. The assay for binding is the quenching of lysozyme fluorescence by eosin through resonant energy transfer. In…

  19. Forensic Analysis of Canine DNA Samples in the Undergraduate Biochemistry Laboratory (United States)

    Carson, Tobin M.; Bradley, Sharonda Q.; Fekete, Brenda L.; Millard, Julie T.; LaRiviere, Frederick J.


    Recent advances in canine genomics have allowed the development of highly distinguishing methods of analysis for both nuclear and mitochondrial DNA. We describe a laboratory exercise suitable for an undergraduate biochemistry course in which the polymerase chain reaction is used to amplify hypervariable regions of DNA from dog hair and saliva…

  20. Evaluation of a Modified Keller Method in a Biochemistry Laboratory Course. (United States)

    Jackman, Lance E.


    Describes a modified Keller plan for teaching a biochemistry laboratory course and evaluates the method's effectiveness by comparing results of students using Keller plan (N=17) to students receiving traditional instruction (N=16). Results suggest the modified Keller plan is a successful instructional method for the course. (Author/SK)

  1. Teaching Protein Purification and Characterization Techniques: A Student-Initiated, Project-Oriented Biochemistry Laboratory Course (United States)

    MacDonald, Gina


    This report describes a biochemistry laboratory that is completely project-oriented. Upper-level biology and chemistry majors work in teams to purify a protein of their choice. After the student groups have completed literature searches, ordered reagents, and made buffers they continue to learn basic protein purification and biochemical techniques…

  2. An SDS-PAGE Examination of Protein Quaternary Structure and Disulfide Bonding for a Biochemistry Laboratory (United States)

    Powers, Jennifer L.; Andrews, Carla S.; St. Antoine, Caroline C.; Jain, Swapan S.; Bevilacqua, Vicky L. H.


    Electrophoresis is a valuable tool for biochemists, yet this technique is often not included in biochemistry laboratory curricula owing to time constraints or lack of equipment. Protein structure is also a topic of interest in many disciplines, yet most undergraduate lab experiments focus only on primary structure. In this experiment, students use…

  3. Integrating Bio-Inorganic and Analytical Chemistry into an Undergraduate Biochemistry Laboratory (United States)

    Erasmus, Daniel J.; Brewer, Sharon E.; Cinel, Bruno


    Undergraduate laboratories expose students to a wide variety of topics and techniques in a limited amount of time. This can be a challenge and lead to less exposure to concepts and activities in bio-inorganic chemistry and analytical chemistry that are closely-related to biochemistry. To address this, we incorporated a new iron determination by…

  4. Biochemistry Facility (United States)

    Federal Laboratory Consortium — The Biochemistry Facility provides expert services and consultation in biochemical enzyme assays and protein purification. The facility currently features 1) Liquid...

  5. Known Structure, Unknown Function: An Inquiry-based Undergraduate Biochemistry Laboratory Course

    CERN Document Server

    Gray, Cynthia; Lee, Christopher T; Dewald, Alison H; Cline, Matthew A; McAnany, Charles E; Columbus, Linda; Mura, Cameron


    Undergraduate biochemistry laboratory courses often do not provide students with an authentic research experience, particularly when the express purpose of the laboratory is purely instructional. However, an instructional laboratory course that is inquiry- and research-based could simultaneously impart scientific knowledge and foster a student's research expertise and confidence. We have developed a year-long undergraduate biochemistry laboratory curriculum wherein students determine, via experiment and computation, the function of a protein of known three-dimensional structure. The first half of the course is inquiry-based and modular in design; students learn general biochemical techniques while gaining preparation for research experiments in the second semester. Having learned standard biochemical methods in the first semester, students independently pursue their own (original) research projects in the second semester. This new curriculum has yielded an improvement in student performance and confidence as ...

  6. Rastreabilidade metrológica em medicina laboratorial. Estudo de kits de bioquímica utilizados em laboratórios de análises clínicas | Metrological traceability in laboratory medicine: study of biochemistry kits used in clinical pathology laboratories

    Directory of Open Access Journals (Sweden)

    Maria Cristina Ferreira Pessoa


    Full Text Available A importância da rastreabilidade metrológica na produção de kits (conjuntos diagnósticos não é de domínio da comunidade laboratorial e, consequentemente, sua influência em validações de métodos e produção de resultados exatos e comparáveis nos laboratórios é pouco discutida. Este estudo espera contribuir para a disseminação deste conhecimento e evidenciar, para a comunidade de laboratoristas, a importância de realizar seus exames com conjuntos diagnósticos que utilizem Material de Referência Certificado (MRC ou Método de Referência (MetR em sua produção. O presente estudo evidencia que a rastreabilidade metrológica foi exclusivamente demonstrada pelo uso de MRC em 57% dos casos e em 26% pelo uso de MetR. Para os conjuntos diagnósticos em que os MRC foram utilizados no processo de fabricação, estes tiveram origem exclusiva do NIST (National Institute os Standards and Technology. Os resultados do estudo indicam que 46% dos conjuntos diagnósticos reportados no ensaio de proficiência da ControlLab – Bioquímica I são produzidos no Brasil, o que demonstra a importância desta indústria no nosso mercado. Entretanto, no que concerne à informação sobre rastreabilidade metrológica, dos 121 conjuntos diagnósticos pesquisados, 14% não informam rastreabilidade e todos são produtos nacionais, sugerindo que existem fabricantes que não estão atentos à disseminação desta informação como forma de atestar a qualidade do seu produto. ============================================= The importance of metrological traceability in the manufacture of diagnostic kits is not well understood in the laboratory community. Therefore, its influence on method validation and the production of accurate and comparable results in clinical laboratories is rarely discussed. This study aims to contribute to the dissemination of the knowledge of metrological traceability and emphasize the importance of using Certified Reference Materials

  7. Vertical integration of biochemistry and clinical medicine using a near-peer learning model. (United States)

    Gallan, Alexander J; Offner, Gwynneth D; Symes, Karen


    Vertical integration has been extensively implemented across medical school curricula but has not been widely attempted in the field of biochemistry. We describe a novel curricular innovation in which a near-peer learning model was used to implement vertical integration in our medical school biochemistry course. Senior medical students developed and facilitated a case-based small group session for first year biochemistry students. Students were surveyed before and after the session on their attitudes about biochemistry, as well as the effectiveness of the session. Prior to the session, the students believed biochemistry was more important to understanding the basic science of medicine than it was to understanding clinical medicine or becoming a good physician. The session improved students' attitudes about the importance of biochemistry in clinical medicine, and after the session they now believe that understanding biochemistry is equally important to the basic sciences as clinical medicine. Students would like more sessions and believe the senior student facilitators were knowledgeable and effective teachers. The facilitators believe they improved their teaching skills. This novel combination of near-peer learning and vertical integration in biochemistry provided great benefit to both first year and senior medical students, and can serve as a model for other institutions. © 2016 by The International Union of Biochemistry and Molecular Biology, 44(6):507-516, 2016.

  8. A semester-long project-oriented biochemistry laboratory based on Helicobacter pylori urease. (United States)

    Farnham, Kate R; Dube, Danielle H


    Here we present the development of a 13 week project-oriented biochemistry laboratory designed to introduce students to foundational biochemical techniques and then enable students to perform original research projects once they have mastered these techniques. In particular, we describe a semester-long laboratory that focuses on a biomedically relevant enzyme--Helicobacter pylori (Hp) urease--the activity of which is absolutely required for the gastric pathogen Hp to colonize the human stomach. Over the course of the semester, students undertake a biochemical purification of Hp urease, assess the success of their purification, and investigate the activity of their purified enzyme. In the final weeks of the semester, students design and implement their own experiments to study Hp urease. This laboratory provides students with an understanding of the importance of biochemistry in human health while empowering them to engage in an active area of research.

  9. Known structure, unknown function: An inquiry-based undergraduate biochemistry laboratory course. (United States)

    Gray, Cynthia; Price, Carol W; Lee, Christopher T; Dewald, Alison H; Cline, Matthew A; McAnany, Charles E; Columbus, Linda; Mura, Cameron


    Undergraduate biochemistry laboratory courses often do not provide students with an authentic research experience, particularly when the express purpose of the laboratory is purely instructional. However, an instructional laboratory course that is inquiry- and research-based could simultaneously impart scientific knowledge and foster a student's research expertise and confidence. We have developed a year-long undergraduate biochemistry laboratory curriculum wherein students determine, via experiment and computation, the function of a protein of known three-dimensional structure. The first half of the course is inquiry-based and modular in design; students learn general biochemical techniques while gaining preparation for research experiments in the second semester. Having learned standard biochemical methods in the first semester, students independently pursue their own (original) research projects in the second semester. This new curriculum has yielded an improvement in student performance and confidence as assessed by various metrics. To disseminate teaching resources to students and instructors alike, a freely accessible Biochemistry Laboratory Education resource is available at

  10. Drug Synthesis and Analysis on a Dime: A Capstone Medicinal Chemistry Experience for the Undergraduate Biochemistry Laboratory (United States)

    Streu, Craig N.; Reif, Randall D.; Neiles, Kelly Y.; Schech, Amanda J.; Mertz, Pamela S.


    Integrative, research-based experiences have shown tremendous potential as effective pedagogical approaches. Pharmaceutical development is an exciting field that draws heavily on organic chemistry and biochemistry techniques. A capstone drug synthesis/analysis laboratory is described where biochemistry students synthesize azo-stilbenoid compounds…

  11. Kinetics of Papain: An Introductory Biochemistry Laboratory Experiment (United States)

    Cornely, Kathleen; Crespo, Eric; Earley, Michael; Kloter, Rachel; Levesque, Aime; Pickering, Mary


    Enzyme kinetics experiments are popular in the undergraduate laboratory. These experiments have pedagogic value because they reinforce the concepts of Michaelis-Menten kinetics covered in the lecture portion of the course and give students the experience of calculating kinetic constants from data they themselves have generated. In this experiment, we investigate the kinetics of the thiol protease papain. The source of the papain is commercially available papaya latex. A specific substrate, Na-benzoyl-arginine-p-nitroanilide (BAPNA), is used, which takes advantage of the fact that papain interacts with a phenylalanine residue two amino acids away from the peptide bond cleaved. Upon hydrolysis by papain, a bright yellow product is released, p-nitroaniline. This allows the reaction to be monitored spectrophotometrically by measuring the rate of formation of the p-nitroaniline product as a function of the increase in absorbance of the solution at the lmax of p-nitroaniline (400 nm) over time at various substrate concentrations. These data are used to plot a Lineweaver-Burk plot from which the vmax and KM are obtained. If time permits, students carry out additional investigations in which e of p-nitroaniline is measured, the enzyme solution protein concentration is measured, the enzyme purity is evaluated by SDS-PAGE, and a pH-rate profile is constructed from experimental data.

  12. Integrating bio-inorganic and analytical chemistry into an undergraduate biochemistry laboratory. (United States)

    Erasmus, Daniel J; Brewer, Sharon E; Cinel, Bruno


    Undergraduate laboratories expose students to a wide variety of topics and techniques in a limited amount of time. This can be a challenge and lead to less exposure to concepts and activities in bio-inorganic chemistry and analytical chemistry that are closely-related to biochemistry. To address this, we incorporated a new iron determination by atomic absorption spectroscopy exercise as part of a five-week long laboratory-based project on the purification of myoglobin from beef. Students were required to prepare samples for chemical analysis, operate an atomic absorption spectrophotometer, critically evaluate their iron data, and integrate these data into a study of myoglobin.

  13. Dishonesty in the biochemistry classroom laboratory: A synthesis of causes and prevention. (United States)

    Del Carlo, Dawn; Bodner, George


    Although reports of academic cheating are abundant, there are relatively few papers in the literature that focus on cheating in the context of science courses and even fewer that address dishonest practices, such as "cooking" or fudging data, within the classroom laboratory. This paper briefly reviews the existing literature on academic dishonesty and explores two theories that can be used to explain why cheating occurs: (1) classroom goal structure and (2) attitudes of neutralization. We conclude with a discussion of the implications of these theories within the context of a biochemistry and molecular biology teaching laboratory.

  14. Fluorescence quantum yield measurements of fluorescent proteins: a laboratory experiment for a biochemistry or molecular biophysics laboratory course. (United States)

    Wall, Kathryn P; Dillon, Rebecca; Knowles, Michelle K


    Fluorescent proteins are commonly used in cell biology to assess where proteins are within a cell as a function of time and provide insight into intracellular protein function. However, the usefulness of a fluorescent protein depends directly on the quantum yield. The quantum yield relates the efficiency at which a fluorescent molecule converts absorbed photons into emitted photons and it is necessary to know for assessing what fluorescent protein is the most appropriate for a particular application. In this work, we have designed an upper-level, biochemistry laboratory experiment where students measure the fluorescence quantum yields of fluorescent proteins relative to a standard organic dye. Four fluorescent protein variants, enhanced cyan fluorescent protein (ECFP), enhanced green fluorescent protein (EGFP), mCitrine, and mCherry, were used, however the methods described are useful for the characterization of any fluorescent protein or could be expanded to fluorescent quantum yield measurements of organic dye molecules. The laboratory is designed as a guided inquiry project and takes two, 4 hr laboratory periods. During the first day students design the experiment by selecting the excitation wavelength, choosing the standard, and determining the concentration needed for the quantum yield experiment that takes place in the second laboratory period. Overall, this laboratory provides students with a guided inquiry learning experience and introduces concepts of fluorescence biophysics into a biochemistry laboratory curriculum.

  15. [Principles of cooperation between the specialties of internal medicine, pathology and clinical biochemistry]. (United States)

    Hölzel, W; Baumgarten, R; Fiedler, H; Zimmermann, S


    The optimal utilization of the knowledge and possibilities of pathological and clinical biochemistry presumes a close cooperation between it and the clinical specialties. The common working team of the GDR Society of Internal Medicine and the GDR Society for Clinical Chemistry and Laboratory Diagnostics makes theses of the central points of the cooperation in care, education, further education and postgraduate study and in research a subject for discussion. As essential tasks in the process of medical care are regarded the balance of the examination programme standing at the disposal, the establishment of diagnostic programmes, the establishment of organisational measures, the ascertainment of a use according to indication, the guarantee of the representance of examination material, the control of plausibility and the interpretation of test results. Since the realization of the tasks to a large extent depends on the cooperation of the specialities in education, further education and postgraduate study during the further education the clinician should become acquainted with the possibilities, the limits and the prerequisites for the performance of laboratory diagnostic investigations, the clinical biochemist with the problems of medical care and the value of the laboratory diagnosis in the total process of the treatment. In the field of research the result is a necessary cooperation in the clarification of patho-biochemical mechanisms, in the search for suitable laboratory diagnostic parameters for diagnostics and control of the course as well as in the statement of the validity of laboratory diagnostic parameters and parameter combinations taking into consideration the factors expenses, benefit and risk as well as further diagnostic possibilities.

  16. Capillary blood sampling: national recommendations on behalf of the Croatian Society of Medical Biochemistry and Laboratory Medicine. (United States)

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


    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.

  17. Team-Based Learning, Faculty Research, and Grant Writing Bring Significant Learning Experiences to an Undergraduate Biochemistry Laboratory Course (United States)

    Evans, Hedeel Guy; Heyl, Deborah L.; Liggit, Peggy


    This biochemistry laboratory course was designed to provide significant learning experiences to expose students to different ways of succeeding as scientists in academia and foster development and improvement of their potential and competency as the next generation of investigators. To meet these goals, the laboratory course employs three…

  18. Biochemistry Instrumentation Core Technology Center (United States)

    Federal Laboratory Consortium — The UCLA-DOE Biochemistry Instrumentation Core Facility provides the UCLA biochemistry community with easy access to sophisticated instrumentation for a wide variety...

  19. Development of a Semester-Long, Inquiry-Based Laboratory Course in Upper-Level Biochemistry and Molecular Biology (United States)

    Murthy, Pushpalatha P. N.; Thompson, Martin; Hungwe, Kedmon


    A semester-long laboratory course was designed and implemented to familiarize students with modern biochemistry and molecular biology techniques. The designed format involved active student participation, evaluation of data, and critical thinking, and guided students to become independent researchers. The first part of the course focused on…

  20. Equilibrium Gel Filtration Chromatography for the Measurement of Protein-Ligand Binding in the Undergraduate Biochemistry Laboratory (United States)

    Craig, Douglas B.


    A laboratory exercise used in the senior biochemistry course at the University of Winnipeg for three years is discussed. It combines liquid chromatography and absorbance spectroscopy and also allows the students to produce a quantitative result within a single three-hour period.

  1. The Determination of Vitamin D-Dependent Calcium Binding Protein in Chick Intesting: An Undergraduate Biochemistry Laboratory Experiment. (United States)

    Lessard, George M.


    Described is an experiment used in an undergraduate biochemistry laboratory involving inducing rickets in chicks and correlating the disease to a reduction in vitamin D-dependent calcium binding protein. Techniques involved are hormone induction, protein isolation, and radioisotope methodology. (Author/DS)

  2. HPLC of the Polypeptides in a Hydrolyzate of Egg-White Lysozyme. An Experiment for the Undergraduate Biochemistry Laboratory. (United States)

    Richardson, W. S., III; Burns, L.


    Describes a simple high-performance liquid chromatography experiment for undergraduate biochemistry laboratories. The experiment illustrates the separation of polypeptides by a step gradient elution using a single pump instrument with no gradient attachments. Discusses instrumentation, analysis, a sample preparation, and results. (CW)

  3. Raman Investigation of Temperature Profiles of Phospholipid Dispersions in the Biochemistry Laboratory (United States)

    Craig, Norman C.


    The temperature dependence of self-assembled, cell-like dispersions of phospholipids is investigated with Raman spectroscopy in the biochemistry laboratory. Vibrational modes in the hydrocarbon interiors of phospholipid bilayers are strongly Raman active, whereas the vibrations of the polar head groups and the water matrix have little Raman activity. From Raman spectra increases in fluidity of the hydrocarbon chains can be monitored with intensity changes as a function of temperature in the CH-stretching region. The experiment uses detection of scattered 1064-nm laser light (Nicolet NXR module) by a Fourier transform infrared spectrometer (Nicolet 6700). A thermoelectric heater-cooler device (Melcor) gives convenient temperature control from 5 to 95°C for samples in melting point capillaries. Use of deuterium oxide instead of water as the matrix avoids some absorption of the exciting laser light and interference with intensity observations in the CH-stretching region. Phospholipids studied range from dimyristoylphosphotidyl choline (C14, transition T = 24°C) to dibehenoylphosphotidyl choline (C22, transition T = 74°C).


    Directory of Open Access Journals (Sweden)

    Rasma Vitolina, Aivars Krauze, Gunars Duburs and Astrida Velena*


    Full Text Available Amlodipine is the third generation calcium antagonist, 1,4-dihydropyridine derivative with the prolonged duration of the antihypertensive action, especially blocking L-type Ca2+ ion channels. It promotes beneficial therapeutic effect by coronary and other blood vessel diseases and thus delays development of the atherosclerosis. It has several known trade names, the most mentioned is Norvasc. Amlodipine is well tolerated in the clinics, it could be used in combinations with other drugs – diuretics, angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists, statins. Amlodipine at nanomolar concentrations binds to the voltage-dependent L-type calcium channels. It possesses optimal lipophylicity. Amlodipine also influences the NO-dependent metabolic processes, stimulates NO synthesis and prolongs NO action duration. Results of the studies of the amlodipine pharmacological and clinical properties are summarized in several reviews. The present review contains opinion from the scientific works of the last decades about the multisided or pleiotropic amlodipine mechanisms of action, it contains information about sometimes controversial clinical studies of the amlodipine vaso- and cardioprotective activity.

  5. [Estimation of uncertainty of measurement in clinical biochemistry]. (United States)

    Enea, Maria; Hristodorescu, Cristina; Schiriac, Corina; Morariu, Dana; Mutiu, Tr; Dumitriu, Irina; Gurzu, B


    The uncertainty of measurement (UM) or measurement uncertainty is known as the parameter associated with the result of a measurement. Repeated measurements usually reveal slightly different results for the same analyte, sometimes a little higher, sometimes a little lower, because the results of a measurement are depending not only by the analyte itself, but also, by a number of error factors that could give doubts about the estimate. The uncertainty of the measurement represent the quantitative, mathematically expression of this doubt. UM is a range of measured values which is probably to enclose the true value of the measured. Calculation of UM for all types of laboratories is regularized by the ISO Guide to the Expression of Uncertainty in Measurement (abbreviated GUM) and the SR ENV 13005 : 2003 (both recognized by European Accreditation). Even if the GUM rules about UM estimation are very strictly, the offering of the result together with UM will increase the confidence of customers (patients or physicians). In this study the authors are presenting the possibilities of UM assessing in labs from our country by using the data obtained in the procedures of methods validation, during the internal and external quality control.

  6. Improvement of the quality of work in a biochemistry laboratory via measurement system analysis. (United States)

    Chen, Ming-Shu; Liao, Chen-Mao; Wu, Ming-Hsun; Lin, Chih-Ming


    An adequate and continuous monitoring of operational variations can effectively reduce the uncertainty and enhance the quality of laboratory reports. This study applied the evaluation rule of the measurement system analysis (MSA) method to estimate the quality of work conducted in a biochemistry laboratory. Using the gauge repeatability & reproducibility (GR&R) approach, variations in quality control (QC) data among medical technicians in conducting measurements of five biochemical items, namely, serum glucose (GLU), aspartate aminotransferase (AST), uric acid (UA), sodium (Na) and chloride (Cl), were evaluated. The measurements of the five biochemical items showed different levels of variance among the different technicians, with the variances in GLU measurements being higher than those for the other four items. The ratios of precision-to-tolerance (P/T) for Na, Cl and GLU were all above 0.5, implying inadequate gauge capability. The product variation contribution of Na was large (75.45% and 31.24% in normal and abnormal QC levels, respectively), which showed that the impact of insufficient usage of reagents could not be excluded. With regard to reproducibility, high contributions (of more than 30%) of variation for the selected items were found. These high operator variation levels implied that the possibility of inadequate gauge capacity could not be excluded. The ANOVA of GR&R showed that the operator variations in GLU measurements were significant (F=5.296, P=0.001 in the normal level and F=3.399, P=0.015 in the abnormal level, respectively). In addition to operator variations, product variations of Na were also significant for both QC levels. The heterogeneity of variance for the five technicians showed significant differences for the Na and Cl measurements in the normal QC level. The accuracy of QC for five technicians was identified for further operational improvement. This study revealed that MSA can be used to evaluate product and personnel errors and to

  7. Anatomy and history of an external quality assessment program for interpretative comments in clinical biochemistry. (United States)

    Vasikaran, Samuel D


    The provision of clinical interpretation of results, either verbally or in the printed report, may be considered an integral part of clinical biochemistry diagnostic service. Proficiency testing or external quality assessment (EQA) of such activity may be useful in education, training, continuing professional development and ensuring the quality of such service. Details of the Patient Report Comments Program (RPCProgram) developed by the Royal College of Pathologists of Australasia (RCPA) Chemical Pathology Quality Assurance Programs Pty Ltd (QAP) is described in this review. The program is aimed at pathologists, clinical scientists and trainees. Registered participants are provided a report with case details and a set of clinical biochemistry results at monthly intervals and submit an interpretative comment for the report. Comments received are broken up into components that are translated into common key phrases. An expert panel evaluates the key phrases, classifies them according to appropriateness and drafts a suggested comment, a case summary and a rationale, which are included in a summary report returned to participants. There is considerable diversity in the quality of interpretative comments received from participants of the PRCProgram. The primary purpose of EQA of interpretative commenting is educational self-assessment, and they are recognized as a continuing professional development activity. Whilst there is some evidence for the utility of interpretative comments in improving patient outcomes, evidence for the utility of EQA in improving quality of comments is awaited.

  8. Secrets from the microbiome: molecular biology meets microbiology meets histopathology...meets clinical biochemistry. (United States)

    Young, Caroline; Quirke, Philip


    The microbiome is the collective term used to describe the bacteria, viruses, fungi and archaea that reside on and in the human body. The majority of these organisms are found within the large bowel. Mounting evidence suggests that changes in the microbiome may be associated with the development of colorectal cancer, a disease which affects 1.3 million people a year worldwide. Using colorectal cancer as an example, this article presents the inter-specialty collaborative approach to microbiome research and discusses the key role that clinical biochemistry is likely to play.

  9. ILIS--An integrated laboratory information system. I. Biochemistry and hematology. (United States)

    Deshpande, S U


    IBM System 34 (central processing unit, 128 kilobytes; fixed disks, 128.4 megabytes) with seven cathode-ray tubes has been used by our clinical laboratories for the last 30 months. All data-entry programs are in a conversational mode, for on-line corrections of possible errors in patient identification and results. Daily reports are removed from the medical records after temporary and permanent cumulative weekly reports are received, which keep a three-month track of the results. The main advantages of the system are: (a) the increasing laboratory work load can be handled with the same staff; (b) the volume of the medical record files on the patients is decreased; (c) an easily retrievable large data base of results is formed for research purposes; (d) faster billing; and (e) the computer system is run without engaging any additional staff.

  10. Doing That Thing That Scientists Do: A Discovery-Driven Module on Protein Purification and Characterization for the Undergraduate Biochemistry Laboratory Classroom (United States)

    Garrett, Teresa A.; Osmundson, Joseph; Isaacson, Marisa; Herrera, Jennifer


    In traditional introductory biochemistry laboratory classes students learn techniques for protein purification and analysis by following provided, established, step-by-step procedures. Students are exposed to a variety of biochemical techniques but are often not developing procedures or collecting new, original data. In this laboratory module,…

  11. Informatics and the clinical laboratory. (United States)

    Jones, Richard G; Johnson, Owen A; Batstone, Gifford


    The nature of pathology services is changing under the combined pressures of increasing workloads, cost constraints and technological advancement. In the face of this, laboratory systems need to meet new demands for data exchange with clinical electronic record systems for test requesting and results reporting. As these needs develop, new challenges are emerging especially with respect to the format and content of the datasets which are being exchanged. If the potential for the inclusion of intelligent systems in both these areas is to be realised, the continued dialogue between clinicians and laboratory information specialists is of paramount importance. Requirements of information technology (IT) in pathology, now extend well beyond the provision of purely analytical data. With the aim of achieving seamless integration of laboratory data into the total clinical pathway, 'Informatics' - the art and science of turning data into useful information - is becoming increasingly important in laboratory medicine. Informatics is a powerful tool in pathology - whether in implementing processes for pathology modernisation, introducing new diagnostic modalities (e.g. proteomics, genomics), providing timely and evidence-based disease management, or enabling best use of limited and often costly resources. Providing appropriate information to empowered and interested patients - which requires critical assessment of the ever-increasing volume of information available - can also benefit greatly from appropriate use of informatics in enhancing self-management of long term conditions. The increasing demands placed on pathology information systems in the context of wider developmental change in healthcare delivery are explored in this review. General trends in medical informatics are reflected in current priorities for laboratory medicine, including the need for unified electronic records, computerised order entry, data security and recovery, and audit. We conclude that there is a

  12. A retrospective study of the clinical hematology and the serum biochemistry tests made on canine dirofilariasis cases in an animal hospital population in Bangkok, Thailand. (United States)

    Niwetpathomwat, Anuchai; Kaewthamasorn, Morakot; Tiawsirisup, Sonthaya; Techangamsuwan, Somporn; Suvarnvibhaja, Siram


    Heartworm disease, caused by the filarial nematode, Dirofilaria immitis, is a major, potentially life-threatening disease of dogs, with worldwide distribution and global significance. It is not only of veterinary importance but it also has zoonotic potential in many regions. It is considered as an endemic disease in Thailand, although clinical data about the disease is rarely reported. The objectives of this study were to characterize the clinical hematology and the biochemistry of canine dirofilariasis cases admitted to Chulalongkorn University, Small Animal Teaching Hospital in Bangkok, Thailand, from 2001-2003. All hematology and serum biochemistry parameter interpretations were based on reference values. A total of 1023 dogs were evaluated in this study. Dogs were divided into three groups based on their heartworm classification (microfilaremic, occult and negative). The major hematological findings in microfilaremic dogs were a mild to moderate anemia, mild to severe thrombocytopenia, marked leukocytosis, moderate to marked neutrophilia, eosinophilia and monocytosis. The most common serum biochemical abnormalities in microfilaremic dogs included increased alkaline phosphatase, alanine aminotransferase and aspartate aminotransferase with a mean+/-SD of 311+/-299, 82+/-76 and 50+/-38 IU/L, respectively. It is likely that this parasitic infection led to the impairment of the hematological and biochemical status of the infected dogs. We believe that investigation of these laboratory based parameters, when associated with the clinical signs, is a very important approach to be considered in the routine clinical follow up, as well as being important for therapeutic evaluations.

  13. An Undergraduate Investigation into the 10-23 DNA Enzyme that Cleaves RNA: DNA Can Cut It in the Biochemistry Laboratory (United States)

    Flynn-Charlebois, Amber; Burns, Jamie; Chapelliquen, Stephanie; Sanmartino, Holly


    A low-cost biochemistry experiment is described that demonstrates current techniques in the use of catalytic DNA molecules and introduces a nonradioactive, nonfluorescent, inexpensive, fast, and safe method for monitoring these nucleic acid reactions. The laboratory involves the exploration of the 10-23 DNA enzyme as it cleaves a specific RNA…

  14. An Inexpensive, Relatively Green, and Rapid Method to Purify Genomic DNA from "Escherichia Coli": An Experiment for the Undergraduate Biochemistry Laboratory (United States)

    Sims, Paul A.; Branscum, Katie M.; Kao, Lydia; Keaveny, Virginia R.


    A method to purify genomic DNA from "Escherichia coli" is presented. The method is an amalgam of published methods but has been modified and optimized for use in the undergraduate biochemistry laboratory. Specifically, the method uses Tide Free 2x Ultra laundry detergent, which contains unspecified proteases and lipases, "n"-butanol, 2-propanol,…

  15. Synthesis, Characterization, and Secondary Structure Determination of a Silk-Inspired, Self-Assembling Peptide: A Laboratory Exercise for Organic and Biochemistry Courses (United States)

    Albin, Tyler J.; Fry, Melany M.; Murphy, Amanda R.


    This laboratory experiment gives upper-division organic or biochemistry undergraduate students a comprehensive look at the synthesis, chemical characterization, self-assembly, and secondary structure determination of small, N-acylated peptides inspired by the protein structure of silkworm silk. All experiments can be completed in one 4 h lab…

  16. Evaluation of an Online Instructional Database Accessed by QR Codes to Support Biochemistry Practical Laboratory Classes (United States)

    Yip, Tor; Melling, Louise; Shaw, Kirsty J.


    An online instructional database containing information on commonly used pieces of laboratory equipment was created. In order to make the database highly accessible and to promote its use, QR codes were utilized. The instructional materials were available anytime and accessed using QR codes located on the equipment itself and within undergraduate…

  17. Analysis of a p53 Mutation Associated with Cancer Susceptibility for Biochemistry and Genetic Laboratory Courses (United States)

    Soto-Cruz, Isabel; Legorreta-Herrera, Martha


    We have devised and implemented a module for an upper division undergraduate laboratory based on the amplification and analysis of a p53 polymorphism associated with cancer susceptibility. First, students collected a drop of peripheral blood cells using a sterile sting and then used FTA cards to extract the genomic DNA. The p53 region is then PCR…

  18. Green, Enzymatic Syntheses of Divanillin and Diapocynin for the Organic, Biochemistry, or Advanced General Chemistry Laboratory (United States)

    Nishimura, Rachel T.; Giammanco, Chiara H.; Vosburg, David A.


    Environmentally benign chemistry is an increasingly important topic both in the classroom and the laboratory. In this experiment, students synthesize divanillin from vanillin or diapocynin from apocynin, using horseradish peroxidase and hydrogen peroxide in water. The dimerized products form rapidly at ambient temperature and are isolated by…

  19. [Clinical laboratory in the 21st century]. (United States)

    Kawai, T


    Alvin Toffler has predicted that the "Third Wave" will be a society which be decentralized, diversified and customized, computer-dependent. Medical care and also clinical laboratory will be revolutionalized in a more or less similar direction to that predicted by him. Laboratory physicians and scientists should try to improve laboratory services, particularly establishment of adequate normal values, common expression of various laboratory results, introduction of medical decision making and recommended guideline for laboratory use in primary health care.

  20. 78 FR 6330 - Clinical Laboratory Improvement Advisory Committee (CLIAC) (United States)


    ... HUMAN SERVICES Centers for Disease Control and Prevention Clinical Laboratory Improvement Advisory... related to improvement in clinical laboratory quality and laboratory medicine practice and specific... laboratory services; revisions to the standards under which clinical laboratories are regulated; the...

  1. Medical and Clinical Laboratory Technologists and Technicians (United States)

    ... Projected Employment, 2024 Change, 2014-24 Employment by Industry Percent Numeric SOURCE: U.S. Bureau of Labor Statistics, Employment Projections program Clinical laboratory technologists and technicians ...

  2. Learning Online Environment for an Extra Curricular Course in Clinical Biochemistry

    Directory of Open Access Journals (Sweden)

    J.M. Martins


    Full Text Available Integration between digital technology and telecommunication resources present multiple possibilities regarding access to education, among them, the longdistance learning process. The purpose of this work is to offer a long distance extra  curricular course for health care students and professionals, intending to contribute with their continued education. The online cou rse (180h was avail able on the webpage in a LMS  platform(Learning Management System, in which 35 students from all over Brazil and 07 tutors (UFPEsubscribed.   The  subscribers had access to: web classrooms (12 withpresentations/notes (62; exercises (15; forums (27; technical dictionaries (119; scientific articles (70; theses e dissertations (04; web search links (50; email (30; clipboards (28; ch ats  (01; exams (01. The number of accesses to the online content by the students  (17.795 and the tutors (3.8 42 showed great participation on the online environment. Online classrooms were greatly accessed (3. 335andthe  forum   demonstrated hasbeen thebest interaction tool (5.188. The asynchronous communication (email and forum seemed more efficient than the synchronous (chat one. Everyone performed the proposed activities between 07/25/08 and 02/05/09. The platform used was efficient in the online  long distance extra  curricular course   i n  clinical  biochemistry , with satisfactory didactic planning and selection of the contents which were properly related to the professionalcompetences to be acquired by the subscribers.

  3. Clinical and Laboratory Diagnosis of Intestinal Tuberculosis

    Directory of Open Access Journals (Sweden)

    Xiao-Chun Shi


    Conclusions: ITB is difficult to diagnose even with modern medical techniques due to its nonspecific clinical and laboratory features. At present, combination of clinical, endoscopic, radiological, and pathological features continues to be the key to the diagnosis of ITB.

  4. Environmental regulation of plant gene expression: an RT-qPCR laboratory project for an upper-level undergraduate biochemistry or molecular biology course. (United States)

    Eickelberg, Garrett J; Fisher, Alison J


    We present a novel laboratory project employing "real-time" RT-qPCR to measure the effect of environment on the expression of the FLOWERING LOCUS C gene, a key regulator of floral timing in Arabidopsis thaliana plants. The project requires four 3-hr laboratory sessions and is aimed at upper-level undergraduate students in biochemistry or molecular biology courses. The project provides students with hands-on experience with RT-qPCR, the current "gold standard" for gene expression analysis, including detailed data analysis using the common 2-ΔΔCT method. Moreover, it provides a convenient starting point for many inquiry-driven projects addressing diverse questions concerning ecological biochemistry, naturally occurring genetic variation, developmental biology, and the regulation of gene expression in nature.

  5. Comparison of the microbial dynamics and biochemistry of laboratory sourdoughs prepared with grape, apple and yogurt. (United States)

    Gordún, Elena; del Valle, Luis J; Ginovart, Marta; Carbó, Rosa


    The microbiological culture-dependent characterization and physicochemical characteristics of laboratory sourdough prepared with grape (GS) were evaluated and compared with apple (AS) and yogurt (YS), which are the usual Spanish sourdough ingredients. Ripe GS took longer than AS and YS to reach the appropriate acidity and achieved lower values of lactic acid. In all sourdoughs, the lactic acid bacteria (LAB) increased during processing and were the dominant microorganisms (>1E+8 CFU/g). GS, as well as AS, had high diversity of LAB species. In ripe YS, Pediococcus pentosaceus was the only species identified; in GS and AS, several Lactobacilli were also found, Lb. plantarum, Lb. brevis, and Lb. sakei; in addition, in GS Weisella cibaria also appeared. Regarding the yeast population, non-Saccharomyces yeasts from GS and AS showed a very high specific population (>1E+7 CFU/g), but this was reduced in ripe sourdough (Saccharomyces group dominated in all sourdoughs. Starting ingredients or raw material provided microbiological specificity to sourdoughs, and grape could be considered one of them.

  6. Current practice in laboratory diagnostics of autoimmune diseases in Croatia. 
Survey of the Working group for laboratory diagnostics of autoimmune diseases of the Croatian Society of Medical Biochemistry and Laboratory Medicine (United States)

    Kuna, Andrea Tešija; Đerek, Lovorka; Kozmar, Ana; Drvar, Vedrana


    Introduction With the trend of increasing incidence of autoimmune diseases, laboratories are faced with exponential growth of the requests for tests relating the diagnosis of these diseases. Unfortunately, the lack of laboratory personnel experienced in this specific discipline of laboratory diagnostic, as well as an unawareness of a method limitation often results in confusion for clinicians. The aim was to gain insight into number and type of Croatian laboratories that perform humoral diagnostics with the final goal to improve and harmonize laboratory diagnostics of autoimmune diseases in Croatia. Materials and methods In order to get insight into current laboratory practice two questionnaires, consisting of 42 questions in total, were created. Surveys were conducted using SurveyMonkey application and were sent to 88 medical biochemistry laboratories in Croatia for the first survey. Out of 33 laboratories that declared to perform diagnostic from the scope, 19 were selected for the second survey based on the tests they pleaded to perform. The survey comprised questions regarding autoantibody hallmarks of systemic autoimmune diseases while regarding organ-specific autoimmune diseases was limited to diseases of liver, gastrointestinal and nervous system. Results Response rate was high with 80 / 88 (91%) laboratories which answered the first questionnaire, and 19 / 19 (1.0) for the second questionnaire. Obtained results of surveys indicate high heterogeneity in the performance of autoantibody testing among laboratories in Croatia. Conclusions Results indicate the need of creating recommendations and algorithms in order to harmonize the approach to laboratory diagnostics of autoimmune diseases in Croatia.

  7. Biochemistry and metabolism of lake trout: laboratory and field studies on the effects of contaminants (United States)

    Passino, Dora R. May


    To evaluate the effects of ambient and higher concentrations of PCB's (Aroclor 1254) and DDE in food and water on fry of lake trout (Salvelinus namaycush) from Lake Michigan, I measured several biochemical indicators of stress in exposed and unexposed (control) fry. No differences between treatments were observed in oxygen consumption rates or lactate concentrations of unexercised fry, but apparent differences in specific swimming speed and lactate response in fry that swam to exhaustion suggested that exposed fry had lower stamina. Observed differences between biochemical profiles of 1-day-old sac fry reared from eggs originating from lake trout collected off Saugatuck and those originating from eggs of brood stock at the Marquette (Michigan) hatchery may have been caused by organochlorine contamination or by genetic and dietary differences between the parental stocks. Activity of the enzyme allantoinase was measured in juvenile and adult lake trout as an indicator of sublethal effects of Great Lakes contaminants. The 50% inhibition of allantoinase in vitro occurred at 6.0 mg/L Cu++, 6.7 mg/L Cd++, 34 mg/L Hg++, and 52 mg/L Pb++. Allantoinase was not affected by in vitro exposure to PCB's up to 7 μg/g, or DDE or DDT up to 10 μg/g; however, in vivo exposure resulting in 2.6 μg/g PCB's in the whole fish activated allantoinase slightly (10% significance level). Allantoinase activity was negatively correlated with total length for fish from Lake Michigan but not for fish from Lake Superior or from laboratory stocks. Mercury, PCB's, and DDT, possibly acting in combination with each other and with additional contaminants, may be the cause of the negative correlation of allantoinase activity with size in Lake Michigan lake trout.

  8. Automation in the clinical microbiology laboratory. (United States)

    Novak, Susan M; Marlowe, Elizabeth M


    Imagine a clinical microbiology laboratory where a patient's specimens are placed on a conveyor belt and sent on an automation line for processing and plating. Technologists need only log onto a computer to visualize the images of a culture and send to a mass spectrometer for identification. Once a pathogen is identified, the system knows to send the colony for susceptibility testing. This is the future of the clinical microbiology laboratory. This article outlines the operational and staffing challenges facing clinical microbiology laboratories and the evolution of automation that is shaping the way laboratory medicine will be practiced in the future.

  9. [Laboratory unification: advantages and disadvantages for clinical microbiology]. (United States)

    Andreu, Antonia; Matas, Lurdes


    This article aims to reflect on which areas or tasks of microbiology laboratories could be unified with those of clinical biochemistry, hematology, immunology or pathology laboratories to benefit patients and the health system, as well as the areas that should remain independent since their amalgamation would not only fail to provide a benefit but could even jeopardize the quality of microbiological diagnosis, and consequently patient care. To do this, the distinct analytic phases of diagnosis are analyzed, and the advantages and disadvantages of amalgamation are evaluated in each phase. The pros and cons of the unification of certain areas such as the computer system, occupational risk units, customer service, purchasing logistics, and materials storage, etc, are also discussed. Lastly, the effect of unification on urgent microbiology diagnosis is analyzed. Microbiological diagnosis should be unique. The microbiologist should perform an overall evaluation of the distinct techniques used for a particular patient, both those that involve direct diagnosis (staining, culture, antigen detection techniques or molecular techniques) and indirect diagnosis (antibody detection). Moreover, the microbiology laboratory should be independent, with highly trained technicians and specialists in microbiology that provide added value as experts in infection and as key figures in the process of establishing a correct etiological diagnosis.

  10. Risk Management in the Clinical Laboratory (United States)

    Njoroge, Sarah W


    Clinical laboratory tests play an integral role in medical decision-making and as such must be reliable and accurate. Unfortunately, no laboratory tests or devices are foolproof and errors can occur at pre-analytical, analytical and post-analytical phases of testing. Evaluating possible conditions that could lead to errors and outlining the necessary steps to detect and prevent errors before they cause patient harm is therefore an important part of laboratory testing. This can be achieved through the practice of risk management. EP23-A is a new guideline from the CLSI that introduces risk management principles to the clinical laboratory. This guideline borrows concepts from the manufacturing industry and encourages laboratories to develop risk management plans that address the specific risks inherent to each lab. Once the risks have been identified, the laboratory must implement control processes and continuously monitor and modify them to make certain that risk is maintained at a clinically acceptable level. This review summarizes the principles of risk management in the clinical laboratory and describes various quality control activities employed by the laboratory to achieve the goal of reporting valid, accurate and reliable test results. PMID:24982831

  11. Observations on the 1996 clinical laboratory conferences. (United States)

    Kisner, H J


    The author reviews five trends in the laboratory and diagnostic industries. The five trends are: consolidation of both the diagnostic companies and clinical laboratories (hospital and commercial); pressure to cut costs; robotics; implication of new technology; and the pressure to cut costs by transitioning certain tasks to nontechnical personnel while dealing with an abundant labor supply.

  12. Immunosensors in Clinical Laboratory Diagnostics. (United States)

    Justino, Celine I L; Duarte, Armando C; Rocha-Santos, Teresa A P


    The application of simple, cost-effective, rapid, and accurate diagnostic technologies for detection and identification of cardiac and cancer biomarkers has been a central point in the clinical area. Biosensors have been recognized as efficient alternatives for the diagnostics of various diseases due to their specificity and potential for application on real samples. The role of nanotechnology in the construction of immunological biosensors, that is, immunosensors, has contributed to the improvement of sensitivity, since they are based in the affinity between antibody and antigen. Other analytes than biomarkers such as hormones, pathogenic bacteria, and virus have also been detected by immunosensors for clinical point-of-care applications. In this chapter, we first introduced the various types of immunosensors and discussed their applications in clinical diagnostics over the recent 6 years, mainly as point-of-care technologies for the determination of cardiac and cancer biomarkers, hormones, pathogenic bacteria, and virus. The future perspectives of these devices in the field of clinical diagnostics are also evaluated.

  13. Decision support for clinical laboratory capacity planning. (United States)

    van Merode, G G; Hasman, A; Derks, J; Goldschmidt, H M; Schoenmaker, B; Oosten, M


    The design of a decision support system for capacity planning in clinical laboratories is discussed. The DSS supports decisions concerning the following questions: how should the laboratory be divided into job shops (departments/sections), how should staff be assigned to workstations and how should samples be assigned to workstations for testing. The decision support system contains modules for supporting decisions at the overall laboratory level (concerning the division of the laboratory into job shops) and for supporting decisions at the job shop level (assignment of staff to workstations and sample scheduling). Experiments with these modules are described showing both the functionality and the validity.

  14. Miniaturization and globalization of clinical laboratory activities. (United States)

    Melo, Murilo R; Clark, Samantha; Barrio, Daniel


    Clinical laboratories provide an invaluable service to millions of people around the world in the form of quality diagnostic care. Within the clinical laboratory industry the impetus for change has come from technological development (miniaturization, nanotechnology, and their collective effect on point-of-care testing; POCT) and the increasingly global nature of laboratory services. Potential technological gains in POCT include: the development of bio-sensors, microarrays, genetics and proteomics testing, and enhanced web connectivity. In globalization, prospective opportunities lie in: medical tourism, the migration of healthcare workers, cross-border delivery of testing, and the establishment of accredited laboratories in previously unexplored markets. Accompanying these impressive opportunities are equally imposing challenges. Difficulty transitioning from research to clinical use, poor infrastructure in developing countries, cultural differences and national barriers to global trade are only a few examples. Dealing with the issues presented by globalization and the impact of developing technology on POCT, and on the clinical laboratory services industry in general, will be a daunting task. Despite such concerns, with appropriate countermeasures it will be possible to address the challenges posed. Future laboratory success will be largely dependent on one's ability to adapt in this perpetually shifting landscape.

  15. Capillary electrophoresis and the clinical laboratory. (United States)

    Jabeen, Rukhsana; Payne, Deborah; Wiktorowicz, John; Mohammad, Amin; Petersen, John


    Over the past 15 years, CE as an analytical tool has shown great promise in replacing many conventional clinical laboratory methods, such as electrophoresis and HPLC. CE's appeal was that it was fast, used very small amounts of sample and reagents, was extremely versatile, and was able to separate large and small analytes, whether neutral or charged. Because of this versatility, numerous methods have been developed for analytes that are of clinical interest. Other than molecular diagnostic and forensic laboratories CE has not been able to make a major impact in the United States. In contrast, in Europe and Japan an increasing number of clinical laboratories are using CE. Now that automated multicapillary instruments are commercially available along with cost-effective test kits, CE may yet be accepted as an instrument that will be routinely used in the clinical laboratories. This review will focus on areas where CE has the potential to have the greatest impact on the clinical laboratory. These include analyses of proteins found in serum and urine, hemoglobin (A1c and variants), carbohydrate-deficient transferrin, forensic and therapeutic drug screening, and molecular diagnostics.

  16. Doing that thing that scientists do: A discovery-driven module on protein purification and characterization for the undergraduate biochemistry laboratory classroom. (United States)

    Garrett, Teresa A; Osmundson, Joseph; Isaacson, Marisa; Herrera, Jennifer


    In traditional introductory biochemistry laboratory classes students learn techniques for protein purification and analysis by following provided, established, step-by-step procedures. Students are exposed to a variety of biochemical techniques but are often not developing procedures or collecting new, original data. In this laboratory module, students develop research skills through work on an original research project and gain confidence in their ability to design and execute an experiment while faculty can enhance their scholarly pursuits through the acquisition of original data in the classroom laboratory. Students are prepared for a 6-8 week discovery-driven project on the purification of the Escherichia coli cytidylate kinase (CMP kinase) through in class problems and other laboratory exercises on bioinformatics and protein structure analysis. After a minimal amount of guidance on how to perform the CMP kinase in vitro enzyme assay, SDS-PAGE, and the basics of protein purification, students, working in groups of three to four, develop a protein purification protocol based on the scientific literature and investigate some aspect of CMP kinase that interests them. Through this process, students learn how to implement a new but perhaps previously worked out procedure to answer their research question. In addition, they learn the importance of keeping a clear and thorough laboratory notebook and how to interpret their data and use that data to inform the next set of experiments. Following this module, students had increased confidence in their ability to do basic biochemistry techniques and reported that the "self-directed" nature of this lab increased their engagement in the project.

  17. Design and development of microcontroller-based clinical chemistry analyser for measurement of various blood biochemistry parameters. (United States)

    Taneja, S R; Gupta, R C; Kumar, Jagdish; Thariyan, K K; Verma, Sanjeev


    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.

  18. Total quality management in clinical virology laboratories. (United States)

    Tibbets, M W; Gomez, R; Kannangai, R; Sridharan, G


    The diagnostic laboratories in India are progressively promoting higher standards and are moving towards accreditation and international acceptance. Hence, the concept of "Quality" will need to be understood and implemented. Total quality management (TQM) in a laboratory is an integrated program involving all laboratory staff and management. TQM is a framework to operate and it is aiming for integration, consistency, increase in efficiency and a continuous drive for improvement. A well structured clinical virology service will include serology setup, cell culture facility and capacity for molecular diagnosis. The quality of results from the laboratory is significantly influenced by many pre-analytical and post-analytical factors which needed attention. The end goal of the TQM should be to provide the best care possible for the patient.

  19. Monitoring and root cause analysis of clinical biochemistry turn around time at an academic hospital. (United States)

    Chauhan, Kiran P; Trivedi, Amit P; Patel, Dharmik; Gami, Bhakti; Haridas, N


    Quality can be defined as the ability of a product or service to satisfy the needs and expectations of the customer. Laboratories are more focusing on technical and analytical quality for reliability and accuracy of test results. Patients and clinicians however are interested in rapid, reliable and efficient service from laboratory. Turn around time (TAT), the timeliness with which laboratory personnel deliver test results, is one of the most noticeable signs of laboratory service and is often used as a key performance indicator of laboratory performance. This study is aims to provide clue for laboratory TAT monitoring and root cause analysis. In a 2 year period a total of 75,499 specimens of outdoor patient department were monitor, of this a total of 4,142 specimens exceeded TAT. With consistent efforts to monitor, root cause analysis and corrective measures, we are able to decreased the specimens exceeding TAT from 7-8 to 3.7 %. Though it is difficult task to monitor TAT with the help of laboratory information system, real time documentation and authentic data retrievable, along with identification of causes for delays and its remedial measures, improve laboratory TAT and thus patient satisfaction.

  20. Antiphospholipid syndrome: a clinical and laboratorial challenge

    Directory of Open Access Journals (Sweden)

    Luci Maria Santana Dusse


    Full Text Available Antiphospholipid syndrome (APS is an acquired autoimmune thrombophilia characterized by the presence of a heterogeneous family of antibodies that bind to plasma proteins with affinity for phospholipid surfaces. The two major protein targets of antiphospholipid antibodies are prothrombin and β2-glycoprotein I (β2GPI. APS leads to aprothrombotic state, and it is characterized by the occurrence of arterial, venous or microvascular thrombosis or recurrent fetal loss. The diagnosis of APS is based on a set of clinical criteria and the detection of lupus anticoagulant (LA, anticardiolipin antibodies (ACA or anti-β2GPI in plasma. Although laboratory tests are essential for APS diagnosis, these tests have limitations associated with the robustness, reproducibility and standardization. The standardization of diagnostic tests for detection of APLAs has been a challenge and a variety of results have been obtained using different commercial kits and in-house techniques. An increased sensitivity of the ELISA kits for detection of ACA effectively has contributed to APS diagnosis. However, the lack of specificity associated with a high number of false-positive results is a clinical and laboratorial challenge, since such results may lead to mistaken clinical decisions, such as prescription of oral anticoagulant, leading to the risk of hemorrhaging. Furthermore, clinicians are often unfamiliar with these tests and have difficulty interpreting them, requiring interaction between clinical and laboratory professionals in order to ensure their correct interpretation.

  1. Concept maps as evaluation tools of the integrative construction level of meanings in the biochemistry laboratory under a constructivist approach

    Directory of Open Access Journals (Sweden)

    Julia Flores


    Full Text Available This descriptive-comparative work was carried out with 13 students in the areas of Biology and Chemistry of the Pedagogical Institute of Caracas in a course of Biochemistry, who formed two lab groups. Its purpose was to compare the level of integrative construction of scientific meanings achieved in the concept maps developed in an integrated manner to the V diagram around a problem situation raised on enzymes, considering previous knowledge about this disciplinary content. Two statistics were used to compare the groups: student's t test for the pre-existing knowledge and Mann-Whitney U for concept maps. A General Index of Integrative Construction of meanings (IGCIS proposed by the authors, was incorporated in a novel way to assess concept maps. The results revealed the discriminatory power of IGCIS, being able to differentiate the groups in a more consistent way and in accordance with their levels of prior knowledge.

  2. Polycystic ovary syndrome: clinical and laboratory evaluation


    Marcos Yorghi Khoury; Edmund Chada Baracat; Dolores Perovano Pardini; Mauro Abi Haidar; Eduardo Leme Alves da Motta; Geraldo Rodrigues de Lima


    OBJECTIVE: To evaluate clinically, and with laboratory, tests, women with polycystic ovary syndrome (PCO). PATIENTS: One hundred and twelve women with PCO were studied. METHODS: The following data was recorded: Current age; age at menarche; menstrual irregularity, occurrence of similar cases in the family; fertility, obstetric history; body mass index (BMI); and presence of hirsutism. Serum measurements of follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin, free testoster...

  3. Nutritional Biochemistry (United States)

    Smith, Scott M.


    This slide presentation reviews some of the effects that space flight has on humans nutritional biochemistry. Particular attention is devoted to the study of protein breakdown, inflammation, hypercatabolism, omega 3 fatty acids, vitamin D, calcium, urine, folate and nutrient stability of certain vitamins, the fluid shift and renal stone risk, acidosis, iron/hematology, and the effects on bone of dietary protein, potassium. inflammation, and omega-3 fatty acids

  4. Prepare, Do, Review: A Skills-Based Approach for Laboratory Practical Classes in Biochemistry and Molecular Biology (United States)

    Arthur, Peter; Ludwig, Martha; Castelli, Joane; Kirkwood, Paul; Attwood, Paul


    A new laboratory practical system is described which is comprised of a number of laboratory practical modules, each based around a particular technique or set of techniques, related to the theory part of the course but not designed to be dependent on it. Each module comprises an online recorded pre-lab lecture, the laboratory practical itself and…

  5. EC4 European Syllabus for Post-Graduate Training in Clinical Chemistry and Laboratory Medicine: version 3 - 2005. (United States)

    Zerah, Simone; McMurray, Janet; Bousquet, Bernard; Baum, Hannsjorg; Beastall, Graham H; Blaton, Vic; Cals, Marie-Josèphe; Duchassaing, Danielle; Gaudeau-Toussaint, Marie-Françoise; Harmoinen, Aimo; Hoffmann, Hans; Jansen, Rob T; Kenny, Desmond; Kohse, Klaus P; Köller, Ursula; Gobert, Jean-Gérard; Linget, Christine; Lund, Erik; Nubile, Giuseppe; Opp, Matthias; Pazzagli, Mario; Pinon, Georges; Queralto, José M; Reguengo, Henrique; Rizos, Demetrios; Szekeres, Thomas; Vidaud, Michel; Wallinder, Hans


    The EC4 Syllabus for Postgraduate Training is the basis for the European Register of Specialists in Clinical Chemistry and Laboratory Medicine. The syllabus: Indicates the level of requirements in postgraduate training to harmonise the postgraduate education in the European Union (EU); Indicates the level of content of national training programmes to obtain adequate knowledge and experience; Is approved by all EU societies for clinical chemistry and laboratory medicine. The syllabus is not primarily meant to be a training guide, but on the basis of the overview given (common minimal programme), national societies should formulate programmes that indicate where knowledge and experience is needed. The main points of this programme are: Indicates the level of requirements in postgraduate training to harmonise the postgraduate education in the European Union (EU); Indicates the level of content of national training programmes to obtain adequate knowledge and experience; Is approved by all EU societies for clinical chemistry and laboratory medicine. Knowledge in biochemistry, haematology, immunology, etc.; Pre-analytical conditions; Evaluation of results; Interpretations (post-analytical phase); Laboratory management; and Quality insurance management. The aim of this version of the syllabus is to be in accordance with the Directive of Professional Qualifications published on 30 September 2005. To prepare the common platforms planned in this directive, the disciplines are divided into four categories: Indicates the level of requirements in postgraduate training to harmonise the postgraduate education in the European Union (EU); Indicates the level of content of national training programmes to obtain adequate knowledge and experience; Is approved by all EU societies for clinical chemistry and laboratory medicine. Knowledge in biochemistry, haematology, immunology, etc.; Pre-analytical conditions; Evaluation of results; Interpretations (post-analytical phase); Laboratory

  6. Neocollagenesis and Neoelastinogenesis: From the Laboratory to the Clinic (United States)

    Mehta-Ambalal, Sujata R


    An internet search was made looking for articles about chemical and physical modalities that are known to induce collagen and elastin formation. Textbooks, independent articles, journals and books on pathology, biochemistry, aesthetic medicine and cosmetic and plastic surgery were used as references. Here, we take a look at various studies, in vitro and in vivo, that lend credence to the products and procedures used in clinical practice to induce neocollagenesis and neoelastinogenesis.

  7. Thai clinical laboratory responsible to economic crisis. (United States)

    Sirisali, K; Vattanaviboon, P; Manochiopinij, S; Ananskulwat, W


    Nowadays, Thailand encounters a serious economic crisis. A clear consensus has been made that a cost-saving system must be the important tool. Both private and government organizations are engaged in this situation. We studied the cost-saving in the clinical laboratory. A questionnaire was distributed to 45 hospital laboratories located in Bangkok. Results showed that efforts to control the cost are the essential policy. There was a variety of factors contributing to the cost-saving process. The usage of public utility, non-recycle material and unnecessary utility were reconsidered. Besides, capital cost (wages and salary) personnel incentive are assessed. Forty three of the 45 respondents had attempted to reduce the cost via curtailing the unnecessary electricity. Eliminating the needless usage of telephone-call. water and unnecessary material was also an effective strategy. A reduction of 86.9%, 80 % and 80.0% of the mentioned factors respectively, was reported. An inventory system of the reagent, chemical and supplies was focused. Most of the laboratories have a policy on cost-saving by decreased the storage. Twenty eight of the 45 laboratories considered to purchase the cheaper with similar quality reagents instead. And some one would purchase a bulky pack when it is the best bargain. A specific system "contact reagent with a free rent instrument" has been used widely (33.3%). Finally, a new personnel management system has been chosen. Workload has rearranged and unnecessary extra-hour work was abandoned.

  8. Molecular virology in the clinical laboratory. (United States)

    Josko, Deborah


    As one can see by the tests listed at, molecular diagnostic techniques have enabled the laboratory professionals to play an integral role in the identification and quantitation of viral infectious agents. Viral loads can be determined for HIV, HBV, and HCV using a variety of molecular methods such as real-time PCR, TMA, NASBA, and bDNA. Determining the amount of viral particles in a sample can not only monitor the status and progression of the disease, but can also guide recommendations for antiviral therapy. Other assays listed include cytomegalovirus, enterovirus, and human metapneumovirus detection, HPV testing, influenza and respiratory virus panels, and West Nile virus detection in blood donations using a variety of molecular methodologies. The use of molecular methodologies in the detection of viral pathogens has grown at an astounding rate, especially in the past two decades. It is now widely accepted that PCR is the "gold standard" for nucleic acid detection in the clinical laboratory as well as in research facilities. This article only touched on some of the common, widely used assays and platforms used in the identification process. With more and more assays being developed, the cost behind molecular testing has decreased since there are more competitors on the market. At one point, laboratorians may have thought of routine molecular testing as the wave of the future. It is obvious the future is upon us. Molecular diagnostics has become part of the daily, routine workload in most clinical laboratories. The advent of fully automated systems with faster turn around times has given laboratory professionals the tools necessary to report out accurate and sensitive results to clinicians who can ultimately improve patient care and outcomes by rendering a correct and rapid diagnosis.

  9. Postmortem biochemistry

    Directory of Open Access Journals (Sweden)

    Mukaddes Gürler


    Full Text Available Postmortem biochemistry is becoming more important in forensic pathology. Involving of biochemical investigations full autopsy can provide to detect divers pathologic conditions such as antemortem acute/chronic diseases, fatal metabolic conditions, survival time, postmortem biochemical changes, and the source of analytes. Biochemical tests may be usefull where the morphological examinations cannot lighten the fatal pathology (Diabetes Mellitus (DM, alcoholic ketoacidosis, sepsis, electrolytic disorders. This article presents the analytes that may be useful in forensic medicine upon the studies performed and published in the literature.

  10. [Excessive spending by misuse of clinical laboratory]. (United States)

    Benítez-Arvizu, Gamaliel; Novelo-Garza, Bárbara; Mendoza-Valdez, Antonia Lorena; Galván-Cervantes, Jorge; Morales-Rojas, Alejandro


    Seventy five percent or more of a diagnosis comes from a proper medical history along with an excellent physical examination. This leaves to the clinical laboratory the function of supporting the findings, determining prognosis, classifying the diseases, monitoring the diseases and, in the minimum of cases, establishing the diagnosis. In recent years there has been a global phenomenon in which the allocation of resources to health care has grown in an excessive way; the Instituto Mexicano del Seguro Social is not an exception with an increase of 29 % from 2009 to 2011; therefore, it is necessary to set containment and reduction without compromising the quality of patient care.

  11. Expression, purification, and characterization of a carbohydrate-active enzyme: A research-inspired methods optimization experiment for the biochemistry laboratory. (United States)

    Willbur, Jaime F; Vail, Justin D; Mitchell, Lindsey N; Jakeman, David L; Timmons, Shannon C


    The development and implementation of research-inspired, discovery-based experiences into science laboratory curricula is a proven strategy for increasing student engagement and ownership of experiments. In the novel laboratory module described herein, students learn to express, purify, and characterize a carbohydrate-active enzyme using modern techniques and instrumentation commonly found in a research laboratory. Unlike in a traditional cookbook-style experiment, students generate their own hypotheses regarding expression conditions and quantify the amount of protein isolated using their selected variables. Over the course of three 3-hour laboratory periods, students learn to use sterile technique to express a protein using recombinant DNA in E. coli, purify the resulting enzyme via affinity chromatography and dialysis, analyze the success of their purification scheme via SDS-PAGE, assess the activity of the enzyme via an HPLC-based assay, and quantify the amount of protein isolated via a Bradford assay. Following the completion of this experiment, students were asked to evaluate their experience via an optional survey. All students strongly agreed that this laboratory module was more interesting to them than traditional experiments because of its lack of a pre-determined outcome and desired additional opportunities to participate in the experimental design process. This experiment serves as an example of how research-inspired, discovery-based experiences can benefit both the students and instructor; students learned important skills necessary for real-world biochemistry research and a more concrete understanding of the research process, while generating new knowledge to enhance the scholarly endeavors of the instructor.

  12. Laboratory research at the clinical trials of Veterinary medicinal Products


    ZHYLA M.I.


    The article analyses the importance of laboratory test methods, namely pathomorfological at conduct of clinical trials. The article focuses on complex laboratory diagnostics at determination of clinical condition of animals, safety and efficacy of tested medicinal product.

  13. Hidden sources of mercury in clinical laboratories. (United States)

    Alvarez-Chavez, C R; Federico-Perez, R A; Gomez-Alvarez, A; Velazquez-Contreras, L E; Perez-Rios, R


    The healthcare sector is an important contributor to mercury (Hg) pollution because of the potential presence of mercury in thermometers, blood pressure cuffs, amalgams, etc. There are also other potential sources of mercury in this sector which are used frequently and in high volumes where the presence of the metal is not obvious and which might be collectively contributing to pollution. For instance, some chemicals used for the clinical diagnosis of illness may contain mercury. The goal of this study was to investigate potential sources of mercury pollution, which originate from clinical laboratory discharges, using an exploratory approach. The focus was on the residue generated during automatic analysis of patients' bodily fluids at a medical center in Hermosillo, Sonora, Mexico. This study shows an overview of what might be happening in the region or the country related to non-obvious sources of mercury in the healthcare sector. The results showed measurable levels of mercury in the residues coming from urine sediment analysis. These amounts do not exceed the maximum allowed by Mexican environmental regulations; nevertheless, the frequency and cumulative volume of residues generated, combined with the potential for persistence and the bioaccumulation of mercury in the environment, warrant attention. The work carried out in this study is being taken as a model for future studies for pollution prevention in the healthcare sector with the goal of measuring mercury emissions to the environment from clinical laboratory wastewater, including identifying sources which--while not obvious--could be important given the frequency and volume of their use in the clinical diagnosis.

  14. Polycystic ovary syndrome: clinical and laboratory evaluation

    Directory of Open Access Journals (Sweden)

    Marcos Yorghi Khoury

    Full Text Available OBJECTIVE: To evaluate clinically, and with laboratory, tests, women with polycystic ovary syndrome (PCO. PATIENTS: One hundred and twelve women with PCO were studied. METHODS: The following data was recorded: Current age; age at menarche; menstrual irregularity, occurrence of similar cases in the family; fertility, obstetric history; body mass index (BMI; and presence of hirsutism. Serum measurements of follicle stimulating hormone (FSH, luteinizing hormone (LH, prolactin, free testosterone, and dehydroepiandrosterone sulfate were taken. RESULTS: All patients presented either oligomenorrhea (31 percent, periods of secondary amenorrhea (9 percent, or both alterations (60 percent. The majority of the patients were infertile (75.6 percent. The LH/FSH ratio was higher than 2:1 in 55 percent of the patients and higher than 3:1 in 26.2 percent. The ultrasonographic aspect of the ovaries was considered to be normal in 31 percent. CONCLUSION: The main clinical feature of the PCO is the irregularity of menses since menarche, and that the laboratory tests would be important to exclude other disorders such as hyperprolactinemia or hyperandrogenemia caused by late-onset congenital adrenal hyperplasia.

  15. Clinical and laboratory features of preleukemia patients

    Institute of Scientific and Technical Information of China (English)

    施均; 邵宗鸿; 陈桂彬; 李克; 刘鸿; 张益枝; 和虹; 赵明峰; 何广胜; 张泓; 储榆林; 郝玉书


    Objective To explore prospective diagnostic criteria for preleukemia.Methods A case control study was done comparing the discrepancies on clinical and laboratory features between patients with preleukemia and those with chronic aplastic anemia (CAA) or atypical paroxysmal nocturnal hemoglubinuria (a-PNH).Results There were eight variables of significance: (1) lymphocytoid micromegakaryocytes in the bone marrow; (2) immature granulocytes in the peripheral blood; (3) ≥2.0% myeloblasts in the bone marrow; (4) positive periodic acid schiff (PAS) stained nucleated erythrocytes; (5) myeloid differentiation index ≥1.8; (6) typical colonal karyotypic abnormalities; (7) negative sister chromatid differentiation; (8) cluster/colony ratio of granulocyte-macrophage colony-forming units (CFU-GM)>4.0. The following criteria were assigned: A: to meet variable one and at least two of the other seven variables and B: to meet at least four of the eight variables. All of the patients with preleukemia met either A or B and none of the patients with CAA or a-PNH did. Conclusions Preleukemia is different from CAA or a-PNH. It has its own clinical and laboratory features, which may be useful for its prospective diagnosis.

  16. Clinical laboratory analytics: Challenges and promise for an emerging discipline

    Directory of Open Access Journals (Sweden)

    Brian H Shirts


    Full Text Available The clinical laboratory is a major source of health care data. Increasingly these data are being integrated with other data to inform health system-wide actions meant to improve diagnostic test utilization, service efficiency, and "meaningful use." The Academy of Clinical Laboratory Physicians and Scientists hosted a satellite meeting on clinical laboratory analytics in conjunction with their annual meeting on May 29, 2014 in San Francisco. There were 80 registrants for the clinical laboratory analytics meeting. The meeting featured short presentations on current trends in clinical laboratory analytics and several panel discussions on data science in laboratory medicine, laboratory data and its role in the larger healthcare system, integrating laboratory analytics, and data sharing for collaborative analytics. One main goal of meeting was to have an open forum of leaders that work with the "big data" clinical laboratories produce. This article summarizes the proceedings of the meeting and content discussed.

  17. An inquiry-based biochemistry laboratory structure emphasizing competency in the scientific process: a guided approach with an electronic notebook format. (United States)

    L Hall, Mona; Vardar-Ulu, Didem


    The laboratory setting is an exciting and gratifying place to teach because you can actively engage the students in the learning process through hands-on activities; it is a dynamic environment amenable to collaborative work, critical thinking, problem-solving and discovery. The guided inquiry-based approach described here guides the students through their laboratory work at a steady pace that encourages them to focus on quality observations, careful data collection and thought processes surrounding the chemistry involved. It motivates students to work in a collaborative manner with frequent opportunities for feedback, reflection, and modification of their ideas. Each laboratory activity has four stages to keep the students' efforts on track: pre-lab work, an in-lab discussion, in-lab work, and a post-lab assignment. Students are guided at each stage by an instructor created template that directs their learning while giving them the opportunity and flexibility to explore new information, ideas, and questions. These templates are easily transferred into an electronic journal (termed the E-notebook) and form the basic structural framework of the final lab reports the students submit electronically, via a learning management system. The guided-inquiry based approach presented here uses a single laboratory activity for undergraduate Introductory Biochemistry as an example. After implementation of this guided learning approach student surveys reported a higher level of course satisfaction and there was a statistically significant improvement in the quality of the student work. Therefore we firmly believe the described format to be highly effective in promoting student learning and engagement.

  18. Clinical and Laboratory Diagnosis of Intestinal Tuberculosis

    Institute of Scientific and Technical Information of China (English)

    Xiao-Chun Shi; Li-Fan Zhang; Yue-Qiu Zhang; Xiao-Qing Liu; Gui-Jun Fei


    Background:Tuberculosis (TB) remains a worldwide problem.Intestinal TB (ITB) constitutes a major public health problem in developing countries and has been associated with significant morbidity and mortality.The aim of this study was to characterize the clinical,radiological,endoscopic,and pathological features of ITB and to define the strategy for establishing the diagnosis.Methods:A retrospective study (from January 2000 to June 2015) was carried out in Peking Union Medical College Hospital and all hospitalized cases were diagnosed as ITB during the study period were included.The relevant clinical information,laboratory results,microbiological,and radiological investigations were recorded.Results:Of the 85 cases,61 cases (71.8%) were ranged from 20 to 50 years.The ileocecal region was involved in about 83.5% (71/85) of patients.About 41.2% (35/85) of patients had co-existing extra ITB,especially active pulmonary TB.Abdominal pain (82.4%) was the most common presenting symptom followed by weight loss (72.9%) and fever (64.7%).Both T-cell spot of TB test (T-SPOT.TB) and purified protein derivatives (PPD) tests were performed in 26 patients:20 (76.9%) positive T-SPOT.TB and 13 (50.0%) positive PPD were detected,with a statistical significant difference (P =0.046).Twenty cases (23.5%) were histopathology and/or pathogen confirmed TB;27 cases (31.8%) were diagnosed by clinical manifestation consistent with ITB and evidence of active extra ITB;38 cases (44.7%) were diagnosed by good response to diagnostic anti-TB therapy.Conclusions:ITB is difficult to diagnose even with modem medical techniques due to its nonspecific clinical and laboratory features.At present,combination of clinical,endoscopic,radiological,and pathological features continues to be the key to the diagnosis of ITB.

  19. Effects of Various Dental Materials on Alkaline Phosphatase Extracted from Pulp: An Experiment for the Biochemistry Laboratory. (United States)

    Thompson, Lorin R.


    A laboratory experiment that demonstrates the effects of various dental materials on a representative enzyme from the pulp is outlined. The experiment encourages students to consider the effects that various restorative materials and techniques might have on enzymes in the living pulp. (Author/MLW)

  20. DNA Fingerprint Analysis of Three Short Tandem Repeat (STR) Loci for Biochemistry and Forensic Science Laboratory Courses (United States)

    McNamara-Schroeder, Kathleen; Olonan, Cheryl; Chu, Simon; Montoya, Maria C.; Alviri, Mahta; Ginty, Shannon; Love, John J.


    We have devised and implemented a DNA fingerprinting module for an upper division undergraduate laboratory based on the amplification and analysis of three of the 13 short tandem repeat loci that are required by the Federal Bureau of Investigation Combined DNA Index System (FBI CODIS) data base. Students first collect human epithelial (cheek)…

  1. Detection of an ABCA1 Variant Associated with Type 2 Diabetes Mellitus Susceptibility for Biochemistry and Genetic Laboratory Courses (United States)

    Legorreta-Herrera, M.; Mosqueda-Romo, N. A.; Hernández-Clemente, F.; Soto-Cruz, I.


    We selected diabetes mellitus for this laboratory exercise to provide students with an explicit model for scientific research concerning the association between the R230C polymorphism and susceptibility to type 2 diabetes mellitus, which is highly prevalent in the Mexican population. We used a collaborative project-based learning to engage…

  2. Endothelial nitric oxide synthase: From biochemistry and gene structure to clinical implications of NOS3 polymorphisms. (United States)

    Oliveira-Paula, Gustavo H; Lacchini, Riccardo; Tanus-Santos, Jose E


    Nitric oxide (NO) is an important vasodilator with a well-established role in cardiovascular homeostasis. While mediator is synthesized from L-arginine by neuronal, endothelial, and inducible nitric oxide synthases (NOS1,NOS3 and NOS2 respectively), NOS3 is the most important isoform for NO formation in the cardiovascular system. NOS3 is a dimeric enzyme whose expression and activity are regulated at transcriptional, posttranscriptional,and posttranslational levels. The NOS3 gene, which encodes NOS3, exhibits a number of polymorphic sites including single nucleotide polymorphisms (SNPs), variable number of tandem repeats (VNTRs), microsatellites, and insertions/deletions. Some NOS3 polymorphisms show functional effects on NOS3 expression or activity, thereby affecting NO formation. Interestingly, many studies have evaluated the effects of functional NOS3 polymorphisms on disease susceptibility and drug responses. Moreover, some studies have investigated how NOS3 haplotypes may impact endogenous NO formation and disease susceptibility. In this article,we carried out a comprehensive review to provide a basic understanding of biochemical mechanisms involved in NOS3 regulation and how genetic variations in NOS3 may translate into relevant clinical and pharmacogenetic implications.

  3. Alterations in body weight and biochemistry in patient treated with different psychotropic drugs in a clinic in Istanbul

    Directory of Open Access Journals (Sweden)

    Yeltekin Demirel,


    Full Text Available Aim Was to compare adult female patients receiving psychiatricdrugs with obese adult females who didn’t receive any drug treatmentwith respect to the alterations in body weight and biochemistry,and find out the contrubution of a team approach for the managementof these alterations.Methods A total of 102 female patients aged mean 40.9±12.4years who had been followed up and treated in the Psychiatry OutpatientClinics in Istanbul University for their psychiatric disordersand were complaining about increased body weight in thetreatment period were included. The controls were composed of261 females aged mean 39.8±13.0 years who had been referred byvarious departments to dietitians due to exogenous obesity but hadno endocrine-metabolic or psychiatric disorders or history of druguse. Initially, antropometric measurements and biochemical testswere performed for all patients.Results In the group receiving psychiatric treatment, the meanbody weight, BMI, waist and hip circumferences, body fat percentage(p<0.001; blood insulin, triglyceride, TSH, fibrinogenand homocysteine levels, and HOMA-IR were found to be higherthan those of the controls (p<0.05, whereas the total protein, albumin,zinc and folate levels were significantly lower (p<0.001.Conclusion The results of this study showed that patients whoneed psychopharmacotherapies were also more susceptible to severalmetabolic and cardiovascular disorders. Therefore, it wouldbe useful if psychiatric patients are treated with a multidisciplinaryteam approach consisting of an endocrinologist, psychiatrist and adietitian specialized in this area to prevent or delay the metabolicdisorders caused by psychiatric disorders and treatments.

  4. Teaching biochemistry to medical students in Singapore--from organic chemistry to problem-based learning. (United States)

    Khoo, H E


    The medical faculty in the National University of Singapore started in 1905 but the Chair in Biochemistry was only established in 1927. For many years the biochemistry course consisted of the teaching of the organic chemistry of substances of physiological importance, nutrition, metabolism and hormones. In 1961, clinical biochemistry was introduced and in the 1980s, genetics and molecular biology were included. By then, most of the organic chemistry content had been removed as greater emphasis was placed on clinical correlation. Laboratory classes consisted of mock glucose tolerance tests and the measurement of various enzymes. By the 1990s, students were no longer interested in such practical classes, so a bold decision was made around 1995 to remove laboratory classes from the curriculum. Unfortunately, this meant that the medical students who might have been interested in laboratory work could no longer do such work. However, the new curriculum in 1999 gave the department an opportunity to offer a laboratory course as an elective for interested students. This new curriculum adopted an integrated approach with Genetics being taught as part of Paediatrics, and a new module (Structural and Cell Biology) comprising aspects of cell biology and biochemistry was introduced. This module is currently taught by staff from Anatomy, Physiology and Biochemistry. Some biochemistry content is now incorporated into the clinical problem scenarios of problem-based learning such as jaundice, diabetes mellitus, anorexia nervosa, etc. So the evolution of teaching biochemistry to medical students in Singapore has paralleled worldwide trends and moved from the didactic teaching of organic chemistry of biomolecules to problem-based learning using clinical cases.

  5. Supply chain management in the clinical laboratory. (United States)

    McHugh, Thomas M


    Between 15 and 45 percent of a clinical laboratory's operating budget is spent on supplies. Given the size of this expenditure, laboratory managers must pay close attention to the supply chain and develop effective strategies to manage their inventory. Areas that need analysis include the carrying cost of supplies, the cost to generate a purchase order, methods to efficiently count supplies on hand, processes to ensure that lot number items are used before their expiration, and detailed analysis of the inventory. At the University of California-San Francisco Medical Center, we investigated options to manage our inventory and implemented a computerized system. The system required modifications to existing practices, which initially seemed unwieldy. However, after a relatively short learning curve, the improvement to operations has been significant, with a reduction in wasted reagents, fewer staff hours used to count supplies, and the ability to provide prompt analysis of the inventory for audits and discussions with administration. Focusing on the supply chain has allowed us to reduce inventory expenses by approximately 8 percent, reduce waste, given us a more focused understanding of our operations, and provided us with the ability to analyze our inventory easily.

  6. Bringing ayahuasca to the clinical research laboratory. (United States)

    Riba, Jordi; Barbanoj, Manel J


    Since the winter of 1999, the authors and their research team have been conducting clinical studies involving the administration of ayahuasca to healthy volunteers. The rationale for conducting this kind of research is twofold. First, the growing interest of many individuals for traditional indigenous practices involving the ingestion of natural psychotropic drugs such as ayahuasca demands the systematic study of their pharmacological profiles in the target species, i.e., human beings. The complex nature of ayahuasca brews combining a large number of pharmacologically active compounds requires that research be carried out to establish the safety and overall pharmacological profile of these products. Second, the authors believe that the study of psychedelics in general calls for renewed attention. Although the molecular and electrophysiological level effects of these drugs are relatively well characterized, current knowledge of the mechanisms by which these compounds modify the higher order cognitive processes in the way they do is still incomplete, to say the least. The present article describes the development of the research effort carried out at the Autonomous University of Barcelona, commenting on several methodological aspects and reviewing the basic clinical findings. It also describes the research currently underway in our laboratory, and briefly comments on two new studies we plan to undertake in order to further our knowledge of the pharmacology of ayahuasca.

  7. Clinical laboratory analytics: Challenges and promise for an emerging discipline


    Brian H Shirts; Jackson, Brian R.; Baird, Geoffrey S.; Baron, Jason M.; Bryan Clements; Ricky Grisson; Ronald George Hauser; Taylor, Julie R.; Enrique Terrazas; Brad Brimhall


    The clinical laboratory is a major source of health care data. Increasingly these data are being integrated with other data to inform health system-wide actions meant to improve diagnostic test utilization, service efficiency, and "meaningful use." The Academy of Clinical Laboratory Physicians and Scientists hosted a satellite meeting on clinical laboratory analytics in conjunction with their annual meeting on May 29, 2014 in San Francisco. There were 80 registrants for the clinical laborator...

  8. 76 FR 5379 - Clinical Laboratory Improvement Advisory Committee (CLIAC) (United States)


    ... HUMAN SERVICES Centers for Disease Control and Prevention Clinical Laboratory Improvement Advisory..., revisions to the standards under which clinical laboratories are regulated; the impact on medical and laboratory practice of proposed revisions to the standards; and the modification of the standards...

  9. 75 FR 1063 - Clinical Laboratory Improvement Advisory Committee (CLIAC) (United States)


    ... Laboratory Improvement Advisory Committee (CLIAC) In accordance with section 10(a)(2) of the Federal Advisory... under which clinical laboratories are regulated; the impact on medical and laboratory practice of... Testing Workgroup and discussion of the Workgroup's proposals related to good laboratory practices...

  10. Liposomal drug delivery system from laboratory to clinic

    Directory of Open Access Journals (Sweden)

    Kshirsagar N


    Full Text Available The main objective of drug delivery systems is to deliver a drug effectively, specifically to the site of action and to achieve greater efficacy and minimise the toxic effects compared to conventional drugs. Amongst various carrier systems, liposomes have generated a great interest because of their versatility. Liposomes are vesicular concentric bilayered structures, which are biocompatible, biodegradable and nonimmumnogenic. They can control the delivery of drugs by targeting the drug to the site of action or by site avoidance drug delivery or by prolonged circulation of drugs. Amphotericin B (Amp B remains the drug of choice in most systemic mycoses and also as a second line treatment for Kala azar. However, its toxic effects often limit its use. Although the liposome delivery system has been tried for several drugs, only a few have been used in patients due to the slow development of necessary large-scale pharmaceutical procedures. This paper reviews the development of the technique for liposomal Amphotericin B (L-Amp-LRC-1, FungisomeTM drug delivery system in our laboratory in collaboration with the department of Biochemistry, Delhi University in India and proving the safety and efficacy of this preparation in clinical practice. It also attempts to compare the efficacy and benefits of our product for Indian patients with those of similar products and it includes facts from the publications that flowed from our work. As compared to conventional Amp B, Fungisome is infused over a much shorter period requiring a smaller volume and no premedication. It was found to be safe in patients who had developed serious unacceptable toxicity with conventional Amp B. In renal transplant patients, Fungisome did not produce any nephrotoxicity. Fungisome is effective in fungal infections resistant to fluconazole, conventional Amp B and in virgin and resistant cases of visceral leishmaniasis. The cost of any drug is of great significance, especially in India

  11. Effect of dietary Ximenia caffra kernel meal on blood and liver metabolic substrate content and the general clinical biochemistry of Sprague Dawley rats. (United States)

    Chivandi, E; Moyo, D; Dangarembizi, R; Erlwanger, K


    We investigated (at the University of the Witwatersrand: GPS coordinates 26°10' 52.96″S; 28°2' 33.61″E) the effects of substituting soya bean meal (SBM) with Ximenia caffra kernel meal (XCKM) as a dietary protein source on blood and liver metabolic substrates content, serum markers of liver and kidney function and the general clinical biochemistry of Sprague Dawley (SD) rats. Five diets with similar energy and protein content were formulated (D1-D5) where XCKM replaced SBM on a crude protein basis at 0, 25, 50, 75 and 100%. Forty weanling male SD rats were randomly assigned to diets D1-D5, fed for 37 days and weighed twice weekly. The rats were then fasted overnight, and fasting blood glucose and triglyceride concentrations were determined from tail-vein-drawn blood. Immediately thereafter, the rats were euthanised and blood was collected via cardiac puncture. Serum was used to assay for markers of the general health profile. Livers were removed and weighed, and samples were used to determine lipid and glycogen content. Rats fed D4 (75% substitution level) had significantly lower (p  0.05) fasting blood glucose and cholesterol concentrations, liver glycogen and lipid content. Additionally, it had no effect (p > 0.05) on serum activity/concentration of surrogate markers of liver (alanine aminotransferase and alkaline phosphatase activity and urea, total bilirubin, globulin and albumin concentrations) and kidney (phosphorus, calcium and creatinine concentrations) function and the general clinical biochemistry of the rats. Defatted XCKM could substitute SBM in rat diets without compromising blood glucose and cholesterol homeostasis, liver and kidney function and the general clinical biochemistry of growing male Sprague Dawley rats.

  12. Experience of Quality Management in Clinical Biochemistry Technology%关于临床生化检验技术质量管理的几点体会

    Institute of Scientific and Technical Information of China (English)

    张燕; 杨自立


    目的:通过回顾本地区医院在临床生化检验技术质量管理方面的具体状况,总结临床生化检验技术质量管理的经验和体会。方法选取本地有代表性的两家医院(本文中不透漏医院真实名字,用甲医院和乙医院代替,两家医院均为二级甲等医院)检验科2013年度检验的血液样本1000份进行生化检验技术质量管理,计算检测结果总符合率。结果甲乙两家医院检测结果的总符合率都比较高,符合率在95%以上的血液样本数占总样本数量的90%以上(P<0.05),经观察分析发现,影响血液样本检测结果总符合率的主要因素有检验科科室内的温度和湿度、操作规程的标准程度、洗液更换情况和试剂平衡时间等。以上几种因素的差异具有统计学意义(P<0.05)。结论本地医院在临床生化检验技术质量管理方面有较高的管理水平,管理效果普遍较好,但也偶尔出现检测失误的现象,在今后的临床实践中要从几个临床生化检验技术的影响因素入手进一步加强质量管理,使检测结果更加精准,为患者提供更好的服务。%Objective Through the review of regional hospital in clinical biochemistry inspection technology of quality management, summarizes the clinical biochemical inspection technology experience and understanding of quality management. Methods To select the local representative of two hospitals (real name in this article do not divulge hospital, replace with a hospital and b hospital, two hospitals are secondary first-class hospital) clinical laboratory tests on 2013 blood samples from 1000 biochemical inspection technology quality management, calculating total coincidence detection results. Results The total coincidence rate of testing results of two hospitals are relatively high, the coincidence rate in more than 95%of the blood samples were more than 90%of the total number of samples ( <0.05), the analysis found

  13. Clinical and laboratory features of hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    Andrés Cárdenas


    Full Text Available

    The clinical presentation of hepatocellular carcinoma (HCC differs between patients in developing countries (African and Chinese populations from those in industrialized countries. In industrialized countries, HCC co-exists with symptomatic cirrhosis in 80% of cases and clinical manifestations are usually related to those of the underlying disease. On the other hand, patients from developing countries have HCC and cirrhosis in approximately 40% of cases. Underlying cirrhosis in many cases is not advanced and does not produce any symptoms or associated symptoms are masked by those of the tumor (right upper quadrant pain, mass in the upper abdomen, weight loss and weakness. In a subset of patients, there are no clinical manifestations as HCC may occur in the context of hepatitis B infection without cirrhosis.

    Clinical Manifestations

    In Western countries, nearly 35% percent of patients with HCC are asymptomatic. Some of the most common clinical manifestations include: abdominal pain (53-58% of patients, especially in epigastrium or right upper quadrant, abdominal mass (30%, weight loss, malaise, anorexia, cachexia, jaundice or fever.

    Physical Exam

    Physical findings vary with the stage of disease. The patient may exhibit slight or moderate wasting when first seen. In patients with cirrhosis, typical stigmata of chronic liver disease may be present. In advanced stages of HCC the liver may be enlarged and there is significant tenderness. An arterial bruit may be heard over the liver

  14. Sigma metrics in clinical chemistry laboratory – A guide to quality control

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    Usha S. Adiga


    Full Text Available Background: Six sigma is a process of quality measurement and improvement program used in industries. Sigma methodology can be applied wherever an outcome of a process is to be measured. A poor outcome is counted as an error or defect. This is quantified as defects per million (DPM. Six sigma provides a more quantitative frame work for evaluating process performance with evidence for process improvement and describes how many sigma fit within the tolerance limits. Sigma metrics can be used effectively in laboratory services. The present study was undertaken to evaluate the quality of the analytical performance of clinical chemistry laboratory by calculating sigma metrics. Methodology: The study was conducted in the clinical biochemistry laboratory of Karwar Institute of Medical Sciences, Karwar. Sigma metrics of 15 parameters with automated chemistry analyzer, transasia XL 640 were analyzed. The analytes assessed were glucose, urea, creatinine, uric acid, total bilirubin (BT, direct bilirubin (BD, total protein, albumin, SGOT, SGPT, ALP, Total cholesterol, triglycerides, HDL and Calcium. Results: We have sigma values <3 for Urea, ALT, BD, BT, Ca, creatinine (L1 and urea, AST, BD (L2. Sigma lies between 3-6 for Glucose, AST, cholesterol, uric acid, total protein(L1 and ALT, cholesterol, BT, calcium, creatinine and glucose (L2.Sigma was more than 6 for Triglyceride, ALP, HDL, albumin (L1 and TG, uric acid, ALP, HDL, albumin, total protein(L2. Conclusion: Sigma metrics helps to assess analytical methodologies and augment laboratory performance. It acts as a guide for planning quality control strategy. It can be a self assessment tool regarding the functioning of clinical laboratory.

  15. Aspectos clínicos e de laboratório de cães soropositivos para leishmaniose Clinical and laboratorial aspects of seropositive dogs to leishmaniosis

    Directory of Open Access Journals (Sweden)

    D.G. Mattos Jr.


    Full Text Available Leihsmaniasis is a protozoal disease transmitted by dipteran insects. The dog is an important domestic host of both visceral and cutaneous forms of the disease. These forms affects humans in many countries, and it is considered a serious risk for human health. This study reports clinical and laboratorial data from 18 dogs. Nine dogs were positive by indirect immunofluorescence technique and the other nine were negative. The dogs were clinically monitored for 30 days and laboratorial changes were assessed. Three blood samples were collected for hemogram and serum biochemistry at 0, 15, and 30 days. The clinical signs of positive dogs were compatible with the disease, including lymphadenopathy, cutaneous ulcers, hyperthermia, apathy, cachexia and ulcerated mucosa. Marked differences were observed in the blood cell counts and blood biochemistry between positive and negative dogs. In conclusion, blood and biochemistry analyses of positive dogs were not sufficient to diagnose the disease within the period studied. The serologic test associated with the clinical signs are important to confirm the diagnosis.


    Directory of Open Access Journals (Sweden)

    Mitsue Haragushi


    Full Text Available Outbreaks of hepatogenous photosensitivity in cattle in Brachiaria decumbens pastures has been associated with Pithomyces chartaraum spores or with lithogenic saponins in pastures. The objective of this work was to evaluate the laboratorial aspects of the hepatic alterations of cattle fed with Brachiaria brizantha and B. decumbens mix and Andropogon gayanus grass, as well as their correlation with the live weight gains. Fifty bulls were divided into two groups of 25 animals and fed, from weaning to slaughter, with one distinct type of grass. During 30 months and every 60 days blood samples were collected from all the animals, and they were weighed and clinically examined. Samples of the grasses were also collected in the same periods. The amount of P. chartarum spores and concentration of lithogenic saponins from the pastures were determined for a subsequent comparison with the clinical biochemistry results. Any animal showed clinic alterations, weight gains, however, were greater in the A. gayanus group. Hemoglobin concentration, hematocryte levels and erythrocytes number, total and indirect bilirubin were correlated with weight gains. Cattle fed with Brachiaria spp. e Andropogon gayanus showed similar hematological and hepatic function profiles. During the experimental period, independent of the grass type ingested, an increase of AST, GGT and bilirrubin was observed also with an absence of clinical signals suggesting a presence of sub-clinical chronic hepatic alteration.

    KEY WORDS: Aspartate aminotransferase, gama glutamyltransferase, photosensitivity, saponin, sporidesmin.

    A fotossensibilização hepatógena em bovinos vem sendo associada a fatores como esporidesmina produzida pelo fungo Pithomyces chartarum e saponinas litogênicas das pastagens, e o consumo de capim Brachiaria tem sido responsabilizado pela ocorrência dessa enfermidade. Avaliaram-se os aspectos laboratoriais das alterações hepáticas de bovinos

  17. Biochemistry and Molecular Biology Education (BAMBED

    Directory of Open Access Journals (Sweden)

    Voet Donald


    Full Text Available Biochemistry and Molecular Biology Education (BAMBED is a journal that is a publication of the In-ternational Union of Biochemistry and Molecular Biology (IUBMB and is published by the AmericanSociety of Biochemistry and Molecular Biology (ASBMB. BAMBED, as its name indicates, publishesarticles of interest to educators in biochemistry and molecular biology. These include invited reviewson subjects not yet in textbooks, discussions of curricular development, new laboratory exercises,and articles on educational research. BAMBED also publishes Features on Problem-Based Learning(PBL, Biotechnology Education, and Multimedia in Biochemistry and Molecular Biology Educati-on. An important aspect of these articles is that their educational eectiveness must be assessed. Ishall discuss in greater detail the types of articles that BAMBED publishes and the criteria used foraccepting them for publication. Conference attendees are encouraged to submit articles to BAMBED.

  18. 42 CFR 414.510 - Laboratory date of service for clinical laboratory and pathology specimens. (United States)


    ... and pathology specimens. 414.510 Section 414.510 Public Health CENTERS FOR MEDICARE & MEDICAID... date of service for clinical laboratory and pathology specimens. The date of service for either a clinical laboratory test or the technical component of physician pathology service is as follows:...

  19. Bringing the Excitement and Motivation of Research to Students; Using Inquiry and Research-Based Learning in a Year-Long Biochemistry Laboratory: Part II--Research-Based Laboratory--A Semester-Long Research Approach Using Malate Dehydrogenase as a Research Model (United States)

    Knutson, Kristopher; Smith, Jennifer; Nichols, Paul; Wallert, Mark A.; Provost, Joseph J.


    Research-based learning in a teaching environment is an effective way to help bring the excitement and experience of independent bench research to a large number of students. The program described here is the second of a two-semester biochemistry laboratory series. Here, students are empowered to design, execute and analyze their own experiments…

  20. Laboratory automation in clinical bacteriology: what system to choose? (United States)

    Croxatto, A; Prod'hom, G; Faverjon, F; Rochais, Y; Greub, G


    Automation was introduced many years ago in several diagnostic disciplines such as chemistry, haematology and molecular biology. The first laboratory automation system for clinical bacteriology was released in 2006, and it rapidly proved its value by increasing productivity, allowing a continuous increase in sample volumes despite limited budgets and personnel shortages. Today, two major manufacturers, BD Kiestra and Copan, are commercializing partial or complete laboratory automation systems for bacteriology. The laboratory automation systems are rapidly evolving to provide improved hardware and software solutions to optimize laboratory efficiency. However, the complex parameters of the laboratory and automation systems must be considered to determine the best system for each given laboratory. We address several topics on laboratory automation that may help clinical bacteriologists to understand the particularities and operative modalities of the different systems. We present (a) a comparison of the engineering and technical features of the various elements composing the two different automated systems currently available, (b) the system workflows of partial and complete laboratory automation, which define the basis for laboratory reorganization required to optimize system efficiency, (c) the concept of digital imaging and telebacteriology, (d) the connectivity of laboratory automation to the laboratory information system, (e) the general advantages and disadvantages as well as the expected impacts provided by laboratory automation and (f) the laboratory data required to conduct a workflow assessment to determine the best configuration of an automated system for the laboratory activities and specificities.

  1. [Knowledge management system for laboratory work and clinical decision support]. (United States)

    Inada, Masanori; Sato, Mayumi; Yoneyama, Akiko


    This paper discusses a knowledge management system for clinical laboratories. In the clinical laboratory of Toranomon Hospital, we receive about 20 questions relevant to laboratory tests per day from medical doctors or co-medical staff. These questions mostly involve the essence to appropriately accomplish laboratory tests. We have to answer them carefully and suitably because an incorrect answer may cause a medical accident. Up to now, no method has been in place to achieve a rapid response and standardized answers. For this reason, the laboratory staff have responded to various questions based on their individual knowledge. We began to develop a knowledge management system to promote the knowledge of staff working for the laboratory. This system is a type of knowledge base for assisting the work, such as inquiry management, laboratory consultation, process management, and clinical support. It consists of several functions: guiding laboratory test information, managing inquiries from medical staff, reporting results of patient consultation, distributing laboratory staffs notes, and recording guidelines for laboratory medicine. The laboratory test information guide has 2,000 records of medical test information registered in the database with flexible retrieval. The inquiry management tool provides a methos to record all questions, answer easily, and retrieve cases. It helps staff to respond appropriately in a short period of time. The consulting report system treats patients' claims regarding medical tests. The laboratory staffs notes enter a file management system so they can be accessed to aid in clinical support. Knowledge sharing using this function can achieve the transition from individual to organizational learning. Storing guidelines for laboratory medicine will support EBM. Finally, it is expected that this system will support intellectual activity concerning laboratory work and contribute to the practice of knowledge management for clinical work support.

  2. [ISO 15189 accreditation in clinical microbiology laboratory: general concepts and the status in our laboratory]. (United States)

    Akyar, Işin


    One important trend in the laboratory profession and quality management is the global convergence of laboratory operations. The goal of an accredited medical laboratory is to continue "offering useful laboratory service for diagnosis and treatment of the patients and also aid to the health of the nation". An accredited clinical laboratory is managed by a quality control system, it is competent technically and the laboratory service meets the needs of all its patients and physicians by taking the responsibility of all the medical tests and therapies. For this purpose, ISO 15189 international standard has been prepared by 2003. ISO 15189 standard is originated from the arrangement of ISO 17025 and ISO 9001:2000 standards. Many countries such as England, Germany, France, Canada and Australia have preferred ISO 15189 as their own laboratory accreditation programme, meeting all the requirements of their medical laboratories. The accreditation performance of a clinical microbiology laboratory is mainly based on five essential points; preanalytical, analytical, postanalytical, quality control programmes (internal, external, interlaboratory) and audits (internal, external). In this review article, general concepts on ISO 15189 accreditation standards for the clinical microbiology laboratories have been summarized and the status of a private laboratory (Acibadem LabMed, Istanbul) in Turkey has been discussed.

  3. Mentoring for retention and advancement in the multigenerational clinical laboratory. (United States)

    Laudicina, R J


    Retention of recent graduates and other laboratory practitioners in the workplace will play a key role in addressing current and projected shortages of clinical laboratory scientists (CLS) and technicians (CLT). In addition, with overrepresentation of the aging Baby Boomer generation in laboratory supervisory and management positions, it is crucial not only to retain younger practitioners, but to prepare them for assuming these important functions in the future. Mentoring, a practice commonly employed in other professions, is widely considered to be useful in employee retention and career advancement. Mentoring has probably been used in the clinical laboratory profession, but has not been well documented. In the clinical laboratory environment, potential mentors are in the Veteran and Baby Boomer generations, and new practitioners who could benefit from mentoring are in Generation X. Generational differences among these groups may present challenges to the use of mentoring. This article will attempt to provide a better understanding of generational differences and show how mentoring can be applied in the setting of the clinical laboratory in order to increase retention and promote career advancement of younger practitioners. A panel of five laboratory managers provided examples of mentoring strategies. Definitions, benefits, and examples of mentoring are addressed in the accompanying article, "Passing the Torch: Mentoring the Next Generation of Laboratory Professionals".

  4. [CAP quality management system in clinical laboratory and its issue]. (United States)

    Tazawa, Hiromitsu


    The CAP (College of American Pathologists) was established in 1962 and, at present, CAP-accredited laboratories include about 6000 institutions all over the world, mainly in the U.S. The essential purpose of CAP accreditation is high quality reservation and improvement of clinical laboratory services for patient care, and is based on seven points, listed below. (1) Establishment of a laboratory management program and laboratory techniques to assure accuracy and improve overall quality of laboratory services. (2) Maintenance and improvement of accuracy objectively by centering on a CAP survey. (3) Thoroughness in safety and health administration. (4) Reservation of the performance of laboratory services by personnel and proficiency management. (5) Provision of appropriate information to physicians, and contribution to improved quality of patient care by close communication with physicians (improvement in patient care). (6) Reduction of running costs and personnel costs based on evidence by employing the above-mentioned criteria. (7) Reduction of laboratory error. In the future, accreditation and/or certification by organizations such as CAP, ISO, etc., may become a requirement for providing any clinical laboratory services in Japan. Taking the essence of the CAP and the characteristics of the new international standard, ISO151589, into consideration, it is important to choose the best suited accreditation and/or certification depending of the purpose of clinical laboratory.

  5. League academic of clinical biochemistry: implementation of experience and participation in first on academic in higher education institution of Juazeiro do Norte – Ceará

    Directory of Open Access Journals (Sweden)

    Vanderlan Nogueira Holanda


    Full Text Available The creation of Academic Leagues in private institutions is usual today. The Academic League of Clinical Biochemistry (LABiC from the Faculdade Leão Sampaio was designed by students of Biomedicine course in 2014 and is the first Academic League of this institution. The research outlined here presents exploratory, descriptive, qualitative approach. It was carried out in a higher education institution of Juazeiro do Norte - CE during June of 2015. As a tool for data collection, we used a questionnaire that was applied to members of LABiC in order to investigate their experiences in relation to the participation in the Academic League. The creation of the first Academic League in a higher education institution of the Cariri region was extremely positive and accepted by the academic community. One year after the creation of LABiC other leagues were created reaffirming the important result of this relevant outreach activity.

  6. 临床生物化学检验课程PBL教学探讨%The effectiveness of PBL teaching in clinical biochemistry

    Institute of Scientific and Technical Information of China (English)

    马洁; 郑铁生; 姜旭淦; 许文荣; 胡嘉波


    在临床生物化学检验课程中实施PBL教学,可提高学生自主学习、获取信息、解决问题、团队合作、创新思维等方面的能力.同时也存在师资力量不足、课程教学体系不匹配、学生能力不足等方而的问题,并提出相应改进策略.%The article is attempted to introduce PBL teaching in clinical biochemistry. The PBL teaching has improved some aspects of students' abilities in the self-study, accessing to information, solving the problem, teamwork and developing thinking. But in the course of PBL teaching, there are three problems: shortage of qualified teachers, teaching system and students' inability. This article puts forward the countermeasures to resolve these problems.

  7. Learning Biochemistry by Chocolate

    Directory of Open Access Journals (Sweden)

    M.C Guedes


    Full Text Available Both sensations and biochemical reactions taken place or promoted during ingestion of chocolate were the motivation for  investigating  the  organic  compounds  present  in  this  source.  Cocoa  and  chocolate  are  composed  by  several substances , among them, aminoacids and alkaloids.The objective of this investigation was to purpose a contextured approach  of  biochemistry  through  the  sensations  and  reactions  involving  aminoacids,  theobromine  and  hormones. Methodology: 1. Theoretical part:  constituted  by theoretical  and tutorial classes  about aminoacids, theobromine and hormones  involved  at  the  metabolism;  2.  Questionary:  ten  questions  based  upon  theoretical  classes,  personal sensations  and  general  aspects  of chocolate;  3.Lecture:  Cientific  articles  searched  in  periodics  by  own  students  as well  as  newspaper  reports;  4.  Experimental:  Laboratory  experiments  including  extraction,  characterization, spectrometric quantification  after  specific reactions  and identification by  Rf  comparison with  standards  on TLC  from cocoa  almonds  and  both  powder  cocoa  and  chocolate.  The  study  was  applied  in  30  students  from  a  chemistry college. Results: The results pointed out to a higher frequency of the students and to a increased interest  from them by   biochemistry  issues  and  cientific  lectures,  as  well  as  a  satisfactory  acquirement  of  theoretical  and  practice knowledge of aminoacids and hormones, spectrometry and chromatography. Conclusion: A contextured approach is quite positive for learning biochemistry to chemists.

  8. [Clinical laboratory approaches to parodontitis treatment optimization]. (United States)

    Soboleva, L A; Shul'diakov, A A; Oseeva, A O; Aleksandrova, E A


    In order to determine cycloferon liniment clinical-pathogenetic efficacy in comprehensive parodontitis therapy examination and treatment of 80 patients was done. It was determined that the cycloferon liniment use in comprehensive treatment of patients with parodontitis let to reduce infectious load in parodontal pockets and local inflammation intensity, to normalize the secretory immunoglobulin level and immune status indices that provided speed up of healing process and reduction relapse frequency.

  9. Clinical laboratory technologist professional development in Camagüey

    Directory of Open Access Journals (Sweden)

    Mercedes Caridad García González


    Full Text Available The paper describes the results of research aimed at assessing the current conditions related to clinical laboratory technologist professional development. A descriptive cross study covering the period between November 2013 and January 2014 is presented. Several techniques for identifying and hierarchically arranging professional developmental related problems were used to study a sample at the Faculty of Health Technology of the Medical University “Carlos Juan Finlay”. The study involved heads of teaching departments and methodologists of health care technology specialties; moreover a survey and a content test were given graduate clinical laboratory technicians. The authors reached at the conclusion that clinical laboratory technologist professional development is limited and usually underestimate the necessities and interests of these graduates. Likewise, a lack of systematization and integration of the biomedical basic sciences contents and the laboratory diagnosis is noticeable.

  10. [Clinical microbiology laboratory and imported parasitic diseases]. (United States)

    Martín-Rabadán, Pablo; Martínez-Ruiz, Rocío; Cuadros, Juan; Cañavate, Carmen


    Imported parasitosis represents an increasingly frequent diagnostic challenge for microbiology laboratories. A surge in immigration and international travel has led to a rise in the number of imported cases of parasitosis, and this trend is expected to continue in the future. The present article addresses this challenge by reviewing recommended diagnostic approaches and tests. Currently, microscopy is always recommended when analysing blood samples for parasites. If malaria is suspected, rapid antigen testing (including at least HRP2 antigen) should also be performed. The work-up for suspected leishmaniasis should include serology, culture, and in selected cases detection of antigen in urine. In suspected Chagas disease, two different serological tests should be performed. PCR for blood protozoa is highly sensitive, although it cannot be used to rule out Chagas disease, since this condition may be present without parasitemia. Accurate diagnosis of intestinal amebiasis usually requires PCR or antigen detection tests. In helminthiasis, traditional microscopy may need to be complemented with other tests, such as agar plate culture for strongyloidiasis, Og4C3 antigen detection for bancroftian filariasis, and antibody detection test for filariasis and schistosomiasis.

  11. Clinical laboratory as an economic model for business performance analysis (United States)

    Buljanović, Vikica; Patajac, Hrvoje; Petrovečki, Mladen


    Aim To perform SWOT (strengths, weaknesses, opportunities, and threats) analysis of a clinical laboratory as an economic model that may be used to improve business performance of laboratories by removing weaknesses, minimizing threats, and using external opportunities and internal strengths. Methods Impact of possible threats to and weaknesses of the Clinical Laboratory at Našice General County Hospital business performance and use of strengths and opportunities to improve operating profit were simulated using models created on the basis of SWOT analysis results. The operating profit as a measure of profitability of the clinical laboratory was defined as total revenue minus total expenses and presented using a profit and loss account. Changes in the input parameters in the profit and loss account for 2008 were determined using opportunities and potential threats, and economic sensitivity analysis was made by using changes in the key parameters. The profit and loss account and economic sensitivity analysis were tools for quantifying the impact of changes in the revenues and expenses on the business operations of clinical laboratory. Results Results of simulation models showed that operational profit of €470 723 in 2008 could be reduced to only €21 542 if all possible threats became a reality and current weaknesses remained the same. Also, operational gain could be increased to €535 804 if laboratory strengths and opportunities were utilized. If both the opportunities and threats became a reality, the operational profit would decrease by €384 465. Conclusion The operational profit of the clinical laboratory could be significantly reduced if all threats became a reality and the current weaknesses remained the same. The operational profit could be increased by utilizing strengths and opportunities as much as possible. This type of modeling may be used to monitor business operations of any clinical laboratory and improve its financial situation by

  12. Antiphospholipid antibody: laboratory, pathogenesis and clinical manifestations

    Directory of Open Access Journals (Sweden)

    T. Ziglioli


    Full Text Available Antiphospholipid antibodies (aPL represent a heterogeneous group of antibodies that recognize various antigenic targets including beta2 glycoprotein I (β2GPI, prothrombin (PT, activated protein C, tissue plasminogen activator, plasmin and annexin A2. The most commonly used tests to detect aPL are: lupus anticoagulant (LAC, a functional coagulation assay, anticardiolipin antibody (aCL and anti-β2GPI antibody (anti-β2GPI, which are enzyme-linked immunoassay (ELISA. Clinically aPL are associated with thrombosis and/or with pregnancy morbidity. Apparently aPL alone are unable to induce thrombotic manifestations, but they increase the risk of vascular events that can occur in the presence of another thrombophilic condition; on the other hand obstetrical manifestations were shown to be associated not only to thrombosis but mainly to a direct antibody effect on the trophoblast.

  13. 1.2.Clinical laboratory diagnosis

    Institute of Scientific and Technical Information of China (English)


    930212 Enzymatic analysis of serum total bileacids and clinical evaluation.WEI Youren (魏有仁),et al.Sino—Japan Friendship Hosp,Bei-jing,100029.CHin J Med Lab Technol 1993;16(1):11—14.An enzymatic colorimetric assay of serum to-tal bile acids (TBA) was reported for the firsttime in China.3 α-hydroxysteroid dehydroge-nase (3α-HSD) had been purified from pseu-domonas testosteroni in the sventies,and hadbeen used as a main enzyme reagent in the enzy-matic analysis of TBA.In this paper,the au-thors introduced a rapid,sensitive colorimetricassay using 3α-HSD,and a couple enzyme 5β-steroid Δ~4 dehydrogenase to imcrease the con-

  14. [View of a Laboratory Physician on the Present and Future of Clinical Laboratories]. (United States)

    Matsuo, Shuji


    It is meaningful to discuss the "present and future of laboratories" for the development of laboratories and education of medical technologists. Laboratory staff must be able to perform urgent high-quality tests and take part in so-called team-based medicine and should be proud of devising systems that efficiently provide laboratory data for all medical staff. On the other hand, there may be staff with a poor sense of professionalism who work no more than is expected and too readily ask firms and commercial laboratories to solve problems. Overwork caused by providing team-based medicine and a decrease in numbers of clinical chemists are concerns. The following are hoped for in the future. Firstly, laboratory staff will become conscious of their own high-level abilities and expand their areas of work, for example, bioscience, proteomics, and reproductive medicine. Secondly, a consultation system for medical staff and patients will be established. Thirdly, clinical research will be advanced, such as investigating unknown pathophysiologies using laboratory data and samples, and developing new methods of measurement. Lastly, it is of overriding importance that staff of laboratory and educational facilities will cooperate with each other to train the next generation. In conclusion, each laboratory should be appreciated, attractive, positive regarding its contribution to society, and show individuality.

  15. 75 FR 12554 - Clinical Laboratory Improvement Advisory Committee: Notice of Charter Renewal (United States)


    ... HUMAN SERVICES Centers for Disease Control and Prevention Clinical Laboratory Improvement Advisory...-463) of October 6, 1972, that the Clinical Laboratory Improvement Advisory Committee, Centers for..., Clinical Laboratory Improvement Advisory Committee, Centers for Disease Control and Prevention,...

  16. Clinical laboratory sciences curriculum redevelopment: an application of change theories. (United States)

    Mundt, Lillian; Vanik, Janet


    The Department of Clinical Laboratory Sciences at Rosalind Franklin University of Medicine and Science (RFUMS) experienced a steady decline in the number of applicants for the Clinical Laboratory Sciences (CLS) Program, even though the department regularly received inquiries from qualified students. The faculty recognized the undergraduate-degreed prospects' desires for both an advanced degree and the procurement of entry-level clinical laboratory knowledge and skills. To address this perceived need, the CLS department developed and implemented a new degree option, the entry-level master's. The new curriculum resulted from a transformational process incorporated into the normal developmental process of curriculum change. This article explores various change theories that were manifested during this transformation process, along with barriers to change and how to overcome them. In addition, the authors demonstrate the need for creation of this entry-level program and provide a curriculum outline.

  17. Laboratory Accreditation in Argentina (United States)

    Collino, Cesar; Chiabrando, Gustavo A.


    Laboratory accreditation is an essential element in the healthcare system since it contributes substantially to decision-making, in the prevention, diagnosis, treatment and follow-up of the health status of the patients, as well as in the organization and management of public healthcare. Therefore, the clinical biochemistry professional works continuously to provide reliable results and contributes to the optimization of operational logistics and integration of a laboratory into the health system. ISO 15189 accreditation, ensures compliance of the laboratory to minimize instances of error through the planning, prevention, implementation, evaluation and improvement of its procedures, which provides skill areas that involve both training undergraduate and graduate professionals in clinical biochemistry. PMID:27683497

  18. Metabolism and biochemistry in hypogravity (United States)

    Leach, Carolyn S.

    The headward shift of body fluid and increase in stress-related hormones that occur in hypogravity bring about a number of changes in metabolism and biochemistry of the human body. Such alterations may have important effects on health during flight and during a recovery period after return to Earth. Body fluid and electrolytes are lost, and blood levels of several hormones that control metabolism are altered during space flight. Increased serum calcium may lead to an increased risk of renal stone formation during flight, and altered drug metabolism could influence the efficacy of therapeutic agents. Orthostatic intolerance and an increased risk of fracturing weakened bones are concerns at landing. It is important to understand biochemistry and metabolism in hypogravity so that clinically important developments can be anticipated and prevented or ameliorated.

  19. Metabolism and biochemistry in hypogravity (United States)

    Leach, Carolyn S.


    The headward shift of body fluid and increase in stress-related hormones that occur in hypogravity bring about a number of changes in metabolism and biochemistry of the human body. Such alterations may have important effects on health during flight and during a recovery period after return to earth. Body fluid and electrolytes are lost, and blood levels of several hormones that control metabolism are altered during space flight. Increased serum calcium may lead to an increased risk of renal stone formation during flight, and altered drug metabolism could influence the efficacy of therapeutic agents. Orthostatic intolerance and an increased risk of fracturing weakened bones are concerns at landing. It is important to understand biochemistry and metabolism in hypogravity so that clinically important developments can be anticipated and prevented or ameliorated.

  20. A Streamlined Molecular Biology Module for Undergraduate Biochemistry Labs (United States)

    Muth, Gregory W.; Chihade, Joseph W.


    Site-directed mutagenesis and other molecular biology techniques, including plasmid manipulation and restriction analysis, are commonly used tools in the biochemistry research laboratory. In redesigning our biochemistry lab curricula, we sought to integrate these techniques into a term-long, project-based course. In the module presented here,…

  1. Understanding the interface between clinical and laboratory staff

    Directory of Open Access Journals (Sweden)

    Ankie van den Broek


    Full Text Available Background: The interface between clinicians and laboratory staff is where the two meet and work together to provide quality care to their clients (patients. Effectiveness of the interface depends on the way the two groups of professionals relate to and communicate with each other. The number and type of tests requested and the use of the test results for clinical decision making can be influenced by the interface between clinicians and laboratory staff. A model to understand the factors and dynamics around the interface is lacking.Objectives: To propose a new conceptual model to gain insight and analyse factors that influence the laboratory–clinical staff interface.Methods: To develop the conceptual model, a literature study was performed, regulatory guidelines and standards for laboratories were analysed and discussions were held with experts on the topic.Result: A conceptual model and analytical framework provided good guidance in understanding and assessing the organisational and personal factors shaping the interface. The model was based on three elements: (1 the three phases of communication (pre-analytical, analytical and post-analytical; (2 the organisational and personal factors of interaction; and (3 the socio-political, economic and cultural context in which clinicians and laboratory staff operate.Conclusion: Assessment of the interface between clinicians and laboratory workers can be performed in a systematic way. Applying this model will provide information to managers of health institutions and heads of laboratories and clinical departments about what happens when clinicians and laboratory staff interact, thus aiding them in designing strategies to improve this interface. Normal 0 21 false false false NL X-NONE X-NONE

  2. Bioterrorism and the Role of the Clinical Microbiology Laboratory. (United States)

    Wagar, Elizabeth


    Regular review of the management of bioterrorism is essential for maintaining readiness for these sporadically occurring events. This review provides an overview of the history of biological disasters and bioterrorism. I also discuss the recent recategorization of tier 1 agents by the U.S. Department of Health and Human Services, the Laboratory Response Network (LRN), and specific training and readiness processes and programs, such as the College of American Pathologists (CAP) Laboratory Preparedness Exercise (LPX). LPX examined the management of cultivable bacterial vaccine and attenuated strains of tier 1 agents or close mimics. In the LPX program, participating laboratories showed improvement in the level of diagnosis required and referral of isolates to an appropriate reference laboratory. Agents which proved difficult to manage in sentinel laboratories included the more fastidious Gram-negative organisms, especially Francisella tularensis and Burkholderia spp. The recent Ebola hemorrhagic fever epidemic provided a check on LRN safety processes. Specific guidelines and recommendations for laboratory safety and risk assessment in the clinical microbiology are explored so that sentinel laboratories can better prepare for the next biological disaster.

  3. Sweet syndrome: Clinical and Laboratory Findings of 31 Cases

    Directory of Open Access Journals (Sweden)

    Serap Güneş Bilgili


    Full Text Available Background and Design: Sweet syndrome is an inflammatory disease characterized by the abrupt onset of pain, red papules and plaques, fever, neutrophilic leukocytosis, and dermal neutrophilic infiltrate. There are not enough data about Sweet syndrome in Turkey. In this article, we studied clinical, laboratory, histopathological, and epidemiological characteristics of patients, who presented to our clinic, and compared the findings with the literature. Materials and Methods: All patients diagnosed with Sweet syndrome in our clinic between 2005 and 2011 were included in the study. The epidemiological, clinical, and laboratory findings were retrospectively evaluated. Results: A total of 31 patients with Sweet’s syndrome - 24 female (77.4%, 7 male (22.6%; aged 23-82 years – included in the study. The average age of the patients was 48 years. Cutaneous lesions were most frequently localized in the upper extremity. Conjunctivitis was the common systemic manifestation, followed by fever, arthralgia, and myalgia. The most common trigger factor was infections of the upper respiratory tract. In histopathological evaluations of skin biopsies, dense neutrophil infiltration compatible with Sweet syndrome was detected in the dermis. Also, findings of vasculitis were determined in 3 patients. Discussion: The clinical and laboratory findings in our study are mostly similar to those reported in the literature. We found evidence of vasculitis in 10% of cases, therefore, we think the presence of vasculitis does not necessarily rule out the diagnosis of Sweet syndrome

  4. Clinical Mass Spectrometry: Achieving Prominence in Laboratory Medicine

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    Annesley, Thomas M.; Cooks, Robert G.; Herold, David A.; Hoofnagle, Andrew N.


    Each year the journal Clinical Chemistry publishes a January special issue on a topic that is relevant to the laboratory medicine community. In January 2016 the topic is mass spectrometry, and the issue is entitled “Clinical Mass Spectrometry: Achieving Prominence in Laboratory Medicine”. One popular feature in our issues is a Q&A on a topic, clearly in this case mass spectrometry. The journal is assembling a panel of 5-6 experts from various areas of mass spectrometry ranging from instrument manufacturing to practicing clinical chemists. Dick Smith is one of the scientist requested to participate in this special issue Q&A on Mass Spectrometry. The Q&A Transcript is attached

  5. Walking the bridge: Nursing students' learning in clinical skill laboratories. (United States)

    Ewertsson, Mona; Allvin, Renée; Holmström, Inger K; Blomberg, Karin


    Despite an increasing focus on simulation as a learning strategy in nursing education, there is limited evidence on the transfer of simulated skills into clinical practice. Therefore it's important to increase knowledge of how clinical skills laboratories (CSL) can optimize students' learning for development of professional knowledge and skills, necessary for quality nursing practice and for patient safety. Thus, the aim was to describe nursing students' experiences of learning in the CSL as a preparation for their clinical practice. Interviews with 16 students were analysed with content analysis. An overall theme was identified - walking the bridge - in which the CSL formed a bridge between the university and clinical settings, allowing students to integrate theory and practice and develop a reflective stance. The theme was based on categories: conditions for learning, strategies for learning, tension between learning in the skills laboratory and clinical settings, and development of professional and personal competence. The CSL prepared the students for clinical practice, but a negative tension between learning in CSL and clinical settings was experienced. However, this tension may create reflection. This provides a new perspective that can be used as a pedagogical approach to create opportunities for students to develop their critical thinking.

  6. Reproduction, physiology and biochemistry (United States)

    This chapter summarizes fundamental knowledge and recent discoveries about the reproduction, physiology and biochemistry of plant-parasitic nematodes. Various types of reproduction are reviewed, including sexual reproduction and mitotic and meiotic parthenogenesis. Although much is known about the p...

  7. Quality in Online Courses: Technical Production Regarding Clinical Biochemistry Online Course Performed by Students in Advanced Learning in Scientific Education Discipline

    Directory of Open Access Journals (Sweden)

    W.B. Maia


    Full Text Available It is important to consider quality and efficacy concerning online courses. This study was accomplished with Master’s students in order to promote technical production regardingClinical Biochemistry online course. In web,, it was accessible strategic and organizational management training in distance learning course. Enrolled students(7, monitors (3 and the manager (1 have made use of thevirtual environment asa channel of communication as well as to construct the extension course (80 hours. Some strategies were discussed and planned for the purpose of a significant apprenticeship. In all, there were 173 standard contents available, which were 4 audiovisual presentations, 13 debating forums, 1 chat, 10 classes,77 scientific articles, 30 tests, 3 glossaries, 1 mini-library, 18 links, 3 texts and 13 folders. Although the managerwas not responsible for the construction ofthe contents, system reports have shown that the manager’s attendance and permanence online were three times superior to other users. It once more revealed that new Information and Communication Technologies(ICTs requires from the manager to plan an efficient pedagogical orientation.

  8. Biochemistry of Statins. (United States)

    Egom, Emmanuel Eroume A; Hafeez, Hafsa


    Cardiovascular disease (CVD) is the leading cause of morbidity and mortality worldwide. Elevated blood lipids may be a major risk factor for CVD. Due to consistent and robust association of higher low-density lipoprotein (LDL)-cholesterol levels with CVD across experimental and epidemiologic studies, therapeutic strategies to decrease risk have focused on LDL-cholesterol reduction as the primary goal. Current medication options for lipid-lowering therapy include statins, bile acid sequestrants, a cholesterol-absorption inhibitor, fibrates, nicotinic acid, and omega-3 fatty acids, which all have various mechanisms of action and pharmacokinetic properties. The most widely prescribed lipid-lowering agents are the HMG-CoA reductase inhibitors, or statins. Since their introduction in the 1980s, statins have emerged as the one of the best-selling medication classes to date, with numerous trials demonstrating powerful efficacy in preventing cardiovascular outcomes (Kapur and Musunuru, 2008 [1]). The statins are commonly used in the treatment of hypercholesterolemia and mixed hyperlipidemia. This chapter focuses on the biochemistry of statins including their structures, pharmacokinetics, and mechanism of actions as well as the potential adverse reactions linked to their clinical uses.

  9. [Perspective for clinical laboratory management and its systematization--effects of the systematization of clinical laboratory management]. (United States)

    Ito, S


    There are a large number of ideas concerning the systematization of clinical laboratory management. Therefore many types of laboratory systems have been constructed. As our hospital is not large, we adopted a small scale laboratory system. In introducing it, we expected not only an increase in value-added labor productivity by automating laboratory tests, but also an improvement in technologist's cost awareness. Consequently, new system equipment has itself performed the former in many sections, but not the latter. Improvement in cost awareness was caused by the technologist's routine work in managing reagent and material stocks. We found that this soft-type systematization has been more important than the advanced hard-type system.

  10. Realistic modeling of clinical laboratory operation by computer simulation. (United States)

    Vogt, W; Braun, S L; Hanssmann, F; Liebl, F; Berchtold, G; Blaschke, H; Eckert, M; Hoffmann, G E; Klose, S


    An important objective of laboratory management is to adjust the laboratory's capability to the needs of patients' care as well as economy. The consequences of management may be changes in laboratory organization, equipment, or personnel planning. At present only one's individual experience can be used for making such decisions. We have investigated whether the techniques of operations research could be transferred to a clinical laboratory and whether an adequate simulation model of the laboratory could be realized. First we listed and documented the system design and the process flow for each single laboratory request. These input data were linked by the simulation model (programming language SIMSCRIPT II.5). The output data (turnaround times, utilization rates, and analysis of queue length) were validated by comparison with the current performance data obtained by tracking specimen flow. Congruence of the data was excellent (within +/- 4%). In planning experiments we could study the consequences of changes in order entry, staffing, and equipment on turnaround times, utilization, and queue lengths. We conclude that simulation can be a valuable tool for better management decisions.

  11. Bringing the Excitement and Motivation of Research to Students; Using Inquiry and Research-Based Learning in a Year-Long Biochemistry Laboratory: Part I--Guided Inquiry--Purification and Characterization of a Fusion Protein--Histidine Tag, Malate Dehydrogenase, and Green Fluorescent Protein (United States)

    Knutson, Kristopher; Smith, Jennifer; Wallert, Mark A.; Provost, Joseph J.


    A successful laboratory experience provides the foundation for student success, creating active participation in the learning process. Here, we describe a new approach that emphasizes research, inquiry and problem solving in a year-long biochemistry experience. The first semester centers on the purification, characterization, and analysis of a…

  12. Clinical laboratories, the select agent program, and biological surety (biosurety). (United States)

    Pastel, Ross H; Demmin, Gretchen; Severson, Grant; Torres-Cruz, Rafael; Trevino, Jorge; Kelly, John; Arrison, Jay; Christman, Joy


    The threat of bioterrorism has led to increased concerns over the availability of biological select agents and toxins (BSAT). Congress has implemented several public laws that have led to the development of federal regulations by the Centers for Disease Control and Prevention (CDC) and the US Department of Agriculture. The CDC regulation 42 CFR 73 has a direct impact on all clinical laboratories that may at some time identify BSAT in a clinical specimen. The Department of Defense has imposed a more stringent layer of regulation called biological surety (biosurety) on top of the requirements of 42 CFR 73 for military laboratories that possess BSAT. However,42 CFR 73 falls into the framework of biosurety. Both sets of regulations have four pillars (safety, physical security, agent account-ability, and personnel reliability) that are built on a foundation of training and covered by a roof of management (operations and plans).

  13. Clinical evaluation, biochemistry and genetic polymorphism analysis for the diagnosis of lactose intolerance in a population from northeastern Brazil

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Lins Ponte


    Full Text Available OBJECTIVE: This work aimed to evaluate and correlate symptoms, biochemical blood test results and single nucleotide polymorphisms for lactose intolerance diagnosis. METHOD: A cross-sectional study was conducted in Fortaleza, Ceará, Brazil, with a total of 119 patients, 54 of whom were lactose intolerant. Clinical evaluation and biochemical blood tests were conducted after lactose ingestion and blood samples were collected for genotyping evaluation. In particular, the single nucleotide polymorphisms C>T-13910 and G>A-22018 were analyzed by restriction fragment length polymorphism/polymerase chain reaction and validated by DNA sequencing. RESULTS: Lactose-intolerant patients presented with more symptoms of flatulence (81.4%, bloating (68.5%, borborygmus (59.3% and diarrhea (46.3% compared with non-lactose-intolerant patients (pT-13910 and G>A-22018 with lactose tolerance in this population and suggest clinical management for patients with lactose intolerance that considers single nucleotide polymorphism detection and a change in the biochemical blood test cutoff from <25 mg/dL to <15 mg/dL.

  14. Verification and validation of diagnostic laboratory tests in clinical virology. (United States)

    Rabenau, Holger F; Kessler, Harald H; Kortenbusch, Marhild; Steinhorst, Andreas; Raggam, Reinhard B; Berger, Annemarie


    This review summarizes major issues of verification and validation procedures and describes minimum requirements for verification and validation of diagnostic assays in clinical virology including instructions for CE/IVD-labeled as well as for self-developed ("home-brewed") tests or test systems. It covers techniques useful for detection of virus specific antibodies, for detection of viral antigens, for detection of viral nucleic acids, and for isolation of viruses on cell cultures in the routine virology laboratory.

  15. Evaluation of Neonatal Hemolytic Jaundice: Clinical and Laboratory Parameters


    Anet Papazovska Cherepnalkovski; Vjekoslav Krzelj; Beti Zafirovska-Ivanovska; Todor Gruev; Josko Markic; Natasa Aluloska; Nikolina Zdraveska; Katica Piperkovska


    BACKGROUND: Neonatal jaundice that occurs in ABO or Rhesus issoimunisation has been recognized as one of the major risk factors for development of severe hyperbilirubinemia and bilirubin neurotoxicity. AIM: Aim of our study was to investigate clinical and laboratory parameters associated with hemolytic jaundice due to Rh and ABO incompatibility and compare results with the group of unspecific jaundice. MATERIAL AND METHODS: One hundred sixty seven (167) neonatal hyperbilirubinemia cas...

  16. Clinical and laboratory characteristics of Achromobacter xylosoxidans infection.



    Achromobacter xylosoxidans was isolated from six patients. The organism causes opportunistic infections in patients who are compromised. A. xylosoxidans is a catalase- and oxidase-positive, motile, gram-negative rod that oxidizes xylose and glucose. The organism exists in a water environment and may be confused with Pseudomonas species. Unlike pseudomonas, achromobacter has peritrichous flagella. The clinical and laboratory characteristics of A. xylosoxidans are presented.

  17. Clinical Laboratory Stressors Used to Study Alcohol–Stress Relationships


    Thomas, Suzanne; Bacon, Amy K.; Sinha, Rajita; Uhart, Magdalena; Adinoff, Bryon


    Understanding the biologic systems that underlie the relationship between stress and alcohol consumption may lead to better prevention efforts and more effective treatments for alcoholism. Clinical laboratory studies offer a unique opportunity to examine these relationships by using a controlled environment to study how an acute stressor affects alcohol drinking and alcohol craving, how individuals in recovery or those at risk for alcoholism may respond differently to stressors relative to co...

  18. Expression, Purification, and Characterization of a Carbohydrate-Active Enzyme: A Research-Inspired Methods Optimization Experiment for the Biochemistry Laboratory (United States)

    Willbur, Jaime F.; Vail, Justin D.; Mitchell, Lindsey N.; Jakeman, David L.; Timmons, Shannon C.


    The development and implementation of research-inspired, discovery-based experiences into science laboratory curricula is a proven strategy for increasing student engagement and ownership of experiments. In the novel laboratory module described herein, students learn to express, purify, and characterize a carbohydrate-active enzyme using modern…

  19. Environmental Regulation of Plant Gene Expression: An Rt-qPCR Laboratory Project for an Upper-Level Undergraduate Biochemistry or Molecular Biology Course (United States)

    Eickelberg, Garrett J.; Fisher, Alison J.


    We present a novel laboratory project employing "real-time" RT-qPCR to measure the effect of environment on the expression of the "FLOWERING LOCUS C" gene, a key regulator of floral timing in "Arabidopsis thaliana" plants. The project requires four 3-hr laboratory sessions and is aimed at upper-level undergraduate…

  20. BOREAS TE-9 NSA Canopy Biochemistry (United States)

    Hall, Forrest G. (Editor); Curd, Shelaine (Editor); Margolis, Hank; Charest, Martin; Sy, Mikailou


    The BOREAS TE-9 team collected several data sets related to chemical and photosynthetic properties of leaves. This data set contains canopy biochemistry data collected in 1994 in the NSA at the YJP, OJR, OBS, UBS, and OA sites, including biochemistry lignin, nitrogen, cellulose, starch, and fiber concentrations. These data were collected to study the spatial and temporal changes in the canopy biochemistry of boreal forest cover types and how a high-resolution radiative transfer model in the mid-infrared could be applied in an effort to obtain better estimates of canopy biochemical properties using remote sensing. The data are available in tabular ASCII files. The data files are available on a CD-ROM (see document number 20010000884), or from the Oak Ridge National Laboratory (ORNL) Distributed Active Archive Center (DAAC).

  1. Clinical, laboratorial and radiographic predictors of Bordetella pertussis infection

    Directory of Open Access Journals (Sweden)

    Camila Vieira Bellettini


    Full Text Available OBJECTIVE: To identify clinical, laboratorial and radiographic predictors for Bordetella pertussis infection.METHODS: This was a retrospective study, which analyzed medical records of all patients submitted to a molecular dignosis (qPCR for B. pertussis from September 2011 to January 2013. Clinical and laboratorial data were reviewed, including information about age, sex, signs/symptoms, length of hospitalization, blood cell counts, imaging findings, coinfection with other respiratory pathogens and clinical outcome.RESULTS: 222 cases were revised. Of these, 72.5% had proven pertussis, and 60.9% were under 1 year old. In patients aging up to six months, independent predictors for B. pertussisinfection were (OR 8.0, CI 95% 1.8-36.3; p=0.007 and lymphocyte count >104/µL (OR 10.0, CI 95% 1.8-54.5; p=0.008. No independent predictors of B. pertussisinfection could be determined for patients older than six months. Co-infection was found in 21.4% of patients, of which 72.7% were up to six months of age. Adenovirus was the most common agent (40.9%. In these patients, we were not able to identify any clinical features to detect patients presenting with a respiratory co-infection, even though longer hospital stay was observed in patients with co-infections (12 vs. 6 days; p=0.009.CONCLUSIONS: Cyanosis and lymphocytosis are independent predictors for pertussis in children up to 6 months old.

  2. Correlation between the limit values of laboratory and clinical mycotoxicosis

    Directory of Open Access Journals (Sweden)

    Stojanov Igor M.


    Full Text Available Analysis of feed for the presence of fungi and mycotoxins is a request necessary to meet in order to ensure a healthy and economical production in livestock. These tests are related to legal regulation which prescribes the maximum legislated content (MLC, both for the presence of mycotoxins and the total number of fungi in certain feeds. Health problems that can occur during the production of animals are sometimes caused by the presence of mycotoxins in the feed. Laboratory testing is a good practice to confirm a suspicion, and allows timely treatment of contaminated feed. Potential problems arise under circumstances when there is a clinical outcome of mycotoxicosis and animal and laboratory findings suggest that the obtained values are below the level that is within the MLC. For these reasons, the subject of our research was to investigate the occurrence of mycotoxins and mold in feed, as well as the clinical presentation for animals that were fed with the feed with allowed values of these agents according to the recommended levels. The aim of this paper was to highlight the problems associated with clinical correlation of sick animals and laboratory findings, and suggest their overcoming. In the period of one year, a total of 176 samples of feed (complete mixture for broilers, corn and soy products were examined for the presence of fungi, 106 samples were examined for the presence of mycotoxins and 26 flocks of broilers and turkeys were clinically observed. Standard methods were used for isolation of molds and the ELISA test was used for the detection of mycotoxins. Clinical and pathomorphological observation of the flocks was done to determine the natural indicators of production. Studies indicated a problem because clinical and pathomorphological findings in some cases were not correlated with laboratory findings of molds and mycotoxins in the feed, and in some cases it did not necessarily mean that the animals were healthy. Synergism and

  3. Acute tramadol poisoning and its clinical and laboratory findings (United States)

    Rahimi, Hamid Reza; Soltaninejad, Kambiz; Shadnia, Shahin


    Background: Tramadol is a centrally acting analgesic with opioid and nonopioid properties, which extensively used in the relief of mild to moderate pain. Tramadol poisoning is a common cause of acute pharmaceutical poisoning in Iran. There are a few studies about clinical and laboratory findings related to acute tramadol poisoning. Therefore, the aim of this study was to demonstrate the clinical and laboratory findings in tramadol acute poisoning cases. Materials and Methods: This was a retrospective descriptive study of patients with acute tramadol poisoning who referred to Loghman Hakim Hospital Poison Center during January to April 2012. Data such as patient's age, sex, time of ingestion, ingested dose, cause of poisoning, mean duration of hospitalization, patient's clinical presentations, laboratory findings, therapeutic measures, and patient's outcome have collected in a predesigned checklist. Results: A total of 144 patients including 111 men (77%) and 33 women (23%) with acute tramadol poisoning was included in this study. The mean ingested dose was 1971.2 mg (100-20000 mg). Seizure (47.91%) was the most frequent clinical symptom. Blood gas on admission showed pH (7.3 ± 0.1), PCO2 (49.7 ± 8.6 mmHg) and HCO3− (24.1 ± 3.8 mEq/L), indicating pure acute respiratory acidosis may be occurred in tramadol-intoxicated patients. There were significant differences between tramadol-intoxicated cases with and without a seizure with regard to the time interval between ingestion and admission on hospital, ingested dose and PCO2. Conclusion: Seizure and rise of PCO2 were the most findings in this study. PMID:25535500

  4. [The purpose of clinical laboratory accreditation in transplantation medicine]. (United States)

    Flegar-Mestrić, Zlata; Nazor, Aida; Perkov, Sonja; Surina, Branka; Siftar, Zoran; Ozvald, Ivan; Vidas, Zeljko


    Although transplantation of solid organs has become a more standardized method of treatment, liver transplantation represents an exceptional multidisciplinary clinical procedure requiring understanding of specific pathophysiological changes that occur in the end stage of liver disease. Liver transplantation has been performed at Merkur University Hospital since 1998, with 360 transplantations performed to date. The most common indications are alcohol liver disease, cirrhosis caused by hepatitis B and C virus, hepatocellular carcinoma and cryptogenetic liver cirrhosis. Laboratory tests required for liver transplantation are performed at Department of Clinical Chemistry, Merkur University Hospital, accredited according to ISO 15189 in 2007 for the areas of clinical chemistry, laboratory hematology and coagulation, laboratory immunology-cell immunophenotyping, and molecular diagnosis. The complexity of liver transplant patients requires constant interaction between the anesthesiologist team and clinical laboratory, which has to ensure fast and efficient intraoperative monitoring of biochemical and liver profile: electrolytes and acid-base status, complete blood count, coagulation profile and monitoring of graft function according to the individual patient's health status. Dynamics of intraoperative changes is measured in whole arterial blood samples on a Nova Biomedical Stat Profile Critical Care Xpress mobile acid-base analyzer. Frequent monitoring of ionized calcium and magnesium levels is very important because of citrated blood transfusion and for appropriate therapeutic procedure. During anhepatic stage, there is a progressive increase in lactate level concentration. After reperfusion, a rapid increase in lactate clearance is an excellent indicator of stable graft initial function and its adequate size. During the transplantation procedure, there is usually a biphasic acid-base disturbance characterized by metabolic acidosis and then by metabolic alkalosis. The

  5. Kikuchi-Fujimoto disease: Clinical and laboratory characteristics and outcome

    Directory of Open Access Journals (Sweden)

    P S Rakesh


    Full Text Available Introduction: Kikuchi-Fujimoto disease is an uncommon disorder with worldwide distribution, characterized by fever and benign enlargement of the lymph nodes, primarily affecting young adults. Awareness about this disorder may help prevent misdiagnosis and inappropriate investigations and treatment. The objective of the study was to evaluate the clinical and laboratory characteristics of histopathologically confirmed cases of Kikuchi′s disease from a tertiary care center in southern India. Materials and Methods: Retrospective analysis of all adult patients with histopathologically confirmed Kikuchi′s disease from January 2007 to December 2011 in a 2700-bed teaching hospital in South India was done. The clinical and laboratory characteristics and outcome were analyzed. Results: There were 22 histopathologically confirmed cases of Kikuchi′s disease over the 5-year period of this study. The mean age of the subjects′ was 29.7 years (SD 8.11 and majority were women (Male: female- 1:3.4. Apart from enlarged cervical lymph nodes, prolonged fever was the most common presenting complaint (77.3%. The major laboratory features included anemia (54.5%, increased erythrocyte sedimentation rate (31.8%, elevated alanine aminotransferase (27.2% and elevated lactate dehydrogenase (LDH (31.8%. Conclusion: Even though rare, Kikuchi′s disease should be considered in the differential diagnosis of young individuals, especially women, presenting with lymphadenopathy and prolonged fever. Establishing the diagnosis histopathologically is essential to avoid inappropriate investigations and therapy.

  6. The increasing impact of laboratory medicine on clinical cardiology. (United States)

    Clerico, Aldo


    The practice of cardiology continues to evolve along with a better understanding of the pathophysiology of cardiovascular disease and the development of new therapeutic procedures. Consequently, new demands are being made on the in vitro diagnostics industry to improve the performance of existing cardiac markers and to develop novel markers for new cardiac disease indications. Indeed, in the last 20 years there has been a progressive increase in new laboratory tests for markers of cardiac diseases. Several highly sensitive and/or specific assays for the detection of myocardial ischemic damage as well as some immunoassays for cardiac natriuretic hormones, now considered a reliable marker of myocardial function, have become commercially available. In parallel, a growing number of some novel risk factors, which can be assessed and monitored by laboratory methods, have been added to the classical risk factors for cardiovascular disease. Finally, the recent explosion of genetic analysis may soon place at the clinical cardiologist's disposal many laboratory tests for defining the diagnosis at the molecular level, assessing new risk factors, and better targeting the pharmaceutical approaches in patients with cardiovascular disease. In the present article, after a brief description of the analytical tests included in these four groups, each group's impact on clinical cardiology is discussed in detail.

  7. On the improvement of blood sample collection at clinical laboratories (United States)


    Background 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. Methods 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. Results 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. Conclusions 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. PMID:24406140

  8. Quality Management Systems in the Clinical Laboratories in Latin America (United States)


    The implementation of management systems in accordance with standards like ISO 9001:2008 (1,2) in the clinical laboratories has conferred and added value of reliability and therefore a very significant input to patient safety. As we know the ISO 9001:2008 (1) a certification standard, and ISO 15189:2012 (2) an accreditation standard, both, at the time have generated institutional memory where they have been implemented, the transformation of culture focused on correct execution, control and following, evidence needed and the importance of register. PMID:27683495

  9. Quality Management Systems in the Clinical Laboratories in Latin America. (United States)

    Garzon, Alba C


    The implementation of management systems in accordance with standards like ISO 9001:2008 (1,2) in the clinical laboratories has conferred and added value of reliability and therefore a very significant input to patient safety. As we know the ISO 9001:2008 (1) a certification standard, and ISO 15189:2012 (2) an accreditation standard, both, at the time have generated institutional memory where they have been implemented, the transformation of culture focused on correct execution, control and following, evidence needed and the importance of register.

  10. [superscript 1]H NMR Spectroscopy-Based Configurational Analysis of Mono- and Disaccharides and Detection of ß-Glucosidase Activity: An Undergraduate Biochemistry Laboratory (United States)

    Periyannan, Gopal R.; Lawrence, Barbara A.; Egan, Annie E.


    A [superscript 1]H NMR spectroscopy-based laboratory experiment explores mono- and disaccharide structural chemistry, and the enzyme-substrate specificity of glycosidic bond cleavage by ß-glucosidase towards cellobiose (ß-linked gluco-disaccharide) and maltose (a-linked gluco-disaccharide). Structural differences between cellobiose, maltose, and…

  11. Biochemical Neuroscience Laboratory (United States)

    Federal Laboratory Consortium — This biochemistry lab is set up for protein analysis using Western blot, enzyme linked immunosorbent assays, immunohistochemistry, and bead-based immunoassays. The...

  12. Environmental biochemistry of current environmental levels of heavy metals: preparation of radiotracers with very high specific radioactivity for metallobiochemical experiments on laboratory animals. (United States)

    Sabbioni, E; Goetz, L; Birattari, C; Bonardi, M


    Environmental toxicology research on dose-response relationships of heavy metals requires experiments on laboratory animals exposed to "low doses" of trace elements which should reflect "present or actual environmental levels" characteristic of polluted environments. Unfortunately no criteria exist to establish the "low doses" to which laboratory animals must be exposed, in practice the choice of the level used is made in an almost arbitrary manner. In order to define the "present environmental levels" of heavy metals which should be administered to laboratory animals an approach is suggested, based upon knowledge of the concentrations of trace elements in the diet, air and food as well as the fractions absorbed. Today daily intakes of trace elements by man are of the order of few micrograms or nanograms thus requiring the use of extremely sensitive analytical techniques to determine the very low amounts of heavy metals in tissues and cellular components. In these fields of research the use of radiotracers with very high specific radioactivity appears particularly advantageous but requires considerable care during their preparation and use. The first part of this paper deals with a definition of the ranges of concentrations of trace elements which should be used for metabolic studies on laboratory animals when they are exposed via different routes such as ingestion, inhalation in injection; the second part describes the production of radiotracers with very high specific radioactivity by proton activation in the cyclotron and by neutron irradiation in the nuclear reactor. Their use to label present levels of heavy metals under conditions adapted for biochemical purposes, as well as the preparation of different metal-labelled chemical species is also reported. Particular attention is directed to quality control of the radiotracer solutions which are administered to the animals including those of radioactivity concentrations, radioisotopic purity, radiochemical purity

  13. Clinical and laboratory characteristics of women with uterine leiomiyoma

    Directory of Open Access Journals (Sweden)

    Özgür ÖZKUL


    Full Text Available The aim of this study was to compare clinical and laboratory findings of women with or without uterine leiomyoma.Study group consisted of 82 women with uterine leiomyoma and the control group comprised 42 healthy women. Women’s age, gravity, parity, blood groups, pattern of menstrual cycles, complaints at presentation, fertility, ultrasonographical findings, surgical operations and thyroid function tests were evaluated.There were no significant differences in blood group distribution, gravity, parity and thyroid function test results between the patients and the control subjects (P>0.05. A significant difference was found in the complaints at presentation between two groups (P<0.001. Mentrual cycles irregularity was more frequently found in the patients compared with the controls (57.3% vs. 42.9%, respectively, P=0.009. Although no infertile woman was found in the control group, 8.5% of patients were found to have infertility. The sensitivity of ultrasonography was found to be 97.6%. Except for the existence of higher infertility rate and the menstrual cycles irregularities, no significant difference was found in the clinical and laboratory findings between women with or without uterine leiomyoma. Therefore, physical examination and imaging methods are remained as the most important diagnostic tools for uterine leiomyoma.

  14. [Advanced data analysis and visualization for clinical laboratory]. (United States)

    Inada, Masanori; Yoneyama, Akiko


    This paper describes visualization techniques that help identify hidden structures in clinical laboratory data. The visualization of data is helpful for a rapid and better understanding of the characteristics of data sets. Various charts help the user identify trends in data. Scatter plots help prevent misinterpretations due to invalid data by identifying outliers. The representation of experimental data in figures is always useful for communicating results to others. Currently, flexible methods such as smoothing methods and latent structure analysis are available owing to the presence of advanced hardware and software. Principle component analysis, which is a well-known technique used to reduce multidimensional data sets, can be carried out on a personal computer. These methods could lead to advanced visualization with regard to exploratory data analysis. In this paper, we present 3 examples in order to introduce advanced data analysis. In the first example, a smoothing spline was fitted to a time-series from the control chart which is not in a state of statistical control. The trend line was clearly extracted from the daily measurements of the control samples. In the second example, principal component analysis was used to identify a new diagnostic indicator for Graves' disease. The multi-dimensional data obtained from patients were reduced to lower dimensions, and the principle components thus obtained summarized the variation in the data set. In the final example, a latent structure analysis for a Gaussian mixture model was used to draw complex density functions suitable for actual laboratory data. As a result, 5 clusters were extracted. The mixed density function of these clusters represented the data distribution graphically. The methods used in the above examples make the creation of complicated models for clinical laboratories more simple and flexible.

  15. Socio-demographic, Clinical and Laboratory Features of Rotavirus Gastroenteritis in Children Treated in Pediatric Clinic


    Azemi, Mehmedali; Berisha, Majlinda; Ismaili-Jaha, Vlora; Kolgeci, Selim; Avdiu, Muharrem; Jakupi, Xhevat; Hoxha, Rina; Hoxha-Kamberi, Teuta


    Aim: The aim of work was presentation of several socio-demographic, clinical and laboratory characteristics of gastroenteritis caused by rotavirus. The examinees and methods: The examinees were children under the age of five years treated at the Pediatric Clinic due to acute gastroenteritis caused by rotavirus. Rotavirus is isolated by method chromatographic immunoassay by Cer Test Biotec. Results: From the total number of patients (850) suffering from acute gastroenteritis, feces test on bac...

  16. Biochemistry Teaching in the Undergraduate Medical Course at Universidade Federalde Viçosa

    Directory of Open Access Journals (Sweden)

    L. Moreira Lima


    Full Text Available Background:The current competencies and abilities required for the training of medical professionals, recommended by the National Curriculum Guidelines for Undergraduate Medicine (DCN have initiated discussions about the teaching of biochemistry in medical schools. Objective: This study aimed to describe the rationale of education in the Clinical Laboratory Applieddisciplines – (LAC I, II, III, IV, V, VI, VII and VIII – which will be taught from first to eighth period of medical school at UFV. Methods:The disciplines weredesigned based on the competencies required for graduates of the course with 30 class hours each, always followingthe period of the study unit, integrated with other disciplines. Results:In the disciplines LACI and LAC II, taught in 2010, thestudents learned basic principles of biosafety, collection and storage of biological samples, validation of diagnostic tests, biochemical tests of cerebrospinal fluid, coagulation and renal function. They learned in the context of solving clinical cases presented and discussed in an integrated manner by a physician and a clinical biochemistry professor. Conclusion:According to the DCN, it is essential to facilitate the construction of knowledge in Biochemistry of themedical student, making the run for making clinical decisions based on scientific evidence.

  17. Lean-Agile Adaptations in Clinical Laboratory Accredited ISO 15189

    Directory of Open Access Journals (Sweden)

    Carlos Vilaplana Pérez


    Full Text Available It’s introduced Lean techniques in a Clinical Laboratory to improve the operability and the efficiency in continuous processes of analysis, failsafe systems, analysis of areas of value pursuit of zero defects and reduction of waste, and it promote continuous improvement in presented difficulties in adapting to the changing needs of the healthcare environment. Whereas it is necessary to incorporate certification and accreditation, note that the adaptability of the clinical laboratory to the changing needs of physicians in obtaining analytical information is reduced. The application of an agile methodology on analytical systems can provide a line of work that allows the incorporation of planning short work cycles on equips quickly with operational autonomy on the basis of demand and respecting the accreditation requirements and flexibility to ensure adequate performance as the intercomparison of results from the different units analytics, analytical quality and turnaround times. Between 2012 and 2014, a process of analysis and improvement was applied to circuits, a 5 s system, transportation of samples, inventory of reactive and samples, motion of personal and samples, reductions of waiting and delays, overproduction, over processing, and defects of results and reports. At last it seems necessary to apply the Agile methodology to adapt to the evolving necessities in time and the different origins of the samples. It’s have used modular systems where the modules of this study are programmed with immunoassay techniques and it has reduced the operative modules depending on the required activity, ensuring the goals of turnaround times, analytic quality, service, health care continuity, and keeping up with the ISO 15189 accreditation requirements. The results of applying the concept of Lean-Agile to a modular system allows us to reduce the associated costs to the seasonal variation of the health care demand and to adapt the system to the changes on

  18. Glycogen storage disease type I: clinical and laboratory profile

    Directory of Open Access Journals (Sweden)

    Berenice L. Santos


    Full Text Available OBJECTIVES: To characterize the clinical, laboratory, and anthropometric profile of a sample of Brazilian patients with glycogen storage disease type I managed at an outpatient referral clinic for inborn errors of metabolism. METHODS: This was a cross-sectional outpatient study based on a convenience sampling strategy. Data on diagnosis, management, anthropometric parameters, and follow-up were assessed. RESULTS: Twenty-one patients were included (median age 10 years, range 1-25 years, all using uncooked cornstarch therapy. Median age at diagnosis was 7 months (range, 1-132 months, and 19 patients underwent liver biopsy for diagnostic confirmation. Overweight, short stature, hepatomegaly, and liver nodules were present in 16 of 21, four of 21, nine of 14, and three of 14 patients, respectively. A correlation was found between height-for-age and BMI-for-age Z-scores (r = 0.561; p = 0.008. CONCLUSIONS: Diagnosis of glycogen storage disease type I is delayed in Brazil. Most patients undergo liver biopsy for diagnostic confirmation, even though the combination of a characteristic clinical presentation and molecular methods can provide a definitive diagnosis in a less invasive manner. Obesity is a side effect of cornstarch therapy, and appears to be associated with growth in these patients.

  19. Review of clinical and laboratory features of human Brucellosis

    Directory of Open Access Journals (Sweden)

    Mantur B


    Full Text Available Infection with Brucella spp. continues to pose a human health risk globally despite strides in eradicating the disease from domestic animals. Brucellosis has been an emerging disease since the discovery of Brucella melitensis by Sir David Bruce in 1887. Although many countries have eradicated B. abortus from cattle, in some areas B. melitensis and B. suis have emerged as causes of this infection in cattle, leading to human infections. Currently B. melitensis remains the principal cause of human brucellosis worldwide including India. The recent isolation of distinct strains of Brucella from marine mammals as well as humans is an indicator of an emerging zoonotic disease. Brucellosis in endemic and non-endemic regions remains a diagnostic puzzle due to misleading non-specific manifestations and increasing unusual presentations. Fewer than 10% of human cases of brucellosis may be clinically recognized and treated or reported. Routine serological surveillance is not practiced even in Brucella - endemic countries and we suggest that this should be a part of laboratory testing coupled with a high index of clinical suspicion to improve the level of case detection. The screening of family members of index cases of acute brucellosis in an endemic area should be undertaken to pick up additional unrecognised cases. Rapid and reliable, sensitive and specific, easy to perform and automated detection systems for Brucella spp. are urgently needed to allow early diagnosis and adequate antibiotic therapy in time to decrease morbidity / mortality. The history of travel to endemic countries along with exposure to animals and exotic foods are usually critical to making the clinical diagnosis. Laboratory testing is indispensable for diagnosis. Therefore alertness of clinician and close collaboration with microbiologist are essential even in endemic areas to correctly diagnose and treat this protean human infection. Existing treatment options, largely based on

  20. The biochemistry of memory. (United States)

    Stock, Jeffry B; Zhang, Sherry


    Almost fifty years ago, Julius Adler initiated a program of research to gain insights into the basic biochemistry of intelligent behavior by studying the molecular mechanisms that underlie the chemotactic responses of Escherichia coli. All living organisms share elements of a common biochemistry for metabolism, growth and heredity - why not intelligence? Neurobiologists have demonstrated that this is the case for nervous systems in animals ranging from worms to man. Motile unicellular organisms such as E. coli exhibit rudimentary behaviors that can be loosely described in terms of cognitive phenomena such as memory and learning. Adler's initiative at least raised the prospect that, because of the numerous experimental advantages provided by E. coli, it would be the first organism whose behavior could be understood at molecular resolution.

  1. [For the improvement of management and assurance in clinical laboratories of education hospitals--from the meeting of clinical laboratory members of public university or college hospitals]. (United States)

    Yoshida, Hiroshi


    Clinical laboratory members, composed of medical doctors, laboratory technologists and office staff from 8 public university or college hospitals and one medical center, have an annual meeting, in which achievements including tested numbers, income, outsourcing ratio, and so on were reported and various agendas from each institution were discussed. The number of agendas for general discussion and in the technologist division has been increasing, which reflects that variables, including management in clinical laboratories, needing solutions have been increasing. Information obtained through discussion could help in the determination of management and the improvement of education and quality assurance in clinical laboratories.

  2. [Clinical, laboratory and therapeutics aspects of Sheehan's syndrome]. (United States)

    Soares, Débora Vieira; Conceição, Flávia Lúcia; Vaisman, Mário


    Sheehan's syndrome is characterized by hypopituitarism that occurs as a result of ischemic pituitary necrosis due to severe postpartum hemorrhage. Nowadays it is not usually seen in developed countries because of the improvements in obstetric care. However, in developing countries it is still frequent and probably one of the most common causes of hypopituitarism. Most patients usually present it months to years later, with a history of failure of postpartum lactation, failure to resume menses and other signs of panhypopituitarism. In mild forms of the disease, patients may remain undetected and do not receive treatment for many years. Early diagnosis and appropriate treatment are important to reduce the morbimortality of the patients with Sheehan's syndrome. The aim of this review is to describe clinical, laboratory and therapeutic aspects of Sheehan's syndrome, including our experience in the replacement of recombinant GH in these patients.

  3. Clinical laboratory stressors used to study alcohol-stress relationships. (United States)

    Thomas, Suzanne; Bacon, Amy K; Sinha, Rajita; Uhart, Magdalena; Adinoff, Bryon


    Understanding the biologic systems that underlie the relationship between stress and alcohol consumption may lead to better prevention efforts and more effective treatments for alcoholism. Clinical laboratory studies offer a unique opportunity to examine these relationships by using a controlled environment to study how an acute stressor affects alcohol drinking and alcohol craving, how individuals in recovery or those at risk for alcoholism may respond differently to stressors relative to control subjects, and how alcohol differentially affects stress reactivity in these groups. This article reviews some of the most common physical, psychological, and pharmacological stressors used in stress-induction studies designed to reveal details about the relationship between stress reactivity and alcohol use and abuse.

  4. Developing and Supporting Students' Autonomy to Plan, Perform, and Interpret Inquiry-Based Biochemistry Experiments (United States)

    Silva, Thanuci; Galembeck, Eduardo


    Laboratory sessions are designed to develop the experimental skills and the acquaintance with instruments that may contribute to a successful career in Biochemistry and associated fields. This study is a report on improving a traditional Biochemistry course by devising the laboratory sessions as an inquiry-based environment to develop the…

  5. Evaluation of clinical and laboratory correlates of sickle leg ulcers. (United States)

    Madu, Anazoeze Jude; Ubesie, Agozie; Madu, Kenechi Anthony; Okwor, Bismarck; Anigbo, Chukwudi


    The exact mechanism for the occurrence of sickle leg ulcers (SLUs) has not been fully explained, although, popular opinion supports a multifactorial etio-pathogenetic process. Leg ulceration in sickle cell is a chronic and debilitating condition which is difficult to treat and may worsen the psychosocial impact of this illness. This study aims to evaluate the laboratory and clinical correlates of SLUs. One hundred sixty-seven patients who had been diagnosed with sickle cell anemia (homozygous S) had their steady-state hemoglobin concentration (Hb), hematocrit, white cell count, platelet count, serum bilirubin, and aspartate transaminase (AST) as well as frequency of crisis per annum evaluated with respect to their relationship to the occurrence of leg ulcers. They were aged 6-53 years (mean age 24.3 years), and prevalence of leg ulcer was found to be 2.75 per 1000 (2.54 per 1000 in females and 2.83 per 1000 in males). The independent sample t-test showed a significant difference in the serum AST levels in those with SLU (p = 0.029), though a positive correlation did not exist. Other predictors of disease severity found to have positive relationship with each other were the AST and total serum bilirubin 0.207 (p = 0.012); Hb and age 0.130 (p = 0.035); Hb and white cell count -0.159 (p = 0.010), white cell count and age -0.113 (p = 0.018). SLUs do not occur in patients with severe disease in sickle cell. The clinical and laboratory indicators of severe sickle cell disease do not correlate positively with the occurrence of SLU. Serum AST may have a relationship with leg ulceration in these patients. Environmental factors most likely play a major part in the etiopathogenesis of leg ulcer and this may require further studies in different sociocultural settings.

  6. Custom software development for use in a clinical laboratory

    Directory of Open Access Journals (Sweden)

    John H Sinard


    Full Text Available In-house software development for use in a clinical laboratory is a controversial issue. Many of the objections raised are based on outdated software development practices, an exaggeration of the risks involved, and an underestimation of the benefits that can be realized. Buy versus build analyses typically do not consider total costs of ownership, and unfortunately decisions are often made by people who are not directly affected by the workflow obstacles or benefits that result from those decisions. We have been developing custom software for clinical use for over a decade, and this article presents our perspective on this practice. A complete analysis of the decision to develop or purchase must ultimately examine how the end result will mesh with the departmental workflow, and custom-developed solutions typically can have the greater positive impact on efficiency and productivity, substantially altering the decision balance sheet. Involving the end-users in preparation of the functional specifications is crucial to the success of the process. A large development team is not needed, and even a single programmer can develop significant solutions. Many of the risks associated with custom development can be mitigated by a well-structured development process, use of open-source tools, and embracing an agile development philosophy. In-house solutions have the significant advantage of being adaptable to changing departmental needs, contributing to efficient and higher quality patient care.

  7. Clinical and laboratory characteristics of children with Kawasaki disease

    Directory of Open Access Journals (Sweden)

    Fatih Akın


    Full Text Available Objective: In this study, we aimed to evaluate clinical and laboratory characteristics of patients with Kawasaki disease (KD in Konya region of Turkey. Methods: The hospital records of patients who were hospitalized with the diagnosis of KD in the Pediatrics Clinics of Konya Training and Research Hospital between May 2010 and June 2012 were reviewed retrospectively. Results: Seven cases were found to have the diagnosis of KD, two of whom were incomplete KD. Oropharynx changes were the most common (100% feature in our patients. Five (71% patients had bulbar conjunctivitis. Three (43% patients had erythema at the site of BCG inoculation. Adenopathy was present in all of our patients with the classical form. A desquamation was observed in one case at the seventh day of fever. No cardiac manifestation was seen. Elevated erythrocyte sedimentation rate and thrombocytosis were present in all patients. All of the patients were received intravenous immunoglobulin in the first ten days of the fever. Conclusion: KD should be considered as a possible diagnosis in any child presenting with prolonged fever. BCG reaction can be attributed as a diagnostic criterion for incomplete form of the disease especially in countries where BCG vaccination is routinely performed. Early treatment is essential to prevent cardiovascular complications.

  8. Clinical and laboratory diagnosis of dengue fever in travelers

    Directory of Open Access Journals (Sweden)

    N. I. Khokhlova


    Full Text Available The paper presents the analysis of clinical and laboratory symptoms in 35 adult patients with denger fever, Novosibirsk residents, which travelled in endemic countries, mostly Tailand. The classic form of the disease was determined in all cases. The moderate form was in 71,5% patients, the severe form was in the rest ones. The diagnosis of dengue was verified by detection of specific immunoglobulin M and in some cases immunoglobulin G and also virus dengue NS1 antigen by immunochromatography. The dominant clinical symptoms in observed patients were fever for 3–8 days (100%, mostly high one (71,4%, asthenia (97,1%, anorexia (100%, myalgia or/and arthralgia (77,1%, exantema (60%, hepatomegaly (62,8%. The gematologic indicators were represented with thrombocytopenia in 91,4% patients (from 167 to 20×109/l и leucopenia in 85,7% patients (from 3,9 to 1,1×109/l. The cytolitic syndrom was revealed in 80% patients with predominance of aspartate aminotransferase activity in early period of the disease. 

  9. Acute Viral Hepatitis A – Clinical, Laboratory and Epidemiological Characteristics

    Directory of Open Access Journals (Sweden)

    Melinda HORVAT


    Full Text Available Background and Aims: Infection with hepatitis A virus is still one of the most common causes of hepatitis worldwide. The clinical manifestation of acute hepatitis A (AHA in adults can vary greatly, ranging from asymptomatic infection to severe and fulminant hepatitis. The aim of this study was to describe the demographic, clinical characteristics, laboratory features and hospital outcome of adult patients with AHA over a consecutive period of 4 years within an area from Eastern European country. Methods: Two hundred and two adult patients diagnosed with AHA were retrospective, observational and analytic analized over a period of 4 years. Based on prothrombin time less than 50, the study group was stratified in medium (79.2% and severe forms (20.8%. We investigated the clinical, laboratory and epidemiological features. Statistical analysis were applied to compare the medium and severe forms of AHA. Results: Most patients (72.7% were younger than 40 years. The main symptoms included: dyspepsia (72.07%, jaundice (86.63%, asteno-adynamia (86.72%, and flu-like symptoms (53.46%. The hemorrhagic cutaneous-mucous manifestations (6.93% associated with the severe forms of AHA (OR =12.19, 95%CI -3.59 - 41.3, p =0.001. We found statistically significant differences for PT (p <0.001, INR (p <0.001, TQ (p <0.001, ALAT (p <0.001, ASAT (p <0.001, ALP (p <0.001 and platelets (p =0.009 between severe and medium AHA forms. We found that TQ, INR, ALAT and ASAT have the highest diagnostic values, statistically significant (p <0.05 for severe AHA forms with AUC (0.99, 0.99, 0.72, 0.70 at values of sensitivity (95%, 90.5%, 89%, 95% and specificity (98%, 99%, 88%,94%. Conclusions Medium severity AHA forms were found in most of the study group patients (79.2%. The severe AHA forms were associated with hemorrhagic cutaneous-mucous manifestations (OR =12.19, p =0.001. The univariate analysis proved a negatively statistically significant correlation between IP and ALAT

  10. 78 FR 59704 - Medicare, Medicaid, and CLIA Programs; Clinical Laboratory Improvement Amendments of 1988... (United States)


    ... Laboratory Improvement Amendments of 1988 Exemption of Laboratories Licensed by the State of Washington... requirements of the Clinical Laboratory Improvement Amendments of 1988 (CLIA) for a period of 6 years. DATES... Laboratory Improvement Amendments of 1988 (CLIA) (Pub. L. 100-578), which was enacted on October 31,...

  11. Complement analysis 2016: Clinical indications, laboratory diagnostics and quality control. (United States)

    Prohászka, Zoltán; Nilsson, Bo; Frazer-Abel, Ashley; Kirschfink, Michael


    In recent years, complement analysis of body fluids and biopsies, going far beyond C3 and C4, has significantly enhanced our understanding of the disease process. Such expanded complement analysis allows for a more precise differential diagnosis and for critical monitoring of complement-targeted therapy. These changes are a result of the growing understanding of the involvement of complement in a diverse set of disorders. To appreciate the importance of proper complement analysis, it is important to understand the role it plays in disease. Historically, it was the absence of complement as manifested in severe infection that was noted. Since then complement has been connected to a variety of inflammatory disorders, such as autoimmune diseases and hereditary angioedema. While the role of complement in the rejection of renal grafts has been known longer, the significant impact of complement. In certain nephropathies has now led to the reclassification of some rare kidney diseases and an increased role for complement analysis in diagnosis. Even more unexpected is that complement has also been implicated in neural, ophtalmological and dermatological disorders. With this level of involvement in some varied and impactful health issues proper complement testing is clearly important; however, analysis of the complement system varies widely among laboratories. Except for a few proteins, such as C3 and C4, there are neither well-characterized standard preparations nor calibrated assays available. This is especially true for the inter-laboratory variation of tests which assess classical, alternative, or lectin pathway function. In addition, there is a need for the standardization of the measurement of complement activation products that are so critical in determining whether clinically relevant complement activation has occurred in vivo. Finally, autoantibodies to complement proteins (e.g. anti-C1q), C3 and C4 convertases (C3 and C4 nephritic factor) or to regulatory proteins

  12. Thiol biochemistry of prokaryotes (United States)

    Fahey, Robert C.


    The present studies have shown that GSH metabolism arose in the purple bacteria and cyanobacteria where it functions to protect against oxygen toxicity. Evidence was obtained indicating that GSH metabolism was incorporated into eucaryotes via the endosymbiosis giving rise to mitochrondria and chloroplasts. Aerobic bacteria lacking GSH utilize other thiols for apparently similar functions, the thiol being coenzyme A in Gram positive bacteria and chi-glutamylcysteine in the halobacteria. The thiol biochemistry of prokaryotes is thus seen to be much more highly diversified than that of eucaryotes and much remains to be learned about this subject.

  13. Analysis of search in an online clinical laboratory manual. (United States)

    Blechner, Michael; Kish, Joshua; Chadaga, Vivek; Dighe, Anand S


    Online laboratory manuals have developed into an important gateway to the laboratory. Clinicians increasingly expect up-to-date laboratory test information to be readily available online. During the past decade, sophisticated Internet search technology has developed, permitting rapid and accurate retrieval of a wide variety of content. We studied the role of search in an online laboratory manual. We surveyed the utilization of search technology in publicly available online manuals and examined how users interact with the search feature of a laboratory handbook. We show how a laboratory can improve its online handbook through insights gained by collecting information about each user's activity. We also discuss future applications for search-related technologies and the potential role of the online laboratory manual as the primary laboratory information portal.

  14. 76 FR 1212 - Joint Biomedical Laboratory Research and Development and Clinical Science Research and... (United States)


    ... AFFAIRS Joint Biomedical Laboratory Research and Development and Clinical Science Research and Development... Eligibility of the Joint Biomedical Laboratory Research and Development and Clinical Science Research and... areas of biomedical, behavioral and clinical science research. The panel meeting will be open to...

  15. 76 FR 79273 - Joint Biomedical Laboratory Research and Development and Clinical Science Research and... (United States)


    ... AFFAIRS Joint Biomedical Laboratory Research and Development and Clinical Science Research and Development... Eligibility of the Joint Biomedical Laboratory Research and Development and Clinical Science Research and... biomedical, behavioral, and clinical science research. The panel meeting will be open to the public...

  16. 78 FR 44954 - Clinical Laboratory Improvement Advisory Committee (CLIAC) (United States)


    ... ] medicine practice and specific questions related to possible revision of the CLIA standards. Examples... laboratories are regulated; the impact of proposed revisions to the standards on medical and laboratory... laboratory interoperability in health information technology will also be discussed. Agenda items are...

  17. Towards quantitative biochemistry: research and reports in biochemistry

    Directory of Open Access Journals (Sweden)



    Full Text Available Nikolay V DokholyanDepartment of Biochemistry and Biophysics, University of North Carolina, School of Medicine, Chapel Hill, NC, USASince the mid twentieth century the field of biochemistry has evolved significantly (Figure 1. Advances made in the fields of structural, chemical, and systems biology, physics, and computation have shaped the new field of biochemistry such that the emphasis became the cellular-wide view of molecular life at the atomic scale. The principal paradigm in the field shifted from focusing on a single or a few biological molecules to focusing on their cellular- and intracellular-wide networks. This shift has resulted in more interdisciplinary approaches to biochemical research, which nowadays combines techniques and strategies from a broad range of fields. The evolution of the field of biochemistry resulted in closer connections to other fields, such as medicinal chemistry, physiology, and medicine. Biochemistry is also one of the central components of the emerging translational medicine paradigm.

  18. Laboratory aspects of clinically significant rapidly growing mycobacteria

    Directory of Open Access Journals (Sweden)

    R Set


    Full Text Available The pathogenic potential of the rapidly growing mycobacteria (RGM has started being recognized. This is due to more sensitive and specific techniques in the laboratory. The RGM are generally defined as nontuberculous species of mycobacteria that show visible growth on agar media within 7 days. RGM are widely distributed in nature and have been isolated from natural water, tap water, and soil. Several biochemical tests, high performance liquid chromatography, and molecular techniques have been developed for rapid identification of these species. The American Thoracic Society and the Infectious Disease Society of America recommend that RGM should be identified to the species level using a recognized acceptable methodology such as polymerase chain reaction restriction enzyme analysis or biochemical testing and routine susceptibility testing of RGM should include amikacin, imipenem, doxycycline, the fluorinated quinolones, a sulphonamide or trimethoprim-sulphamethoxazole, cefoxitin, clarithromycin, linezolid, and tobramycin. The diseases caused by these organisms have varied manifestations. They have been responsible for a number of healthcare-associated outbreaks and pseudo-outbreaks. For recognition of outbreaks, it is important to be familiar with the causative organisms like RGM which are most frequently involved in healthcare-associated outbreaks and pseudo outbreaks. It is essential to intervene as soon as possible to interrupt this transmission. Large gaps still exist in our knowledge of RGM. Unquestionably more studies are required. Through this review, we wish to emphasize that reporting of RGM from clinical settings along with their sensitivity patterns is an absolute need of the hour.

  19. The Biochemistry of Mitosis (United States)

    Wieser, Samuel; Pines, Jonathon


    In this article, we will discuss the biochemistry of mitosis in eukaryotic cells. We will focus on conserved principles that, importantly, are adapted to the biology of the organism. It is vital to bear in mind that the structural requirements for division in a rapidly dividing syncytial Drosophila embryo, for example, are markedly different from those in a unicellular yeast cell. Nevertheless, division in both systems is driven by conserved modules of antagonistic protein kinases and phosphatases, underpinned by ubiquitin-mediated proteolysis, which create molecular switches to drive each stage of division forward. These conserved control modules combine with the self-organizing properties of the subcellular architecture to meet the specific needs of the cell. Our discussion will draw on discoveries in several model systems that have been important in the long history of research on mitosis, and we will try to point out those principles that appear to apply to all cells, compared with those in which the biochemistry has been specifically adapted in a particular organism. PMID:25663668

  20. Laboratory of Cell and Molecular Biology (United States)

    Federal Laboratory Consortium — The Laboratory of Cell and Molecular Biology investigates the organization, compartmentalization, and biochemistry of eukaryotic cells and the pathology associated...

  1. Implications of the introduction of laboratory demand management at primary care clinics in South Africa on laboratory expenditure

    Directory of Open Access Journals (Sweden)

    Ozayr H. Mahomed


    Full Text Available Background: Diagnostic health laboratory services are regarded as an integral part of the national health infrastructure across all countries. Clinical laboratory tests contribute substantially to health system goals of increasing quality of care and improving patient outcomes.Objectives: This study aimed to analyse current laboratory expenditures at the primary healthcare (PHC level in South Africa as processed by the National Health Laboratory Service and to determine the potential cost savings of introducing laboratory demand management.Methods: A retrospective cross-sectional analysis of laboratory expenditures for the 2013/2014 financial year across 11 pilot National Health Insurance health districts was conducted. Laboratory expenditure tariff codes were cross-tabulated to the PHC essential laboratory tests list (ELL to determine inappropriate testing. Data were analysed using a Microsoft Access database and Excel software.Results: Approximately R35 million South African Rand (10% of the estimated R339 million in expenditures was for tests that were not listed within the ELL. Approximately 47% of expenditure was for laboratory tests that were indicated in the algorithmic management of patients on antiretroviral treatment. The other main cost drivers for non-ELL testing included full blood count and urea, as well as electrolyte profiles usually requested to support management of patients on antiretroviral treatment.Conclusions: Considerable annual savings of up to 10% in laboratory expenditure are possible at the PHC level by implementing laboratory demand management. In addition, to achieve these savings, a standardised PHC laboratory request form and some form of electronic gatekeeping system that must be supported by an educational component should be implemented.

  2. Effect of Replacement of New Reverse Osmosis Film of Water Purification System to Clinical Biochemistry%实验室纯水系统更换反渗透膜对生化检验的影响

    Institute of Scientific and Technical Information of China (English)

    莫基浩; 刘鲜茹; 李少侠


    目的:研究实验室纯水系统更换新反渗透膜后,所产纯水的质量是否符合生化检验的要求并评价其影响。方法通过Beckman Coulter生化分析系统配套纯水机天创TCHS-RO/100A自带电阻表和 HM COM-100电导率测量笔连续监测新产纯水中的实时离子含量。用正常纯水在 AU680上重复20次测量 ALT,AST,TBIL,ALP,GGT,TP,ALB,BUN, CR,UA,GLU,TC,TG,HDL,LDL,CK,LDH,P,Ca(对照组),更换为新产纯水后进行相同试验操作(试验组),以评估新产纯水对生化分析的影响。连续5天,每天3次(间隔2 h)监测新产纯水的 TG试剂空白,监测水中甘油水平。结果开机30 min后,HM COM-100测得电导率降至(0.1±0.0)μS/cm,机载电阻表测得新产纯水在开机50 min后稳定在18.25 MΩcm。在用 AU680进行生化分析时,对照组中TG测量值=1.04 mmol/L,试验组=21.39 mmol/L,差异有统计学意义(P<0.01),而除TG其他生化项目偏倚均在5%以内,CV<1/4CLIA’88,差异无统计学意义(P>0.05)。TG试剂空白在第5天稳定在A660nm=0.0156±0.0004。结论新纯水系统在生产约2800 L水后,所产纯水中的甘油可以清除干净。实验室纯水系统在更换反渗透膜后,需要对水质进行连续监测,以评价其对常规生化项目检测的影响。%Objective To test if the quality of produced water could come up to the standards of clinical biochemistry,and e-valuate the effect of the produced water after replacement of a new reverse osmosis film of the laboratory water purification system.Methods The ion concentration of the produced water was tested by ohmmeter in Beckman Coulter supporting TianChuang water purification system TCHS-RO/100A and HM COM-100 conductivity meter.The biochemical index ALT,AST,TBIL,ALP,GGT,TP,ALB,BUN,CR,UA,GLU,TC,TG,HDL,LDL,CK,LDH,P,Ca of mixed serum were tested 20 times by AU680 under the condition of

  3. First-Year Residents' Caring, Medical Knowledge, and Clinical Judgment in Relation to Laboratory Utilization. (United States)

    Yarnold, Paul R.; And Others


    A study of 36 first-year Northwestern University (Illinois) medical residents found that students' medical knowledge was a predictor of increased laboratory test use, that clinical judgment was a predictor of decreased laboratory use, and that level of caring was statistically unrelated to amount of laboratory use. (Author/MSE)

  4. 77 FR 26069 - Joint Biomedical Laboratory Research and Development and Clinical Science Research and... (United States)


    ... AFFAIRS Joint Biomedical Laboratory Research and Development and Clinical Science Research and Development... following three panels of the Joint Biomedical Laboratory Research and Development and Clinical Science... review by the Board involve a wide range of medical specialties within the general areas of...

  5. Lignin biochemistry and soil N determine crop residue decomposition and soil priming (United States)

    Cropping history can affect soil properties, including available N, but little is known about the interactive effects of residue biochemistry, temperature and cropping history on residue decomposition. A laboratory incubation examined the role of residue biochemistry and temperature on the decomposi...

  6. A biochemistry discipline designed for the nutrition course

    Directory of Open Access Journals (Sweden)

    A.A.G. Bianco


    Full Text Available Biochemistry is widely considered an essential background in a Nutrition Course framework. At theFaculdade de Saude Publica, USP, it is a direct requirement to eight disciplines of the syllabus and anindirect requirement to another nine disciplines. Nevertheless, a previous interview study involvingNutrition students and Nutritionists revealed a contradictory image of Biochemistry. Although stu-dents and Nutritionists admitted the important role played by Biochemistry, most of the respondentsdeclared that they could not foresee any application of Biochemical contents in their professional life.Aiming to change this situation, a deep intervention in the Biochemistry discipline was carried on.The discipline was planned in such a way that all the contents to be taught was directly derived fromsubjects or situations matching the interests of nutrition students. Instead of a classical lecture basedcourse, collaborative learning was the methodological choice, taking advantage of practical activitiesinvolving educational software and laboratory work as well. The course was carried on in 180 hoursand a variety of strategies were employed, especially small group discussion and problem solving. Thestudents were given a booklet containing all the exercises and problems, which acted as course guide.At the end of the course, an evaluation survey was carried out. It is noticeable that, according tostudents answers: 100% agreed that Biochemistry was intimately linked to Nutrition; 83% appreciatedthe didactical methodologies employed; 89% would like to continue studying Biochemistry in a furtherdiscipline; 96% declared that the discipline has raised their interest in Biochemistry. In respect tothe assessment of the students, these results are in accordance with the opinion of teachers and TAsengaged in restructuring Biochemistry courses.

  7. The path to clinical proteomics research: integration of proteomics, genomics, clinical laboratory and regulatory science. (United States)

    Boja, Emily S; Rodriguez, Henry


    Better biomarkers are urgently needed to cancer detection, diagnosis, and prognosis. While the genomics community is making significant advances in understanding the molecular basis of disease, proteomics will delineate the functional units of a cell, proteins and their intricate interaction network and signaling pathways for the underlying disease. Great progress has been made to characterize thousands of proteins qualitatively and quantitatively in complex biological systems by utilizing multi-dimensional sample fractionation strategies, mass spectrometry and protein microarrays. Comparative/quantitative analysis of high-quality clinical biospecimen (e.g., tissue and biofluids) of human cancer proteome landscape has the potential to reveal protein/peptide biomarkers responsible for this disease by means of their altered levels of expression, post-translational modifications as well as different forms of protein variants. Despite technological advances in proteomics, major hurdles still exist in every step of the biomarker development pipeline. The National Cancer Institute's Clinical Proteomic Technologies for Cancer initiative (NCI-CPTC) has taken a critical step to close the gap between biomarker discovery and qualification by introducing a pre-clinical "verification" stage in the pipeline, partnering with clinical laboratory organizations to develop and implement common standards, and developing regulatory science documents with the US Food and Drug Administration to educate the proteomics community on analytical evaluation requirements for multiplex assays in order to ensure the safety and effectiveness of these tests for their intended use.

  8. The role of the clinical laboratory in the future of health care: lean microbiology. (United States)

    Samuel, Linoj; Novak-Weekley, Susan


    This commentary will introduce lean concepts into the clinical microbiology laboratory. The practice of lean in the clinical microbiology laboratory can remove waste, increase efficiency, and reduce costs. Lean, Six Sigma, and other such management initiatives are useful tools and can provide dividends but must be accompanied by organizational leadership commitment to sustaining the lean culture in the laboratory setting and providing resources and time to work through the process.

  9. The National Market for Medicare Clinical Laboratory Testing (United States)

    U.S. Department of Health & Human Services — Current Medicare payment policy for outpatient laboratory services is outdated. Future reforms, such as competitive bidding, should consider the characteristics of...

  10. Biochemistry (by Jochanan Stenesh) (United States)

    Glasfeld, Arthur


    Plenum: New York, 1998. Hardcover, ISBN 0 306-45732-6. 95. Paperback, ISBN 0 306 45733 4. 55 (set of 3). Solutions manual and transparencies available. According to the promotional materials accompanying this text, its intended audience is students in one-semester undergraduate biochemistry courses. At just over 500 pages, the book is shorter than the norm of well over 1000 pages. The challenge, then, is to present the subject in a coherent and compelling fashion while necessarily omitting a large fraction of the material that one normally finds in more inclusive texts. That kind of editing is obviously going to lead to squawking from some quarters, so I should put my prejudices on the table. I teach a one-semester course in biochemical structure, and I have a long-standing interest in using molecular models to explain biochemical behavior, both in research and in teaching. The editing performed by Professor Stenesh is likely to trouble someone with a structural or mechanistic background. Rather than selectively excluding some topics, Stenesh has created a table of contents that looks like it's from a much longer text. The usual chapters on biochemical structure, catalysis, metabolism and molecular genetics are included here. The ax fell elsewhere, and most obvious to my eye are the omissions of structure and chemical mechanism beyond those few chapters that are dedicated to them. A brief presentation on the structure and function of hemoglobin is given in the chapter on proteins, and the catalytic mechanism of chymotrypsin is briefly presented in the chapter on catalysis. But in chapters on metabolism, the structures of substrates and products are shown while mechanisms of conversion are omitted. For example, in the description of aldolase, we're informed that the enzyme catalyzes a reverse aldol condensation, but the reader isn't shown how the aldol condensation relates to the chemical conversion we see in the figure. (Part of the problem may be that the text

  11. Contributions of Analytical Chemistry to the Clinical Laboratory. (United States)

    Skogerboe, Kristen J.


    Highlights several analytical techniques that are being used in state-of-the-art clinical labs. Illustrates how other advances in instrumentation may contribute to clinical chemistry in the future. Topics include: biosensors, polarization spectroscopy, chemiluminescence, fluorescence, photothermal deflection, and chromatography in clinical…

  12. Evaluation of Neonatal Hemolytic Jaundice: Clinical and Laboratory Parameters

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    Anet Papazovska Cherepnalkovski


    CONCLUSIONS: The laboratory profile in ABO/Rh isoimmunisation cases depicts hemolytic mechanism of jaundice. These cases carry a significant risk for early and severe hyperbilirubinemia and are eligible for neurodevelopmental follow-up. Hematological parameters and blood grouping are simple diagnostic methods that assist the etiological diagnosis of neonatal hyperbilirubinemia.

  13. Cost effectiveness analysis of clinically driven versus routine laboratory monitoring of antiretroviral therapy in Uganda and Zimbabwe.

    Directory of Open Access Journals (Sweden)

    Antonieta Medina Lara

    Full Text Available BACKGROUND: Despite funding constraints for treatment programmes in Africa, the costs and economic consequences of routine laboratory monitoring for efficacy and toxicity of antiretroviral therapy (ART have rarely been evaluated. METHODS: Cost-effectiveness analysis was conducted in the DART trial (ISRCTN13968779. Adults in Uganda/Zimbabwe starting ART were randomised to clinically-driven monitoring (CDM or laboratory and clinical monitoring (LCM; individual patient data on healthcare resource utilisation and outcomes were valued with primary economic costs and utilities. Total costs of first/second-line ART, routine 12-weekly CD4 and biochemistry/haematology tests, additional diagnostic investigations, clinic visits, concomitant medications and hospitalisations were considered from the public healthcare sector perspective. A Markov model was used to extrapolate costs and benefits 20 years beyond the trial. RESULTS: 3316 (1660LCM;1656CDM symptomatic, immunosuppressed ART-naive adults (median (IQR age 37 (32,42; CD4 86 (31,139 cells/mm(3 were followed for median 4.9 years. LCM had a mean 0.112 year (41 days survival benefit at an additional mean cost of $765 [95%CI:685,845], translating into an adjusted incremental cost of $7386 [3277,dominated] per life-year gained and $7793 [4442,39179] per quality-adjusted life year gained. Routine toxicity tests were prominent cost-drivers and had no benefit. With 12-weekly CD4 monitoring from year 2 on ART, low-cost second-line ART, but without toxicity monitoring, CD4 test costs need to fall below $3.78 to become cost-effective (<3xper-capita GDP, following WHO benchmarks. CD4 monitoring at current costs as undertaken in DART was not cost-effective in the long-term. CONCLUSIONS: There is no rationale for routine toxicity monitoring, which did not affect outcomes and was costly. Even though beneficial, there is little justification for routine 12-weekly CD4 monitoring of ART at current test costs in low

  14. Using the Revised Bloom's Taxonomy in the clinical laboratory: thinking skills involved in diagnostic reasoning. (United States)

    Su, Whei Ming; Osisek, Paul J; Starnes, Beth


    Achieving effective transfer of theoretical knowledge to clinical practice requires knowledge of thinking paradigms in relation to specific nursing content. It is a challenge to develop instructional designs for teaching and assessing implicit thought processes involved in clinical reasoning. The authors demonstrate the use of the Revised Bloom's Taxonomy to teach thinking skills involved in diagnostic reasoning in a clinical laboratory.

  15. Customer satisfaction survey with clinical laboratory and phlebotomy services at a tertiary care unit level. (United States)

    Koh, Young Rae; Kim, Shine Young; Kim, In Suk; Chang, Chulhun L; Lee, Eun Yup; Son, Han Chul; Kim, Hyung Hoi


    We performed customer satisfaction surveys for physicians and nurses regarding clinical laboratory services, and for outpatients who used phlebotomy services at a tertiary care unit level to evaluate our clinical laboratory and phlebotomy services. Thus, we wish to share our experiences with the customer satisfaction survey for clinical laboratory and phlebotomy services. Board members of our laboratory designed a study procedure and study population, and developed two types of questionnaire. A satisfaction survey for clinical laboratory services was conducted with 370 physicians and 125 nurses by using an online or paper questionnaire. The satisfaction survey for phlebotomy services was performed with 347 outpatients who received phlebotomy services by using computer-aided interviews. Mean satisfaction scores of physicians and nurses was 58.1, while outpatients' satisfaction score was 70.5. We identified several dissatisfactions with our clinical laboratory and phlebotomy services. First, physicians and nurses were most dissatisfied with the specimen collection and delivery process. Second, physicians and nurses were dissatisfied with phlebotomy services. Third, molecular genetic and cytogenetic tests were found more expensive than other tests. This study is significant in that it describes the first reference survey that offers a survey procedure and questionnaire to assess customer satisfaction with clinical laboratory and phlebotomy services at a tertiary care unit level.

  16. CLSI-Derived Hematology and Biochemistry Reference Intervals for Healthy Adults in Eastern and Southern Africa (United States)

    Karita, Etienne; Ketter, Nzeera; Price, Matt A.; Kayitenkore, Kayitesi; Kaleebu, Pontiano; Nanvubya, Annet; Anzala, Omu; Jaoko, Walter; Mutua, Gaudensia; Ruzagira, Eugene; Mulenga, Joseph; Sanders, Eduard J.; Mwangome, Mary; Allen, Susan; Bwanika, Agnes; Bahemuka, Ubaldo; Awuondo, Ken; Omosa, Gloria; Farah, Bashir; Amornkul, Pauli; Birungi, Josephine; Yates, Sarah; Stoll-Johnson, Lisa; Gilmour, Jill; Stevens, Gwynn; Shutes, Erin; Manigart, Olivier; Hughes, Peter; Dally, Len; Scott, Janet; Stevens, Wendy; Fast, Pat; Kamali, Anatoli


    Background Clinical laboratory reference intervals have not been established in many African countries, and non-local intervals are commonly used in clinical trials to screen and monitor adverse events (AEs) among African participants. Using laboratory reference intervals derived from other populations excludes potential trial volunteers in Africa and makes AE assessment challenging. The objective of this study was to establish clinical laboratory reference intervals for 25 hematology, immunology and biochemistry values among healthy African adults typical of those who might join a clinical trial. Methods and Findings Equal proportions of men and women were invited to participate in a cross sectional study at seven clinical centers (Kigali, Rwanda; Masaka and Entebbe, Uganda; two in Nairobi and one in Kilifi, Kenya; and Lusaka, Zambia). All laboratories used hematology, immunology and biochemistry analyzers validated by an independent clinical laboratory. Clinical and Laboratory Standards Institute guidelines were followed to create study consensus intervals. For comparison, AE grading criteria published by the U.S. National Institute of Allergy and Infectious Diseases Division of AIDS (DAIDS) and other U.S. reference intervals were used. 2,990 potential volunteers were screened, and 2,105 (1,083 men and 1,022 women) were included in the analysis. While some significant gender and regional differences were observed, creating consensus African study intervals from the complete data was possible for 18 of the 25 analytes. Compared to reference intervals from the U.S., we found lower hematocrit and hemoglobin levels, particularly among women, lower white blood cell and neutrophil counts, and lower amylase. Both genders had elevated eosinophil counts, immunoglobulin G, total and direct bilirubin, lactate dehydrogenase and creatine phosphokinase, the latter being more pronounced among women. When graded against U.S.-derived DAIDS AE grading criteria, we observed 774 (35

  17. CLSI-derived hematology and biochemistry reference intervals for healthy adults in eastern and southern Africa.

    Directory of Open Access Journals (Sweden)

    Etienne Karita

    Full Text Available BACKGROUND: Clinical laboratory reference intervals have not been established in many African countries, and non-local intervals are commonly used in clinical trials to screen and monitor adverse events (AEs among African participants. Using laboratory reference intervals derived from other populations excludes potential trial volunteers in Africa and makes AE assessment challenging. The objective of this study was to establish clinical laboratory reference intervals for 25 hematology, immunology and biochemistry values among healthy African adults typical of those who might join a clinical trial. METHODS AND FINDINGS: Equal proportions of men and women were invited to participate in a cross sectional study at seven clinical centers (Kigali, Rwanda; Masaka and Entebbe, Uganda; two in Nairobi and one in Kilifi, Kenya; and Lusaka, Zambia. All laboratories used hematology, immunology and biochemistry analyzers validated by an independent clinical laboratory. Clinical and Laboratory Standards Institute guidelines were followed to create study consensus intervals. For comparison, AE grading criteria published by the U.S. National Institute of Allergy and Infectious Diseases Division of AIDS (DAIDS and other U.S. reference intervals were used. 2,990 potential volunteers were screened, and 2,105 (1,083 men and 1,022 women were included in the analysis. While some significant gender and regional differences were observed, creating consensus African study intervals from the complete data was possible for 18 of the 25 analytes. Compared to reference intervals from the U.S., we found lower hematocrit and hemoglobin levels, particularly among women, lower white blood cell and neutrophil counts, and lower amylase. Both genders had elevated eosinophil counts, immunoglobulin G, total and direct bilirubin, lactate dehydrogenase and creatine phosphokinase, the latter being more pronounced among women. When graded against U.S. -derived DAIDS AE grading criteria

  18. The clinical laboratory in the investigation of hemoglobin disorders


    Lais Pinto de Almeida; Annelise Corrêa Wengerkievicz; Nilceia Maria Viviani; Dulcinéia Martins Albuquerque; Maria Elizabete Mendes; Nairo Massakazu Sumita


    As alterações na síntese da hemoglobina resultam em um grupo de distúrbios hereditários, os quais podem ser classificados como hemoglobina variante, se a alteração tiver origem em uma mutação no gene da hemoglobina, produzindo cadeias anormais, ou como talassemias, se a estrutura é normal, porém a síntese ocorre em quantidade alterada. Este trabalho tem como objetivo descrever a condução do diagnóstico laboratorial de quatro casos de distúrbios da hemoglobina, a fim de ilustrar o papel do lab...

  19. Clinical and laboratory findings in 220 children with recurrent abdominal pain

    NARCIS (Netherlands)

    C. Gijsbers; M.A. Benninga; H.R. Büller


    Aim: To investigate the clinical and laboratory findings in children with recurrent abdominal pain (RAP). Methods: Consecutive patients with RAP (Apley criteria), age 4-16 years, referred to a secondary medical centre were evaluated by a standardized history, physical examination and laboratory test

  20. Clinical, laboratory and electrophysiological features of Morvan's fibrillary chorea. (United States)

    Lee, Will; Day, Timothy J; Williams, David R


    Morvan's Fibrillary Chorea (MFC) is a rare autoimmune disorder causally associated with auto-antibodies directed at the voltage-gated potassium channel (VGKC-Abs). It classically presents with sleep disturbances, neuromyotonia and dysautonomia. We aimed to systematically characterise the features of MFC by describing a patient and reviewing published literature. Case notes of 27 patients with MFC (one from our clinic and 26 from the literature) were reviewed and clinical data were extracted and analysed. We found that MFC mainly affects men (96%) and runs a subacute course over months. Neoplasia (56%), VGKC-Abs positivity (79%) and autoimmunity (41%) are frequent associations. Myokymia, insomnia and hyperhidrosis were almost universally described. Other autonomic features were present in 63% with the most common being cardiovascular and bowel disturbances. Clinical, radiological or electroencephalographical features of limbic encephalitis were present in 19% of patients. Outcome was fair with an overall recovery rate of 78%. All patients with malignancies underwent surgery. Immunotherapies including corticosteroids, intravenous immunoglobulins and plasma exchange were instituted in 22 patients and 19 (86%) responded. Of all symptomatic treatments tried, carbamazepine, phenytoin, sodium valproate, levetiracetam and niaprazine were found to be effective. The broad clinical spectrum of VGKC-Abs diseases can make early recognition of MFC difficult. Myokymia, insomnia and hyperhidrosis are invariably present. There may be abnormalities on cerebrospinal fluid testing and VGKC-Abs can occasionally be absent. Early initiation of immunotherapies and malignancy screening are important to prevent adverse outcomes in a condition that generally responds favourably to treatment.

  1. Pre-analytical phase in clinical chemistry laboratory

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    Neogi SS


    Full Text Available The laboratory testing process is divided into the pre-analytical, analytical and post-analytical phases. For obtaining reliable test results, the prevention and detection of errors at all steps is required. While analytical standards have been developed by recognized quality control criteria, there is a scarcity in the development of standards for the preanalytical phase. This phase is most prone to errors as the steps involved are directly dependent on humans and are out of direct control of the laboratory. Such errors in preanalytical stage often only become apparent in the analytical or post-analytical phase. The development of a pre-analytical quality manual is essential in achieving total quality control. Correct practices and strategies of error prevention can reduce preanalytical errors. This review focuses on prevention of pre-analytical errors that occur while collecting a specimen of blood, urine and cerebrospinal fluid. Most of these can be easily prevented with understanding and education of the personnel involved in and responsible for executing this crucial pre-analytical phase.

  2. Experimental Psychopathology: From laboratory studies to clinical practice

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    Pierre Philippot


    Full Text Available Recently, David Barlow (2004, a pioneer in the field of anxiety disorders, has proposed that psychologists should abandon the concept of psychotherapy and rather use the one of “psychological treatment”. The provoking idea behind this proposal is that the concept of psychotherapy, relying on the notion of “therapeutic school” should be discarded by professional psychologists because it relies too much on conceptions based on pre-scientific models. Barlow (2004 insists that, today, psychology as an empirical science has gathered sufficient knowledge and know-how to found clinical practice. It is no longer necessary to rely on pre-scientific theories. Further, Barlow’s perspective opens clinical practice to the entire field of psychology, i.e. to the advances accomplished by research on emotion, cognition, learning, development, etc.


    Directory of Open Access Journals (Sweden)

    C. E.S. Rocha


    Full Text Available INTRODUCTION: Being present in high school in chemistry and biology disciplines, biochemistry is to explain the chemical and biological reactions in cells. His concepts are seen as abstract and difficult to understand and can be contextualized through experimentation. Experimentation is used in the classroom to allow students to view the applicability of the contents through observation, creating hypotheses, discussion and conclusions. OBJECTIVES: The aim of this study was to evaluate the presence of experimentation in biochemistry content  in high school books. MATERIALS AND METHODS: In this way, it was analyzed the presence of experimental activities in the textbooks approved by the National Textbook Plan 2015 "Biology 1", authored by César da Silva Junior, Sezar Sasson and Nelson Caldini Junior, and in the book " Chemistry - Volume 3 "by Martha Reis. RESULTS: At the end of the unit where the biochemical concepts are covered in the book "Biology 1" is presented an interdisciplinary project called "Enzymes - chemical tools of life" that proposes four experiments on catalase, pH and contact surface enzyme-substrate. They are easy activities to be implemented with affordable materials. Already at the Chemistry book, when addressing the biochemistry there is only one proposal for experimental activity called "Glycolic Extract of milk proteins". In this case, we need materials like food processor and enameled pots, which can hinder your performance in virtual classes, however, the experiment is easy to perform. Both books contain questions after the experimental proposals enhancing the questioning of the activities and understanding the contents addressed. CONCLUSIONS: The present experimental activities in the textbooks are mostly easy to apply and is not required sophisticated equipment of Sciences laboratories. It also allows the contextualization of theory and practice enhancing the process of teaching and learning with the proposals made.

  4. Implementation of a companion diagnostic in the clinical laboratory

    DEFF Research Database (Denmark)

    Mancini, Irene; Pinzani, Pamela; Simi, Lisa


    A companion diagnostic test provides information that is essential for the safe and effective use of a corresponding therapeutic product as indicated in the drug instructions. The implementation of a companion diagnostic follows the rules of a molecular test for somatic mutations in a routine...... of mutation under study, the sample to be assayed and its preparation procedure. In addition, the results of a molecular assay require a complex interpretation process of the analytical data as the patient's genotype, the translation of the identified variant into a predicted phenotype and knowledge......, as an example, the BRAF genotype analysis in tumor tissue samples for identification of melanoma patients that can benefit treatment with BRAF inhibitors. The manuscript is focused on the following aspects: i) medical rationale, ii) methodologies of analysis, iii) laboratory performance evaluation and iv...

  5. Genetic, Clinical, and Laboratory Markers for DOCK8 Immunodeficiency Syndrome

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    Jeremiah C. Davis


    Full Text Available DOCK8 immunodeficiency syndrome (DIDS is a combined immunodeficiency characterized by recurrent viral infections, severe atopy, and early onset malignancy. Genetic studies revealed large, unique deletions in patients from different families and ethnic backgrounds. Clinical markers of DIDS include atopic dermatitis, allergies, cutaneous viral infections, recurrent respiratory tract infections, and malignancy. Immune assessments showed T cell lymphopenia, hyper-IgE, hypo-IgM, and eosinophilia. The impaired lymphocyte functions in DIDS patients appear central for disease pathogenesis.

  6. Valores bioquímicos sanguíneos en hembras brahman bajo condiciones de pastoreo Clinical biochemistry values in serum from grazing brahman cows

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    Nestor Alonso Villa


    g/L; globulines 40±10 g/L; urea 3.31±1.43 mmol/L; AST 158±34 U/L; Ca 2.50±0.21 mmol/L, and Mg 1.40±0.44 mmol/L. The increasing of beta-hydroxybutyrates and globulines, and a high activity of AST were the most frequent alterations. The serum biochemistry values for grazing B. indicus cattle are similar to the described values for B. taurus.

  7. Sesame seed allergy: Clinical manifestations and laboratory investigations

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    Fazlollahi MR.


    Full Text Available Background: Plant-origin foods are among the most important sources of food allergic reactions. An increase in the incidence of sesame seed allergy among children and adults has been reported in recent years. The aim of this preliminary study was to investigate the prevalence, importance and clinical manifestations of sesame allergy among Iranian patients.Methods: In a cross-sectional survey, 250 patients with suspected IgE-mediated food allergies completed a questionnaire and underwent skin prick tests with sesame extract as well as cross-reacting foods (walnut, soya and peanut. Total IgE and sesame-specific IgE levels were measured. Patients with positive skin test reactions and/or IgE specific for sesame without clinical symptoms were considered sensitive to sesame. The patients who also had clinical symptoms with sesame consumption were diagnosed as allergic to sesame.Results: Of the 250 patients enrolled in this study, 129 were male and 121 female, with a mean age of 11.7 years. The most common food allergens were cow's milk, egg, curry, tomato and sesame. Sesame sensitivity was found in 35 patients (14.1%. Only five patients (2% had sesame allergy. Sesame-sensitive patients had a significantly higher frequency of positive prick test to cross-reacting foods when compared to non-sensitized patients (p=0.00. The type of symptom was independent of gender and age of the patients, but urticaria and dermatitis-eczema were significantly more frequent in sensitized patients (p=0.008.Conclusions: This is the first study addressing the prevalence of sesame seed allergy in Iranian population. We found sesame to be a common and important cause of food allergy. The panel of foods recommended for use in diagnostic allergy tests should be adjusted.

  8. Socio-demographic, Clinical and Laboratory Features of Rotavirus Gastroenteritis in Children Treated in Pediatric Clinic (United States)

    Azemi, Mehmedali; Berisha, Majlinda; Ismaili-Jaha, Vlora; Kolgeci, Selim; Avdiu, Muharrem; Jakupi, Xhevat; Hoxha, Rina; Hoxha-Kamberi, Teuta


    Aim: The aim of work was presentation of several socio-demographic, clinical and laboratory characteristics of gastroenteritis caused by rotavirus. The examinees and methods: The examinees were children under the age of five years treated at the Pediatric Clinic due to acute gastroenteritis caused by rotavirus. Rotavirus is isolated by method chromatographic immunoassay by Cer Test Biotec. Results: From the total number of patients (850) suffering from acute gastroenteritis, feces test on bacteria, viruses. protozoa and fungi was positive in 425 (49.76%) cases. From this number the test on bacteria was positive in 248 (58.62%) cases, on viruses it was positive in 165 (39.0%), on protozoa in 9 (2.12%) cases and on fungi only one case. Rotavirus was the most frequent one in viral test, it was isolated in 142 (86.06%) cases, adenoviruses were found in 9 (5.45%) cases and noroviruses in only one case. The same feces sample that contained rotavirus and adenoviruses were isolated in five cases, whereas rotavirus with bacteria was isolated in the same feces sample in five cases. The biggest number of cases 62 (43.66%) were of the age 6-12 months, whereas the smallest number 10 (7.04%) cases were of the age 37-60 months. There were 76 (53.52%) of cases of male gender, from rural areas there were 81 (57.04%) cases and there were 58 (40.80%) cases during the summer period. Among the clinical symptoms the most prominent were diarrhea, vomiting, high temperature, whereas the different degree of dehydration were present in all cases (the most common one was moderate dehydration). The most frequent one was isonatremic dehydration in 91 (64.08%) cases, less frequent one was hypernatremic dehydration in 14 (9.85%) cases. The majority of cases (97.89%) had lower blood pH values, whereas 67 (47.17%) cases had pH values that varied from 7.16 -7.20 (curve peak), normal values were registered in only 3 (2.11%) cases. Urea values were increased in 45 (31.07%) cases (the maximum value

  9. The Frequency of the Accidental Contamination with Laboratory Samples in Yazd Clinical Laboratories’ personnel in 2011

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    Jafari, AA. (PhD


    Full Text Available Background and Objective: laboratory personnel have always accidental exposure to clinical samples, which can cause the transmission of infection. This threat can be prevented and controlled by education for the use of safety instruments. The purpose was to determine the frequency of accidental exposure to laboratory samples among Yazd laboratory personnel in 2011. Material and Methods: This descriptive cross-sectional study was conducted on 100 of Yazd clinical laboratory personnel. The data was collected, using a valid and reliable questioner, via interview and analyzed by means of SPSS software. Results: Eighty-six percent of the subjects reported an experience of accidental exposure to clinical samples, such as blood, serum and urine. The causes were carelessness (41% and work overload (29%. Needle- stick was the most prevalent injury (52% particularly in sampler workers (51% and in their hands (69%. There wasn’t significant relationship between accidental exposure to laboratory samples and the variables such as private and governmental laboratories (p=0.517, kind of employment (p=0.411, record of services (p=0.439 and academic degree (p=0.454. The subjects aged 20-29 (p=0.034 and worked in sampling unit had the highest accidental exposure. Conclusion: based on the results, inexperience of the personnel especially in sampling room, overload at work and ignorance of applying safety instruments are known as the most important reasons for accidental exposure to clinical samples. Keywords: Contamination; accidental Exposure; Infectious agents; laboratory; personnel

  10. [The analytical reliability of clinical laboratory information and role of the standards in its support]. (United States)

    Men'shikov, V V


    The article deals with the factors impacting the reliability of clinical laboratory information. The differences of qualities of laboratory analysis tools produced by various manufacturers are discussed. These characteristics are the causes of discrepancy of the results of laboratory analyses of the same analite. The role of the reference system in supporting the comparability of laboratory analysis results is demonstrated. The project of national standard is presented to regulate the requirements to standards and calibrators for analysis of qualitative and non-metrical characteristics of components of biomaterials.

  11. Excellence in clinical laboratories: the standard ISO 15189:2007

    Directory of Open Access Journals (Sweden)

    Antonio Scipioni


    Full Text Available I laboratori clinici operano in stretto contatto con i pazienti e collaborano direttamente alla loro cura, in modo corresponsabile con i medici e i reparti ospedalieri. L’importanza della loro attività per la salute pubblica rende obbligatoria l’esplicitazione di alcuni punti finora spesso considerati ovvii. Ai pazienti dev’essere infatti garantito che: - i metodi di analisi utilizzati siano stati preliminarmente valutati, per confermare la loro rispondenza agli obiettivi dell’analisi stessa, verificati, per controllarne l’effettiva efficacia e, se necessario, validati per garantire che siano appropriati allo scopo; - il personale che esegue le analisi sia stato adeguatamente formato e quindi tecnicamente competente; - il laboratorio assicuri un’adeguata consulenza allo staff clinico che richiede le analisi, allo scopo di ottenere una sinergia tra il laboratorio e il clinico che ha in cura il paziente, sia nella fase di prelievo di materiale biologico, sia nella fase di interpretazione dei risultati. Tutto ciò è necessario per dimostrare ai pazienti

  12. Percutaneous renal graft biopsy: a clinical, laboratory and pathological analysis

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    Marilda Mazzali


    Full Text Available CONTEXT: Renal allograft biopsies have been used as a good method for monitoring the evolution of kidney transplants for at least 20 years.1 Histological analysis permits differential diagnosis of the causes of allograft dysfunction to be made. OBJECTIVES: To correlate the data of urinalysis and serum creatinine with histological diagnosis of renal graft in a group of renal transplant patients. DESIGN: Accuracy study, retrospective analysis. SETTING: A university terciary referral center. SAMPLE: 339 percutaneous allograft biopsies obtained from 153 patients. Blood and urine samples were obtained before the graft biopsy. MAIN MEASUREMENTS: Laboratory evaluation and hystological analysis (light microscopy, imunofluorescent eletronic microscopy. RESULTS: Most of the biopsies (58.9% were performed during the first month post-transplant. An increase in serum creatinine was associated with acute tubular and/or cortical necrosis. Proteinuria and normal serum creatinine were associated with glomerular lesions. Non-nephrotic range proteinuria and an increase in serum creatinine were associated with chronic rejection. CONCLUSIONS: Evaluation of serum creatinine and urinalysis can be useful in suggesting the histological graft diagnosis.

  13. Development and Use of Challenge Exams for Clinical Laboratory Nursing 2: Part 2 Final Report. (United States)

    Hattstaedt, Mary Jane; Isaac, Margaret M.

    The report describes the development of a set of equivalency tests for students in Nursing 2 who have had prior clinical laboratory training or experience in pediatrics, obstetrics, or geriatrics. For each of the three areas the examination packet includes: the course clinical objectives, the challenge examination objectives, a self-study guide, a…

  14. An Enzymatic Clinical Chemistry Laboratory Experiment Incorporating an Introduction to Mathematical Method Comparison Techniques (United States)

    Duxbury, Mark


    An enzymatic laboratory experiment based on the analysis of serum is described that is suitable for students of clinical chemistry. The experiment incorporates an introduction to mathematical method-comparison techniques in which three different clinical glucose analysis methods are compared using linear regression and Bland-Altman difference…

  15. 78 FR 28292 - Joint Biomedical Laboratory Research and Development and Clinical Science Research and... (United States)


    ... AFFAIRS Joint Biomedical Laboratory Research and Development and Clinical Science Research and Development... areas of biomedical, behavioral and clinical science research. The panel meetings will be open to the... location changes have been made for the following panel meetings of the of the Joint Biomedical...

  16. Nomenclature and basic concepts in automation in the clinical laboratory setting: a practical glossary. (United States)

    Evangelopoulos, Angelos A; Dalamaga, Maria; Panoutsopoulos, Konstantinos; Dima, Kleanthi


    In the early 80s, the word automation was used in the clinical laboratory setting referring only to analyzers. But in late 80s and afterwards, automation found its way into all aspects of the diagnostic process, embracing not only the analytical but also the pre- and post-analytical phase. While laboratories in the eastern world, mainly Japan, paved the way for laboratory automation, US and European laboratories soon realized the benefits and were quick to follow. Clearly, automation and robotics will be a key survival tool in a very competitive and cost-concious healthcare market. What sets automation technology apart from so many other efficiency solutions are the dramatic savings that it brings to the clinical laboratory. Further standardization will assure the success of this revolutionary new technology. One of the main difficulties laboratory managers and personnel must deal with when studying solutions to reengineer a laboratory is familiarizing themselves with the multidisciplinary and technical terminology of this new and exciting field. The present review/glossary aims at giving an overview of the most frequently used terms within the scope of laboratory automation and to put laboratory automation on a sounder linguistic basis.

  17. [Assessment of the quality of laboratory diagnosis of intestinal parasitic diseases by the laboratories participating in the Federal System of External Quality Assessment of Clinical Laboratory Testing]. (United States)

    Malakhov, V N; Dovgalev, A S; Astanina, S Iu; Serdiuk, A P


    In 2010-2013, the quality of microscopic detection of the causative agents ofparasitic diseases in the feces has been assessed by the specialists of the laboratories of the therapeutic-and-prophylactic institutions (TPIs) and Hygiene and Epidemiology Centers, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare, which are participants of the Federal System of External Quality Assessment of Clinical Laboratory Testing. Thirty-two specimens containing 16 species of human helminths and 4 species of enteric protozoa in different combinations were examined. The findings suggest that the quality of microscopic detection of the causative agents of parasitic diseases is low in the laboratories of health care facilities and that the specialists of the laboratories of TPIs and Hygiene and Epidemiology Centers, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare, do not not possess the knowledge and skills necessary to make a laboratory diagnosis of helminths and enteric protozoa. The average detection rates of helminths and protozoa were at a level of 64 and 36%, respectively. The correct results showed that the proportion of helminths and protozoa were 94.5 and 5.5%, respectively. According to the biological and epidemiological classification of helminths, there were higher detection rates for contact group parasites (Enterobius vermicularis and Hymenolepis nana) and geohelminths (Ascaris, Trichuris trichiura, and others). Biohelminths (Opisthorchis, tapeworms, and others) Were detectable slightly worse.

  18. Detection of intestinal protozoa in the clinical laboratory. (United States)

    McHardy, Ian H; Wu, Max; Shimizu-Cohen, Robyn; Couturier, Marc Roger; Humphries, Romney M


    Despite recent advances in diagnostic technology, microscopic examination of stool specimens remains central to the diagnosis of most pathogenic intestinal protozoa. Microscopy is, however, labor-intensive and requires a skilled technologist. New, highly sensitive diagnostic methods have been developed for protozoa endemic to developed countries, including Giardia lamblia (syn. G. intestinalis/G. duodenalis) and Cryptosporidium spp., using technologies that, if expanded, could effectively complement or even replace microscopic approaches. To date, the scope of such novel technologies is limited and may not include common protozoa such as Dientamoeba fragilis, Entamoeba histolytica, or Cyclospora cayetanensis. This minireview describes canonical approaches for the detection of pathogenic intestinal protozoa, while highlighting recent developments and FDA-approved tools for clinical diagnosis of common intestinal protozoa.

  19. Does breast feeding influence liver biochemistry?

    DEFF Research Database (Denmark)

    Jørgensen, Marianne Hørby; Ott, Peter; Juul, Anders


    It is assumed that early feeding can affect liver biochemistry because breast-fed infants have a higher risk of hyperbilirubinemia than formula-fed infants. The authors sought to determine how feeding mode affected liver biochemistry in healthy term infants.......It is assumed that early feeding can affect liver biochemistry because breast-fed infants have a higher risk of hyperbilirubinemia than formula-fed infants. The authors sought to determine how feeding mode affected liver biochemistry in healthy term infants....

  20. The European Register of Specialists in Clinical Chemistry and Laboratory Medicine: guide to the Register, version 3-2010

    DEFF Research Database (Denmark)

    McMurray, Janet; Zérah, Simone; Hallworth, Michael;


    In 1997, the European Communities Confederation of Clinical Chemistry and Laboratory Medicine (EC4) set up a Register for European Specialists in Clinical Chemistry and Laboratory Medicine. The operation of the Register is undertaken by a Register Commission (EC4RC). During the last 12 years, more...... than 2200 specialists in Clinical Chemistry and Laboratory Medicine have joined the Register. In 2007, EC4 merged with the Forum of European Societies of Clinical Chemistry and Laboratory Medicine (FESCC) to form the European Federation of Clinical Chemistry and Laboratory Medicine (EFCC). Two previous...

  1. Soil Microbiology, Ecology, and Biochemistry (United States)

    The 4th edition of Soil Microbiology, Ecology, and Biochemistry Edited by Eldor Paul continues in the vein of the 3rd edition by providing an excellent, broad-reaching introduction to soil biology. The new edition improves on the previous by providing extensive supplementary materials, links to outs...

  2. Commentary: Biochemistry Re-Natured (United States)

    White, Harold B.


    In his last commentary on "Biochemistry Denatured," this author dealt with his perception that college students today have spent too little of their childhood years playing outside in nature and as a consequence have not learned basic things about the world from personal experience. This "nature-deficit disorder" removes many opportunities for…

  3. Promising New Directions in Biochemistry (United States)

    Olivera, Baldomero M.


    "Biochemistry," by Lubert Stryer, has become one of the standard textbooks for the field. The Fifth Edition has two new authors: Jeremy Berg, Professor and Director of Biophysics and Biophysical Chemistry at Johns Hopkins University School of Medicine; and John Tymoczko, the Towsley Professor of Biology at Carleton College. The new edition does,…

  4. Neurobrucellosis: Clinical and laboratory findings in 22 patients

    Directory of Open Access Journals (Sweden)

    Rasoolinejad M


    Full Text Available Brucellosis is a multisystem disease with diverse clinical presentations and involvement of the nervous system is considered to 5 to be 10% in adult patients and 1% in children. The presentations of neurobrucellosis includes meningoencephalitis, subarachnoid haemorrhage, myelitis, radiculoneuritis, intracerebral and epidural abscess, psychosis and vascular syndrome. Twenty-two patients with neurobrucellosis are described. Ten patients had meningoencephalitis, seven patients had meningitis, three patients had polyradiculopathy and one patient presented with spinal epidural abscess and one patient had brain abscess. Results of an agglutination test for Brucella in serum were positive for all patients (>1:160; eight of 15 patients had positive agglutination test in CSF. Five patients had positive blood cultures, 3 patients had positive bone marrow cultures and 2 of 15 patients had positive CSF cultures. All of cultures were Brucella Mellitensis. Antimicrobial treatment included concurrent administration of Doxycycline, Rifampin and Trimethoprim-Sulfametoxazole. Four patients received Dexamethason concurrently. In conclusion, nervous system involvement is a serious manifestation of brucellosis. As brucellosis is an endemic disease in Iran we suggest that brucellosis be investigated with neurological symptoms and signs.

  5. Sheehan syndrome: clinical and laboratory evaluation of 20 cases. (United States)

    Ozkan, Yusuf; Colak, Ramis


    Sheehan syndrome (SS) or post-partum pituitary necrosis is a pituitary insufficiency secondary to excessive post-partum blood losses. SS is a very significant cause of maternal morbidity and mortality in developing countries although it is a rarity in developed countries in which obstetrical care has been improved. In this study, we reviewed 20 cases retrospectively who were diagnosed as SS in our clinic. The patients aged 40 to 65 years with a mean age of 51.12 +/- 9.44 years (mean +/- SD). Time to make a definitive diagnosis of the disease ranged between 5 and 25 years with a mean of 16.35 +/- 4.74 years. Three of our patient (15%) had a previous diagnosis of SS. Three patients (15%) were referred to emergency service for hypoglycemia, three patients (15%) for hypothyroidism and one patient (5%) for hyponatremia. Dynamic examination of the pituitary revealed GH, Prolactin, FSH, TSH and ACTH insufficiency in all of the patients. One of our patients had a sufficient LH response to LHRH challenge. All of the patients were imaged with pituitary MRI. Eleven patients had empty sella and 9 patients had partial empty sella. SS is still a common problem in our country, especially in rural areas. Considering the duration of disease, important delays occur in diagnosis and treatment of the disease.

  6. [Vasculitic Peripheral Neuropathies: Clinical Features and Diagnostic Laboratory Tests]. (United States)

    Ogata, Katsuhisa


    Vasculitic peripheral neuropathy (VPN) occurs due to ischemic changes of peripheral nerves, resulting from a deficit of vascular blood supply due to damaged vasa nervorum leading to vasculitis. VPN usually manifests as sensorimotor or sensory disturbances accompanied by pain, presenting as a type of multiple mononeuropathy, with a scattered distribution in distal limbs. VPN may also present as a mononeuropathy, distal symmetric polyneuropathy, plexopathy, or radiculopathy. The rapidity of VPN is variable, ranging from days to months, with symptoms occasionally changing with the appearance of new lesions. Careful history taking and neurological examination provides an exact diagnosis. The most common cause of VPN is primary vasculitis predominantly affecting small vessels, including vasa nervorum, anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis, and polyarteritis nodosa. Similar vasculitic processes can also result from a systemic collagen disorder or secondary vasculitis. Electrophysiological studies and pathological investigation of biopsied peripheral nerves and muscles are important for diagnosis of vasculitis. Serological tests, including ANCA, are useful for diagnosis of vasculitis. Accurate neurological examinations are essential for diagnosis and evaluation of clinical course.

  7. Quality of Control of Clinical-Biochemical Laboratories – Serbian Case

    Directory of Open Access Journals (Sweden)

    Vinko Peric


    Full Text Available In the last 20 years in medical laboratories, numerous activities regarding quality and accreditation system were taken. Approach to this problem in European countries is different, so the task of the Accreditation Work Group of the Confederation of European societies for clinical chemistry (EC 4 to help the efforts to harmonize this issue. External quality control in clinical-chemical laboratories imposed the need for the implementation of quality management system. »Good laboratory practice« and its principles were adopted by nominated bodies, both international and national. In the beginning, the standard ISO 9001 was applied for certification and for accreditation EN 45001 and ISO Guide 25, which are prepared for testing and calibration laboratories. Standard ISO 17025 is the successor of the previous documents and for now it is a reference for mentioned laboratories. Accreditation Work Group of the Confederation of European societies for clinical chemistry (EC 4 made an amendment of the requirements for medical laboratories, which this standard describes. Standard draft ISO 15189 was adopted on February 2003 as a final version with requirements for medical laboratories.

  8. [The issues and basic principles of training of physicians of clinical laboratory diagnostics]. (United States)

    Morozova, V T; Naumova, E V


    The article considers the main positions concerning the clinical laboratory diagnostics as an independent clinical specialty and the principles of professional training and improvement of specialists. The basic issues complicating the training and improvement of personnel to be kept in line with actual needs of laboratory service of public health system are discussed. Among them are the availability of laboratory academic sub disciplines demanding a profound special theoretical education and technical skills; the need to account in the process of professional training the variety of forms, sizes and types of laboratory structures in different medical institutions; the need of special training programs for numerous specialists with non-medical basic education. The combination of the present system of postgraduate training of specialists on chairs of state educational organizations with initiative involvement of specialists in various public forms of permanent professional improvement (professional scientific societies meetings, research conferences, internet seminars, etc.) is supported Along with a positive appraisal of the existing system of training in the state educational institutions and corresponding regulation documents, a critique is expressed regarding certain actual documents which improperly limit the administrative functions of physicians of clinical laboratory diagnostics and complicate training of bacteriologists for clinical laboratories.

  9. A Two-Week Guided Inquiry Protein Separation and Detection Experiment for Undergraduate Biochemistry (United States)

    Carolan, James P.; Nolta, Kathleen V.


    A laboratory experiment for teaching protein separation and detection in an undergraduate biochemistry laboratory course is described. This experiment, performed in two, 4 h laboratory periods, incorporates guided inquiry principles to introduce students to the concepts behind and difficulties of protein purification. After using size-exclusion…

  10. Yeast identification in the clinical microbiology laboratory: phenotypical methods. (United States)

    Freydiere, A M; Guinet, R; Boiron, P


    Emerging yeast pathogens are favoured by increasing numbers of immunocompromised patients and by certain current medical practices. These yeasts differ in their antifungal drug susceptibilities, and rapid species identification is imperative. A large variety of methods have been developed with the aim of facilitating rapid, accurate yeast identification. Significant recent commercial introductions have included species-specific direct enzymatic colour tests, differential chromogenic isolation plates, direct immunological tests, and enhanced manual and automated biochemical and enzymatic panels. Chromogenic isolation media demonstrate better detection rates of yeasts in mixed cultures than traditional media, and allow the direct identification of Candida albicans by means of colony colour. Comparative evaluation of rapid methods for C. albicans identification, including the germ tube test, shows that chromogenic media may be economically advantageous. Accurate tests for single species include the Bichrolatex Albicans and Krusei Color tests, both immunologically based, as well as the Remel Rapid Trehalose Assimilation Broth for C. glabrata. Among broad-spectrum tests, the RapID Yeast Plus system gives same-day identification of clinical yeasts, but performance depends on inoculum density and geographic isolate source. The API 20 C AUX system is considered a reference method, but newer systems such as Auxacolor and Fungichrom are as accurate and are more convenient. Among automated systems, the ID 32 C strip, the Vitek Yeast Biochemical Card and the Vitek 2 ID-YST system correctly identify >93% of common yeasts, but the ID-YST is the most accurate with uncommon yeasts, including C. dubliniensis. Spectroscopic methods such as Fourier transformed-infrared spectroscopy offer potential advantages for the future. Overall, the advantages of rapid yeast identification methods include relative simplicity and low cost. For all rapid methods, meticulous, standardized

  11. Clinical and Laboratory Findings of Patients with Breath Holding Spells

    Directory of Open Access Journals (Sweden)

    Özlem Özdemir


    Full Text Available Aim: The aim of this prospective study was to evaluate the clinical characteristics; physical findings, cardiological, hematological and neurological problems; treatment approaches; and the prognosis of children with breath holding spells.Materials and Method: Seventhy patients were included in this study. All patients were evaluated with detailed history and physical examination. Complete blood count, serum iron and iron binding capacity were studied; cardiological (telecardiography, electrocardiography, if necessary echocardiography and event recorder and neurological investigations (electroencephalography were done during the admission. Patients with iron deficiency anemia and iron deficiency were treated with ferrous sulphate orally. In patients with normal hematological values, no medication was used. After a two-month treatment period patients underwent control hematological evaluation. Frequency of the spells, age of disappearance of spells (defined as 6 months without spells, disappearance ratios between the three groups were compared. Results: The percentage of cyanotic, palloric and mixt type of breath holding spells of 70 patients included in the study were 67.1, 14.3 and 18.6, respectively. It was determined that psychogenic factors played a role in 77.1% of our patients. There were iron deficiency anemia in 39 (55.7%, iron deficiency in 12 (17.2% and normal hematological parameters in 19 (27.1% of 70 patients. The QTc values were normal in all of them. EEG’s were normal in 56 (80%, dysrhythmic in 11 (15.7% and pathologic in (4.3%. There was a positive family history of breath holding spells in 44.3% of those with breath holding spells. Conclusion: We determined that there was a correlation between the iron levels and the frequency of spells. The lower the iron levels the higher the frequency of spells. There was a dramatic decrease of 92% in spells with low doses of iron supplementation especially in the anemic group. (Journal of

  12. PNH revisited: Clinical profile, laboratory diagnosis and follow-up

    Directory of Open Access Journals (Sweden)

    Gupta P


    Full Text Available Background: Paroxysmal nocturnal hemoglobinuria (PNH is characterized by intravascular hemolysis, marrow failure, nocturnal hemoglobinuria and thrombophila. This acquired disease caused by a deficiency of glycosylphosphatidylinositol (GPI anchored proteins on the hematopoietic cells is uncommon in the Indian population. Materials and Methods: Data of patients diagnosed with PNH in the past 1 year were collected. Clinical data (age, gender, various presenting symptoms, treatment information and follow-up data were collected from medical records. Results of relevant diagnostic tests were documented i.e., urine analysis, Ham′s test, sucrose lysis test and sephacryl gel card test (GCT for CD55 and CD59. Results: A total of 5 patients were diagnosed with PNH in the past 1 year. Presenting symptoms were hemolytic anemia (n=4 and bone marrow failure (n=1. A GCT detected CD59 deficiency in all erythrocytes in 4 patients and CD55 deficiency in 2 patients. A weak positive PNH test for CD59 was seen in 1 patient and a weak positive PNH test for CD55 was seen in 3 patients. All patients were negative by sucrose lysis test. Ham′s test was positive in two cases. Patients were treated with prednisolone and/or androgen and 1 patient with aplastic anemia was also given antithymocyte globulin. A total of 4 patients responded with a partial recovery of hematopoiesis and 1 patient showed no recovery. None of the patients received a bone marrow transplant. Conclusion: The study highlights the diagnostic methods and treatment protocols undertaken to evaluate the PNH clone in a developing country where advanced methods like flowcytometry immunophenotyping (FCMI and bone marrow transplants are not routinely available.


    Directory of Open Access Journals (Sweden)



    Full Text Available INTRODUCTION: Malaria is a major health concern across the world and is endemic in our country. It is imperative for us to know the varied manifestations and lab features both classically described and rare features for early detection of this disease and further treatment. This study was undertaken to study the clinical features, lab features and complications of malaria in a tertiary care centre. METHODOLOGY: It is a retrospective study done on 75 cases of confirmed and treated cases of malaria for a period of one year in KIMS hospital, Bangalore. Detailed history examination and lab features of these patients were recorded and analyzed. RESULTS: A total of 75 cases of confirmed malaria were treated during study period of which 57[76%] were males Out of 75 cases 46[61%] had vivax malaria infection, 10[13%] had falciparum infection and 19[26%] had mixed infections of falciparum and vivax. In all 3 groups more number of cases was seen in age group of 18 – 40 years. fever was the major presentation (100% in the patients and Pain abdomen along with fever seen in 15 [20%] patients. Head ache was another predominant complaint in 35[46.6%] On examination Icterus was seen in 11 [14.6%] patients Pallor was seen in 13[17.3%] patients Systolic BP of 2ULN was seen in 9[12%] patients Out of these 6[8%] patients had severe malaria as defined by WHO category of severe malaria. CONCLUSIONS: Being more vigilant and well versed with the varied presentations/lab features of malaria and anticipating complications early, effective treatment can be instituted thus reducing the morbidity and mortality of this endemic disease.

  14. Identifying the Clinical Laboratory Tests from Unspecified "Other Lab Test" Data for Secondary Use. (United States)

    Pan, Xuequn; Cimino, James J


    Clinical laboratory results are stored in electronic health records (EHRs) as structured data coded with local or standard terms. However, laboratory tests that are performed at outside laboratories are often simply labeled "outside test" or something similar, with the actual test name in a free-text result or comment field. After being aggregated into clinical data repositories, these ambiguous labels impede the retrieval of specific test results. We present a general multi-step solution that can facilitate the identification, standardization, reconciliation, and transformation of such test results. We applied our approach to data in the NIH Biomedical Translational Research Information System (BTRIS) to identify laboratory tests, map comment values to the LOINC codes that will be incorporated into our Research Entities Dictionary (RED), and develop a reference table that can be used in the EHR data extract-transform-load (ETL) process.

  15. [Akita University Graduate School of Medicine: status of clinical laboratory medicine education]. (United States)

    Ito, Wataru; Chihara, Junichi


    Education in laboratory medicine is important. However, many medical students and doctors cannot understand this importance. This problem may be caused by the unclear character of laboratory medicine in research as well as hospital work, resulting in a lack of staff in the Department of Laboratory Medicine. One of the characters of laboratory medicine is its all-inclusive actions unrestrained by medical specialty. Thus, we tell medical students that the staff of laboratory medicine are suitable members of the infection control team (ICT) and nutrition support team (NST) in lectures. Moreover, we also teach allergy, immunology, infection, and sex-specific medicine, which are some subjects the topics of research. Many students in Akita University recognize that the staff of the Department of Laboratory Medicine are specialists of infection and allergy. On the other hand, young doctors can also receive postgraduate clinical training and conduct research not restricted to allergy and infection. We have a policy whereby the Department of Laboratory Medicine always opens its door widely to everyone including students and doctors. Nine staff joined the Department of Laboratory Medicine of Akita University about ten years, and now, can fully provide students with medical education. To solve some problems regarding education in laboratory medicine, we should promote our roles in medical education as well as in hospitals, and increase the number of staff.

  16. Implementation of External Quality Assessment Scheme in Clinical Chemistry for District Laboratories in Bhutan. (United States)

    Jamtsho, Rixin; Nuchpramool, Wilairat


    External Quality Assessment Scheme (EQAS) involves evaluation of a number of laboratories by an outside agency on the performance of a number of laboratories based on their analytical performance of tests on samples supplied by the external agency. In developing countries, establishment of national EQAS by preparing homemade quality control material is a useful scheme in terms of resources and time to monitor the laboratory performance. The objective of this study is to implement an EQAS to monitor the analytical performance of the district laboratories in Bhutan. Baseline information was collected through questionnaires. Lyophilized human serum including normal and abnormal levels were prepared and distributed to 19 participating laboratories. Nine routine analytes were included for the study. Their results were evaluated using Variance index scores (VIS) and Coefficient of variations (CV) was compared with Clinical Laboratory Improvement Act (CLIA) Proficiency Testing Criteria (PT) for each analyte. There was significant decrease in CV at the end of the study. The percentages of results in acceptable VIS as 'A' were 63, 60, 66, 69, 73 and 74, 75, 76 and 79 % in November 2009-July 2010 respectively. From our results, we concluded that, establishment of EQAS through distribution of home-made quality control material could be the useful scheme to monitor the laboratory performance in clinical chemistry in Bhutan.

  17. Wanderings in biochemistry. (United States)

    Lengyel, Peter


    My Ph.D. thesis in the laboratory of Severo Ochoa at New York University School of Medicine in 1962 included the determination of the nucleotide compositions of codons specifying amino acids. The experiments were based on the use of random copolyribonucleotides (synthesized by polynucleotide phosphorylase) as messenger RNA in a cell-free protein-synthesizing system. At Yale University, where I joined the faculty, my co-workers and I first studied the mechanisms of protein synthesis. Thereafter, we explored the interferons (IFNs), which were discovered as antiviral defense agents but were revealed to be components of a highly complex multifunctional system. We isolated pure IFNs and characterized IFN-activated genes, the proteins they encode, and their functions. We concentrated on a cluster of IFN-activated genes, the p200 cluster, which arose by repeated gene duplications and which encodes a large family of highly multifunctional proteins. For example, the murine protein p204 can be activated in numerous tissues by distinct transcription factors. It modulates cell proliferation and the differentiation of a variety of tissues by binding to many proteins. p204 also inhibits the activities of wild-type Ras proteins and Ras oncoproteins.

  18. Comparative genomic hybridization: technical development and cytogenetic aspects for routine use in clinical laboratories. (United States)

    Lapierre, J M; Cacheux, V; Da Silva, F; Collot, N; Hervy, N; Wiss, J; Tachdjian, G


    Comparative genomic hybridization (CGH) offers a new global approach for detection of chromosomal material imbalances of the entire genome in a single experiment without cell culture. In this paper, we discuss the technical development and the cytogenetic aspects of CGH in a clinical laboratory. Based only on the visual inspection of CGH metaphase spreads, the correct identification of numerical and structural anomalies are reported. No commercial image analysis software was required in these experiments. We have demonstrated that this new technology can be set up easily for routine use in a clinical cytogenetics laboratory.

  19. Biochemistry of neuroendocrine tumours. (United States)

    de Herder, Wouter W


    Several circulating or urinary tumour markers can be used for the diagnosis and follow-up of functioning and clinically non-functioning neuroendocrine tumours of the pancreatic islet cells and intestinal tract. Among the specific tumour markers are serotonin and its metabolites--e.g. 5-hydroxyindoleacetic acid (5-HIAA)--in carcinoid tumours and the carcinoid syndrome, insulin and its precursors or breakdown products in insulinoma, and gastrin in gastrinoma. Plasma vasointestinal polypeptide (VIP) determinations have been used in the diagnosis of VIPoma, plasma glucagon for glucagonoma, and serum somatostatin for somatostatinoma. Among the tumour-non-specific markers are: chromogranins, neuron-specific enolase (NSE), alpha-subunits of the glycoprotein hormones, catecholamines, pancreatic polypeptide (PP), ghrelin and adrenomedullin.

  20. Gender Performance Differences in Biochemistry (United States)

    Rauschenberger, Matthew M.; Sweeder, Ryan D.


    This study examined the historical performance of students at Michigan State University in a two-part biochemistry series Biochem I (n = 5,900) and Biochem II (n = 5,214) for students enrolled from 1997 to 2009. Multiple linear regressions predicted 54.9-87.5% of the variance in student from Biochem I grade and 53.8-76.1% of the variance in…

  1. Attempt of seminar in biochemistry teaching for Uygur clinical medicine undergraduate%专题讨论在民考民医学本科生生物化学教学中的尝试

    Institute of Scientific and Technical Information of China (English)

    许晨波; 孙玉萍; 斯坎德尔·白克力; 库热西·玉努斯


    目的探讨专题讨论在生物化学教学中的作用。方法在生物化学教学中利用课余时间开展专题讨论。选择新疆医科大学民考民临床医学本科专业2011级1班86名学生为研究对象,教学结束后采用问卷形式进行满意度调查,用Excel按选择项的百分比进行数据的描述分析。结果86.9%的学生认为专题讨论教学形式好;100.0%的学生认为对学以致用、知识融会贯通很有或较有帮助;100.0%的学生认为课余时间讨论对知识增长很有或较有必要性;97.8%的学生认为课余时间查阅资料很有或较有收获,100.0%的学生对专题讨论的内容很有或较有兴趣,并认为讨论内容新颖、实用;100.0%的学生认为对拓宽学习思路很有或较有帮助;43.5%的学生认为超出大纲内容可考试,39.1%的学生认为不考试;准备时间亦在5~7 d。结论生物化学教学中应用专题讨论有助于调动学生的积极性和各种能力的培养,有利于学生对所学专业知识的巩固和理解。%Objective To discuss the significance of the seminar in biochemistry teaching for Uygur clinical medical undergraduates. Methods 2011 grade totally 86 Uygur clinical medical under-graduates in Xinjiang Medical University were enrolled as the research object and questionnaire was used to make satisfaction survey. Data descript and analysis was performed according to the percentage of each option. Results 86.9%students thought that topic seminar was good;100.0%students thought that semi-nar can help apply and mastery the knowledge;100.0%students considered that seminar conducted dur-ing extracurricular time was necessary to the growth of knowledge;97.8%students considered that search-ing for references in the spare time was helpful;100.0%students were interested in the content of the seminar and thought it was novel and practical;100.0%students thought that seminar can help broaden thinking way;43.5%students

  2. Measles Outbreak in Macedonia: Epidemiological, Clinical and Laboratory Findings and Identification of Susceptible Cohorts


    Irena T Kondova; Zvonko Milenkovic; Sanja P Marinkovic; Golubinka Bosevska; Gordana Kuzmanovska; Goran Kondov; Sonja Alabakovska; Muller, Claude P.; Hübschen, Judith M


    OBJECTIVES: Despite a 92-99% national vaccination coverage since 2000, the former Yugoslav Republic of Macedonia experienced a large measles outbreak between 2010 and 2011. Here we investigate the characteristics of patients hospitalized during this outbreak at the Clinic of Infectious Diseases in Skopje. METHODS: Epidemiological, clinical and laboratory data of 284 measles patients, including 251 from Skopje (43.80% of the 573 reported cases) and 33 from elsewhere in Macedonia were collected...

  3. Clinical microbiology: Should microbiology be a clinical or a laboratory speciality?

    Directory of Open Access Journals (Sweden)

    Bhattacharya Sanjay


    Full Text Available Clinical microbiology is a specific combination of knowledge, attitude and practice aimed at direct clinical involvement in infectious disease management using the core principles of medical microbiology and clinical medicine. In this article certain areas in microbiology, where a more proactive approach could make a significant difference in clinical outcome has been delineated. The article reiterates the role of a medical microbiologist in a hospital setting. The practices described are the norm in well-organized hospitals. These areas include management of positive blood cultures, management of patients in intensive care units (ICUs, hospital infection control and public health microbiology, development of hospital and community anti-infective policy, organization of clinical-microbiological meetings and provision of emergency out-of-hours service. The implementation of this clinical approach and increased engagement with direct patient care would require changes in existing training structure and working patterns of medical and technical staffs in microbiology.

  4. Clinical symptoms and laboratory findings supporting early diagnosis of Crimean-Congo hemorrhagic fever in Iran. (United States)

    Mostafavi, Ehsan; Pourhossein, Behzad; Chinikar, Sadegh


    Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic disease, which is usually transmitted to humans by tick bites or contact with blood or other infected tissues of livestock. Patients suffering from CCHF demonstrate an extensive spectrum of clinical symptoms. As it can take considerable time from suspecting the disease in hospital until reaching a definitive diagnosis in the laboratory, understanding the clinical symptoms and laboratory findings of CCHF patients is of paramount importance for clinicians. The data were collected from patients who were referred to the Laboratory of Arboviruses and Viral Hemorrhagic Fevers at the Pasteur institute of Iran with a primary diagnosis of CCHF between 1999 and 2012 and were assessed by molecular and serologic tests. Referred patients were divided into two groups: patients with a CCHF positive result and patients with a CCHF negative result. The laboratory and clinical findings of these two groups were then compared. Two-thousand five hundred thirty-six probable cases of CCHF were referred to the laboratory, of which 871 cases (34.3%) were confirmed to be CCHF. Contact with infected humans and animals increased the CCHF infection risk (P important role in patient survival and the application of the findings of this study can prove helpful as a key for early diagnosis.

  5. Bridging the gap between clinical failure and laboratory fracture strength tests using a fractographic approach

    NARCIS (Netherlands)

    Aboushelib, M.N.; Feilzer, A.J.; Kleverlaan, C.J.


    Objective: The aim of this study was to analyze and to compare the fracture type and the stress at failure of clinically fractured zirconia-based all ceramic restorations with that of morphologically similar replicas tested in a laboratory setup. Methods: Replicas of the same shape and dimensions we

  6. The value of clinical and laboratory diagnostics for chest pain patients at the emergency department

    NARCIS (Netherlands)

    Jellema, Laurens-Jan C.; Backus, Barbra E.; Six, A. Jacob; Braam, Richard; Groenemeijer, Bjorn; van der Zaag-Loonen, Hester J.; Tio, Rene; van Suijlen, Jeroen D. E.


    Background: The focus during the diagnostic process for patients with acute chest pain is to discriminate patients who can be safely discharged from those who are at risk for an acute coronary syndrome (ACS). In this study the diagnostic value of the clinical examination is compared with laboratory

  7. A typology of evidence based practice research heuristics for clinical laboratory science curricula. (United States)

    Leibach, Elizabeth K; Russell, Barbara L


    A typology of EBP research heuristics was defined relative to clinical laboratory science levels of practice. Research skills requisite for CLS baccalaureate level are associated mainly with quality control of analytic processes. Research skills at master's level are associated with pre- and post-analytic investigations, as well. Doctoral level CLS practice portends to utilize research skills facilitating quality investigations at the systems level.

  8. The role of liquid chromatography-tandem mass spectrometry in the clinical laboratory

    NARCIS (Netherlands)

    van den Ouweland, Johannes M. W.; Kema, Ido P.


    Liquid chromatography coupled to mass spectrometry (LC-MS/MS) is increasingly used as a routine methodology in clinical laboratories for the analysis of low molecular weight molecules. The high specificity in combination with high sensitivity and multi-analyte potential makes it an attractive comple

  9. 76 FR 38342 - Medicare Program; Clinical Laboratory Fee Schedule: Signature on Requisition (United States)


    ...; Clinical Laboratory Fee Schedule: Signature on Requisition AGENCY: Centers for Medicare & Medicaid Services... calendar year 2011 Physician Fee Schedule final rule with comment period that requires the signature of a... the prior policy that the signature of a physician or qualified non-physician practitioner is...

  10. Examination of the specific clinical symptoms and laboratory findings of Crimean-Congo hemorrhagic fever

    Directory of Open Access Journals (Sweden)

    Cetin Kilinc


    Interpretation & conclusion: It was inferred that certain clinical symptoms and laboratory findings such as fever, headache, widespread body pain, fatigue, leucopenia, nausea, vomiting, high CK levels, thrombocytopenia, AST/ ALT elevation and elevated LDH levels are highly specific and are required to be considered in the definitive diagnosis of CCHF, particularly in regions where this infection is observed as endemic.

  11. Magnetic resonance imaging of sacroiliitis in early seronegative spondylarthropathy. Abnormalities correlated to clinical and laboratory findings

    DEFF Research Database (Denmark)

    Puhakka, K B; Jurik, A G; Schiøttz-Christensen, Berit


    OBJECTIVE: To compare a new MRI scoring system of the sacroiliac joints (SIJs) in early spondylarthropathy (SpA) with clinical and laboratory parameters. METHODS: Forty-one patients (24 males, 17 females) with a median age of 26 yr and a median duration of inflammatory low back pain of 19 months...

  12. Clinical and laboratory findings of 97 pediatric brucellosis patients in central Turkey. (United States)

    Yoldas, Tamer; Tezer, Hasan; Ozkaya-Parlakay, Aslinur; Sayli, Tulin Revide


    Brucellosis is a disease transmitted to humans by consumption of unpasteurized animal milk, or through direct contact with infected animals. The aim of this study was to evaluate clinical, laboratory findings of pediatric patients with brucellosis. Data of 97 patients diagnosed with brucellosis between January 2000 and December 2010 were evaluated retrospectively.

  13. A FMEA clinical laboratory case study: how to make problems and improvements measurable. (United States)

    Capunzo, Mario; Cavallo, Pierpaolo; Boccia, Giovanni; Brunetti, Luigi; Pizzuti, Sante


    The authors have experimented the application of the Failure Mode and Effect Analysis (FMEA) technique in a clinical laboratory. FMEA technique allows: a) to evaluate and measure the hazards of a process malfunction, b) to decide where to execute improvement actions, and c) to measure the outcome of those actions. A small sample of analytes has been studied: there have been determined the causes of the possible malfunctions of the analytical process, calculating the risk probability index (RPI), with a value between 1 and 1,000. Only for the cases of RPI > 400, improvement actions have been implemented that allowed a reduction of RPI values between 25% to 70% with a costs increment of FMEA technique can be applied to the processes of a clinical laboratory, even if of small dimensions, and offers a high potential of improvement. Nevertheless, such activity needs a thorough planning because it is complex, even if the laboratory already operates an ISO 9000 Quality Management System.

  14. Anemia in inflammatory bowel disease: prevalence, differential diagnosis and association with clinical and laboratory variables

    Directory of Open Access Journals (Sweden)

    Rodrigo Andrade Alves

    Full Text Available CONTEXT AND OBJECTIVES:Anemia is the most frequent extraintestinal complication of inflammatory bowel disease. This study aimed to: 1 determine the prevalence of anemia among patients with inflammatory bowel disease; 2 investigate whether routine laboratory markers are useful for diagnosing anemia; and 3 evaluate whether any association exists between anemia and clinical/laboratory variables.DESIGN AND SETTING:Cross-sectional at a federal university.METHODS:44 outpatients with Crohn's disease and 55 with ulcerative colitis were evaluated. Clinical variables (disease activity index, location of disease and pharmacological treatment and laboratory variables (blood count, iron laboratory, vitamin B12 and folic acid were investigated.RESULTS:Anemia and/or iron laboratory disorders were present in 75% of the patients with Crohn's disease and in 78.2% with ulcerative colitis. Anemia was observed in 20.5% of the patients with Crohn's disease and in 23.6% with ulcerative colitis. Iron-deficiency anemia was highly prevalent in patients with Crohn's disease (69.6% and ulcerative colitis (76.7%. Anemia of chronic disease in combination with iron deficiency anemia was present in 3% of the patients with Crohn's disease and in 7% of the patients with ulcerative colitis. There was no association between anemia and disease location. In ulcerative colitis, anemia was associated with the disease activity index.CONCLUSIONS:Most patients present iron laboratory disorders, with or without anemia, mainly due to iron deficiency. The differential diagnosis between the two most prevalent types of anemia was made based on clinical data and routine laboratory tests. In ulcerative colitis, anemia was associated with the disease activity index.

  15. Detection of Cryptosporidium and Giardia in clinical laboratories in Europe--a comparative study. (United States)

    Manser, M; Granlund, M; Edwards, H; Saez, A; Petersen, E; Evengard, B; Chiodini, P


    To determine the routine diagnostic methods used and compare the performance in detection of oocysts of Cryptosporidium species and cysts of Giardia intestinalis in faecal samples by European specialist parasitology laboratories and European clinical laboratories. Two sets of seven formalin-preserved faecal samples, one containing cysts of Giardia intestinalis and the other, containing oocysts of Cryptosporidium, were sent to 18 laboratories. Participants were asked to examine the specimens using their routine protocol for detecting these parasites and state the method(s) used. Eighteen laboratories answered the questionnaire. For detection of Giardia, 16 of them used sedimentation/concentration followed by light microscopy. Using this technique the lower limit of detection of Giardia was 17.2 cysts/mL of faeces in the best performing laboratories. Only three of 16 laboratories used fluorescent-conjugated antibody-based microscopy. For detection of Cryptosporidium acid-fast staining was used by 14 of the 17 laboratories that examined the samples. With this technique the lower limit of detection was 976 oocysts/mL of faeces. Fluorescent-conjugated antibody-based microscopy was used by only five of the 17 laboratories. There was variation in the lower limit of detection of cysts of Giardia and oocysts of Cryptosporidium between laboratories using the same basic microscopic methods. Fluorescent-conjugated antibody-based microscopy was not superior to light microscopy under the conditions of this study. There is a need for a larger-scale multi-site comparison of the methods used for the diagnosis of these parasites and the development of a Europe-wide laboratory protocol based upon its findings.

  16. Instrumentation of Microscale Techniques for Biochemistry Teaching at FES Zaragoza, UNAM

    Directory of Open Access Journals (Sweden)

    Araceli García-del Valle


    Full Text Available Biochemistry teaching requires many laboratory sessions where theoretical knowledge may be put on test. At the same time, there is always some risk due to exposure to toxic materials, dangerous chemicals storage and waste disposal. Compliance with new regulations to prevent environmental contamination may also constitute a real hindrance for biochemistry teaching as experimental science. Therefore, we have designed microscale techniques, in order to reduce costs as well as the negative impact of laboratory practical sessions due to risk and environmental contamination. To develop microscale techniques does not only mean to reduce equipment size and amount of the reagents that are required for the usual experiments. Microscale techniques serve particularly well as a motivating approach to experimental biochemistry teaching that produces highly motivated students at the same time that requires minor costs, decreases working time, laboratory space, reagents volume and diminishes the generation of dangerous waste. We have demonstrated all these positive effects in biochemistry teaching and prompted the formal implementation of microscale techniques into the formal activities from the Cell and Tissue Biochemistry Laboratory I (BCT-I from the Chemistry, Pharmacy and Biology (QFB curricula at the National Autonomous University of Mexico (UNAM. First, we reviewed the BCT-I manual, choosing all the laboratory practices that might be microscaled. Then, we elaborated and validated all necessary protocols to analyse linearity, accuracy and reproducibility of the determinations, demonstrating that microscale techniques allow truthful results, comparable to full scale techniques.

  17. [Security Management in Clinical Laboratory Departments and Facilities: Current Status and Issues]. (United States)

    Ishida, Haku; Nakamura, Junji; Yoshida, Hiroshi; Koike, Masaru; Inoue, Yuji


    We conducted a questionnaire survey regarding the current activities for protecting patients' privacy and the security of information systems (IS) related to the clinical laboratory departments of university hospitals, certified training facilities for clinical laboratories, and general hospitals in Yamaguchi Prefecture. The response rate was 47% from 215 medical institutions, including three commercial clinical laboratory centers. The results showed that there were some differences in management activities among facilities with respect to continuing education, the documentation or regulation of operational management for paper records, electronic information, remaining samples, genetic testing, and laboratory information for secondary use. They were suggested to be caused by differences in functions between university and general hospitals, differences in the scale of hospitals, or whether or not hospitals have received accreditation or ISO 15189. Regarding the IS, although the majority of facilities had sufficiently employed the access control to IS, there was some room for improvement in the management of special cases such as VIPs and patients with HIV infection. Furthermore, there were issues regarding the login method for computers shared by multiple staff, the showing of the names of personnel in charge of reports, and the risks associated with direct connections to systems and the Internet and the use of portable media such as USB memory sticks. These results indicated that further efforts are necessary for each facility to continue self-assessment and make improvements.

  18. [The challenges of standardization in clinical diagnostic laboratories of medical organizations]. (United States)

    Men'shikov, V V


    The generalized data concerning the conditions of application of regulations of national standards in clinical diagnostic laboratories of medical organizations is presented. The primary information was provided by 14 regions of 6 federal administrative okrugs of Russia. The causes of challenges of application of requirements of standards are presented. They are mostly related with insufficient financial support, lacking of manpower, difficulties with reagents supply, inadequate technical maintenance of devices and absence of support of administration of medical organizations. The recommendations are formulated concerning the necessity of publishing the document of Minzdrav of Russia to determine the need in application of standards in laboratory practice.

  19. Clinical and Laboratory evaluation of measleslike rash in children and young adults

    Directory of Open Access Journals (Sweden)

    Stewien Klaus Eberhard


    Full Text Available A clinical and laboratory evaluation of 11 children and young adults with measleslike rash was done during the measles outbreak in the Greater São Paulo Metropolitan area at the end of 1996 and spread over the country during 1997. Measles was laboratory confirmed in 07 patients by specific IgM detection in acute serum specimens using an IgM-capture EIA, by specific IgG seroconversion in serum pairs, and by reverse transcription PCR and virus isolation in peripheral blood lymphocytes. Clinical presentations were not always classic; one of the 07 cases had received measles vaccine and corresponded to modified clinical case of measles. The 4 remaining cases were negative for measles and were diagnosed as exanthem subitum (2 cases, scarlet fever and Kawasaki disease. The present study reinforces the view that clinical features alone are not sufficient for establishing an accurate diagnosis in the post-vaccine era, and a surveillance system based on sensitive laboratory results is needed so that it can confirm IgM-negative measles cases.

  20. Autoverification in a core clinical chemistry laboratory at an academic medical center

    Directory of Open Access Journals (Sweden)

    Matthew D Krasowski


    Full Text Available Background: Autoverification is a process of using computer-based rules to verify clinical laboratory test results without manual intervention. To date, there is little published data on the use of autoverification over the course of years in a clinical laboratory. We describe the evolution and application of autoverification in an academic medical center clinical chemistry core laboratory. Subjects and Methods: At the institution of the study, autoverification developed from rudimentary rules in the laboratory information system (LIS to extensive and sophisticated rules mostly in middleware software. Rules incorporated decisions based on instrument error flags, interference indices, analytical measurement ranges (AMRs, delta checks, dilution protocols, results suggestive of compromised or contaminated specimens, and ′absurd′ (physiologically improbable values. Results: The autoverification rate for tests performed in the core clinical chemistry laboratory has increased over the course of 13 years from 40% to the current overall rate of 99.5%. A high percentage of critical values now autoverify. The highest rates of autoverification occurred with the most frequently ordered tests such as the basic metabolic panel (sodium, potassium, chloride, carbon dioxide, creatinine, blood urea nitrogen, calcium, glucose; 99.6%, albumin (99.8%, and alanine aminotransferase (99.7%. The lowest rates of autoverification occurred with some therapeutic drug levels (gentamicin, lithium, and methotrexate and with serum free light chains (kappa/lambda, mostly due to need for offline dilution and manual filing of results. Rules also caught very rare occurrences such as plasma albumin exceeding total protein (usually indicative of an error such as short sample or bubble that evaded detection and marked discrepancy between total bilirubin and the spectrophotometric icteric index (usually due to interference of the bilirubin assay by immunoglobulin (Ig M monoclonal

  1. [Management and accounting solution required in clinical laboratory department in the hospital and the balanced scorecard (BSC)]. (United States)

    Takahashi, Toshiro


    This is to describe required accounting knowledge and the techniques for the clinical laboratory department management level people to operate their division from the viewpoint of management. Especially, the necessity and the efficacy of the BSC implementation in the clinical laboratory department are being explained.

  2. Clinical and clinical laboratory correlates in sea otters dying unexpectedly in rehabilitation centers following the Exxon Valdez oil spill (United States)

    Rebar, A.H.; Lipscomb, T.P.; Harris, R.K.; Ballachey, B.E.


    Following the Exxon Valdez oil spill, 347 oiled sea otters (Enhydra lutris) were treated in rehabilitation centers. Of these, 116 died, 94 within 10 days of presentation. Clinical records of 21 otters dying during the first 10 days of rehabilitation were reviewed to define the laboratory abnormalities and clinical syndromes associated with these unexpected deaths. The most common terminal syndrome was shock characterized by hypothermia, lethargy, and often hemorrhagic diarrhea. In heavily and moderately oiled otters, shock developed within 48 hours of initial presentation, whereas in lightly oiled otters shock generally occurred during the second week of captivity. Accompanying laboratory abnormalities included leukopenia with increased numbers of immature neutrophils (degenerative left shift), lymphopenia, anemia, azotemia (primarily prerenal), hyperkalemia, hypoproteinemia/hypoalbuminemia, elevations of serum transaminases, and hypoglycemia. Shock associated with hemorrhagic diarrhea probably occurred either as a direct primary effect of oiling or as an indirect effect secondary to confinement and handling in the rehabilitation centers. Lightly oiled otters were less likely to die from shock than were heavily oiled otters (22% vs. 72%, respectively). Heavily oiled otters developed shock more rapidly and had greater numbers of laboratory abnormalities, suggesting that exposure to oil was an important contributing factor.

  3. Development of an internal dynamic web site to promote quality assurance in a clinical laboratory. (United States)

    Pernet, Pascal; Mario, Nathalie; Vaubourdolle, Michel


    In clinical laboratories, one challenging quality assurance objective is to maintain standardized practices. Meeting this objective entails ensuring information flow, which is necessary to smooth running of the laboratory. To facilitate information flow, we developed an internal quality Web site on our local network. The dynamic generated pages of the site were constructed with EasyPHP v.1.6, a complete freeware package providing PHP dynamic language and databases. The site comprises various sections: general news, specific laboratory units news, documents (quality manual, guidelines, emergency processes), schedules, National Quality Control results, forum, etc. Five to 10 pages are updated each week. This work was facilitated by the use of PHP-written pages and data tables, which enable us to record in real time the operation of our assurance quality project and to improve traceability. This approach could be extended to other aspects of quality management and could help meet the future IS015189 standard requirements.

  4. External quality assessment on detection of hepatitis C virus RNA in clinical laboratories of China

    Institute of Scientific and Technical Information of China (English)

    WANG Lu-nan; ZHANG Rui; SHEN Zi-yu; CHEN Wen-xiang; LI Jin-ming


    Background As with many studies carried out in European countries, a quality assurance program has been established by the National Center for Clinical Laboratories in China (NCCL). The results showed that the external quality assessment significantly improves laboratory performance for quantitative evaluation of hepatitis C virus (HCV) RNA.Methods Serum panels were delivered twice annuatly to the clinical laboratories which performed HCV RNA detection in China. Each panel made up of 5 coded samples. All laboratories were requested to carry out the detection within the required time period and report on testing results which contained qualitative and/or quantitative test findings, reagents used and relevant information about apparatus. All the positive samples were calibrated against the first International Standard for HCV RNA in a collaborative study and the range of comparison target value (TG) designated as ±0.5 log.Results The numbers of laboratories reporting on qualitative testing results for the first and second time external quality assessment were 168 and 167 in the year of 2003 and increased to 209 and 233 in 2007; the numbers of laboratories reporting on quantitative testing results were 134 and 147 in 2003 and rose to 340 and 339 in 2007. Deviation between the mean value for quantitative results at home in 2003 and the target value was above 0.5 log, which was comparatively high.By 2007, the target value was close to the national average except for the low concentrated specimens (103 IU/ml). The percentage of results within the range of GM±0.5 log10 varied from 8.2% to 93.5%. Some laboratories had some difficulties in the exact quantification of the lowest (3.00 log IU/ml) as well as of the highest viral levels (6.37 log IU/ml) values, very near to the limits of the dynamic range of the assays.Conclusions The comparison of these results with the previous study confirms that a regular participation in external quality assessment (EQA) assures the

  5. Utilizing Isolation, Purification, and Characterization of Enzymes as Project-Oriented Labs for Undergraduate Biochemistry (United States)

    Deal, S. Todd; Hurst, Michael O.


    Senior-level biochemistry labs are mostly verification-type laboratories with little chance for exploration. We have developed a project-based biochemistry laboratory which gives them a chance to carry out a major biochemistry project. In the first quarter it is based on the purification of the enzyme lysozyme. The students are given some basic information, and then work out the details of their own procedures, make up their own solutions, and work at their own pace. Students use centrifugation, ion-exchange chromatography, spectral enzyme assays, and SDS-gel electrophoresis to purify and characterize the protein. In the second quarter students are given acid phosphatase and the basic assay for the enzyme, and then develop and carry out a method for determining the kinetic parameters of the enzyme. These experiments continue the development of laboratory independence of the students which steadily progresses in most curriculum

  6. Dengue in children: a systematic review of clinical and laboratory factors associated with severity. (United States)

    Wakimoto, Mayumi Duarte; Camacho, Luiz Antonio Bastos; Guaraldo, Lusiele; Damasceno, Luana Santana; Brasil, Patrícia


    Dengue is a potentially life-threatening illness, and children are at higher risk of severity. This review aimed to systematize the identified clinical and laboratory parameters associated with severe dengue in children, as monitoring these signs and fluid-replacement therapy are actually the cornerstones of dengue treatment. Of the 527 studies initially reviewed, 21 were selected as follows: three cohort studies, three case-control studies, 14 cross-sectional studies and one not defined. Eighteen studies were carried out in Asia and three in the Americas. Hepatomegaly, lethargy, abdominal pain, bleeding, hemoconcentration and thrombocytopenia, all referenced as warning signs in the WHO 2009 Guidelines, were the clinical and laboratory parameters independently associated with severity in more than one study. The recognition of these known warning signs associated to severe dengue disease underlines the usefulness of the WHO 2009 classification.

  7. Using the e-Chasqui, web-based information system, to determine laboratory guidelines and data available to clinical staff. (United States)

    Blaya, Joaquin A; Yagui, Martin; Contreras, Carmen C; Palma, Betty; Shin, Sonya S; Yale, Gloria; Suarez, Carmen; Fraser, Hamish S F


    13% of all drug susceptibility tests (DSTs) performed at a public laboratory in Peru were duplicate. To determine reasons for duplicate requests an online survey was implemented in the e-Chasqui laboratory information system. Results showed that 59.6% of tests were ordered because clinical staff was unaware of ordering guidelines or of a previous result. This shows a benefit of using a web-based system and the lack of laboratory information available to clinical staff in Peru.

  8. Microbial contamination of removable prosthodontic appliances from laboratories and impact of clinical storage. (United States)

    Williams, D W; Chamary, N; Lewis, M A O; Milward, P J; McAndrew, R


    Decontamination of dental instruments has recently been the subject of considerable debate. However, little information is available on the potential bacterial colonisation of dental appliances returning from dental laboratories and their need for decontamination. This study investigated the extent and nature of microbial contamination of removable prosthodontic appliances produced at different dental laboratories and stored in two clinical teaching units (CTU 1 and CTU 2) of a dental hospital and school. Forty consecutive dental prosthodontic appliances that were being stored under varying conditions in the two clinical teaching units were selected for study; the appliances having been produced 'in-house' (hospital laboratory) or 'out-of-house' (external commercial laboratory). Two appliances, that were known to have undergone decontamination before storage, were used as controls. Swabs were taken according to a standard protocol and transferred to the microbiological laboratory with bacterial growth expressed as colony forming units (cfu) per cm(2). Microbial sampling yielded growth from 23 (58%) of the 40 appliances studied (CTU 1, n = 22; CTU 2, n = 18), with 38% of these having a high level of contamination (>42,000 cfu/cm(2)). The predominant bacteria isolated were Bacillus spp. (57%), pseudomonads (22%) and staphylococci (13%). Fungi of the genus Candida were detected in 38% of the samples. There was no significant difference in contamination of the appliances in relation to either their place of production or the CTU (p >0.05). However, the level of contamination was significantly higher (p = 0.035) for those appliances stored in plastic bag with fluid (n = 16) compared to those stored on models (n = 19). No growth was recovered from the two appliances that had undergone decontamination before storage. The research showed that appliances received from laboratories are often contaminated and therefore there is a need for routine disinfection of such items

  9. The European Register of Specialists in Clinical Chemistry and Laboratory Medicine: guide to the Register, version 3-2010.

    LENUS (Irish Health Repository)

    McMurray, Janet


    In 1997, the European Communities Confederation of Clinical Chemistry and Laboratory Medicine (EC4) set up a Register for European Specialists in Clinical Chemistry and Laboratory Medicine. The operation of the Register is undertaken by a Register Commission (EC4RC). During the last 12 years, more than 2200 specialists in Clinical Chemistry and Laboratory Medicine have joined the Register. In 2007, EC4 merged with the Forum of European Societies of Clinical Chemistry and Laboratory Medicine (FESCC) to form the European Federation of Clinical Chemistry and Laboratory Medicine (EFCC). Two previous Guides to the Register have been published, one in 1997 and another in 2003. The third version of the Guide is presented in this article and is based on the experience gained and development of the profession since the last revision. Registration is valid for 5 years and the procedure and criteria for re-registration are presented as an Appendix at the end of the article.

  10. The European Register of Specialists in Clinical Chemistry and Laboratory Medicine: Code of Conduct, Version 2--2008.

    LENUS (Irish Health Repository)

    McMurray, Janet


    In 1997, the European Communities Confederation of Clinical Chemistry and Laboratory Medicine (EC4) set up a Register for European Specialists in Clinical Chemistry and Laboratory Medicine. The operation of the Register is undertaken by a Register Commission (EC4RC). During the last 10 years, more than 2000 specialists in Clinical Chemistry and Laboratory Medicine have joined the Register. In 2007, EC4 merged with the Federation of European Societies of Clinical Chemistry and Laboratory Medicine (FESCC) to form the European Federation of Clinical Chemistry and Laboratory Medicine (EFCC). A Code of Conduct was adopted in 2003 and a revised and updated version, taking account particularly of the guidelines of the Conseil Européen des Professions Libérales (CEPLIS) of which EFCC is a member, is presented in this article. The revised version was approved by the EC4 Register Commission and by the EFCC Executive Board in Paris on 6 November, 2008.

  11. Role of the clinical pathology laboratory in the evaluation of endometrial carcinomas for Lynch syndrome. (United States)

    Djordjevic, Bojana; Broaddus, Russell R


    Molecular diagnostic testing of endometrial carcinomas in the pathology laboratory has recently emerged as a key component of the clinical evaluation of Lynch syndrome in many centers. Testing modalities involve immunohistochemical and PCR-based analyses. This article outlines the routine application of these analyses, provides a practical guide for troubleshooting some of the common technical issues related to their performance, and reviews common pitfalls in their interpretation. Discrepancies between tissue testing and genetic testing results are discussed in the context of the current understanding of endometrial cancer biology. The merits of universal versus targeted tissue testing based on clinical patient history and histological tumor appearance are also addressed.

  12. Evaluation of Vitek 2 for identification of yeasts in the clinical laboratory. (United States)

    Meurman, O; Koskensalo, A; Rantakokko-Jalava, K


    The Vitek 2 system was compared with conventional assimilation, fermentation and morphological methods for its ability to identify yeast isolates from among 151 clinical specimens and 16 known type culture or quality control strains. An unequivocal identification was obtained for 155 (92.8%) isolates, with low discrimination for nine (5.4%) and false identification for three (1.8%) isolates. All isolates of Candida albicans, Candida glabrata and Candida krusei were identified correctly. It was concluded that the Vitek 2 system offers an excellent alternative for the identification of yeasts in a clinical laboratory.

  13. Laboratory evaluation of the Beckman Synchron CX3 clinical chemistry analyzer. (United States)

    Peake, M J; Pejakovic, M; White, G H


    In this evaluation of the Beckman Synchron CX3, the multi-analyte clinical chemistry analyzer exhibited high precision, good linearity, and no carryover for each of the eight analytes measured. Results obtained correlated well with those produced by our routine instrumentation (Beckman Astra, Varian atomic absorption spectrophotometer). The instrument can process up to 75 samples per hour (600 tests per hour if all tests available are requested) and, after calibration, can provide urgent results for the complete panel of tests within 2 1/2 min. The performance characteristics of this instrument make it ideal as a routine or a "stat" analyzer for commonly requested tests in the clinical chemistry laboratory.

  14. EFLM WG-Preanalytical phase opinion paper: local validation of blood collection tubes in clinical laboratories. (United States)

    Lippi, Giuseppe; Cornes, Michael P; Grankvist, Kjell; Nybo, Mads; Simundic, Ana-Maria


    The selection or procurement of blood collection devices in healthcare facilities is often an underestimated issue. This is probably due to different factors including the lack of knowledge of policymakers, hospital administrators and even laboratory managers about the importance of preanalytical quality and phlebotomy process, as well as to the absence of reliable guidelines or recommendations on how to precisely assess the quality of blood collection devices around the globe. With the awareness that a gap remains between manufacturers' and local validation of blood collection devices, the Working Group for Preanalytical Phase (WG-PRE) of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) has drafted a consensus document aimed to provide a set of essential requisites, technical criteria (e.g. presence of physical defects, malfunctioning, safety problems) and clinical issues for supporting laboratory professionals in organization blood collection tubes tenders and validating new devices before local routine implementation. The laboratory professionals should also make sure that the tenders accurately and strictly define the responsibilities for validation experiments and the potential consequences in the case the validation outcome shows that tubes due not fulfill the expectations.

  15. Impact of sonography in gouty arthritis: Comparison with conventional radiography, clinical examination, and laboratory findings

    Energy Technology Data Exchange (ETDEWEB)

    Schueller-Weidekamm, Claudia [Department of Diagnostic Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)]. E-mail:; Schueller, Gerd [Department of Diagnostic Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Aringer, Martin [Department of Rheumatology, Internal Medicine III, Medical University of Vienna (Austria); Weber, Michael [Department of Diagnostic Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Kainberger, Franz [Department of Diagnostic Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)


    Objective: To explore the typical sonographic features of gray-scale and Power Doppler of acute and chronic gouty arthritis in conjunction with radiographic, clinical, and laboratory findings. Materials and methods: All hand, finger, and toe joints of 19 patients with acute and chronic gout were examined with gray-scale and Power Doppler sonography. The number and size of bone changes detected with sonography was compared to radiographic findings. Vascularization of the synovial tissue was scored on Power Doppler (grades 0-3), and was compared with clinical appearance, including swelling, tenderness, and redness (grades 0-3). Results: In acute gout, mild to moderate echogenic periarticular nodules with sonotransmission and hypervascularization of the edematous surrounding soft tissue were found. In chronic gout, tophaceous nodules completely blocked transmission of US wave, leading to strong reflexion and dorsal shadowing in a minority of cases. No significant difference in the detection of large bone changes (>2 mm) was found between sonography and radiography. However, gray-scale sonography was significantly more sensitive in the detection of small bone changes (p < 0.001). Power Doppler scores were statistically significantly higher than clinical examination scores (p < 0.001). Discussion: Sonography is superior to radiographs in evaluating small bone changes. The inflammatory process in joints can be better detected with Power Doppler sonography than with clinical examination. Typical sonographic appearance of acute and in particular of chronic gout might provide clues on gouty arthritis that adds to the information available from conventional radiography, clinical, and laboratory findings.

  16. Epidemiologival, clinical, pathological and laboratory findings of botulism in cattle in the State of Santa Catarina


    Luciane Orbem Veronezi


    The study was carried out through the epidemiological, clinical, pathological and laboratory findings of botulism in cattle in the state of Santa Catarina, during the period from 1987 to 2008. The data were obtained through information from the files of the Department of Animal Pathology CAV/UDESC and in the properties which the disease continued to occur. In properties with the botulism associated phosphorus deficiency cattle, the animals were kept on native pastures, in most ...

  17. The laboratory of clinical virology in monitoring patients undergoing monoclonal antibody therapy. (United States)

    Cavallo, R


    The relevant efficacy of monoclonal antibodies (mAbs) has resulted in the successful treatment of several diseases, although susceptibility to infections remains a major problem. This review summarizes aspects of the literature regarding viral infections and mAbs, specifically addressing the risk of infection/reactivation, the measures that can reduce this risk, and the role played by the laboratory of clinical virology in monitoring patients undergoing mAb therapy.

  18. The EC4 European syllabus for post-graduate training in clinical chemistry and laboratory medicine

    DEFF Research Database (Denmark)

    Wieringa, Gijsbert; Zerah, Simone; Jansen, Rob


    Laboratory medicine's practitioners across the European community include medical, scientific and pharmacy trained specialists whose contributions to health and healthcare is in the application of diagnostic tests for screening and early detection of disease, differential diagnosis, monitoring...... in translating knowledge and skills into ability to practice. In a 'Specialist knowledge' division, the expectations from the individual disciplines of Clinical Chemistry/Immunology, Haematology/Blood Transfusion, Microbiology/ Virology, Genetics and In Vitro Fertilisation are described. Beyond providing...

  19. MODULAR ANALYTICS: A New Approach to Automation in the Clinical Laboratory


    Horowitz, Gary L.; Zaman, Zahur; Blanckaert, Norbert J. C.; Chan, Daniel W.; Dubois, Jeffrey A.; Golaz, Olivier; Mensi, Noury; Keller, Franz; Stolz, Herbert; Klingler, Karl; Marocchi, Alessandro; Prencipe, Lorenzo; McLawhon, Ronald W.; Nilsen, Olaug L.; Oellerich, Michael


    MODULAR ANALYTICS (Roche Diagnostics) (MODULAR ANALYTICS, Elecsys and Cobas Integra are trademarks of a member of the Roche Group) represents a new approach to automation for the clinical chemistry laboratory. It consists of a control unit, a core unit with a bidirectional multitrack rack transportation system, and three distinct kinds of analytical modules: an ISE module, a P800 module (44 photometric tests, throughput of up to 800 tests/h), and a D2400 module (16 photometric tests, throughp...

  20. Does breast feeding influence liver biochemistry?

    DEFF Research Database (Denmark)

    Jørgensen, Marianne Hørby; Ott, Peter; Juul, Anders;


    It is assumed that early feeding can affect liver biochemistry because breast-fed infants have a higher risk of hyperbilirubinemia than formula-fed infants. The authors sought to determine how feeding mode affected liver biochemistry in healthy term infants....

  1. Teaching Biochemistry Online at Oregon State University (United States)

    Ahern, Kevin


    A strategy for growing online biochemistry courses is presented based on successes in ecampus at Oregon State University. Four free drawing cards were key to the effort--YouTube videos, iTunes U online free course content, an Open Educational Resource textbook--Biochemistry Free and Easy, and a fun set of educational songs known as the Metabolic…

  2. Laboratory-based surveillance in the molecular era: the TYPENED model, a joint data-sharing platform for clinical and public health laboratories. (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


    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.

  3. [The clinical immunology laboratory in diagnosis and monitoring of systemic lupus erythematosus and connective tissue diseases]. (United States)

    Sinico, R A; Radice, A


    The laboratory and particularly clinical immunology laboratories have an essential role in diagnosing and monitoring systemic lupus erythematosus (SLE), as well as other connective tissue diseases. The role of the clinical immunology laboratory in these diseases is to confirm or exclude diagnosis, to monitor disease activity, and to identify subgroup of patients. To obtain the best results in terms of diagnostic performance and clinical usefulness, the following recommendations should be fulfilled: anti-nuclear antibodies (ANA) determination by indirect immunofluorescence on Hep-2 cells is an effective screening assay in patients with clinical features of SLE. A negative ANA test makes the diagnosis of SLE unlikely. Anti-dsDNA antibodies are highly specific for SLE and are associated with renal involvement. The method of choice for anti-dsDNA is the Farr assay; however, the necessity of using radioactive materials reduces its applicability. As an alternative, immunofluorescence on Crithidia Luciliae can be used in the diagnostic phase due to its high specificity. The detection of antibodies to extractable nuclear antigens (ENA) and to phospholipids (lupus anticoagulant and anti-cardiolipin antibodies) is useful in identifying subgroups of patients at risk for some clinical manifestations. Anti-dsDNA measurement with a quantitative assay (the Farr assay or ELISA) is currently the best method to monitor disease activity along with complement levels. New assays (anti-C1q and anti-nucleosome antibodies) have been recently proposed for the diagnosis (anti-nucleosome) and monitoring of SLE patients (anti-C1q and anti-nucleosome antibodies), with promising results.

  4. Clinical and Laboratory Presentation of Hairy Cell Leukemia (Hcl and Rate of Response to Cladribine

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    M Forat Yazdi


    Full Text Available Introduction: HCL is a rare malignant condition that is curable if diagnosed early. HCL can present with reduced blood cells and splenomegaly which maybe misdiagnosed with other conditions. The aim of the present study was to determine the frequency of early clinical and laboratory findings as well as the response rate of patients to the standard treatment regimen of Cladribine. Methods: The study was an uncontrolled clinical trial including 25 HCL patients referring to Oncology Clinics of Shahid Sadoughi (Yazd - Iran and Shahid Beheshti (Tehran - Iran between 1999 and 2005. Data was gathered by a pre–designed questionnaire. 21 out of 25 patients were treated with Cladribine and the clinical and laboratory response was assessed. Results: Of the 25 patients studied, 20 patients (80% were male and 5 patients (20% were female. Most of the patients at diagnosis were 55–67 years old and the most common presenting symptom was fatigue and lassitude secondary to anemia. Two patients were asymptomatic and were diagnosed incidentally. Splenomegaly was the main clinical finding which was present in about 80% of the males and all of the females. Accordingly, hairy cells in the peripheral blood smear, leukopenia and anemia were the most common laboratory findings. In contrast to previous results, pancytopenia was found in only 60% of the patients. Response rate was 90% (19 out of 21 of which 61.9% (13 patients and 28.5% (6 patients had complete remission (CR and partial remission (PR, respectively. Conclusion: According to the results, it can be concluded that HCL should be considered as a possible diagnosis in the context of fatigue, splenomegaly and reduced blood cell count. The results of the present study were similar to other similar international studies.

  5. Variability of Creatinine Measurements in Clinical Laboratories: Results from the CRIC Study (United States)

    Joffe, Marshall; Hsu, Chi-yuan; Feldman, Harold I.; Weir, Matthew; Landis, J.R.; Hamm, L. Lee


    across laboratories necessitates calibration of SCr measures to a common standard. Failing to do so may substantially affect study eligibility and clinical interpretations when they are determined by Cr-based estimates of GFR. PMID:20389058

  6. Symposium 19: The contributions of the Department of Biochemistry/USP towards Biochemistry teaching

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    Bayardo Baptista Torres


    Full Text Available K-Education(Portuguese Chair: V. Trindade Bayardo Torres; Clovis Wannmacher; Denise MacedoThe contributions of the Department of Biochemistry/USP towards Biochemistry teaching.O ensino de Bioquímica nos últimos 20 anosBayardo B. TorresDepartamento de Bioquímica, Instituto de Química, USP. São Paulo, Brazil.Among the contributions of the Department of Biochemistry/USP one must recall:1. Winter school for graduate studentsThis course, now at the ninth edition, is intended for students in the final stage of their Masters or PhD in Biochemistry or related areas from any institution of higher education.Modern and important techniques are offered as possible support to help the student’s projects.2. Summer courses for undergraduate studentsThe Department offers every year, since 1999, complementary courses for undergraduate students to extend their knowledge in biochemical subjects not ordinarily treated in introductory courses. Some examples:Plant Molecular Biology, Biochemistry and Diseases, Biochemistry of Mind, Biochemistry of Ageing, Cancer Biochemistry, Nutrition and Sports, Biochemistry of Beauty, Biochemistry of the Envenomation Response, etc.3. Summer courses for high school teachers. Some examples:Biochemistry of Nutrition, DNA – Techniques and Applications, Biochemistry in the kitchen.4. Software developmentMany software for biochemistry teaching/learning were developed and are freely available at the Biblioteca Digital de Ciências []. Some examples:Oxygen consumption by mitochondria, Muscle contraction, Electron transport chain and oxidative phosphorylation, Free radicals, Enzyme kinetics, cAMP signalization, Interactive study of protein structure, Leptin, Insulin and Obesity.5. A Biochemistry textbook. 

  7. Simple clinical and laboratory predictors of Chikungunya versus dengue infections in adults.

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    Vernon J Lee

    Full Text Available BACKGROUND: Dengue and chikungunya are co-circulating vector-borne diseases with substantial overlap in clinical presentations. It is important to differentiate between them during first presentation as their management, especially for dengue hemorrhagic fever (DHF, is different. This study compares their clinical presentation in Singapore adults to derive predictors to assist doctors in diagnostic decision-making. METHODS: We compared 117 patients with chikungunya infection diagnosed with reverse transcription-polymerase chain reaction (RT-PCR with 917 dengue RT-PCR-positive adult patients (including 55 with DHF. We compared dengue fever (DF, DHF, and chikungunya infections by evaluating clinical characteristics of dengue and chikungunya; developing classification tools via multivariate logistic regression models and classification trees of disease etiology using clinical and laboratory factors; and assessing the time course of several clinical variables. FINDINGS: At first presentation to hospital, significantly more chikungunya patients had myalgia or arthralgia, and fewer had a sore throat, cough (for DF, nausea, vomiting, diarrhea, abdominal pain, anorexia or tachycardia than DF or DHF patients. From the decision trees, platelets <118 × 10(9/L was the only distinguishing feature for DF versus chikungunya with an overall correct classification of 89%. For DHF versus chikungunya using platelets <100 × 10(9/L and the presence of bleeding, the overall correct classification was 98%. The time course analysis supported platelet count as the key distinguishing variable. INTERPRETATION: There is substantial overlap in clinical presentation between dengue and chikungunya infections, but simple clinical and laboratory variables can predict these infections at presentation for appropriate management.

  8. An Undergraduate Laboratory Experiment for Upper-Level Forensic Science, Biochemistry, or Molecular Biology Courses: Human DNA Amplification Using STR Single Locus Primers by Real-Time PCR with SYBR Green Detection (United States)

    Elkins, Kelly M.; Kadunc, Raelynn E.


    In this laboratory experiment, real-time polymerase chain reaction (real-time PCR) was conducted using published human TPOX single-locus DNA primers for validation and various student-designed short tandem repeat (STR) primers for Combined DNA Index System (CODIS) loci. SYBR Green was used to detect the amplification of the expected amplicons. The…

  9. 50th anniversary of Clinical Chemistry and Laboratory Medicine--a historical overview. (United States)

    Körber, Friedrich; Plebani, Mario


    In the early 1960s, Joachim Brugsch, one of the founders of Clinical Chemistry and Laboratory Medicine (CCLM) (then Zeitschrift für Klinische Chemie), had the idea to found a journal in the upcoming field of clinical chemistry. He approached Ernst Schütte, who was associated with the De Gruyter publishing house through another journal, to participate, and Schütte thus became the second founder of this Journal. The aim was to create a vehicle allowing the experts to express their opinions and raise their voices more clearly than they could in a journal that publishes only original experimental papers, a laborious and difficult, but important endeavor, as the profession of clinical chemistry was still in the early stages of development at this time. The first issue of this Journal was published in early 1963, and today, we are proud to celebrate the 50th anniversary of CCLM. This review describes the development of this Journal in light of the political situation of the time when it was founded, the situation of the publisher Walter De Gruyter after the erection of the Berlin Wall, and the development of clinical chemistry, and later on, laboratory medicine as a well-acknowledged discipline and profession.

  10. Measurement of cholesterol and other lipoprotein constituents in the clinical laboratory. (United States)

    Warnick, G R


    Measurements of lipids and lipoproteins in the clinical laboratory have become increasingly important because of their predictive association with cardiovascular diseases, especially coronary artery disease. The US National Institutes of Health-sponsored National Cholesterol Education Program and counterparts in other countries have developed national consensus guidelines for diagnosis and treatment of coronary artery disease which provide risk cut-points and define use of the lipid/lipoprotein analytes in case finding and therapy. Total and low density lipoprotein cholesterol and triglycerides are measured as positive risk factors and high density lipoprotein cholesterol as an inverse risk factor for coronary artery disease. A National Cholesterol Education Program-sponsored expert laboratory panel has developed guidelines for measurements with requisite analytical performance targets for total error and corresponding precision and bias. The US Centers for Disease Control and Prevention have established reference methods for total and high density lipoprotein cholesterol and for triglycerides, with a method for low density lipoprotein cholesterol in development. Standardization programs for research laboratories and a Cholesterol Reference Method Laboratory Network for diagnostic manufacturers and clinical laboratories provide reliable access and documentation of traceability to accepted reference methods. Methods for the lipid/lipoprotein analytes have improved dramatically in recent years and, coupled with improved chemistry analyzer systems and more attention to standardization by manufacturers, offer considerable improvement in analytical performance. Fully automated homogeneous assays for high density lipoprotein cholesterol and newer similar assays for low-density lipoprotein cholesterol have potential for better precision as well as more convenient and cost-effective measurements. Attention to pre-analytical sources of variation is also important in making

  11. [Histological view of ethics in medicine and handling of residual samples in clinical laboratories]. (United States)

    Yoshida, Hiroshi


    One of the important ethical issues in clinical laboratory medicine is whether organs and/or specimens should belong to the examinees. Tracing back to ancient Greece, an episode of the death of Asklepios, killed by Zeus to revive the dead, and the great contribution of Hippocrates to medicine including the vow and ethics of medicine, have been described. In the relationship between doctors and patients, the former had been superior to the latter for more than 2400 years, however, the situation has been changing from that to the same position since 1960th, along with the development of bioethics from medical ethics. For the promotion of bioethics, world medical associations have contributed declarations and continuous discussion. The declarations are based on the avoidance of actions detrimental to the life, health, privacy or dignity of examinees. On the medical use of human organs and specimens in relation to human rights, the mind and the body, discussion has continued, however, a consensus on the details has not been reached. A view on the use of residual samples for methodological study, teaching and research in the clinical laboratory was proposed by the Japanese Society of Laboratory Medicine in 2002. Briefly, it included confidentiality of the laboratory staff, responsibility of the laboratory director, the absence of a necessity to obtain consent for the use of residual samples for methodological study when they are made anonymous or pooled, and the recommendation to obtain a judgement by an ethics committee for research use. The background and discussion for the proposal and the current situation on how to obtain consent from patients in Japan are mentioned.

  12. Redox biochemistry of hydrogen sulfide. (United States)

    Kabil, Omer; Banerjee, Ruma


    H(2)S, the most recently discovered gasotransmitter, might in fact be the evolutionary matriarch of this family, being both ancient and highly reduced. Disruption of gamma-cystathionase in mice leads to cardiovascular dysfunction and marked hypertension, suggesting a key role for this enzyme in H(2)S production in the vasculature. However, patients with inherited deficiency in gamma-cystathionase apparently do not present vascular pathology. A mitochondrial pathway disposes sulfide and couples it to oxidative phosphorylation while also exposing cytochrome c oxidase to this metabolic poison. This report focuses on the biochemistry of H(2)S biogenesis and clearance, on the molecular mechanisms of its action, and on its varied biological effects.

  13. Study on fatty liver diagnosed by abdominal ultrasonography and clinical laboratory findings

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    Yang, Jeong Hwa [Cheju Halla College, Cheju (Korea, Republic of)


    The study obtained the following conclusions by making a comparative study on fatty liver diagnosed by abdominal ultrasonography and clinical laboratory findings. I surveyed the value of abdominal ultrasound in 400 patients without clinical symptoms at C Health Clinic Center, Seoul. Compare with blood pressure was high (systolic/diastolic) in 7.5%/4.5% on persons who were diagnosed fatty liver. At the time of the diagnosis, Total cholesterol level was increased in fatty liver patients, HDL-cholesterol level was high in fatty liver patients. And Trigryceride level was increased in fatty liver persons, LDL-cholesterol was high in fatty liver persons. SGOT level was increased in 5.5% on patients who were diagnosed fatty liver, 0% on persons who were normal and SGPT level was high in 29.5% on people who were diagnosed fatty liver, 0% on patients who were diagnosed normal.



    A.D. Sialakouma; Palmer, G A; M. Botsaki; X. Papanikou; N.M. Vaxevanidis


    Biomedical science is a sensitive discipline and presents unique challenges due to its social character, continuous development and competitiveness. The issue of quality management systems and accreditation is gaining increasing interest in this sector. All over Europe, Health Services Units have started to introduce quality management systems and harmonization of criteria for accreditation is of increasing importance. Moreover, clinical laboratories, like the Assisted Reproduction laboratori...

  15. Three cases of CLIPPERS: a serial clinical, laboratory and MRI follow-up study. (United States)

    Kastrup, O; van de Nes, J; Gasser, T; Keyvani, K


    The aim of the study was to further determine the pathophysiology, clinical course, MRI-features and response to therapy of chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS), which has recently been proposed as a rare chronic inflammatory central nervous system disorder responsive to immunosuppressive therapy. Three patients with this rare entity underwent serial clinical and bimonthly MRI follow-up over a period of up to 16 months. Extensive laboratory work-up and brain biopsy were performed. Intravenous methylprednisolone or oral dexamethasone was administered as treatment, additionally cyclophosphamide in one patient. Clinically, diplopia, nystagmus, ataxia and facial paresthesia were the cardinal symptoms. Magnetic resonance imaging (MRI) disclosed patchy spot-like gadolinium enhancement in a "salt-and-pepper like appearance" in the pons, midbrain and cerebellum, in two cases with thalamic and in the other with spinal involvement. Brain biopsies demonstrated a predominantly angiocentric but also diffuse infiltration pattern by small mature lymphocytes. Treatment with steroids led to rapid clinical improvement and marked resolution of MRI lesions. As discontinuation of steroids led to clinical relapse, one patient was treated with a further course of steroids and the other with steroids and cyclophosphamide as immunosuppressive therapy. This led to stable remission with only mild clinical residue and normalization of MRI. Extensive laboratory and radiological work-up could not identify any other cause of the disease. Of note, in two cases a marked elevation of IgE in serum was found initially and throughout the course. CLIPPERS seems to be a distinct inflammatory central nervous system disorder. It shows characteristic MRI core features. Extrapontine involvement seems to be frequent. Histologically it is characterised by predominantly angiocentric infiltration by small mature lymphocytes. A pathogenetic

  16. Clinical, laboratory and ultrasonographic findings in Egyptian buffalo (Bubalus bubalis with caecal and colonic dilatation

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    Arafat Khalphallah


    Full Text Available The present study was conducted to describe the clinical, laboratory and ultrasonographic findings of caecal and colonic dilatation in Egyptian buffalo (Bubalus bubalis. A total number of forty buffaloes were included in the study and divided into two groups: control group (n = 20 and diseased group (n = 20. Diseased buffalo were admitted to the Veterinary Teaching Hospital at Assiut University-Egypt. Each of the diseased animals was subjected to clinical, rectal, laboratory and ultrasonographic examinations. Clinically, buffalo with dilated caecum/colon showed reduced appetite, distended right abdomen, abdominal pain and tensed abdomen. Rectal examination indicated empty rectum with the presence of mucus and dilated loop of caecum and/or colon. Buffalo with dilated caecum/colon showed significant (P < 0.05 hypoproteinemia and hypoalbuminemia with significant (P < 0.05 increase in blood serum activities of aspartate aminotransferase (AST and alkaline phosphatase (ALK. Ultrasonographically, the dilated caecum and proximal loop of colon occupied the last right three intercostal space (ICSs particularly their ventral part, intertangled with the liver dorsally in these ICSs. Dilated colon did not hinder the visibility of the liver. The dilated caecum/colon also filled the whole right flank region, with hiding of right kidney, loops and peristaltic movement of the small intestines. The closest wall of the dilated caecum and proximal loop of the colon was imaged as thick semi-circular echogenic line. The furthest wall and contents of dilated caecum/colon were not imaged. In conclusion, buffalo with caecal and/or colonic dilatation have non-specific clinical and laboratory findings; however the affected animals show characteristic ultrasonographic findings.

  17. Time study of clinical and nonclinical workload in pathology and laboratory medicine. (United States)

    Trotter, Martin J; Larsen, Erik T; Tait, Nicholas; Wright, James R


    We describe a detailed, cross-sectional, self-report time study of laboratory physician tasks in a regionalized, multisite academic setting, using custom data collection templates programmed into personal digital assistants (PDAs). The 7-week study was completed by 56 medical and scientific staff (86% participation rate). Participants recorded 12,781 PDA entries of specific tasks completed during the study period. The mean number of entries per worked day per participant was 8.14 (range, 1.96-14.33). Study results demonstrated that professional staff worked, on average, 53.5 hours per week. Percentage work time spent in each activity area was as follows: clinical, direct, 50.6%; administration, 18.5%; clinical, indirect, 9.5%; research, 8.2%; learning/continuing education, 5.3%; teaching, 4.9%; and quality assurance, 3.1%. These percentages varied significantly by laboratory medicine subspecialty and by type of academic appointment. The findings confirm that activities not directly involved with patient care, such as administration, quality assurance, teaching, research, and professional development, typically occupy 40% to 50% of a laboratory physician's time.

  18. Hypereosinophilic syndrome: Clinical, laboratory, and imaging manifestations in patients with hepatic involvement

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    Kim, Gi Beom; Lee, Jong Min; Sung, Yeong Soon; Kang, Duk Sik [Kyungpook Natioanl University College of Medicine, Daegu (Korea, Republic of); Kim, Ok Hwoa [Dongkang general Hospital, Ulsan (Korea, Republic of)


    The hypereosinophilic syndrome (HES) commonly involves liver and spleen but only a few literature has reported the imaging features. In this article, we present the imaging features of the liver and spleen in HES patients together with clinical and laboratory features. This study included 5 HES patients with hepatic involvement. Extensive laboratory tests including multiple hematologic, serologic, parasitological, and immunologic examinations were performed. Imaging studies included CT, ultrasound (US)of upper abdomen and hepatosplenic scintigraphy. All patients were periodically examined by laboratory and imaging studies for 4 to 24 months. The common clinical presentations were weakness, mild fever, and dry cough. All patients revealed leukocytosis with eosinophilia of 40 to 80% and benign eosinophilic hyperplasia of the bone marrow. The percutaneous biopsy of the hepatic focal lesions performed in 2 patients showed numerous benigin eosinophilic infiltrates and one of them revealed combined calibration necrosis of hepatocytes. All cases revealed hepatomegaly with multiple focal lesions on at least on of CT, US, or scintigraphy. These findings completely disappeared in 2 to 6 months following medication of corticosteroid or antihistamines. The HES involved the liver and CT, US, or scintigraphic studies showed hepatic multifocal lesions with hepatomegaly. Differential diagnosis of these findings should include metastatic disease, lymphoma, leukemia, candidiasis or other opportunistic infections.

  19. Searching for Alien Life Having Unearthly Biochemistry (United States)

    Jones, Harry


    The search for alien life in the solar system should include exploring unearth-like environments for life having an unearthly biochemistry. We expect alien life to conform to the same basic chemical and ecological constraints as terrestrial life, since inorganic chemistry and the laws of ecosystems appear to be universal. Astrobiologists usually assume alien life will use familiar terrestrial biochemistry and therefore hope to find alien life by searching near water or by supplying hydrocarbons. The assumption that alien life is likely to be based on carbon and water is traditional and plausible. It justifies high priority for missions to search for alien life on Mars and Europa, but it unduly restricts the search for alien life. Terrestrial carbon-water biochemistry is not possible on most of the bodies of our solar system, but all alien life is not necessarily based on terrestrial biochemistry. If alien life has a separate origin from Earth life, and if can survive in an environment extremely different from Earth's, then alien life may have unearthly biochemistry. There may be other solvents than water that support alien life and other elements than carbon that form complex life enabling chain molecules. Rather than making the exploration-restricting assumption that all life requires carbon, water, and terrestrial biochemistry, we should make the exploration-friendly assumption that indigenous, environmentally adapted, alien life forms might flourish using unearthly biochemistry in many places in the solar system. Alien life might be found wherever there is free energy and a physical/chemical system capable of using that energy to build living structures. Alien life may be discovered by the detection of some general non-equilibrium chemistry rather than of terrestrial biochemistry. We should explore all the potential abodes of life in the solar system, including those where life based on terrestrial biochemistry can not exist.

  20. In memory of Professor Leonor Michaelis in Nagoya: great contributions to biochemistry in Japan in the first half of the 20th century. (United States)

    Nagatsu, Toshiharu Toshi


    Leonor Michaelis spent the years of 1922-1926 as Professor of Biochemistry of the Aichi Medical College (now Graduate School of Medicine, Nagoya University) in Nagoya, Japan. Michaelis succeeded in gathering many bright young biochemists from all over Japan into his laboratory, and made tremendous contributions to the promotion of biochemistry in Japan. Michaelis was invited to many places in Japan to present lectures over those years. Kunio Yagi, who was Professor of Biochemistry at Nagoya University in the second half of the 20th century, succeeded in crystallizing the "Michaelis" enzyme-substrate complex. Historically, Michelis has had an enormous impact on biochemistry in Japan.

  1. MALDI-TOF mass spectrometry in the clinical mycology laboratory: identification of fungi and beyond. (United States)

    Posteraro, Brunella; De Carolis, Elena; Vella, Antonietta; Sanguinetti, Maurizio


    MALDI-TOF mass spectrometry (MS) is becoming essential in most clinical microbiology laboratories throughout the world. Its successful use is mainly attributable to the low operational costs, the universality and flexibility of detection, as well as the specificity and speed of analysis. Based on characteristic protein spectra obtained from intact cells - by means of simple, rapid and reproducible preanalytical and analytical protocols - MALDI-TOF MS allows a highly discriminatory identification of yeasts and filamentous fungi starting from colonies. Whenever used early, direct identification of yeasts from positive blood cultures has the potential to greatly shorten turnaround times and to improve laboratory diagnosis of fungemia. More recently, but still at an infancy stage, MALDI-TOF MS is used to perform strain typing and to determine antifungal drug susceptibility. In this article, the authors discuss how the MALDI-TOF MS technology is destined to become a powerful tool for routine mycological diagnostics.

  2. Application of PCR-based methods for diagnosis of intestinal parasitic infections in the clinical laboratory. (United States)

    Verweij, Jaco J


    For many years PCR- and other DNA-based methods of pathogen detection have been available in most clinical microbiology laboratories; however, until recently these tools were not routinely exploited for the diagnosis of parasitic infections. Laboratories were initially reluctant to implement PCR as incorporation of such assays within the algorithm of tools available for the most accurate diagnosis of a large variety of parasites was unclear. With regard to diagnosis of intestinal parasitic infections, the diversity of parasites that one can expect in most settings is far less than the parasitological textbooks would have you believe, hence developing a simplified diagnostic triage is feasible. Therefore the classical algorithm based on population, patient groups, use of immuno-suppressive drugs, travel history etc. is also applicable to decide when to perform and which additional techniques are to be used, if a multiplex PCR panel is used as a first-line screening diagnostic.

  3. Clinical results of stereotactic hellium-ion radiosurgery of the pituitary gland at Lawrence Berkeley Laboratory

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    Levy, R.P.; Fabrikant, J.I.; Lyman, J.T.; Frankel, K.A.; Phillips, M.H.; Lawrence, J.H.; Tobias, C.A.


    The first therapeutic clinical trial using accelerated heavy-charged particles in humans was performed at Lawrence Berkeley Laboratory (LBL) for the treatment of various endocrine and metabolic disorders of the pituitary gland, and as suppressive therapy for adenohypophyseal hormone-responsive carcinomas and diabetic retinopathy. In acromegaly, Cushing's disease, Nelson's syndrome and prolactin-secreting tumors, the therapeutic goal in the 433 patients treated has been to destroy or inhibit the growth of the pituitary tumor and control hormonal hypersecretion, while preserving a functional rim of tissue with normal hormone-secreting capacity, and minimizing neurologic injury. An additional group of 34 patients was treated for nonsecreting chromophobe adenomas. This paper discusses the methods and results of stereotactic helium-ion radiosurgery of the pituitary gland at Lawrence Berkeley Laboratory. 11 refs.

  4. Physicochemical inactivation of Lassa, Ebola, and Marburg viruses and effect on clinical laboratory analyses

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    Mitchell, S.W.; McCormick, J.B.


    Clinical specimens from patients infected with Lassa, Ebola, or Marburg virus may present a serious biohazard to laboratory workers. The authors have examined the effects of heat, alteration of pH, and gamma radiation on these viruses in human blood and on the electrolytes, enzymes, and coagulation factors measured in laboratory tests that are important in the care of an infected patient. Heating serum at 60 degrees C for 1 h reduced high titers of these viruses to noninfectious levels without altering the serum levels of glucose, blood urea nitrogen, and electrolytes. Dilution of blood in 3% acetic acid, diluent for a leukocyte count, inactivated all of these viruses. All of the methods tested for viral inactivation markedly altered certain serum proteins, making these methods unsuitable for samples that are to be tested for certain enzyme levels and coagulation factors.

  5. ASVCP quality assurance guidelines: control of preanalytical, analytical, and postanalytical factors for urinalysis, cytology, and clinical chemistry in veterinary laboratories. (United States)

    Gunn-Christie, Rebekah G; Flatland, Bente; Friedrichs, Kristen R; Szladovits, Balazs; Harr, Kendal E; Ruotsalo, Kristiina; Knoll, Joyce S; Wamsley, Heather L; Freeman, Kathy P


    In December 2009, the American Society for Veterinary Clinical Pathology (ASVCP) Quality Assurance and Laboratory Standards committee published the updated and peer-reviewed ASVCP Quality Assurance Guidelines on the Society's website. These guidelines are intended for use by veterinary diagnostic laboratories and veterinary research laboratories that are not covered by the US Food and Drug Administration Good Laboratory Practice standards (Code of Federal Regulations Title 21, Chapter 58). The guidelines have been divided into 3 reports: (1) general analytical factors for veterinary laboratory performance and comparisons; (2) hematology, hemostasis, and crossmatching; and (3) clinical chemistry, cytology, and urinalysis. This particular report is one of 3 reports and documents recommendations for control of preanalytical, analytical, and postanalytical factors related to urinalysis, cytology, and clinical chemistry in veterinary laboratories and is adapted from sections 1.1 and 2.2 (clinical chemistry), 1.3 and 2.5 (urinalysis), 1.4 and 2.6 (cytology), and 3 (postanalytical factors important in veterinary clinical pathology) of these guidelines. These guidelines are not intended to be all-inclusive; rather, they provide minimal guidelines for quality assurance and quality control for veterinary laboratory testing and a basis for laboratories to assess their current practices, determine areas for improvement, and guide continuing professional development and education efforts.

  6. Age of onset influences on clinical and laboratory profile of patients with systemic lupus erythematosus. (United States)

    Sassi, Rafael Hennemann; Hendler, Jordana Vaz; Piccoli, Giovana Fagundes; Gasparin, Andrese Aline; da Silva Chakr, Rafael Mendonça; Brenol, João Carlos Tavares; Monticielo, Odirlei André


    The present study aims to evaluate differences in clinical and laboratory manifestations and medication use in the different ages of disease onset in patients with systemic lupus erythematosus (SLE). This cross-sectional study consisted of 598 SLE patients (550 female and 48 male), who attended the Rheumatology Clinic of the Hospital de Clínicas de Porto Alegre between 2003 and 2015. Demographic, clinical and laboratory data were collected. The patients were classified into three groups according to their ages at disease diagnosis. Mean age of diagnosis was 33.6 ± 14.3 years, and the median (25th-75th percentile) disease duration was 13 (7-20) years. Among the patients studied, 419 (70%) were adult-onset (aSLE), 90 (14.8%) were late-onset (lSLE) and 89 (14.8%) were childhood-onset (cSLE). The female to male ratio was higher in aSLE (18:1) compared to the other groups (p = 0.001). Arthritis was predominantly found in aSLE (78.5%) when compared with lSLE (57.7%) (p drugs.

  7. Direct oral anticoagulants and antiplatelet agents. Clinical relevance and options for laboratory testing. (United States)

    Sibbing, D; Spannagl, M


    Oral anticoagulants and platelet receptor blockers are widely used in clinical practice with the aim of reducing the risk of thrombotic complications in patients with cardiovascular diseases. Their regular intake and adequate antithrombotic action is vital and this is way numerous assays have been developed for laboratory testing and monitoring of these agents. Available assays can be stratified into pharmacokinetic and pharmacodynamic assays. Such assays are increasingly used in clinical routine and their daily use is triggered by the advent of the novel direct oral anticoagulants (DOACs) as an alternative for vitamin K antagonist (VKA) treatment, which are dabigatran, rivaroxaban and apixaban, and by the advent of prasugrel or ticagrelor as an alternative for clopidogrel with regard to platelet P2Y12 receptor inhibition. In this review the most important and most commonly used laboratory assays are summarized as well as their clinical implications with the focus on DOACs as an alternative for VKAs and the different P2Y12 receptor blockers for antiplatelet treatment.

  8. Clinical and laboratory features of systemic sclerosis complicated with localized scleroderma. (United States)

    Toki, Sayaka; Motegi, Sei-ichiro; Yamada, Kazuya; Uchiyama, Akihiko; Kanai, Sahori; Yamanaka, Masayoshi; Ishikawa, Osamu


    Localized scleroderma (LSc) primarily affects skin, whereas systemic sclerosis (SSc) affects skin and various internal organs. LSc and SSc are considered to be basically different diseases, and there is no transition between them. However, LSc and SSc have several common characteristics, including endothelial cell dysfunction, immune activation, and excess fibrosis of the skin, and there exist several SSc cases complicated with LSc during the course of SSc. Clinical and laboratory characteristics of SSc patients with LSc remain unclear. We investigated the clinical and laboratory features of 8 SSc patients with LSc among 220 SSc patients (3.6%). The types of LSc included plaque (5/8), guttate (2/8), and linear type (1/8). All cases were diagnosed as having SSc within 5 years before or after the appearance of LSc. In three cases of SSc with LSc (37.5%), LSc skin lesions preceded clinical symptoms of SSc. Young age, negative antinuclear antibody, and positive anti-RNA polymerase III antibody were significantly prevalent in SSc patients with LSc. The positivity of anticentromere antibody tended to be prevalent in SSc patients without LSc. No significant difference in the frequency of complications, such as interstitial lung disease, reflux esophagitis, and pulmonary artery hypertension, was observed. The awareness of these characteristic of SSc with LSc are essential to establish an early diagnosis and treatment.

  9. Clinical and laboratory signs associated to serious dengue disease in hospitalized children

    Directory of Open Access Journals (Sweden)

    Sheila Moura Pone

    Full Text Available Abstract Objective: To evaluate the validity of clinical and laboratory signs to serious dengue disease in hospitalized children. Methods: Retrospective cohort of children (19 and negative likelihood ratio <0.6. Pleural effusion and abdominal distension had higher sensitivity (82.6%. History of bleeding (epistaxis, gingival or gastrointestinal bleeding and severe hemorrhage (pulmonary or gastrointestinal bleeding in physical examination were more frequent in serious dengue disease (p < 0.01, but with poor accuracy (positive likelihood ratio = 1.89 and 3.89; negative likelihood ratio = 0.53 and 0.60, respectively. Serum albumin was lower in serious dengue forms (p < 0.01. Despite statistical significance (p < 0.05, both groups presented thrombocytopenia. Platelets count, hematocrit, and hemoglobin parameters had area under the curve <0.5. Conclusions: Lethargy, abdominal distension, pleural effusion, and hypoalbuminemia were the best clinical and laboratorial markers of serious dengue disease in hospitalized children, while bleeding, severe hemorrhage, hemoconcentration and thrombocytopenia did not reach adequate diagnostic accuracy. In pediatric referral hospitals, the absence of hemoconcentration does not imply absence of plasma leakage, particularly in children with previous fluid replacement. These findings may contribute to the clinical management of dengue in children at referral hospitals.

  10. Assessment of noise levels in clinical and laboratory areas of dental teaching institution, Ahmedabad

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    Sujal M Parkar


    Full Text Available Aim: To measure and assess the noise levels produced by different dental equipments. Materials and Methods: Measurement of the noise level was performed in preclinics, clinics, and dental laboratory of different departments of Ahmedabad Dental College and Hospital. The noise levels were determined using a Mini sound meter (CEM USA, which was placed at the dentist′s and laboratory technician′s ear level and at a distance of 1 m from a main noise source. The level of noise was measured in decibel (dB while the instruments were at maximum running speed. Results: In dental laboratory, the nosiest dental equipment was gypsum lathe trimmer with the noise level ranging from 87.36 to 98.3 dB. In preclinical area, the sound produced by low-speed air-rotor ranges from 66.68 to 69.28 dB. In clinical areas, the highest noise produced was by high-speed air-rotor (73.36 to 81.8 dB. The noise created by suction pump when in contact with mucosa was in range from 73.1 to 80.32 dB. The noise levels generated during cutting were significantly higher (P < 0.05 than those of noncutting, which was proved in the course of the measurements. Conclusion: At the end of the study it can be concluded that the sound levels are below that causes damage to the human ear (85 dB. However, dental technicians and other personnel working all day in noisy laboratories could be at risk of Noise-Induced Hearing Loss if they did not choose not to wear ear protection.

  11. Clinical and Laboratory Findings of Lead Hepatotoxicity in the Workers of a Car Battery Manufacturing Factory

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    Bita Dadpour


    Full Text Available Background: Occupational lead poisoning is common in workers of some industries, but lead hepatotoxicity has rarely been reported. Several animal studies have revealed lead induced liver damage but clinical studies concerning the manifestations of lead induced liver toxicity in humans are scares. This study was designed to investigate the clinical manifestations and pathological parameters of hepatic dysfunction and its relationship with blood and urine lead concentrations in a car battery-manufacturing workers. Methods: This cross sectional study was carried out in Mashhad, Iran, during April-June 2011. One hundred and twelve workers underwent blood and urine sampling for determination of lead concentrations and liver function tests. Clinical signs and symptoms of possible lead hepatotoxicity were investigated. Results: Mean (±SD age of the workers was 28.78 (±5.17 yr with a daytime work of 8.67 (±1.41 h and mean work duration of 3.89 (±2.40 yr. Mean blood lead concentration (BLC and urine lead concentration (ULC were 398.95 (±177.41 µg/l and 83.67(±50 μg/l, respectively. We found no correlation between the clinical findings and BLC or ULC. A weak correlation (R: 0.27, P=0.087 between serum alkaline phosphatase concentration and BLC was obtained. No significant relationship was found between other liver function tests and BLC or ULC. Conclusion: We found no specific clinical and laboratory abnormalities of liver in the workers of car battery manufacturer who had chronic lead toxicity. Further investigations with more specific laboratory tests such as LDH5 and gamma glutamyl transferase (GGT as well as novel biomarkers of metal induced hepatotoxicity might be helpful in evaluating lead hepatotoxicity.

  12. Prognostic value of clinical, laboratory and molecular predictors in the formation of personalized approaches to breast cancer treatment

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    Phokhach A.V.


    group without Herceptin (27,4±3,4 months and higher than the HER-2 / neu-negative patients (38,1±3,0 months. The value of coefficient Spearman rank correlation to tumor response and the factor of menopause, age, general condition of the patient were - 0.174; -0.222; -0.250 (P 0.05, in accordance. In the presence of neutropenia at 1 week after treatment it has been revealed significantly better tumor response to treatment - the correlation coefficient: 0.204 (p <0.05. Conclusion. Molecular subtypes detection had shown that HER-2/neu-positive and tripple negative breast cancer demonstrated the most aggresive course of disease. It was found that a more pronounced tumor response to combination chemotherapy can be expected in young patients, pre-menopausal, high ECOG status. The presence of neutropenia has a significantly positive impact on the results of treatment of patients with metastatic breast cancer. Citation: Phokhach AV, Elhajj MH, Bondarenko IN, Zavizion VF, Hurtovyi VA. [Prognostic value of clinical, laboratory and molecular predictors in the formation of personalized approaches to breast cancer treatment]. Morphologia. 2016;10(2:53-60. Russian.

  13. Evaluation of clinical and laboratory markers of cardiometabolic risk in overweight and obese children and adolescents

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    Heloísa Marcelina da Cunha Palhares

    Full Text Available OBJECTIVE: This study analyzed the frequency of cardiometabolic risk markers and metabolic syndrome occurrence in overweight and obese children and adolescents. METHODS: The participants included 161 overweight (n=65 and obese (n=96 individuals aged between 5 and 19 years. Clinical markers were assessed (body mass index, body fat percentage, waist circumference, acanthosis, systolic and diastolic blood pressures, laboratory parameters [glucose, insulin, cholesterol (total and fractions and triglyceride levels and homeostasis model assessment of insulin resistance (HOMA-IR index] and leptin and adiponectin levels. The frequency of changes, odds ratios and correlations among markers were determined. Metabolic syndrome was assessed according to International Diabetes Federation criteria. RESULTS: A high frequency of acanthosis (51.6%; increased waist circumference (45.4%, systolic blood pressure / diastolic blood pressure (8.1% / 9.3%, glucose (10%, insulin (36.9% and HOMA-IR (44.3% values; and reduced high-density lipoprotein levels (47.2% were observed. Leptin levels were increased in 95% of obese and in 66% of overweight subjects. Adiponectin was decreased in 29.5% of obese and in 34% of overweight subjects. An odd ratio analysis revealed a greater probability of increased waist circumference (9.0, systolic blood pressure (4.1, triglyceride (2.3 and insulin (2.9 levels and HOMA-IR (3.0 in the obese group than in the overweight group. The clinical and laboratory parameters and leptin levels exhibited significant correlations, whereas adiponectin was negatively correlated with systolic blood pressure. The occurrence rate of metabolic syndrome was 13.6%. CONCLUSIONS: The high frequency of changes in clinical, laboratory and adipokine markers indicates the need for early interventions aimed at preventing cardiometabolic complications in adulthood.

  14. Clinical evaluation of analytical variations in serum creatinine measurements: why laboratories should abandon Jaffe techniques

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    Drion Iefke


    Full Text Available Abstract Background Non-equivalence in serum creatinine (SCr measurements across Dutch laboratories and the consequences hereof on chronic kidney disease (CKD staging were examined. Methods National data from the Dutch annual external quality organization of 2009 were used. 144 participating laboratories examined 11 pairs of commutable, value-assigned SCr specimens in the range 52–262 μmol/L, using Jaffe or enzymatic techniques. Regression equations were created for each participating laboratory (by regressing values as measured by participating laboratories on the target values of the samples sent by the external quality organization; area under the curves were examined and used to rank laboratories. The 10th and 90th percentile regression equation were selected for each technique separately. To evaluate the impact of the variability in SCr measurements and its eventual clinical consequences in a real patient population, we used a cohort of 82424 patients aged 19–106 years. The SCr measurements of these 82424 patients were introduced in the 10th and 90th percentile regression equations. The newly calculated SCr values were used to calculate an estimated glomerular filtration rate (eGFR using the 4-variable Isotope Dilution Mass Spectrometry traceable Modification of Diet in Renal Disease formula. Differences in CKD staging were examined, comparing the stratification outcomes for Jaffe and enzymatic SCr techniques. Results Jaffe techniques overestimated SCr: 21%, 12%, 10% for SCr target values 52, 73 and 94 μmol/L, respectively. For enzymatic assay these values were 0%, -1%, -2%, respectively. eGFR using the MDRD formula and SCr measured by Jaffe techniques, staged patients in a lower CKD category. Downgrading to a lower CKD stage occurred in 1-42%, 2-37% and 12–78.9% of patients for the 10th and 90th percentile laboratories respectively in CKD categories 45–60, 60–90 and >90 ml/min/1.73 m2. Using enzymatic techniques, downgrading

  15. Evaluation of clinical, laboratory, and electrophoretic profiles for diagnosis of malnutrition in hospitalized dogs

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    Andrei Kelliton Fabretti


    Full Text Available Malnutrition is a major factor associated with increased rates of mortality and readmission, longer hospital stays, and greater health care spending. Recognizing malnourished or at-risk animals allows for nutritional intervention and improved prognosis. This study evaluated the association between clinical, laboratory, and electrophoretic variables and the nutritional status (NS of hospitalized dogs in order to generate a profile of the sick dog and to facilitate the diagnosis of malnutrition. We divided 215 dogs into groups according to the severity of the underlying disease and we determined the clinical NS based on the assessment of the body condition score and the muscle mass score. The NS was classified as clinically well nourished, clinical moderate malnutrition, or clinical severe malnutrition. Statistical analyses were conducted by using the chi-square test or Fisher’s exact test; the Kruskal-Wallis test was used for continuous variables. A strong association was found between malnutrition and the severity of the underlying disease. In hospitalized dogs, low body mass index values, anemia, low hemoglobin concentrations, high fibrinogen concentrations, decreased albumin fraction, and increased gamma-globulin fraction (in electrophoresis were associated with malnutrition, reinforcing the classification of poor NS. However, the skin and coat characteristics, the total number of lymphocytes, blood glucose, cholesterol, and total protein concentration were not found to be good predictors of NS.

  16. Current research on cigarette toxicity: critical appraisal in view of clinical laboratory

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    Prajwal Gyawali


    Full Text Available Cigarette smoking has been implicated as a potential risk factor for development and progression of chronic obstructive pulmonary disease (COPD and cardiovascular disease (CVD, including ischemic heart disease. Although, several methods are in existence to measuring cigarette toxicity, evidence regarding adoption of a gold standard technique is still imprecise. In this study, we reviewed articles describing methods of measuring cigarette toxicity in relation to clinical laboratory practice. A critical analysis of the benefits and limitations of each method in relation to low-middle income countries is discussed. [Int J Res Med Sci 2016; 4(6.000: 1785-1793

  17. [Ethical issues in a market dispute between clinical laboratories and a health plan: case report]. (United States)

    Pinheiro, Malone Santos; de Brito, Ana Maria Guedes; Jeraldo, Verônica de Lourdes Sierpe; Pinheiro, Kariny Souza


    In Brazil the private health plans appear as an alternative to the public health assistance. This segment suffered great intensification in the seventies and eighties, culminating in the entry of large insurance company in the scenario of supplementary medicine. Quickly, the service providers associated with these insurance companies, consolidating them in the market and triggering a relationship of dependency. This article analyzed, in the form of a case report, a marketing dispute between clinical laboratories and a health plan, emphasizing the moral and ethical aspects involved in this episode.

  18. LC-MS/MS analysis of steroids in the clinical laboratory. (United States)

    Keevil, Brian G


    Liquid chromatography-tandem mass spectrometry (LC-MS/MS) is a powerful tool that is changing the way we analyse steroids in the clinical laboratory. It is already opening up the field of steroid analysis in endocrinology and is providing new applications for individual steroids and panels of steroids in different clinical conditions. LC-MS/MS is now well-accepted technology and is increasingly being used to replace problematic immunoassay methods because of greater sensitivity and specificity. Improved sample preparation, modern chromatography methods, and sensitive, faster scanning mass spectrometers have all played a role in improving LC-MS/MS. LC-MS/MS is also playing a key role in improving the quality of assays through the development of reference measurement procedures, characterisation of reference materials and multi-site calibration programmes. There is increasing interest in multiplexing steroid assays into panels of diagnostic tests to aid and improve the diagnosis and monitoring of disease.

  19. Useful Demonstrations for a Medial Biochemistry Course. (United States)

    Ragatz, Barth H.; Modrak, Gina


    Describes six demonstrations used in a medical biochemistry course. These demonstrations focus on: (1) platelet aggregometry; (2) ion-transporting antibiotics; (3) glycosylated hemoglobin; (4) molecular models; (5) serum preparation; and (6) bioluminescence. (JN)

  20. Laboratory and clinical trials of cocamide diethanolamine lotion against head lice (United States)

    Brunton, Elizabeth R.; Brown, Christine M.


    Context. During the late 1990s, insecticide resistance had rendered a number of treatment products ineffective; some companies saw this as an opportunity to develop alternative types of treatment. We investigated the possibility that a surfactant-based lotion containing 10% cocamide diethanolamine (cocamide DEA) was effective to eliminate head louse infestation. Settings and Design. Initial in vitro testing of the lotion formulation versus laboratory reared body/clothing lice, followed by two randomised, controlled, community-based, assessor blinded, clinical studies. Materials and Methods. Preliminary laboratory tests were performed by exposing lice or louse eggs to the product using a method that mimicked the intended use. Clinical Study 1: Children and adults with confirmed head louse infestation were treated by investigators using a single application of aqueous 10% cocamide DEA lotion applied for 60 min followed by shampooing or a single 1% permethrin creme rinse treatment applied to pre-washed hair for 10 min. Clinical Study 2: Compared two treatment regimens using 10% cocamide DEA lotion that was concentrated by hair drying. A single application left on for 8 h/overnight was compared with two applications 7 days apart of 2 h duration, followed by a shampoo wash. Results. The initial laboratory tests showed a pediculicidal effect for a 60 min application but limited ovicidal effect. A longer application time of 8 h or overnight was found capable of killing all eggs but this differed between batches of test material. Clinical Study 1: Both treatments performed badly with only 3/23 (13%) successful treatments using cocamide DEA and 5/25 (23.8%) using permethrin. Clinical Study 2: The single overnight application of cocamide DEA concentrated by hair drying gave 10/56 (17.9%) successes compared with 19/56 (33.9%) for the 2 h application regimen repeated after 1 week. Intention to treat analysis showed no significant difference (p = 0.0523) between the treatments

  1. Laboratory and clinical trials of cocamide diethanolamine lotion against head lice

    Directory of Open Access Journals (Sweden)

    Ian F. Burgess


    Full Text Available Context. During the late 1990s, insecticide resistance had rendered a number of treatment products ineffective; some companies saw this as an opportunity to develop alternative types of treatment. We investigated the possibility that a surfactant-based lotion containing 10% cocamide diethanolamine (cocamide DEA was effective to eliminate head louse infestation.Settings and Design. Initial in vitro testing of the lotion formulation versus laboratory reared body/clothing lice, followed by two randomised, controlled, community-based, assessor blinded, clinical studies.Materials and Methods. Preliminary laboratory tests were performed by exposing lice or louse eggs to the product using a method that mimicked the intended use. Clinical Study 1: Children and adults with confirmed head louse infestation were treated by investigators using a single application of aqueous 10% cocamide DEA lotion applied for 60 min followed by shampooing or a single 1% permethrin creme rinse treatment applied to pre-washed hair for 10 min. Clinical Study 2: Compared two treatment regimens using 10% cocamide DEA lotion that was concentrated by hair drying. A single application left on for 8 h/overnight was compared with two applications 7 days apart of 2 h duration, followed by a shampoo wash.Results. The initial laboratory tests showed a pediculicidal effect for a 60 min application but limited ovicidal effect. A longer application time of 8 h or overnight was found capable of killing all eggs but this differed between batches of test material. Clinical Study 1: Both treatments performed badly with only 3/23 (13% successful treatments using cocamide DEA and 5/25 (23.8% using permethrin. Clinical Study 2: The single overnight application of cocamide DEA concentrated by hair drying gave 10/56 (17.9% successes compared with 19/56 (33.9% for the 2 h application regimen repeated after 1 week. Intention to treat analysis showed no significant difference (p = 0.0523 between the

  2. Clinical and laboratory characteristics of adolescents with platelet function disorders and heavy menstrual bleeding

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    Amesse Lawrence S


    Full Text Available Abstract Background Platelet function disorders (PFDs have emerged as an important etiology of heavy menstrual bleeding (HMB in adolescents. However, neither clinical nor laboratory data have been methodically analyzed in this population subset. The objective of this study was to evaluate these parameters in order to distinguish characteristics of the disorder that in turn will lead to earlier diagnosis and therapy initiation. Methods Retrospective review of medical records from postmenarcheal adolescents with documented PFDs referred to a hemophilia treatment center and university faculty practices for bleeding diatheses with their clinical and laboratory data evaluated. Results Of 63 teens with documented PFDs, HMB was the most common clinical manifestation of PFD (43; 68.3%. Of these, 37 (86% were diagnosed with PFD either at or after menarche with the diagnosis based on HMB symptoms alone. Only 6 (14% were diagnosed with a PFD prior to menarche, based on associated bleeding, i.e., epistaxis, ecchymosis, and all developed HMB after menstruation onset. Interestingly, 20 girls were diagnosed with a PFD prior to menarche and of these, only 6 (30% went on to develop HMB after pubertal transition, while the majority (14; 70% did not. The average age-at-PFD diagnosis was 14.5yrs, significantly differing from the 10.9yrs average age-at-PFD diagnosis in their counterparts that, after menarche, did not develop HMB (PP P Conclusions Adolescents with PFDs and HMB appear to be clinically distinct from their non-HMB counterparts. This group of girls is characterized by HMB the major bleeding symptom, significantly high incidences of blood group O and the δ-SPD with a PFD diagnosed well after menarche. High false negative standard platelet function study results indicate additional diagnostic strategies, particularly for δ-SPD, should be considered.


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    A.B. Sé


    Full Text Available The pros and cons of Problem Based Learning (PBL have been extensivelydiscussed in the literature. We describe PBL-like strategies used at UnB (some ofthem since 1999 that may be useful elsewhere to improve undergraduatebiochemistry teaching with clinical applications. The main activities are: (i aseminar/poster system, (ii a true-or-false applied biochemistry exam (prepared bypeer tutors, (iii a 9-hour-exam on metabolism (based in actual papers, (iv anAdvanced Biochemistry course (directed to peer tutors, (v pizza-and-pasta (formetabolism teaching and free radicals (real science for students experiments,(vi the BioBio blog (, (vii student lectures onhealth issues directed to the community, and (viii the BioBio Show. The mainobjective of these activities is providing students with a more practical andentertaining approach to biochemistry using philosophic PBL principles such asthe application of basic knowledge to real situations (diseases, experiments andscientific discoveries. We also emphasize (a the importance of peer-tutor activityfor optimized learning of students and peer tutors, (b the relevance of a closerinteraction between students and professors, and (c the necessity to initiatestudents precociously in actual basic/medical science and contact with the public.Most activities have been evaluated by the students through written questionnairesand informal conversations, for several semesters, indicating good acceptanceand approval of these methods.

  4. [Role and future aspects of hospital clinical laboratories in medical team approaches]. (United States)

    Suwabe, Akira


    The recent progress in medicine increases the routine works of the physicians or nurses and decreases the chances to obtain the new information on the laboratory medicine. Although the patients desire to know their test results in detail, it is likely to be difficult to obtain them from the physician in charge. Thereby, the quality of the medical services may be deteriorated. In these situations, needs of the medical team approaches in which the medical technologists (MTs) in the hospital laboratories participate are increasing. In Japan, there are a variety of medical team approaches in which MTs are involved. In our university hospital, MTs play important roles in the infection control team (ICT), in the nutrition support team (NST), in the educational class for the patients with diabetes mellitus, in the clinical research center, in the order-made medicine realizing project, in the infertility center and in the laboratory information room. In April 2010, the new payment system for the team approaches such as ICT or NST was established. In the future, the team approaches other than ICT or NST could be chosen for the subjects for the payment if they are recognized as important. The goal of the team approaches is to realize a patient-oriented medicine. MTs can reconfirm that they are working as one of the medical staffs through these team approaches. It is important to always find out a possibility of new team approaches.

  5. Accreditation of medical laboratories in Croatia--experiences of the Institute of Clinical Chemistry, University Hospital "Merkur", Zagreb. (United States)

    Flegar-Mestrić, Zlata; Nazor, Aida; Perkov, Sonja; Surina, Branka; Kardum-Paro, Mirjana Mariana; Siftar, Zoran; Sikirica, Mirjana; Sokolić, Ivica; Ozvald, Ivan; Vidas, Zeljko


    Since 2003 when the international norm for implementation of quality management in medical laboratories (EN ISO 15189, Medical laboratories--Particular requirements for quality and competence) was established and accepted, accreditation has become practical, generally accepted method of quality management and confirmation of technical competence of medical laboratories in the whole world. This norm has been translated into Croatian and accepted by the Croatian Institute for Norms as Croatian norm. Accreditation is carried out on voluntary basis by the Croatian Accreditation Agency that has up to now accredited two clinical medical biochemical laboratories in the Republic of Croatia. Advantages of accredited laboratory lie in its documented management system, constant improvement and training, reliability of test results, establishing users' trust in laboratory services, test results comparability and interlaboratory (international) test results acceptance by adopting the concept of metrological traceability in laboratory medicine.

  6. Practical way to develop 10-color flow cytometry protocols for the clinical laboratory (United States)

    Tárnok, Attila; Bocsi, Jozsef


    The latest development of commercial routine flow cytometers (FCM) is that they are equipped with three (blue, red, violet) or more lasers and many PMT detectors. Nowadays routine clinical instruments are capable of detecting 10 or more fluorescence colors simultaneously. Thereby, presenting opportunities for getting detailed information on the single cell level for cytomics and systems biology for improve diagnostics and monitoring of patients. The University Leipzig, Germany) recently started a cluster of excellence to study the molecular background of life style and environment associated diseases, enrolling 25000 individuals (LIFE). To this end the most comprehensive FCM protocol has to be developed for this study. We aimed to optimize fluorochrome and antibody combinations to the characteristics of the instrument for successful 10-color FCM. Systematic review of issues related to sampling, preparation, instrument settings, spillover and compensation matrix, reagent performance, and general principles of panel construction was performed. 10-color FCM enables for increased accuracy in cell subpopulation identification, the ability to obtain detailed information from blood specimens, improved laboratory efficiency, and the means to consistently detect major and rare cell populations. Careful attention to details of instrument and reagent performance allows for the development of panels suitable for screening of samples from healthy and diseased donors. The characteristics of this technique are particularly well suited for the analysis of broad human population cohorts and have the potential to reach the everyday practice in a standardized way for the clinical laboratory.

  7. Epidemiological, clinical and laboratory findings of infectious keratitis at Mansoura Ophthalmic Center, Egypt (United States)

    Badawi, Amani E; Moemen, Dalia; El-Tantawy, Nora L


    AIM To analyze the epidemiological, clinical and laboratory findings of infectious keratitis. METHODS A retrospective study on cases of infective keratitis, attended our institution from Mar. 2013 to Feb. 2015, was done at Mansoura Ophthalmic Center, Egypt. Corneal scrapings were performed and processed for direct microscopy and culture in appropriate media using standard laboratory protocols. RESULTS Out of 245 patients enrolled for study, 247 corneal scrapings were obtained. Ocular trauma was the most common predisposing factor (51.4%), followed by diabetes mellitus (15.1%). Cultures were positive in 110 scraping samples (44.5%): 45.5% samples had pure fungal infection, 40% had pure bacterial infections and 10% had mixed fungal and bacterial growths. Acanthamoeba was detected in 5 (4.5%) samples. The most common fungal pathogen was Aspergillus spp. (41%). The most common bacterial isolates were Staphylococcus aureus (38.2%) and Pseudomonas aeruginosa (21.8%). CONCLUSION Incidence of fungal keratitis is high in our region. Therapeutic approach can initially be based on clinical features and sensitivity/resistance patterns. Microbiological research should direct the antimicrobial treatment. Antibiotic resistance to fluoroquinolones and aminoglycosides is an important consideration. PMID:28149778

  8. Performance of the tutorial function in the Professor of Hematology, specialty: Clinical Laboratory.

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    Oriol Meneses Echemendia


    Full Text Available In the context of the battle of ideas, arises the career, degree in health technology, imposing new challenges to the medical university context, inserting new actors to the teaching - learning process and with them the professor-tutor's figure. For that reason , an evaluative project was developed in the hematology profile in the specialty of clinical laboratory, with the purpose of elaborating a strategy for the improvement of the teaching tutorial, on the base of systematic-structural-functional model; giving answer to the main detected problems. To carry out the study was used a qualitative focus, selecting the integrated paradigm. It was done an investigation action in the seven municipal university headquarters of the county where the process of teaching-learning of the new pedagogic model is developed in the profile. once selecting the scale of priority of the detected difficulties using the interaction and the interdependence among investigator and investigated, the "methodological strategy for the improvement of the teaching tutorial in hematology of clinical laboratory" was designed to propose three strategic actions, valued positively by the expert ones who endorsed the feasibility and effectiveness of their setting in practice to contribute to the improvement of the teaching tutorial in the formation of health technologies.

  9. Use of artificial intelligence in analytical systems for the clinical laboratory. (United States)

    Place, J F; Truchaud, A; Ozawa, K; Pardue, H; Schnipelsky, P


    The incorporation of information-processing technology into analytical systems in the form of standard computing software has recently been advanced by the introduction of artificial intelligence (AI), both as expert systems and as neural networks.This paper considers the role of software in system operation, control and automation, and attempts to define intelligence. AI is characterized by its ability to deal with incomplete and imprecise information and to accumulate knowledge. Expert systems, building on standard computing techniques, depend heavily on the domain experts and knowledge engineers that have programmed them to represent the real world. Neural networks are intended to emulate the pattern-recognition and parallel processing capabilities of the human brain and are taught rather than programmed. The future may lie in a combination of the recognition ability of the neural network and the rationalization capability of the expert system.In the second part of the paper, examples are given of applications of AI in stand-alone systems for knowledge engineering and medical diagnosis and in embedded systems for failure detection, image analysis, user interfacing, natural language processing, robotics and machine learning, as related to clinical laboratories.It is concluded that AI constitutes a collective form of intellectual propery, and that there is a need for better documentation, evaluation and regulation of the systems already being used in clinical laboratories.

  10. Stability and inactivation of HTLV-III/LAV under clinical and laboratory environments. (United States)

    Resnick, L; Veren, K; Salahuddin, S Z; Tondreau, S; Markham, P D


    The stability of human T-cell lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV) under environmental conditions encountered in a clinical or laboratory setting and its inactivation by commonly used chemical disinfectants were investigated. Under our experimental conditions utilizing a highly concentrated viral preparation, virus with an initial infectious titer of approximately 7 log10 tissue culture infectious dose (TCID50) per milliliter can be recovered for more than a week from an aqueous environment held at room temperature (23 to 27 degrees C) or at 36 to 37 degrees C. Virus recovery is reduced at a rate of approximately 1 log10TCID50 per 20 minutes when held at 54 to 56 degrees C. Dried and held at room temperature, HTLV-III/LAV retains infectivity for more than three days with a reduction of approximately 1 log10TCID50 per nine hours. Viral infectivity is undetectable and reduced more than 7 log10TCID50 within one minute with 0.5% sodium hypochlorite, 70% alcohol, or 0.5% nonidet-P40, and within ten minutes with 0.08% quaternary ammonium chloride or with a 1:1 mixture of acetone-alcohol. These results help provide a rational basis to prevent the accidental spread of HTLV-III/LAV in the laboratory or clinical setting.

  11. Molecular-based mycobacterial identification in a clinical laboratory setting: a comparison of two methods.

    LENUS (Irish Health Repository)

    O'Donnell, N


    Many mycobacterial species are pathogenic to humans, with infection occurring worldwide. Infection with Mycobacterium tuberculosis is a well-described global phenomenon, but other mycobacterial species are increasingly shown to be the cause of both pulmonary and extrapulmonary infection and are managed differently from M. tuberculosis infection. Rapid and accurate differentiation of mycobacterial species is, therefore, critical to guide timely and appropriate therapeutic and public health management. This study evaluates two commercially available DNA strip assays, the Genotype Common Mycobacteria (CM) assay (Hain Lifescience, Nehren, Germany) and the Speed-oligo Mycobacteria assay (Vircell, Spain) for their usefulness in a clinical laboratory setting. Both assays were evaluated on 71 clinical mycobacterial isolates, previously identified using Gen-Probe AccuProbe and through a UK mycobacteriology reference laboratory, as well as 29 non-mycobacterial isolates. Concordant results were obtained for 98% of isolates using both assays. The sensitivity was 97% (95% confidence interval [CI]: 93.3-100%) for the CM assay and 98.6% (95% CI: 95.9-100%) for the Speed-oligo assay. Overall, both assays proved to be useful tools for rapid and sensitive mycobacterial species identification, although interpretation of results was easier with the CM assay. Finally, results were available within one day, compared to current identification times which range between seven days and four weeks.

  12. miRNA assays in the clinical laboratory: workflow, detection technologies and automation aspects. (United States)

    Kappel, Andreas; Keller, Andreas


    microRNAs (miRNAs) are short non-coding RNA molecules that regulate gene expression in eukaryotes. Their differential abundance is indicative or even causative for a variety of pathological processes including cancer or cardiovascular disorders. Due to their important biological function, miRNAs represent a promising class of novel biomarkers that may be used to diagnose life-threatening diseases, and to monitor disease progression. Further, they may guide treatment selection or dosage of drugs. miRNAs from blood or derived fractions are particularly interesting candidates for routine laboratory applications, as they can be measured in most clinical laboratories already today. This assures a good accessibility of respective tests. Albeit their great potential, miRNA-based diagnostic tests have not made their way yet into the clinical routine, and hence no standardized workflows have been established to measure miRNAs for patients' benefit. In this review we summarize the detection technologies and workflow options that exist to measure miRNAs, and we describe the advantages and disadvantages of each of these options. Moreover, we also provide a perspective on data analysis aspects that are vital for translation of raw data into actionable diagnostic test results.

  13. Indirect laryngeal surgery in the clinical voice laboratory: the renewal of a lost art. (United States)

    Hogikyan, N D; Pynnonen, M


    Since the advent of precision instruments and safe techniques for direct laryngoscopic surgery under general anesthesia, indirect laryngeal surgery has become very uncommon. A review of the recent literature finds that few authors advocate indirect surgery under topical anesthesia, and many otolaryngologists dismiss this technique as being either of only historical interest or an idiosyncratic method practiced only by a handful of clinicians. The societal mandate for cost-effective healthcare and the availability of relatively low-cost, high-quality endoscopes and video equipment warrant a renewed and broader interest in this type of surgery. In this article, we review a series of 27 indirect surgical procedures performed under topical anesthesia in the clinical voice laboratory. We discuss the indications, outcomes, advantages, and disadvantages of this surgery, and we present a brief analysis of its cost-effectiveness. We conclude that indirect laryngeal surgery in the clinical voice laboratory is an effective, safe, efficient, and less costly alternative to some procedures routinely performed under general anesthesia.

  14. Obtaining valid laboratory data in clinical trials conducted in resource diverse settings: lessons learned from a microbicide phase III clinical trial.

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    Tania Crucitti

    Full Text Available BACKGROUND: Over the last decade several phase III microbicides trials have been conducted in developing countries. However, laboratories in resource constrained settings do not always have the experience, infrastructure, and the capacity to deliver laboratory data meeting the high standards of clinical trials. This paper describes the design and outcomes of a laboratory quality assurance program which was implemented during a phase III clinical trial evaluating the efficacy of the candidate microbicide Cellulose Sulfate 6% (CS [1]. METHODOLOGY: In order to assess the effectiveness of CS for HIV and STI prevention, a phase III clinical trial was conducted in 5 sites: 3 in Africa and 2 in India. The trial sponsor identified an International Central Reference Laboratory (ICRL, responsible for the design and management of a quality assurance program, which would guarantee the reliability of laboratory data. The ICRL provided advice on the tests, assessed local laboratories, organized trainings, conducted supervision visits, performed re-tests, and prepared control panels. Local laboratories were provided with control panels for HIV rapid tests and Chlamydia trachomatis/Neisseria gonorrhoeae (CT/NG amplification technique. Aliquots from respective control panels were tested by local laboratories and were compared with results obtained at the ICRL. RESULTS: Overall, good results were observed. However, discordances between the ICRL and site laboratories were identified for HIV and CT/NG results. One particular site experienced difficulties with HIV rapid testing shortly after study initiation. At all sites, DNA contamination was identified as a cause of invalid CT/NG results. Both problems were timely detected and solved. Through immediate feedback, guidance and repeated training of laboratory staff, additional inaccuracies were prevented. CONCLUSIONS: Quality control guidelines when applied in field laboratories ensured the reliability and validity

  15. Clinical and laboratory description of a series of cases of acute viral myositis

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    Silvana Paula Cardin


    Full Text Available ABSTRACT OBJECTIVE: Describe the clinical and laboratory profile, follow-up, and outcome of a series of cases of acute viral myositis. METHOD: A retrospective analysis of suspected cases under observation in the emergency department was performed, including outpatient follow-up with the recording of respiratory infection and musculoskeletal symptoms, measurement of muscle enzymes, creatine phosphokinase (CPK, lactate dehydrogenase (LDH, transaminases (AST and ALT, blood count, C-reactive protein, and erythrocyte sedimentation rate in the acute phase and during follow-up until normalization. RESULTS: Between 2000 and 2009, 42 suspected cases were identified and 35 (27 boys were included. The median age was 7 years and the diagnosis was reported in 89% in the first emergency visit. The observed respiratory symptoms were cough (31%, rhinorrhea (23%, and fever (63%, with a mean duration of 4.3 days. Musculoskeletal symptoms were localized pain in the calves (80%, limited ambulation (57%, gait abnormality (40%, and muscle weakness in the lower limbs (71%, with a mean duration of 3.6 days. There was significant increase in CPK enzymes (5507 ± 9180 U/L, LDH (827 ± 598 U/L, and AST (199 ± 245 U/L, with a tendency to leukopenia (4590 ± 1420 leukocytes/mm3. The complete recovery of laboratory parameters was observed in 30 days (median, and laboratory and clinical recurrence was documented in one case after 10 months. CONCLUSION: Typical symptoms with increased muscle enzymes after diagnosis of influenza and self-limited course of the disease were the clues to the diagnosis. The increase in muscle enzymes indicate transient myotropic activity related to seasonal influenza, which should be considered, regardless of the viral identification, possibly associated with influenza virus or other respiratory viruses.

  16. Preparative Protein Production from Inclusion Bodies and Crystallization: A Seven-Week Biochemistry Sequence (United States)

    Peterson, Megan J.; Snyder, W. Kalani; Westerman, Shelley; McFarland, Benjamin J.


    We describe how to produce and purify proteins from "Escherichia coli" inclusion bodies by adapting versatile, preparative-scale techniques to the undergraduate laboratory schedule. This 7-week sequence of experiments fits into an annual cycle of research activity in biochemistry courses. Recombinant proteins are expressed as inclusion bodies,…


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    A.D. Sialakouma


    Full Text Available Biomedical science is a sensitive discipline and presents unique challenges due to its social character, continuous development and competitiveness. The issue of quality management systems and accreditation is gaining increasing interest in this sector. All over Europe, Health Services Units have started to introduce quality management systems and harmonization of criteria for accreditation is of increasing importance. Moreover, clinical laboratories, like the Assisted Reproduction laboratories and biochemical laboratories are required to apply a Quality Management System in order to ensure their correct, scientific and effective operation. Ultimately, it is a moral obligation for every health care organisation to supply the best possible care for the patient. The specific features and the diversity of clinical laboratories led to the introduction (2003 and, recently to the revision (2007 of the international standard ISO 15189, which is the first international standard developed specifically to address the requirements for accreditation of this type of laboratory. The basic principles for the quality assurance in the clinical laboratories are: x Complete and unambiguous standardized operating procedures. x Complete and unambiguous directives of operation. x Obligatory detailed written documentation, i.e., how each action is done, who will do it, where will this action take place and when. x Suitable scheduling of calibration/control/preventive maintenance of laboratory equipment and recording of each activity. x Distribution of responsibilities among the staff and continuous education and briefing according to current scientific data. x Complete and informed record file keeping. x Continuous improvement which is monitored with the adoption of quantified indicators. x Internal and external audit of all activities. x Troubleshooting. All these principles should be supported by the Management in order that the necessary adaptations should be made

  18. Are tutor-students capable of writing good biochemistry exams?

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    Sé Alexandre B.


    Full Text Available In a previous article we described the relevance of student seminars for the learning process of appliedbiochemistry for medical and nutrition students (Hermes-Lima et al., Biochem. Mol.Biol.Educ. 30:30-34,2002. First semester students of a basic biochemistry course (BioBio are divided in 10 groupsof 5 members, and each group is assigned to a specic topic (diabetes, cholesterol, etc under thesupervision of a tutor-student. The tutors have already coursed BioBio and are currently undertakingan advanced biochemistry course. In order to evaluate the learning of applied biochemistry for BioBiostudents a true or false exam (TFE is performed. This exam is made of 50 questions (5 on eachtopic elaborated by the tutors under the supervision of the teacher. The TFE corresponds to 10percent of the grade of BioBio and focus on clinical and/or applied biochemistry situations. At theend of the exam, BioBio students were asked to share their opinions about TFEs (n = 401, from2001/1 to 2003/2. When asked to give a 0-to-4 score regarding (a the diculty level of the test,(b the technical quality and (c if the exam makes an appropriate evaluation of applied biochemistryknowledge, the scores were 2.9, 3.4 and 2.9, respectively. BioBio students were also asked if they ndvalid to be evaluated by a tutor-made exam and if they would like to participate in the making ofTFEs; 96 and 58 percent answered yes, respectively.In another survey, we interviewed former BioBio students from the 2nd to the 7th semesters (n=95about TFEs (since 1999-1 regarding technical aspects, which included (1 clarity of questions, (2 levelof diculty, (3 clinical application and (4 thinking (as opposed to memorizing abilities demanded;the 0-to-4 scores were 3.1, 2.9, 2.6, and 2.5, respectively. Other four questions were on the validityof tutors writing TFEs and their capacity to perform such a task; the average score was 3.2. Oursurveys show the students good acceptance of the seminar system

  19. Vestibular migraine in children and adolescents: clinical findings and laboratory tests

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    Thyra eLanghagen


    Full Text Available Introduction: Vestibular migraine (VM is the most common cause of episodic vertigo in children. We summarize the clinical findings and of laboratory test results in a cohort of children and adolescents with VM. We discuss the limitations of current classification criteria for dizzy children. Methods: A retrospective chart analysis was performed on 118 children with suspected VM at a tertiary care center. Patients with complaints related to migraine and who presented with vertigo/dizziness were grouped in the following categories: (1 definite vestibular migraine (dVM; (2 probable vestibular migraine (pVM; (3 suspected vestibular migraine (sVM; (4 benign paroxysmal vertigo (BPV; and (5 migraine with/without aura (oM according to the International Classification of Headache Disorders, 3rd edition (beta version. Results: The mean age of all patients was 12±3 years (range 3-18 years, 70 females. 36 patients (30% fulfilled criteria for dVM, 33 (28% for pVM, 34 (29% for sVM, 7 (6% for BPV, and 8 (7% for oM. Somatoform vertigo co-occurred in 27% patients. Episodic syndromes were reported in 8%; the family history of migraine was positive in 65%. Mild central ocular motor signs were found in 24% (most frequently horizontal saccadic pursuit. Laboratory tests showed that about 20% had pathological function of the horizontal vestibulo-ocular reflex, and almost 50% had abnormal postural sway patterns. Conclusion: Patients with definite, probable, and suspected VM do not differ in the frequency of ocular motor, vestibular, or postural abnormalities. VM is the best explanation for their symptoms. It is essential to establish diagnostic criteria in clinical studies. In clinical practice, however, the most reasonable diagnosis should be made in order to begin treatment. Such a procedure also minimizes the fear of the parents and children, reduces the need to interrupt leisure time and school activities, and prevents the development of somatoform vertigo.

  20. Demographic, clinical, and laboratory features of Turkish patients with late onset ankylosing spondylitis

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    Ahmet Karaarslan


    Full Text Available Ankylosing spondylitis (AS is a chronic inflammatory disease, which typically begins in early decades of life with primarily axial joints involvement. This disease rarely affects patients older than 50 years of age. The aim of this study was to compare and evaluate the demographic, clinical, and laboratory features of late onset and early onset AS patients who were followed up in a single rheumatology center. A total of 339 patients who have been diagnosed with AS according to modified New York criteria were included in the study. The patients whose initial symptoms were observed after 50 years of age were accepted as late onset AS. Out of 339 patients, 27 (7.9% were diagnosed as late onset AS and 312 (92.3% patients were evaluated as early onset AS. Of 27 late onset patients, 10 were male and 17 were female. Delay in the diagnosis was 5.8 years for early onset AS, while it was 3.8 years for late onset AS (p = 0.001. Higher levels of acute phase reactants and more methotrexate (MTX use were detected in early onset AS patients compared to late onset AS (p = 0.001, p = 0.007, respectively. Statistically, there was no difference between these two groups, with regard to disease clinical activity indexes, anthropometric measurement parameters, uveitis and peripheral joint involvement. In this study, we showed that early and late onset AS patients may present with different clinical, genetic, and laboratory features. Late onset AS patients are characterized with lower human leukocyte antigen-B27 sequence, less inflammatory sign, delayed diagnosis, and less MTX and anti-tumor necrosis factor alpha drug usage.

  1. Diagnostic clinical and laboratory findings in response to predetermining bacterial pathogen: data from the Meningitis Registry.

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    Maria Karanika

    Full Text Available BACKGROUND: Childhood meningitis continues to be an important cause of mortality in many countries. The search for rapid diagnosis of acute bacterial meningitis has lead to the further exploration of prognostic factors. This study was scheduled in an attempt to analyze various clinical symptoms as well as rapid laboratory results and provide an algorithm for the prediction of specific bacterial aetiology of childhood bacterial meningitis. METHODOLOGY AND PRINCIPAL FINDINGS: During the 32 year period, 2477 cases of probable bacterial meningitis (BM were collected from the Meningitis Registry (MR. Analysis was performed on a total of 1331 confirmed bacterial meningitis cases of patients aged 1 month to 14 years. Data was analysed using EPI INFO (version 3.4.3-CDC-Atlanta and SPSS (version 15.0-Chicago software. Statistically significant (p or = 15000/microL (OR 2.19 with a PPV of 77.8% (95%CI 40.0-97.2. For the diagnosis of Haemophilus influenzae, the most significant group of diagnostic criteria included, absence of haemorrhagic rash (OR 13.61, age > or = 1 year (OR 2.04, absence of headache (OR 3.01, CSF Glu < 40 mg/dL (OR 3.62 and peripheral WBC < 15,000/microL (OR 1.74 with a PPV of 58.5% (95%CI 42.1-73.7. CONCLUSIONS: The use of clinical and laboratory predictors for the assessment of the causative bacterial pathogen rather than just for predicting outcome of mortality seems to be a useful tool in the clinical management and specific treatment of BM. These findings should be further explored and studied.

  2. Clinical and laboratory characteristics of acute community-acquired urinary tract infections in adult hospitalised patients. (United States)

    Piljic, Dilista; Piljic, Dragan; Ahmetagic, Sead; Ljuca, Farid; Porobic Jahic, Humera


    Urinary tract infections (UTI) cause a great number of morbidity and mortality. These infections are serious complications in pregnancy, patients with diabetes, polycystic kidneys disease, sickle cell anaemia, kidney transplant and in patients with functional or structural anomalies of the urinary tract. The aim of this investigation was to determine a dominant causative agents of UTI and some of the clinical and laboratory characteristics of acute community-acquired UTI in adult hospitalised patients. We studied 200 adult patients with acute community-acquired UTI hospitalised in the Clinic for Infectious Diseases Tuzla from January 2006 to December 2007. The patients were divided into two groups: a group of patients with E. coli UTI (147) and a group of patients with non-E. coli UTI (53). In these two groups, the symptoms and signs of illness, blood test and urine analysis results were analysed. Our results have shown that the patients with E. coli UTI frequently had fever higher than 38,5 degrees C (p<0,0001), chills (p=0,0349), headache (p=0,0499), cloudy urine (p<0,0001), proteinuria (p=0,0011) and positive nitrite-test (p=0,0002). The patients with non-E. coli UTI frequently had fever lower than 38,5 degrees C (p<0,0001) and urine specific gravity <1015 (p=0,0012). There was no significant difference in blood test results between patients with E. coli and non-E. coli UTI. These clinical and laboratory findings can lead us to early etiological diagnosis of these UTI before urine culture detection of causative agents, which takes several days. Early etiological diagnosis of the E. coli and non-E. coli UTI is necessary for an urgent administration of appropriate empirical antibiotic treatment. This is very important in prevention of irreversible kidney damage, prolonged treatment, complications, as well as recidives and chronicity of the illness.

  3. Demographic, clinical, and laboratory features of Turkish patients with late onset ankylosing spondylitis. (United States)

    Karaarslan, Ahmet; Yilmaz, Hatice; Aycan, Hakan; Orman, Mehmet; Kobak, Senol


    Ankylosing spondylitis (AS) is a chronic inflammatory disease, which typically begins in early decades of life with primarily axial joints involvement. This disease rarely affects patients older than 50 years of age. The aim of this study was to compare and evaluate the demographic, clinical, and laboratory features of late onset and early onset AS patients who were followed up in a single rheumatology center. A total of 339 patients who have been diagnosed with AS according to modified New York criteria were included in the study. The patients whose initial symptoms were observed after 50 years of age were accepted as late onset AS. Out of 339 patients, 27 (7.9%) were diagnosed as late onset AS and 312 (92.3%) patients were evaluated as early onset AS. Of 27 late onset patients, 10 were male and 17 were female. Delay in the diagnosis was 5.8 years for early onset AS, while it was 3.8 years for late onset AS (p = 0.001). Higher levels of acute phase reactants and more methotrexate (MTX) use were detected in early onset AS patients compared to late onset AS (p = 0.001, p = 0.007, respectively). Statistically, there was no difference between these two groups, with regard to disease clinical activity indexes, anthropometric measurement parameters, uveitis and peripheral joint involvement. In this study, we showed that early and late onset AS patients may present with different clinical, genetic, and laboratory features. Late onset AS patients are characterized with lower human leukocyte antigen-B27 sequence, less inflammatory sign, delayed diagnosis, and less MTX and anti-tumor necrosis factor alpha drug usage.

  4. Combining content and elements of communication into an upper-level biochemistry course. (United States)

    Whittington, Carli P; Pellock, Samuel J; Cunningham, Rebecca L; Cox, James R


    This report describes how a science communication module was incorporated into an advanced biochemistry course. Elements of communication were taught synergistically with biochemistry content in this course in an effort to expose students to a variety of effective oral communication strategies. Students were trained to use these established techniques and incorporated them into various presentations throughout the course. Three students describe their use of specific resources and how the skills learned relate to their future career. The importance and relevance of science communication are receiving unprecedented national attention. The academic scientific community must respond by incorporating more communication-centered instruction and opportunities in the classroom and laboratory.

  5. The Biochemistry Tetrahedron and the Development of the Taxonomy of Biochemistry External Representations (TOBER) (United States)

    Towns, Marcy H.; Raker, Jeffrey R.; Becker, Nicole; Harle, Marissa; Sutcliffe, Jonathan


    Visual literacy, the ability to interpret and create external representations (ERs), is essential to success in biochemistry. Studies have been conducted that describe students' abilities to use and interpret specific types of ERs. However, a framework for describing ERs derived through a naturalistic inquiry of biochemistry classrooms has not…

  6. Clinical-Laboratory Parallels in Patients with Demodectic Blepharitis at Cosmecevtic’s Use

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    I. B. Medvedev


    Full Text Available Purpose. To study the influence of the new cosmecevtic — cream «Demazol» on the dynamics of clinical and laboratory parameters (akarogramms with Demodex blepharitis.Patients and methods. There were 56 patients with Demodex blepharitis with symptoms of blepharitis or blepharoconjunctivitis in the study. In all cases, the clinical diagnoses were confirmed by laboratory investigations of epilated lashes. The akarogramms indicated the number of adult mite larvae and eggs of parasites separately for each eye. The cream was applied topically on the eyelids 2 times a day following our instructions, and before this, we provided pretreatment alcohol eucalyptus or sage tincture. The course of treatment was 1.5 months. Alongside this, we conducted drug correction of the status of the tear film via artificial tears eyedrops and therapy of blepharitis or blepharoconjunctivitis withantibiotics, steroids or non-steroidal anti-inflammatory drugs. A controlled laboratory testing for the presence of the mite Demodex folliculorum was undertaken after the course of treatment with cream. Evaluation of the efficacy of the cream was undertaken in accordance with the age of patients (up to 70 groups of patients 70 years and older, and the amount of mites.Results. The cosmetic cream «Demazol» had eliminated all forms of the mite Demodex — adults, larvae and eggs of parasites after 45 days of application. The number of mites after the course was significantly reduced: 5.7 times (by the number of adults; 3.7 times (the number of larvae and 12 times (the number of parasite eggs. Reduction the number of ticks was noted in general by 95% of patients; full or substantial reduction by 62.5%, proving the specific efficacy of «Demazol.» The clinical effect of varying degrees (excluding akarogramm was noted in 49 of 56 patients (87.5%. The percentage of patients with a moderate pronounced effect from the cream was 78.6%. The combination of a pronounced

  7. Using Elearning techniques to support problem based learning within a clinical simulation laboratory. (United States)

    Docherty, Charles; Hoy, Derek; Topp, Helena; Trinder, Kathryn


    This paper details the results of the first phase of a project that used eLearning to support students' learning within a simulated environment. The locus was a purpose built Clinical Simulation Laboratory (CSL) where the School's newly adopted philosophy of Problem Based Learning (PBL) was challenged through lecturers reverting to traditional teaching methods. The solution, a student-centred, problem-based approach to the acquisition of clinical skills was developed using learning objects embedded within web pages that substituted for lecturers providing instruction and demonstration. This allowed lecturers to retain their facilitator role, and encouraged students to explore, analyse and make decisions within the safety of a clinical simulation. Learning was enhanced through network communications and reflection on video performances of self and others. Evaluations were positive, students demonstrating increased satisfaction with PBL, improved performance in exams, and increased self-efficacy in the performance of nursing activities. These results indicate that an elearning approach can support PBL in delivering a student centred learning experience.


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    S Afsharpaiman


    Full Text Available "nBrucellosis is not uncommon in children in endemic areas. We described clinical and laboratory features and therapeutic regimens for brucellosis in children under 14 who admitted in the Pediatric Medical Center Hospital, Tehran, Iran from March 1988 until February 2001. The male: female ratio was 2:1. Family history of brucellosis and consumption of un-pasteurized milk and dairy products was positive in 20.4% and 65.9%, respectively. The common clinical findings were arthritis (79.5%, fever (77.4%, anorexia (61.4%, sweating (52.3%, splenomegaly (43.2%, hepatomegaly (34.1% and lymphadenopathy (13.65. Anemia, leukopenia and thrombocytopenia were recorded in 56.8%, 31.8% and 9.1%, respectively. Out of all patients, seropositivity rate for brucellosis was found in 97.7% using serum agglutination test. Culture of blood and bone marrow specimen were positive in 30% and 50% of samples obtained, respectively. Rifampin and co-trimoxazole were the most commonly used combination in 68.1%. The overall relapse rate was 13.6%. Arthritis and fever were the most common clinical findings of brucellosis. Wright test is a very sensitive method to detect brucella infection. Public education and control measures should be applied to prevent the zoonotic and human brucellosis. 

  9. Porphyria cutanea tarda. Clinical features and laboratory findings in 40 patients. (United States)

    Grossman, M E; Bickers, D R; Poh-Fitzpatrick, M B; Deleo, V A; Harber, L C


    Porphyria cutanea tarda is the most common disorder of porphyrin metabolism in the United States and Europe. This report presents the clinical, laboratory and pathologic features of 40 patients with porphyria cutanea tarda. Each patient was followed up for variable times during 1960-76 at the Clinical Research Center and the Dermatology Service of the Columbia-Presbyterian Medical Center; at the New York University Medical Center; or at the Rockefeller University Hospital. Earlier age at onset; diminution of alcohol ingestion as the major etiologic factor; and, an increased incidence in females indicate new environmental influences. The most frequently associated etiologic factor, aside from alcohol intake, was use of estrogens for contraception; postmenopausal syndrome; or treatment of prostatic carcinoma. Cutaneous findings in the patients included bullae (85%); increased skin fragility (75%); facial hypertrichosis (63%); hyperpigmentation (55%); sclerodermoid changes (18%); and, dystrophic calcification with ulceration (8%). Diabetes mellitus was found in 15%; systemic lupus erythematosus in 5%; elevated serum iron level in 62%; and, abnormal liver function test results in 60%. Histologic abnormalities were seen in liver biopsies of 34 patients. Phlebotomy is the treatment of choice. In 32 patients so treated, clinical remissions averaged 30.9 months. 31% (10 patients) had a relapse but additional phlebotomies resulted in 2nd remissions. Chloroquine and plasmaphoresis treatments were also briefly discussed.

  10. [Specific clinical, epidemiological patterns and laboratory diagnostics of enterovirus infection in the Republic of Belarus]. (United States)

    Amvros'eva, T V; Poklonskaia, N V; Bogush, Z F; Kazinets, O N; Germanovich, F A; Fisenko, E G; Titov, L P; Kvacheva, Z B; Bezruchko, A A; Scheslenok, E P


    The clinical and epidemiological patterns as well as the results of the laboratory verification of the outbreak of enterovirus infection (EVI) in Minsk during the period of summer-autumn, 2000, are presented. During this outbreak a variety of clinical forms were observed, the serous meningitis being prevalent (57.5%). Practically simultaneous occurrence of infection on the territory of all administrative districts of the city, the predominant involvement of children aged up to 14 years into the outbreak, a high proportion of simultaneous casualities in the multiple foci. A number of circulating enteroviruses (EV)--ECHO 30, ECHO 6 of three serotypes and Coxsackie B5--were simultaneously isolated from clinical material. EV of the same serotypes were isolated from tap drinking water, and neutralizing antibodies to these serotypes were often detected in the patients blood sera. Infectious EV were also present in samples of bottled water and in water reservoirs used for bathing. The routes of EV transmission and the improvement of EVI control are discussed.

  11. Demographic, clinical, laboratory and treatment characteristics of spondyloarthritis patients with and without acute anterior uveitis

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    Marcelo Gehlen

    Full Text Available CONTEXT AND OBJECTIVE: Acute anterior uveitis is a common extra-articular manifestation in spondyloarthritis patients. The aim of this study was to compare demographic, clinical, laboratory and treatment data among spondyloarthritis patients with and without acute anterior uveitis. DESIGN AND SETTING: This was a cross-sectional analytical study at the Rheumatology Outpatient Clinic of the Evangelical University Hospital, Curitiba, Brazil. METHODS: Spondyloarthritis patients with without acute anterior uveitis were compared regarding demographic data, spondyloarthritis subtype, peripheral arthritis, enthesitis, disease activity, functional index, physical examination, radiological involvement, HLA-B27 and treatment. RESULTS: Presence of acute anterior uveitis was not found to have any relationship with functional index, degree of radiological involvement, peripheral arthritis or enthesitis. Acute anterior uveitis showed a negative association with skin manifestations (P = 0.04 and a trend towards higher disease activity (P = 0.06. CONCLUSION: In the study sample, it could not be shown that AAU had any association with the functional and radiological prognoses. The patients with spondyloarthritis with and without acute anterior uveitis did not differ clinically except for a higher proportion of ankylosing spondylitis and smaller presence of skin involvement in those with uveitis.


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    Ana Paula Jesus de Almeida


    Full Text Available INTRODUCTION: The use of video in teaching and learning processes provides a challenging environment, able to stimulate the intellect and facilitate understanding in life science studies. Videos can be of extraordinary importance in education and dissemination of knowledge, contributing to greater learning, but is rarely used and exploited properly, especially for teaching biochemistry. Biochemistry is considered complex because it involves many molecular structures and processes, especially considering the number of events and molecules involved in the metabolism. OBJECTIVES: This study aimed to introduce biochemistry for the students of basic education using the theme "Light, Science and Life" in a playful and fun way. MATERIALS AND METHODS: A video about bioluminescence was designed and prepared aiming to use it as a support for learning biochemistry by students of basic education of public schools located in Salvador, Bahia. In order to prepare the video, undergraduate students initially revised the literature in order to acquire proper knowledge, and along with their teacher advisor worked the elaboration of texts, textbook and questionnaire and applied at school. DISCUSSION AND RESULTS: Analysis the qualitative results of the experiment on the preparation and use of the video about "Bioluminescence" focused mainly on the content of biochemistry linked to theme Light, Science and Life, and demonstrated the importance of such work in the teaching-learning process. The dynamics used allowed greater interaction between students and teacher, and the teaching of biochemistry in a fun way beyond the university walls. CONCLUSION: The teaching through recreational resources, e.g. videos and other educational strategies that foster learning should be encouraged from basic education, always bearing in order to transmit through these teaching methods the main concepts covered in biochemistry.


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    H. G. Cordeiro


    Full Text Available INTRODUCTION: The economic and social development of Brazil in the last decade has contributed to the installation of new graduate and undergraduate programs, as are the case with bachelor degrees in Biochemistry at UFV, UFSJ and UEM. These graduates are prepared to work in industry, research institutes and universities in areas of knowledge involving Biochemistry and Molecular Biology. This is happening in developed countries since the first half of the last century, surprising and late is the implementation of bachelor of Biochemistry in Brazil. OBJECTIVES: The aim of this study was to perform a comparative analysis of the Bachelor in Biochemistry in Brazil from the perspective of the main difficulties of implementing and courses maintenance. MATERIAL AND METHODS: This is a descriptive research with a qualitative approach. Interviews were conducted with undergraduate students, graduates, professors, staff and managers from bachelor degrees in Biochemistry at UFV, UFSJ and UEM. The sampling procedure was non probabilistic for judgment (choice of the subjects involved and interested in the course of biochemistry to undergraduate students, graduates, professors and staff and non probabilistic for convenience to managers. The qualitative assessment to depict the representative keywords was performed using words cloud by WordleTM. RESULTS: The study included 5 managers, 24 professors, 12 staff, 25 undergraduate students, 5 graduates. For the students the main reason for the course selection should be scientific vocation and affinity with chemistry and biology; most cited positive parameters were faculty and great structure, practical classes and broad playing field; most cited negatives were high mandatory disciplines, little student free time and lack of sophisticated equipment. Despite the conception of the programs have happened in different contexts and regions we noted similarities deficiencies and distresses. CONCLUSION: Difficulties must be

  14. Hematological and Biochemistry Profile and Risk Factors Associated with Pulmonary Tuberculosis Patients in Guyana

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    Rajini Kurup


    Full Text Available Objective. To evaluate the hematological and biochemistry profile of patients with or without HIV-TB at the Georgetown Chest Clinic, Guyana. Methods. An observational, laboratory based study was designed to assess the relationship of PTB and HIV with patients routine biochemical and hematological values. The study was conducted during the period January 2013 to December 2014; a total sample size of 316 patients was enrolled following exclusion and inclusion criteria. Results. Mean age of study population was 40.1 ± 13.8 (95% CI 38.6–41.7 and most were between 40 and 49 age group (27.8%, 95% CI 23.2–33.0. More males were in the study 74.4% (95% CI 69.3–78.8 than females 81% (95% CI 21.1–30.7. 30% (95% CI 25.3–35.3 had a sputum smear grade of 3+ and 62.5% (95% CI 47.0–75.7 showed a CD4 count <200. The study demonstrated significantly low hemoglobin (Hb 91.7% (95% CI 78.2–97.1, low WBC 27.8% (95% CI 15.8–44.0, high indirect bilirubin 7.4% (95% CI 2.1–23.3, ALT 41.8% (95% CI 28.4–56.7, and AST 72.2% (95% CI 57.3–83.3 among TB-HIV patients. Homelessness RR (relative risk 2.2 (95% CI 0.48–12.3, smoking RR 1.09 (95% CI 1.01–1.19, and gender (male RR 1.2 (95% CI 0.61–2.26 were main associated risk factors. Conclusions. There is slight variation among PTB and PTB-HIV coinfected patients in some hematological and biochemistry parameters.


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    D. G. Rekalov


    Full Text Available Rheumatoid arthritis (RA leads not only to a rapid development of disability, but can influence the life of these patients. One-third of patients with rheumatoid arthritis may have signs of disability during the first 3 years of the onset of the disease, while mortality in patients with RA almost two times higher in comparison with the general population. Analysis of recent prospective studies on the progression of the pathological process and predicting of the long-term outcomes in RA clearly indicate the need for clinical evaluation and a comprehensive laboratory and instrumental diagnosis of the disease in the initial manifestations of the most followed by early adequate pathogenetic therapy. The purpose of this survey was to determine modern clinical aspects of diagnosis, the possibility of standard and specialized instrumental examinations in patients with eRA, followed by predicting long-term results. We studied 52 specialized publications on clinical classification and a modern laboratory and diagnostic tests for eRA. This review presents the data of the importance of differentiation of several stages of RA in relation to the time factor. The data on the sensitivity and specificity of the diagnostic classification and clinical criteria of eRA and an algorithm for the identification of the disease were presented. It was shown prognostic value of the main serological markers of RA, and the predictive value for early detection of antibodies to the circulating peptide as a marker of the severity of bone-destructive changes in patients with certain clinical manifestations. Antibodies to the circulating peptide (ACPA can be detected many years before the onset of RA. Study of anti-citrulline mutated vimentin (anti-MCV in patients with eRA can be applied as a marker of activity of the process and the subsequent possibility of use for predicting long-term results. This review presents the major diagnostic errors using standard instrumental

  16. Assessment of clinical and laboratory parameters that reflect inflammatory response and organ function in sepsis

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    Herdiman T. Pohan


    APTT were prolong in severe sepsis and septic shock more than 18.8 and  48 seconds respectively. The d-dimer was also increased mostly in all groups. In conclusions that clinical examinations include level of consciousness, heart rate, mean arterial pressure, temperature and respiration rate and additional laboratory examinations include hamatological, biochemical, blood gas analysis and coagulation  examinations can be used as parameters in diagnosis of sepsis. Some parameters include level of consciousness (Glasgow coma scale, serum creatinine, hemoglobin, platelet count and fibrinogen can differ sepsis according to severity. (Med J Indones 2005; 14: 26-32Keywords: Clinical response, SIRS, sepsis

  17. Management of stress and stress-related diseases: Emerging computer-based technologies and the rationale for clinical laboratory assessment


    Ezekiel Uba Nwose; Ross Stuart Richards


    Background : Over the years, the issue of stress management in mental health has been discussed without reference to the clinical laboratory perspectives. Translational research and the vast array of emerging diagnostic technologies in alternative medical practice are now bridging the gap. While it would be scientific arrogance for the clinical practitioner and scientist to ignore the trend, the new technologies seeking clinical acceptability necessarily require expatiation of the scientific ...

  18. Polymyalgia rheumatica (PMR): clinical, laboratory, and immunofluorescence studies in 13 patients. (United States)

    Shintani, Shuzo; Shiigai, Tatsuo; Matsui, Yoshiki


    Thirteen elderly patients with polymyalgia rheumatica (PMR) are presented. The clinical and laboratory findings suggest that many progressive symptoms are due to the non-specific inflammatory changes in various organs of the body, especially in muscles and joints. An immunofluorescence study of muscle biopsy specimens revealed IgG, IgA, and fibrinogen deposits in the perifascicular area of the perimysium. This finding suggests that immune complexes play a role in the pathogenesis of this condition and that the pathophysiology of PMR is an interstitial inflammatory process. We think that the inflammatory findings affecting the interstitial tissue of muscles in the immunofluorescence study are relatively specific to PMR, and will be affected by steroid treatment.

  19. Importance/performance analysis: a tool for service quality control by clinical laboratories. (United States)

    Scammon, D L; Weiss, R


    A study of customer satisfaction with clinical laboratory service is used as the basis for identifying potential improvements in service and more effectively targeting marketing activities to enhance customer satisfaction. Data on customer satisfaction are used to determine the aspects of service most critical to customers, how well the organization is doing in delivery of service, and how consistent service delivery is. Importance-performance analysis is used to highlight areas for future resource reallocation and strategic emphasis. Suggestions include the establishment of performance guidelines for customer contact personnel, the enhancement of timely delivery of reports via electronic transmission (computer and fax), and the development of standardized graphics for request and report forms to facilitate identification of appropriate request forms and guide clients to key items of information on reports.

  20. Clinical and laboratory features of pheochromocytoma in a 52-year-old female patient

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    Otmara Aranguren Barreto


    Full Text Available The article aims to describe the clinical and laboratory features of a female patient suffering from pheochromocytoma. The case is a 52-year-old female patient who presents to our healthcare center with high blood pressure, cold limbs, sweating, jitteriness, and episodes of oppressive chest pain that appear several times per day. She also reports fatigue and a 13-kilogram weight loss. The sonogram revealed a nodular image in the right adrenal gland that had low echogenicity and regular margins measuring 5 mm. The image was confirmed with a contrast-enhanced adrenal CAT scan. Urine vanillylmandelic acid levels were high and an adrenal biopsy confirmed a pheochromocytoma measuring 4.5 x 3.5 x 3 cm.

  1. Comparison of four types of diet using clinical, laboratory and psychological studies. (United States)

    Lockie, A H; Carlson, E; Kipps, M; Thomson, J


    Thirty-seven people of different dietary habits-vegans, ovolactovegetarians, whole-food omnivores and average omnivores-were studied using nine-day weighed food intakes, clinical and laboratory assessments, standard psychology questionnaires, measurements of urinary cortisol and catecholamine levels and questionnaires on life-style and health factors. The vegan diet most clearly approximated current thinking on diet, as expressed in the NACNE Report, but was deficient in vitamin D, riboflavin, and vitamin B12. Cholesterol levels were significantly higher in both diet and serum in all groups compared with the vegans. There was no significant difference in social background, money spent on food, exercise, smoking, stress levels or psychological parameters between groups.

  2. Utility and necessity of repeat testing of critical values in the clinical chemistry laboratory.

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    Aijun Niu

    Full Text Available CONTEXT: Routine repeat testing of critical values is a long-standing practice in many clinical laboratories; however, its usefulness and necessity remain to be empirically established and no regulatory requirements yet exist for verification of the critical value results obtained by repeat analysis. OBJECTIVE: To determine whether repeat testing of critical values is useful and necessary in a clinical chemistry laboratory. METHODS: A total of 601 chemistry critical values (potassium, n = 255; sodium, n = 132; calcium, n = 108; glucose, n = 106 obtained from 72,259 routine clinical chemistry specimens were repeat tested. The absolute value and the percentage of difference between the two testing runs were calculated for each of the four critical values and then compared with the allowable error limit put forth in the College of American Pathologists (CAP. RESULTS: Among the repeat data for the 601 critical values, a total of 24 showed large differences between the initial result and the repeated result which exceeded the CAP limits for allowable error. The number and rates (% of large differences for within and outside the analytical measurement range (AMR were 12 (2.1% and 12 (41.4%, respectively. For the 572 critical values within the AMR for each test category, the mean absolute difference (mmol/L and difference(% between the two testing runs were: potassium, 0.1 mmol/L (2.7%; sodium, 2.1 mmol/L (1.7%; calcium, 0.05 mmol/L (3.0%; glucose, 0.18 mmol/L (2.6%. CONCLUSIONS: When the initial chemistry critical values are within the AMR, repeated testing does not improve accuracy and is therefore unnecessary. When the initial chemistry critical values are outside the AMR, however, the benefit of repeated testing justifies its performance and makes it necessary. Performing repeat clinical testing on a case-by-case, rather than routine, basis can improve patient care by delivering critical values more rapidly while providing savings


    Directory of Open Access Journals (Sweden)



    Full Text Available SUMMARYDuring recent decades, antifungal susceptibility testing has become standardized and nowadays has the same role of the antibacterial susceptibility testing in microbiology laboratories. American and European standards have been developed, as well as equivalent commercial systems which are more appropriate for clinical laboratories. The detection of resistant strains by means of these systems has allowed the study and understanding of the molecular basis and the mechanisms of resistance of fungal species to antifungal agents. In addition, many studies on the correlation of in vitro results with the outcome of patients have been performed, reaching the conclusion that infections caused by resistant strains have worse outcome than those caused by susceptible fungal isolates. These studies have allowed the development of interpretative breakpoints for Candida spp. and Aspergillus spp., the most frequent agents of fungal infections in the world. In summary, antifungal susceptibility tests have become essential tools to guide the treatment of fungal diseases, to know the local and global disease epidemiology, and to identify resistance to antifungals.

  4. Efficacy and safety of far infrared radiation in lymphedema treatment: clinical evaluation and laboratory analysis. (United States)

    Li, Ke; Zhang, Zheng; Liu, Ning Fei; Feng, Shao Qing; Tong, Yun; Zhang, Ju Fang; Constantinides, Joannis; Lazzeri, Davide; Grassetti, Luca; Nicoli, Fabio; Zhang, Yi Xin


    Swelling is the most common symptom of extremities lymphedema. Clinical evaluation and laboratory analysis were conducted after far infrared radiation (FIR) treatment on the main four components of lymphedema: fluid, fat, protein, and hyaluronan. Far infrared radiation is a kind of hyperthermia therapy with several and additional benefits as well as promoting microcirculation flow and improving collateral lymph circumfluence. Although FIR therapy has been applied for several years on thousands of lymphedema patients, there are still few studies that have reported the biological effects of FIR on lymphatic tissue. In this research, we investigate the effects of far infrared rays on the major components of lymphatic tissue. Then, we explore the effectiveness and safety of FIR as a promising treatment modality of lymphedema. A total of 32 patients affected by lymphedema in stage II and III were treated between January 2015 and January 2016 at our department. After therapy, a significant decrease of limb circumference measurements was noted and improving of quality of life was registered. Laboratory examination showed the treatment can also decrease the deposition of fluid, fat, hyaluronan, and protein, improving the swelling condition. We believe FIR treatment could be considered as both an alternative monotherapy and a useful adjunctive to the conservative or surgical lymphedema procedures. Furthermore, the real and significant biological effects of FIR represent possible future applications in wide range of the medical field.

  5. [The quality management in clinical diagnostic laboratory in conditions of the Federal Center of traumatology, orthopedics and endoprosthesis replacement of Minzdrav of Russia (Cheboksary)]. (United States)

    Nikolaev, N S; Nazarova, V V; Dobrovol'skaia, N Iu; Orlova, A V; Pchelova, N N


    The article presents experience of clinical diagnostic laboratory of the Federal Center of traumatology, orthopedics and endoprosthesis replacement of Minzdrav of Russia (Cheboksary) in the area of quality management of medical laboratory services on the basis of evaluation of efficacy and effectiveness of processes. The factors effecting quality of functioning of clinical diagnostic laboratory are indicated. The criteria and indicators of efficacy of work of employees of clinical diagnostic laboratory are presented.

  6. Comprehensive reference ranges for hematology and clinical chemistry laboratory parameters derived from normal Nigerian adults.

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    Timzing Miri-Dashe

    Full Text Available BACKGROUND: Interpretation of laboratory test results with appropriate diagnostic accuracy requires reference or cutoff values. This study is a comprehensive determination of reference values for hematology and clinical chemistry in apparently healthy voluntary non-remunerated blood donors and pregnant women. METHODS AND FINDINGS: Consented clients were clinically screened and counseled before testing for HIV, Hepatitis B, Hepatitis C and Syphilis. Standard national blood donors' questionnaire was administered to consented blood donors. Blood from qualified volunteers was used for measurement of complete hematology and chemistry parameters. Blood samples were analyzed from a total of 383 participants, 124 (32.4% males, 125 (32.6% non-pregnant females and 134 pregnant females (35.2% with a mean age of 31 years. Our results showed that the red blood cells count (RBC, Hemoglobin (HB and Hematocrit (HCT had significant gender difference (p = 0.000 but not for total white blood count (p>0.05 which was only significantly higher in pregnant verses non-pregnant women (p = 0.000. Hemoglobin and Hematocrit values were lower in pregnancy (P = 0.000. Platelets were significantly higher in females than men (p = 0.001 but lower in pregnant women (p =  .001 with marked difference in gestational period. For clinical chemistry parameters, there was no significant difference for sodium, potassium and chloride (p>0.05 but gender difference exists for Bicarbonate (HCO3, Urea nitrogen, Creatinine as well as the lipids (p0.05. CONCLUSIONS: Hematological and Clinical Chemistry reference ranges established in this study showed significant gender differences. Pregnant women also differed from non-pregnant females and during pregnancy. This is the first of such comprehensive study to establish reference values among adult Nigerians and difference observed underscore the need to establish reference values for different populations.

  7. Molecular analysis and association with clinical and laboratory manifestations in children with sickle cell anemia

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    Roberta Faria Camilo-Araújo


    Full Text Available Objectives: To analyze the frequency of βS-globin haplotypes and alpha-thalassemia, and their influence on clinical manifestations and the hematological profile of children with sickle cell anemia. Method: The frequency of βS-globin haplotypes and alpha-thalassemia and any association with clinical and laboratorial manifestations were determined in 117 sickle cell anemia children aged 3–71 months. The confirmation of hemoglobin SS and determination of the haplotypes were achieved by polymerase chain reaction-restriction fragment length polymorphism, and alpha-thalassemia genotyping was by multiplex polymerase chain reaction (single-tube multiplex-polymerase chain reaction. Results: The genotype distribution of haplotypes was 43 (36.7% Central African Republic/Benin, 41 (35.0% Central African Republic/Central African Republic, 20 (17.0% Rare/atypical, and 13 (11.1% Benin/Benin. The frequency of the α3.7 deletion was 1.71% as homozygous (−α3.7/−α3.7 and 11.9% as heterozygous (−α3.7/αα. The only significant association in respect to haplotypes was related to the mean corpuscular volume. The presence of alpha-thalassemia was significantly associated to decreases in mean corpuscular volume, mean corpuscular hemoglobin and reticulocyte count and to an increase in the red blood cell count. There were no significant associations of βS-globin haplotypes and alpha-thalassemia with clinical manifestations. Conclusions: In the study population, the frequency of alpha-thalassemia was similar to published data in Brazil with the Central African Republic haplotype being the most common, followed by the Benin haplotype. βS-globin haplotypes and interaction between alpha-thalassemia and sickle cell anemia did not influence fetal hemoglobin concentrations or the number of clinical manifestations.

  8. Laboratory and clinical tests of a prototype pressure sensor for clincial assessment of prosthetic socket fit. (United States)

    Polliack, A A; Craig, D D; Sieh, R C; Landsberger, S; Mcneal, D R


    Lower limb prosthetic socket fabrication is a highly refined process relying on the prosthetist's skill and experience. Despite their best efforts, patients often return with complications. Additionally, clinical application of technological advances for the quantification of biomechanical factors at the socket interface has not changed in practice. Measuring pressure levels at the stump/socket interface could provide valuable information in the process of prosthetic socket fabrication, fit and modification. This paper presents findings on the performance of a prototype capacitance pressure sensor designed for prosthetic socket use. Bench tests using compressed air were performed to measure accuracy, hysteresis and drift responses in both a flatbed chamber and a custom-modified pressure vessel. For the contoured testing, the sensors were placed on nine sites on a positive trans-tibial stump mould and enveloped with a silicone liner. Additionally, a preliminary clinical evaluation was performed with two trans-tibial amputee subjects at the nine sites during normal ambulation. Bench test results showed that the prototype capacitance sensor performed well in all categories, exhibiting a 2.42% (flatbed) and 9.96% (contoured) accuracy error, a 12.93% (flatbed) and 12.95% (contoured) hysteresis error, and a 4.40% (flatbed) and 6.20% (contoured) drift error. The clinical study showed that after three hours of continual use, no noticeable sensor drift occurred between pre and post-test calibration values. The results from this study were encouraging and the authors hope to conduct further laboratory and clinical trials to assess the influence of shear force and dynamic loading on sensor response.

  9. Impact of Endurance Exercise Training in the Fasted State on Muscle Biochemistry and Metabolism in Healthy Subjects: Can These Effects be of Particular Clinical Benefit to Type 2 Diabetes Mellitus and Insulin-Resistant Patients? (United States)

    Hansen, Dominique; De Strijcker, Dorien; Calders, Patrick


    Exercise training intervention is a cornerstone in the care of type 2 diabetes mellitus (T2DM) and insulin resistance (IR), and it is pursued in order to optimize exercise interventions for these patients. In this regard, the nutritional state of patients during exercise (being in the fed or fasted state) can be of particular interest. The aim of the present review is to describe the impact of endurance exercise (training) in the fasted versus fed state on parameters of muscle biochemistry and metabolism linked to glycemic control or insulin sensitivity in healthy subjects. From these data it can then be deduced whether exercise training in the fasted state may be relevant to patients with T2DM or IR. In healthy subjects, acute endurance exercise in the fasted state is accompanied by lower blood insulin and elevated blood free fatty acid concentrations, stable blood glucose concentrations (in the first 60-90 min), superior intramyocellular triacylglycerol oxidation and whole-body lipolysis, and muscle glycogen preservation. Long-term exercise training in the fasted state in healthy subjects is associated with greater improvements in insulin sensitivity, basal muscle fat uptake capacity, and oxidation. Therefore, promising results of exercise (training) in the fasted state have been found in healthy subjects on parameters of muscle biochemistry and metabolism linked to insulin sensitivity and glycemic control. Whether exercise training intervention in which exercise sessions are organized in the fasted state may be more effective in improving insulin sensitivity or glycemic control in T2DM patients and insulin-resistant individuals warrants investigation.

  10. Effects of intensive mariculture on sediment biochemistry

    DEFF Research Database (Denmark)

    Pusceddu, Antonio; Fraschetti, Simonetta; Mirto, Simone


    The exponential growth of off-shore mariculture that has occurred worldwide over the last 10 years has raised concern about the impact of the waste produced by this industry on the ecological integrity of the sea bottom. Investigations into this potential source of impact on the biochemistry...... of the sea floor have provided contrasting results, and no compelling explanations for these discrepancies have been provided to date. To quantify the impact of fish-farm activities on the biochemistry of sediments, we have investigated the quantity and biochemical composition of sediment organic matter...... regions, with the exception of seagrass sediments in Spain, the biochemistry of the sediments showed significant differences between the control and fish-farm locations. However, the variables explaining the differences observed varied among the regions and between habitats, suggesting idiosyncratic...

  11. Enzymatic degradation of polygalacturonic acid by Yersinia and Klebsiella species in relation to clinical laboratory procedures. (United States)

    Starr, M P; Chatterjee, A K; Starr, P B; Buchanan, G E


    As scored by several specified plating procedures, clinical and environmental strains of Yersinia enterocolitica, Yersinia pseudotuberculosis, and Klebsiella pneumoniae "Oxytocum" showed detectable, albeit generally weak, ability to digest polygalacturonic (pectic) acid. None of these bacterial strains had the vigorous and rapid pectolytic activity on these polygalacturonic acid-containing media that is typical of soft-rot Erwinia species, although some of the Oxytocum strains came fairly close. Analyses of the pectolytic enzyme contents of the cells and culture supernatants of the Yersinia and Klebsiella species revealed that readily detectable quantities of cell-bound polygalacturonic acid trans-eliminase and hydrolytic polygalacturonase were formed by the Yersinia and Klebsiella species; however, the total units of enzyme activity produced by these bacteria were, in general, lower than were produced by soft-rot Erwinia species. Furthermore, unlike the situation in soft-rot Erwinia cultures, these pectolytic enzymes of Yersinia and Klebsiella species were not excreted rapidly and massively into the growth medium. Cultures of other enterobacteria (Citrobacter species, Enterobacter species, Erwinia amylovora, Erwinia herbicola, Escherichia coli, Proteus species, Salmonella typhimurium, and Serratia marcescens) showed no pectolytic ability whatsoever by any of the plating procedures used and (to the extent they were so examined) produced no pectolytic enzymes detectable either in their cells or culture supernatants. This slow or weak release of pectolytic enzymes by Yersinia and Klebsiella species has a bearing on clinical laboratory procedures suitable for detecting their pectolytic activity; methods adequate for this purpose are detailed.

  12. Corelations between radiological score with clinical and laboratory parameters in rheumatoid arthritis

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    Mihaela Chicu


    Full Text Available Staging in rheumatoid arthritis (RA and evaluating the effectiveness of drug treatment involves the determination of radiological scores (for narrowing and erosions, this being the most specific changes and most commonly found in RA.Matherials and methods: Our study was condacted over a period of 12 months in Medical Rehabilitation Clinic of „Sf. Spiridon” Iasi Hospital, on a group of 40 women patients with RA in various stages of evolution. X-ray examination was done on hands and feet at the beginning and the end of the study period. There were computed radiographic Sharp scores for narrowing and erosions and the total score. Erosions were examined for 16 joints in each hand. For narrowing five joints were evaluated. For accuracy, radiological examination was done on mammography film. Rezults:After calculating Sharp scores - Van der Heide version - I compared them with the levels of clinical (HAQ, NAT, NAD, DAS28, bone densitometry and laboratory (ESR, CRP, rheumatoid factor, IL-1β parameters.Conclusions: The values of radiological scores for narrowing and erosions are directly correlate with DAS28, HAQ, rheumatoid factors levels and IgG values, and indirectly correlated with IL-1β levels.

  13. Measles outbreak in Macedonia: epidemiological, clinical and laboratory findings and identification of susceptible cohorts.

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    Irena T Kondova

    Full Text Available OBJECTIVES: Despite a 92-99% national vaccination coverage since 2000, the former Yugoslav Republic of Macedonia experienced a large measles outbreak between 2010 and 2011. Here we investigate the characteristics of patients hospitalized during this outbreak at the Clinic of Infectious Diseases in Skopje. METHODS: Epidemiological, clinical and laboratory data of 284 measles patients, including 251 from Skopje (43.80% of the 573 reported cases and 33 from elsewhere in Macedonia were collected. RESULTS: The most affected age groups were children up to 4 years of age and adolescents/adults of 15 years and older. Most patients were unvaccinated (n=263, 92.61% and many had non-Macedonian nationalities (n=156, 54.93% or belonged to the Roma ethnicity (n=73, 25.70%. Bronchopneumonia and diarrhea were the most common complications. Eighty-two out of 86 tested patients (95.35% had measles-specific IgM antibodies. The outbreak was caused by the measles variant D4-Hamburg. CONCLUSIONS: The epidemic identified pockets of susceptibles in Skopje and indicated that additional vaccination opportunities in particular for people with non-Macedonian nationality and traveler communities are warranted to ensure efficient measles control in Macedonia. The high attack rate among children of less than 1 year suggests that vaccination before 12 months of age should be considered in high risk settings.

  14. Strongyloidiasis: prevalence, risk factors, clinical and laboratory features among diarrhea patients in Ibadan Nigeria. (United States)

    Dada-Adegbola, H O; Oluwatoba, O A; Bakare, R A


    Strongyloidiasis is a parasitic infection caused by Strongyloides stercoralis. The infection is usually mild or asymptomatic in normal immunocompetent individuals, but could be very severe or even fatal due to hyper infection in individuals who are immunosuppressed. This study aimed at determining the prevalence, risk factors and features of strongyloidiasis among diarrhea patients in Ibadan. This is a descriptive cross-sectional study of diarrhea patients from a teaching hospital, three major government hospitals and one mission hospital in Ibadan. Self administered questionnaire, clinical assessment and laboratory investigations were used to confirm health status and presence of S. stercoralis. Diagnosis was made by microscopic examination of stool in saline preparation and formol-ether concentration. One thousand and ninety patients, (562 (51.6%) males and 528 (48.4%) females) consisting 380 (34.9%) children and 710 (65.1%) adults who had diarrhea were studied. The prevalence rate for the parasite among diarrhea patients was 3.0%. While the risk factor for infection remains contact with contaminated soil, malnutrition, steroid therapy, HIV/AIDS, lymphomas, tuberculosis, and chronic renal failure. Others are maleness, institutionalism and alcoholism. Predominant clinical presentations are abdominal pain, chronic diarrhea, and bloating and weight loss, Strongyloides stercoralis should be considered in diarrhea patients who are either malnourished or immunosuppressed.

  15. Hemoglobin variants: biochemical properties and clinical correlates. (United States)

    Thom, Christopher S; Dickson, Claire F; Gell, David A; Weiss, Mitchell J


    Diseases affecting hemoglobin synthesis and function are extremely common worldwide. More than 1000 naturally occurring human hemoglobin variants with single amino acid substitutions throughout the molecule have been discovered, mainly through their clinical and/or laboratory manifestations. These variants alter hemoglobin structure and biochemical properties with physiological effects ranging from insignificant to severe. Studies of these mutations in patients and in the laboratory have produced a wealth of information on hemoglobin biochemistry and biology with significant implications for hematology practice. More generally, landmark studies of hemoglobin performed over the past 60 years have established important paradigms for the disciplines of structural biology, genetics, biochemistry, and medicine. Here we review the major classes of hemoglobin variants, emphasizing general concepts and illustrative examples.

  16. Tularemia in Children: Evaluation of Clinical, Laboratory and Treatment Outcomes of 15 Tularemia Cases

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    Ekrem Koyuncu


    Full Text Available Introduction: Tularemia is a zoonotic diseases caused by Francisella tularensis. The aim of this study was to evaluate the clinical and laboratory findings of 15 children with the diagnosis of tularemia.Materials and Methods: Fifteen cases admitted with fever, sore throat, lymphadenopathy and a F. tularensis antibody titer of 1/160 and above in the microagglutination test (MAT were evaluated retrospectively. Their sociodemographic characteristics, contact with animals, history of tick bite, duration of complaints, clinical and laboratory findings, treatments and clinical courses were studied.Results: The mean age of patients was 11.5±5.1 (3-17 years and 61.3% were male. Fifty-three percent of the patients were living in rural areas, and had contact with contaminated water. Swelling in the neck (93.3%, sore throat (66.7% and fever (66.7% were the most frequently observed symptoms. Oropharyngeal tularemia (66.7% was predominated. In 27% of the patients LAPs were drained surgically, and in 13.3% of cases they were drained by itself. The mean duration between onset of tularemia symptoms and diagnosis was 53±45.3 (5-150 days. Sixty percent of patients were received beta-lactam-antibiotics before admission. It was noted that 6 patients with suppurative lymph nodes were admitted to hospital within median 61 (20-150 days, while others were admitted within median 35 (5-75 days (p<0.05. Mean leukocyte count was 8558.6±1384.5 (6030-11400/mm3, mean CRP was 5.8±2.9 (1-6.7 mg/dl, and mean ESR was 33.1±28.9 (6-103 mm/h. MAT showed that titers ranged from 1/160 to 1/1280. Gentamicin was given in seven patients (47%, streptomycin in five patients (33%, and doxycycline in 3 patients (20%.Conclusions: Tularemia should to be taken into account in the differential diagnosis in patients having tonsillopharyngitis and cervical lymphadenopathy without response to beta-lactam antibiotics in rural areas. (Journal of Current Pediatrics 2013;11:61-6

  17. Clinical and laboratory aspects of a trichinellosis outbreak in Izmir, Turkey

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    Turk M.


    Full Text Available Epidemiological, clinical and laboratory data were collected during an outbreak of trichinellosis, which occurred in Izmir, Turkey, between January and March 2004. The source of the infection was raw meatballs made with a mixture of uncooked beef and pork. Of 474 persons who were admitted at the Ataturk Training and Research Hospital during this period with a history of raw meatball consumption, the diagnosis of trichinellosis was confirmed for 154 (32.5 %, 87 males and 67 females; mean age 31 years, range 6-67 years. Among persons with a confirmed diagnosis, 79 % had myalgia, 77 % weakness and malaise, 63 % arthralgia, 40 % jaw pain, 68 % fever, 63 % periorbital and/or facial oedema, 49 % oedema at the trunk and limb, 42 % abdominal pain, 40 % nausea and vomiting, 28 % diarrhoea, 23 % subconjunctival haemorrhage, 25 % macular or petechial rash, 4 % subungual haemorrhage, 15 % cardiac complaints and 0.2 % neurological complaints. Nine patients (5.8 % were hospitalised due to severe myalgia (n = 2, high fever (n = 3, neurological manifestations (n = 1, thrombophlebitis (n = 2 and palmar erythema (n = 1. Eosinophilia was present in 88 % of the confirmed cases at the admission. Elevated levels of serum creatine phosphokinase, lactic dehydrogenase and aspartate aminotransferase were detected in 72 %, 70 % and 16 % of the confirmed cases, respectively. The seroconversion occurred in most of the infected people between the 4th and 6th weeks after the infection. All of the confirmed cases were treated with mebendazole. People with severe symptoms were treated also with prednisolone (60 mg/day for three days and those with a moderately severe clinical pattern received a non-steroid anti-inflammatory drug (naproxen sodium, 550 mg/day. All confirmed cases recovered without any clinical sequela.

  18. Clinical and laboratory peculiarities of acute myocardial infarction after chronic tonsillitis

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    Shvarts Y.G.


    Full Text Available Aim: The definition of the relationship of clinical and laboratory features of acute myocardial infarction depending on the suffering of chronic tonsillitis. Materials and methods. The study included 54 patients with acute myocardial infarction suffering for 1-2 days. The collection of the anamnesis, assessment of clinical factors, inspection of the palatine tonsils, clinical and biochemical blood tests have been done. Markers of myocardial necrosis, an electrocardiogram with calculation of a dispersion of interval QT, echocardiogram have been taken into account. Results. 45 of 54 patients reported the symptoms of chronic tonsillitis in their lifetime. At 17 patients the previous diagnosis of chronic tonsillitis has been made, in 6 of them bilateral tonsillectomy was held. All of the patients were divided into 2 groups: 1 with proven chronic tonsillitis (17 patients and 2 — the others (37 patients. At patients with chronic tonsillitis substantially more developed acute heart failure at sick this group glucose of the blood at receipt was higher than in 2 groups (p=0,004, given distinction was independent of presence of diabetes. According to the echocardiography 1 group of patients determined course-diastolic dimensions of the right ventricle increase in comparison with 2 groups (p=0,01. Conclusion. In patients with chronic tonsillitis more severe course of acute myocardial infarction has been determined, which became evident in the relatively high values of blood glucose on admission. The frequent development of congestive heart failure, and increase of the course-diastolic dimensions of the right ventricle have been also revealed.

  19. Prediction of dengue disease severity among pediatric Thai patients using early clinical laboratory indicators.

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    James A Potts

    Full Text Available Dengue virus is endemic in tropical and sub-tropical resource-poor countries. Dengue illness can range from a nonspecific febrile illness to a severe disease, Dengue Shock Syndrome (DSS, in which patients develop circulatory failure. Earlier diagnosis of severe dengue illnesses would have a substantial impact on the allocation of health resources in endemic countries.We compared clinical laboratory findings collected within 72 hours of fever onset from a prospective cohort children presenting to one of two hospitals (one urban and one rural in Thailand. Classification and regression tree analysis was used to develop diagnostic algorithms using different categories of dengue disease severity to distinguish between patients at elevated risk of developing a severe dengue illness and those at low risk. A diagnostic algorithm using WBC count, percent monocytes, platelet count, and hematocrit achieved 97% sensitivity to identify patients who went on to develop DSS while correctly excluding 48% of non-severe cases. Addition of an indicator of severe plasma leakage to the WHO definition led to 99% sensitivity using WBC count, percent neutrophils, AST, platelet count, and age.This study identified two easily applicable diagnostic algorithms using early clinical indicators obtained within the first 72 hours of illness onset. The algorithms have high sensitivity to distinguish patients at elevated risk of developing severe dengue illness from patients at low risk, which included patients with mild dengue and other non-dengue febrile illnesses. Although these algorithms need to be validated in other populations, this study highlights the potential usefulness of specific clinical indicators early in illness.

  20. Evaluation of clinical manifestations and laboratory findings of primary hyperparathyroidism in Imam Hospital (1988-1998

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    Alam Salimi M


    Full Text Available Introduction: Clinical manifestations of primary hyper-para-thyroidism (pHPT had been dramatically changed during last 25 years. Evaluation of changes in clinical findings was the aim of this study. Materials and methods: In a retrospective, descriptive case series, patients' records of all 47 pHPT (44 females, 3 males from 1988 till 1998 were studied. Patients’ clinical presentations, signs and symptoms, laboratory and radiologic findings were reviewed and the results were compared with 34 patients' studied during 1978-1987. Serum Ca>10.5 mg/dl with increased or high normal PTH were the diagnostic criteria of pHPT. Results: Patients’ age range was 11-70 and mean ±SD was 38±16 years, with a female to male ratio of 14:1. 57 percent of the patients had bone pain and muscle weakness, 12 percent were asymptomatic, 10 percent had pathologic fractures, 8 percent had renal stones, 8 percent had symptoms of hypercalcemia, and 2 percent had giant cell lesion. The mean±SD of serum calcium was 11.48±1.16 mg/dl, phosphorus was 2.4±0.6 mg/dl and 24-h urinary Ca was 294±197 mg. Serum PTH was increased from 1.5 to 500 folds. The frequency of single adenoma in right inferior, left inferior, and left superior gland were 43 percent, 30 percent, and 13 percent respectively. Conclusion: In the study 12 percent of patients were asymptomatic whereas there was no asymptomatic case in the previous study. Prevalence of severe bone disease and the interval between onset of symptoms and diagnosis was also reduced. According to this study detection of pHPT in asymptomatic phase remarkably increased.

  1. Estimation of the coefficient of variation from laboratory analysis of split specimens for quality control in clinical trials. (United States)

    Connett, J E; Lee, W W


    An explicit statistical model is proposed for the coefficient of variation for laboratory analyses of constituents of blood, serum, saliva, or other specimens. A method for computing the maximum likelihood estimate of the key parameter is described, and compared with two simpler noniterative estimates. Validity of the model is explored by analysis of data from the central laboratory of a large cooperative clinical trial. Simulation studies are employed to compare the accuracy of the three estimators of the coefficient of variation. For most laboratory measurements for which the model is valid, one of the two noniterative estimates is nearly as accurate and unbiased as the maximum likelihood estimate.

  2. Oxidative stress in marine environments: biochemistry and physiological ecology. (United States)

    Lesser, Michael P


    Oxidative stress-the production and accumulation of reduced oxygen intermediates such as superoxide radicals, singlet oxygen, hydrogen peroxide, and hydroxyl radicals-can damage lipids, proteins, and DNA. Many disease processes of clinical interest and the aging process involve oxidative stress in their underlying etiology. The production of reactive oxygen species is also prevalent in the world's oceans, and oxidative stress is an important component of the stress response in marine organisms exposed to a variety of insults as a result of changes in environmental conditions such as thermal stress, exposure to ultraviolet radiation, or exposure to pollution. As in the clinical setting, reactive oxygen species are also important signal transduction molecules and mediators of damage in cellular processes, such as apoptosis and cell necrosis, for marine organisms. This review brings together the voluminous literature on the biochemistry and physiology of oxidative stress from the clinical and plant physiology disciplines with the fast-increasing interest in oxidative stress in marine environments.

  3. Commentary: PhDs in biochemistry education-5 years later. (United States)

    Offerdahl, Erika G; Momsen, Jennifer L; Osgood, Marcy


    In this commentary, the discussion of PhDs in biochemistry education research is expanded to explore a number of diverse pathways leading to a competitive research program in biochemistry education research.

  4. Commentary: PhDs in Biochemistry Education--5 Years Later (United States)

    Offerdahl, Erika G.; Momsen, Jennifer L.; Osgood, Marcy


    In this commentary, the discussion of PhDs in biochemistry education research is expanded to explore a number of diverse pathways leading to a competitive research program in biochemistry education research.

  5. Clinical characteristics and laboratory analyses of acute myeloid leukemia with t(16;21)(p11;q22)


    Zhang, Zhifen; ZOU, JIANWEN; Li, Yuantang; Liu, Zhanfeng; Xu, Rui; TIAN, WENJUN; ZHAO, ZONGCHEN; Sun, Hui; Han, Jingying; Wang, Jia; Zhang, Bingchang; Ju, Ying


    The present study reviewed three patients with acute myeloid leukemia (AML) who had the specific genetic abnormality t(16;21)(p11;q22). To investigate the clinical and laboratory characteristics of AML with t(16;21)(p11;q22) translocation, the similarities and differences of clinical characteristics and laboratory examinations were compared, and a literature review was conducted. According to the French-American-British classification system, patient 1 was M4, patient 2 was M1 and patient 3 w...

  6. Optimized molecular resolution of cross-contamination alerts in clinical mycobacteriology laboratories

    Directory of Open Access Journals (Sweden)

    de Viedma Darío


    Full Text Available Abstract Background The phenomenon of misdiagnosing tuberculosis (TB by laboratory cross-contamination when culturing Mycobacterium tuberculosis (MTB has been widely reported and it has an obvious clinical, therapeutic and social impact. The final confirmation of a cross-contamination event requires the molecular identification of the same MTB strain cultured from both the potential source of the contamination and from the false-positive candidate. The molecular tool usually applied in this context is IS6110-RFLP which takes a long time to provide an answer, usually longer than is acceptable for microbiologists and clinicians to make decisions. Our purpose in this study is to evaluate a novel PCR-based method, MIRU-VNTR as an alternative to assure a rapid and optimized analysis of cross-contamination alerts. Results MIRU-VNTR was prospectively compared with IS6110-RFLP for clarifying 19 alerts of false positivity from other laboratories. MIRU-VNTR highly correlated with IS6110-RFLP, reduced the response time by 27 days and clarified six alerts unresolved by RFLP. Additionally, MIRU-VNTR revealed complex situations such as contamination events involving polyclonal isolates and a false-positive case due to the simultaneous cross-contamination from two independent sources. Conclusion Unlike standard RFLP-based genotyping, MIRU-VNTR i could help reduce the impact of a false positive diagnosis of TB, ii increased the number of events that could be solved and iii revealed the complexity of some cross-contamination events that could not be dissected by IS6110-RFLP.

  7. Clinical and laboratory differences between Epstein-Barr and cytomegalovirus infectious mononucleosis in children

    Directory of Open Access Journals (Sweden)

    Medović Raša


    Full Text Available Introduction. Infective mononucleosis is most commonly caused by Epstein-Barr virus (EBV, and in smaller percentage by cytomegalovirus (CMV. Objective. The aim of this paper was to determine the clinical and laboratory differences between EBV and CMV infectious mononucleosis in children. Methods. Cohort retrospective analytical research was conducted. We used data from medical history in six years period and monitored anamnestic data, frequency of inspection and palpation obtained data during physical examination, several laboratory tests, abdomen ultrasonography examination finding and emergence of disease complications. Statistical processing of data has been performed using SPSS 20. Results. Total number of examined children was 137, out of which 85.4% were with EBV and 14.6% with CMV infection. Affected children were most commonly younger than eight years. Boys were affected more often. There was no difference in frequency of high temperature, sore throat, bad breath, and respiratory symptomatology between examined children. Differences were discovered in frequency of stomachaches, eyelid swelling, skin rash and fatigue. Differences were not proven in the frequency of angina, lymphadenopathy and splenohepatomegaly between the groups. Values of transaminases and lactic dehydrogenases significantly decreased after seven days of hospitalization in both groups. In children with EBV, values of transaminases declined faster than in children with CMV. Anemia and bacterial superinfection of pharynx were most common disease complications. Thrombocytopenia was more common in children with CMV infection. Average duration of hospitalization was 6.7 days. Conclusion. In children with CMV abdominal pain, eyelid swelling, skin rash, fatigue and thrombocytopenia were more common. In children with EBV values of transaminases declined significantly faster.

  8. Will Regulatory and Financial Considerations Dampen Innovation in the Clinical Microbiology Laboratory? (United States)

    Gilligan, Peter H; Miller, Melissa B


    Over a million prosthetic joints are placed in patients in the United States annually. Of those that fail, 25% will be due to infection, with an estimated cost approaching 1 billion dollars. Despite the clinical and economic importance of these infections, the techniques for their detection are relatively insensitive. An innovative method for detecting these infections by using blood culture bottles (BCB) to culture specimens of periprosthetic tissue (PPT) was described in a recent article [T. N. Peel, et al., mBio 7(1):e01776-15, 2016, doi:10.1128/mBio.01776-15]. There are two potential stumbling blocks to the widespread implementation of this innovation. First, the FDA judges such an application of BCB as an "off-label use" and as such, a laboratory-developed test (LDT). LDTs are coming under greater scrutiny by the FDA and may require extensive, costly validation studies in laboratories that adopt this methodology. Second, the Center for Medicare and Medicaid Services has established a Hospital Acquired Condition Reduction Act under which institutions performing in the lowest quartile forfeit 1% of their Medicare reimbursement. Hospital-acquired infections are an important component of this quality metric. Although prosthetic joint infection (PJI) rates are not currently a hospital quality metric, given their cost and increasing frequency, it is reasonable to expect that they may become one. Will those with financial oversight allow an innovative technique that will require an expensive validation and may put the institution at risk for loss of CMS reimbursement?

  9. Effects of ostracism and sex on alcohol consumption in a clinical laboratory setting. (United States)

    Bacon, Amy K; Cranford, Alexi N; Blumenthal, Heidemarie


    Drinking to cope with negative affect is a drinking pattern that leads to problematic alcohol use both in college and after graduation. Despite theory and correlational evidence to this effect, establishing a link between stress and alcohol consumption among college students in the laboratory has yielded both a limited number of studies and, at times, inconsistent results. The present study attempts to resolve these issues through investigating the effects of an ecologically relevant stressor-ostracism-on alcohol consumption in a clinical laboratory setting. Social drinking college students (N = 40; 55% female) completed a 5-min game of Cyberball and were randomly assigned either to be included or excluded in the virtual ball-toss game. The amount (in ml) of beer consumed in a subsequent mock taste test served as our primary dependent variable, with breath alcohol concentration (BrAC) as a secondary dependent variable. Results indicated that excluded participants reported a trend toward an increase in negative affect from pre- to post-Cyberball, and endorsed significantly lower self-esteem, belonging, control, and belief in a meaningful existence compared to included participants. A significant Sex × Condition effect indicated that excluded women consumed less beer than both included women and excluded men, supported by a nonsignificant trend in BrAC. Men did not differ in their consumption of beer as a result of Cyberball condition. Implications of sex and social context on alcohol use are discussed, as well as ostracism as a method for investigating relationships between social stress and alcohol use.

  10. Fatal dengue hemorrhagic fever in adults: emphasizing the evolutionary pre-fatal clinical and laboratory manifestations.

    Directory of Open Access Journals (Sweden)

    Ing-Kit Lee

    Full Text Available BACKGROUND: A better description of the clinical and laboratory manifestations of fatal patients with dengue hemorrhagic fever (DHF is important in alerting clinicians of severe dengue and improving management. METHODS AND FINDINGS: Of 309 adults with DHF, 10 fatal patients and 299 survivors (controls were retrospectively analyzed. Regarding causes of fatality, massive gastrointestinal (GI bleeding was found in 4 patients, dengue shock syndrome (DSS alone in 2; DSS/subarachnoid hemorrhage, Klebsiella pneumoniae meningitis/bacteremia, ventilator associated pneumonia, and massive GI bleeding/Enterococcus faecalis bacteremia each in one. Fatal patients were found to have significantly higher frequencies of early altered consciousness (≤24 h after hospitalization, hypothermia, GI bleeding/massive GI bleeding, DSS, concurrent bacteremia with/without shock, pulmonary edema, renal/hepatic failure, and subarachnoid hemorrhage. Among those experienced early altered consciousness, massive GI bleeding alone/with uremia/with E. faecalis bacteremia, and K. pneumoniae meningitis/bacteremia were each found in one patient. Significantly higher proportion of bandemia from initial (arrival laboratory data in fatal patients as compared to controls, and higher proportion of pre-fatal leukocytosis and lower pre-fatal platelet count as compared to initial laboratory data of fatal patients were found. Massive GI bleeding (33.3% and bacteremia (25% were the major causes of pre-fatal leukocytosis in the deceased patients; 33.3% of the patients with pre-fatal profound thrombocytopenia (<20,000/µL, and 50% of the patients with pre-fatal prothrombin time (PT prolongation experienced massive GI bleeding. CONCLUSIONS: Our report highlights causes of fatality other than DSS in patients with severe dengue, and suggested hypothermia, leukocytosis and bandemia may be warning signs of severe dengue. Clinicians should be alert to the potential development of massive GI bleeding

  11. Pharmaco-epidemiological, clinical and laboratory characteristics of drug-induced liver injury in tuberculosis

    Directory of Open Access Journals (Sweden)

    M. V. Koroleva


    Full Text Available Objective: improving the efficiency of pharmacotherapy of drug-induced liver injury in tuberculosis by clarifying pharmaco-epidemiological, clinical and laboratory features.Materials and Methods: A retrospective analysis of primary medical records of 250 patients with pulmonary tuberculosis, patients «Volgograd Regional Clinical TB Dispensary № 1». We evaluated the dynamics of biochemical parameters characterizing the development of hepatic cytolytic syndrome, examined the impact of gender and age on the incidence of liver damage, we investigated the relationship of clinical tuberculosis and chemotherapy regimen with the incidence of drug-induced liver injury, examined the clinical manifestations of liver disease.Results: Drug-induced liver injury as a complication of a specific anti-TB treatment was diagnosed in 67 patients (26,8%. In 170 patients (68,0% showed increase in alanine aminotransferase and asparaginaminotrasferazy. Hepatotoxicity significantly more common in patients with disseminated tuberculosis with the collapse of the lung tissue, smear, and a high degree of disease severity. Risk factors for drug liver damage were female gender and age older than 50 years. Women develop liver disease at an earlier date, and displays it harder than men. The earliest and most informative routine biochemical tests, reflecting the state of the liver in the dynamics are ALT and AST. It was found that the mode of the standard anti-TB treatment determines the type of liver injury: the first, 2a and 3rd modes prevails cytolytic hepatocellular type, with 2b mode – combined (mixed type 4th – type of cholestatic liver damage. It was found that repeated, after the development of hepatotoxic reactions, the appointment of anti-TB drugs without gepatoprotektsii in 94% of patients leads to repeated drug-induced liver damage. Cancel specific therapy against the background of cytolytic syndrome promotes the formation of

  12. [Evaluation of clinical and laboratory findings of adult visceral leishmaniasis cases]. (United States)

    Ural, Serap; Kaptan, Figen; Sezak, Nurbanu; El, Sibel; Örmen, Bahar; Türker, Nesrin; Demirdal, Tuna; Vardar, İlknur; Özkan Çayıröz, Pınar; Çakalağaoğlu, Fulya


    Visceral leishmaniasis (VL, kala-azar) is a zoonotic infection caused by Leishmania species which are transmitted to humans by the bites of infected female phlebotomine sandflies. Leishmania infantum is the responsible species of VL in Aegean, Mediterranean, and Central Anatolia regions of Turkey mainly observed sporadically in pediatric age groups. The aim of this study was to evaluate the clinical and laboratory findings of adult patients with VL who were admitted to our hospital. A total of 10 patients (3 female, 7 male; age range: 18-67 years, mean age: 39.3 ± 16.51) followed in the infectious diseases clinic of the hospital between 2000 and 2013 were evaluated retrospectively. The diagnosis of VL was based on the presence of appropriate clinical and physical examination, as well as biochemical findings, positive serological test results (indirect fluorescent antibody test, and rK39 rapid antigen test) and/or detection of amastigote forms of parasite in the bone marrow aspiration samples. Of the cases three were diagnosed with both bone marrow and serology positivity, five with bone marrow positivity and one of each only with liver biopsy and positive serology result. Time interval from onset of the symptoms until the establishment of the specific clinical diagnosis was ranged from 2 to 12 weeks. The most frequent initial symptoms were fever, fatigue and abdominal distension. None of the patients had immunosupressive conditions such as HIV infection, corticosteroid use, immunosupressive treatment, or transplantation. All the patients were from Aegean region and six were living in rural areas. In all cases, hepatosplenomegaly, increased erythrocyte sedimentation rate, albumin/globulin ratio inversion, anemia, leukopenia and among nine cases trombocytopenia were detected. In one case acute renal failure has been developed before treatment and the patient was admitted to dialysis program. Bacterial superinfection occurred in two cases. Patients were treated with

  13. 乡镇卫生院、社区服务中心临床实验室质量控制管理%Study of quality control management in clinical laboratories in township hospitals and community service centers

    Institute of Scientific and Technical Information of China (English)



    Objective:To develop quality control management activities in clinical laboratories in township hospitals and community service centers so as to improve the overall test level of laboratories .Methods:4 item categories in laboratories attending quality control ability test from 2012 to 2013 were evaluated to record passing rates of the test performances.Results:Respective analysis of the test results of laboratories attending quality control ability test in 2013 and 2014 showed that the passing rates in complete blood count, routine biochemistry test, urine dry chemistry analysis and HBV serum markers were on the rise.Conclusion:Through the employees training, laboratory on-site guidance and laboratory quality control activities, the passing rates of the test performances of the laboratories attending quality control ability test showed a rising trend year by year.%目的:开展乡镇卫生院、社区服务中心临床实验室质量控制管理活动,提高实验室整体检验水平. 方法:从2012年至2013年对参加检验质量控制的实验室4类项目进行测评,记录测试成绩通过率. 结果:分别对2012年至2013年参加质量控制实验室的检验测试结果分析可见,全血细胞计数、常规生化项目、尿液干化学分析、乙肝病毒血清标志物测试成绩通过率不断上升. 结论:通过对从业人员培训学习和实验室现场指导、开展实验室质量控制活动,参加实验室质量控制能力测试单位测试成绩通过率均呈逐年上升趋势.

  14. The biochemistry of blister fluid from pediatric burn injuries: proteomics and metabolomics aspects. (United States)

    Zang, Tuo; Broszczak, Daniel A; Broadbent, James A; Cuttle, Leila; Lu, Haitao; Parker, Tony J


    Burn injury is a prevalent and traumatic event for pediatric patients. At present, the diagnosis of burn injury severity is subjective and lacks a clinically relevant quantitative measure. This is due in part to a lack of knowledge surrounding the biochemistry of burn injuries and that of blister fluid. A more complete understanding of the blister fluid biochemistry may open new avenues for diagnostic and prognostic development. Burn insult induces a highly complex network of signaling processes and numerous changes within various biochemical systems, which can ultimately be examined using proteome and metabolome measurements. This review reports on the current understanding of burn wound biochemistry and outlines a technical approach for 'omics' profiling of blister fluid from burn wounds of differing severity.

  15. Approaches to enhance the teaching quality of experimental biochemistry for MBBS students in TSMU, China. (United States)

    Yu, Lijuan; Yi, Shuying; Zhai, Jing; Wang, Zhaojin


    With the internationalization of medical education in China, the importance of international students' education in medical schools is also increasing. Except foreign students majoring in Chinese language, English Bachelor of Medicine, Bachelor of Surgery (MBSS) students are the largest group of international students. Based on problems in the teaching process for experimental biochemistry, we designed teaching models adapted to the background of international students and strengthened teachers' teaching ability at Taishan Medical University. Several approaches were used in combination to promote teaching effects and increase the benefit of teaching to teachers. The primary data showed an increased passion for basic medical biochemistry and an improved theoretical background for MBSS students, which will be helpful for their later clinical medicine studies. © 2017 by The International Union of Biochemistry and Molecular Biology, 2017.

  16. Biochemistry in Biology and Chemistry Courses. (United States)

    Wood, E. J.


    Discusses the state of biochemistry education in the United Kingdom. Gives an overview of the current educational system. Lists the problems of the school children, the school teachers, and the university teachers and emphasizes problems in the school syllabi. Suggests solutions to these problems. (CW)

  17. Identification of Threshold Concepts for Biochemistry (United States)

    Loertscher, Jennifer; Green, David; Lewis, Jennifer E.; Lin, Sara; Minderhout, Vicky


    Threshold concepts (TCs) are concepts that, when mastered, represent a transformed understanding of a discipline without which the learner cannot progress. We have undertaken a process involving more than 75 faculty members and 50 undergraduate students to identify a working list of TCs for biochemistry. The process of identifying TCs for…

  18. Jmol-Enhanced Biochemistry Research Projects (United States)

    Saderholm, Matthew; Reynolds, Anthony


    We developed a protein research project for a one-semester biochemistry lecture class to enhance learning and more effectively train students to understand protein structure and function. During this semester-long process, students select a protein with known structure and then research its structure, sequence, and function. This project…

  19. A Biochemistry and Molecular Biology Course for Secondary School Teachers (United States)

    Fernandez-Novell, J. M.; Cid, E.; Gomis, R.; Barbera, A.; Guinovart, J. J.


    This article describes a course for reinforcing the knowledge of biochemistry in secondary school science teachers. The Department of Biochemistry and Molecular Biology of the University of Barcelona designed a course to bring these teachers up to date with this discipline. In addition to updating their knowledge of biochemistry and molecular…

  20. Television Medical Dramas as Case Studies in Biochemistry (United States)

    Millard, Julie T.


    Several case studies from popular television medical dramas are described for use in an undergraduate biochemistry course. These cases, which illustrate fundamental principles of biochemistry, are used as the basis for problems that can be discussed further in small groups. Medical cases provide an interesting context for biochemistry with video…

  1. Historical milestones in measurement of HDL-cholesterol: impact on clinical and laboratory practice. (United States)

    Langlois, Michel R; Blaton, Victor H


    High-density lipoprotein cholesterol (HDL-C) comprises a family of particles with differing physicochemical characteristics. Continuing progress in improving HDL-C analysis has originated from two separate fields-one clinical, reflecting increased attention to HDL-C in estimating risk for coronary heart disease (CHD), and the other analytical, reflecting increased emphasis on finding more reliable and cost-effective HDL-C assays. Epidemiologic and prospective studies established the inverse association of HDL-C with CHD risk, a relationship that is consistent with protective mechanisms demonstrated in basic research and animal studies. Atheroprotective and less atheroprotective HDL subpopulations have been described. Guidelines on primary and secondary CHD prevention, which increased the workload in clinical laboratories, have led to a revolution in HDL-C assay technology. Many analytical techniques including ultracentrifugation, electrophoresis, chromatography, and polyanion precipitation methods have been developed to separate and quantify HDL-C and HDL subclasses. More recently developed homogeneous assays enable direct measurement of HDL-C on an automated analyzer, without the need for manual pretreatment to separate non-HDL. Although homogeneous assays show improved accuracy and precision in normal serum, discrepant results exist in samples with atypical lipoprotein characteristics. Hypertriglyceridemia and monoclonal paraproteins are important interfering factors. A novel approach is nuclear magnetic resonance spectroscopy that allows rapid and reliable analysis of lipoprotein subclasses, which may improve the identification of individuals at increased CHD risk. Apolipoprotein A-I, the major protein of HDL, has been proposed as an alternative cardioprotective marker avoiding the analytical limitations of HDL-C.

  2. Clinical-laboratory characteristics of ANA-positive chronic idiopathic urticaria. (United States)

    Magen, Eli; Waitman, Dan-Andrei; Dickstein, Yoav; Davidovich, Valentina; Kahan, Natan R


    Despite the established association between chronic idiopathic/spontaneous urticaria (CIU) and presence of antinuclear antibodies (ANAs), the prevalence of autoimmune comorbidities in this population has not been analyzed. Here, we aim to identify clinical and laboratory manifestations associated with ANA-positive CIU. ANA-positive patients were identified via electronic data capture from the electronic patient record database of Leumit Health care Services (LHS) of Israel. Patient characteristics, medical histories, and details of diagnostic workup, medical treatment, and follow-up were retrieved by performing a chart review of electronic patient records (EPRs). The prevalence of target diseases among ANA(+) CIU(+), ANA(+) CIU(-), and ANA(-) CIU(+) patients was calculated. A total of 91 ANA(+) CIU(+), 3131 ANA(+) CIU(-), and 478 ANA(-) CIU(+) patients were identified. The ANA(+) CIU(+) group was characterized by higher prevalence of Sjögren's syndrome (SS)-A 52 antibodies (Ab) (7.7% versus 2.4%; p = 0.008), SS-A 60 Ab (11% versus 2.8%; p = ANA(-) CIU(+) group. Additionally, ANA(+) CIU(+) patients were more likely to be diagnosed with thyroid autoimmune diseases, higher C-reactive protein (6.4 ± 10.3 versus 4.1 ± 8.8 mg/L; p = 0.027), and more profound basopenia (0.04 ± 0.09 versus 0.15 ± 0.11 cell/mm(3); p ANA(-) CIU patients. More ANA(+) CIU(+) patients were resistant to four-fold standard licensed doses of antihistamines than ANA(-) CIU(+) patients [11 (12.1%) versus 29 (6.1%); p = 0.046]. ANA-positive CIU is characterized by higher prevalence of SS-A 52, SS-A 60, and SS-B antibodies and poorer clinical response to antihistamine medications.

  3. Clinical feasibility and safety of a novel miniature mobile cardiac catheterization laboratory in diagnosis and treatment for coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    Liang Ming; Han Yaling; Wang Geng; Yao Tianming; Sun Jingyang; Li Fei; Xu Kai


    Background The lack of medical facilities causes delayed diagnosis and treatment of coronary heart disease in remote mountainous area and/or at disaster site.The miniature mobile cardiac catheterization laboratory was developed to be an intervention platform for coronary heart disease diagnosis and treatment by our team.Pre-clinical research indicated that the miniature mobile cardiac catheterization laboratory performed well in the rescue of critical cardiovascular diseases,even ST-segment elevation myocardial infarction.The present study aimed to evaluate the clinical safety and timeliness of the miniature mobile cardiac catheterization laboratory for emergent coronary interventional diagnosis and treatment.Methods X-ray radiation safety and disinfection efficacy in the miniature mobile cardiac catheterization laboratory were tested during working status.Coronary angiography and/or percutaneous coronary intervention were performed in remote mountainous areas on patients who were first diagnosed as having coronary heart disease by senior interventional cardiologists.The percutaneous coronary intervention procedures and results from patients in the miniature mobile cardiac catheterization laboratory were compared with patients who were treated in the hospital catheter lab.Results The X-ray radiation dosages in the miniature mobile cardiac catheterization laboratory were 39.55 μGy/s,247.4 μGy/h,90.3 μGy/h and 39.4 μGy/h which were corresponded to 0 m,1 m,2 m and 3 m away from the tube central of the medium C-arm.And the radiation dosages used in the miniature mobile cardiac catheterization laboratory were less than the corresponding positions in the hospital catheter lab.The numbers of bacteria colonies in the miniature mobile cardiac catheterization laboratory in different environments range from (60±8) cfu/m3 to (120±10) cfu/m3 and met the demands of percutaneous coronary intervention.A total of 17 patients who received angiography in the miniature mobile

  4. Pulmonary embolism in the elderly: a review on clinical, instrumental and laboratory presentation

    Directory of Open Access Journals (Sweden)

    Luca Masotti


    Full Text Available Luca Masotti1,8, Patrick Ray2, Marc Righini3, Gregoire Le Gal4, Fabio Antonelli5, Giancarlo Landini1, Roberto Cappelli6, Domenico Prisco7, Paola Rottoli81Internal Medicine, Cecina Hospital, Cecina, Italy; 2Department of Emergency Medicine, Centre Hospitalo-Universitaire Pitié-Salpêtrière, Université Pierre et Marie Curie-Paris 6, Paris, France; 3Division of Angiology and Hemostasis, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland; 4Department of Internal Medicine and Chest Diseases, Brest University Hospital, Brest, France; 5Clinical Chemistry, Cecina Hospital, Cecina, Italy; 6Department of Internal, Cardiovascular and Geriatric Medicine, University of Siena, Siena, Italy; 7Department of Critical Care Medicine, Thrombosis Centre, Careggi Hospital, Florence, Italy; 8Departiment of Clinical Medicine and Immunological Sciences, Division of Respiratory Diseases, University of Siena, Siena, ItalyObjective: Diagnosis of pulmonary embolism (PE remains difficult and is often missed in the elderly due to nonspecific and atypical presentation. Diagnostic algorithms able to rule out PE and validated in young adult patients may have reduced applicability in elderly patients, which increases the number of diagnostic tools use and costs. The aim of the present study was to analyze the reported clinical presentation of PE in patients aged 65 and more.Materials and Methods: Prospective and retrospective English language studies dealing with the clinical, instrumental and laboratory aspects of PE in patients more than 65 and published after January 1987 and indexed in MEDLINE using keywords as pulmonary embolism, elderly, old, venous thromboembolism (VTE in the title, abstract or text, were reviewed.Results: Dyspnea (range 59%–91.5%, tachypnea (46%–74%, tachycardia (29%–76%, and chest pain (26%–57% represented the most common clinical symptoms and signs. Bed rest was the most frequent risk factor for VTE (15%–67%; deep vein


    Directory of Open Access Journals (Sweden)

    E. N. Simovanyan


    Full Text Available Adverse course of enterovirus-71 infection (EVI-71 in children, frequent development of the nervous system pathology determine the need for early disease diagnosis. The study included 139 children aged 6 months to 13 years. Modern EVI-71 features is a frequent defeat of children aged from 3 to 7 years, attending organized groups, the priority development of combined moderate severity forms without nervous system pathology. EVI-71 is characterized by cyclical course, appearance in the first two disease days fever, murrain-like, catarrhal, lymphoproliferative syndromes, conjunctivitis, headaches. The second stage of the disease (3— 6 days in 37.9% children accompanied by attaching of meningitis and meningoencephalitis symptoms (common cerebral, meningeal and encephalic syndromes, changes in cerebrospinal fluid. In the EVI-71 diagnosis must be observed epidemiological history, clinical and laboratory parameters, detection of enterovirus-71 and its RNA from feces, oropharyngeal mucus and cerebrospinal fluid. Patients with EVI-71 need for combined treatment, including causal agents and pathogenetic therapy. 

  6. [Clinical laboratory medicine: continuous amelioration with a book of objectives and satisfaction survey]. (United States)

    Reix, Nathalie; Agin, Arnaud; Bahram, Seiamak; Dali-Youcef, Nassim; Grucker, Daniel; Jaulhac, Benoît; Lepiller, Quentin; Lessinger, Jean-Marc; Mauvieux, Laurent; Monier, Laurie; Schramm, Frédéric; Stoll-Keller, Françoise; Vallat, Laurent; Ludes, Bertrand; Candolfi, Ermanno; Filisetti, Denis


    We report in this publication the use of two educational tools, a questionnaire of satisfaction and a training book, to improve the training of students during their internship in clinical laboratory at the "Pôle de biologie des Hôpitaux universitaires de Strasbourg" in France. First, the ongoing training was assessed by the interns with a questionnaire measuring satisfaction. The analysis of this questionnaire identified four key points to improve: 1) define the teaching objectives, 2) organize the training with a schedule, 3) revise certain teaching methods and 4) ensure better integration of the students in the team of medical biologists. After this assessment, we implemented a training book to answer these four points. Indeed, the training book presents the objectives, the schedule of training, and how to validate the educational objectives. A new assessment was performed again using the same methodology. Results showed an improvement in student satisfaction from 74 to 88 %. The questionnaire of satisfaction and the training book are presented in this article. The aim of the assessment of training combined with the training book is to incite the actors of the training (students and teachers) to continually improve the training. The objectives of the Pôle de Biologie are to obtain an 80 % satisfaction rate during the 6 months trainings and to reduce or eliminate dissatisfaction, and finally to ensure the validation by students of 80 to 100 % of their predetermined objectives.

  7. Behaviour of Clinical, Anthropometric and Laboratory Variables in Patients with Metabolic Syndrome

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    Madelaine Hernández Tamayo


    Full Text Available Background: Diagnosing patients with metabolic syndrome is important because of the high prevalence and risk they present. Objective: to determine the behaviour of some clinical, anthropometric and laboratory variables in patients with metabolic syndrome. Methods: A descriptive study was conducted. The sample included 161 patients selected at random in different research stages from a universe including all the patients who attended six different consultations in Urbano Noris municipality, Holguín, from September 2008 to June 2009. Diagnosis was performed according to the ATP-III. Variance analysis and Fisher's exact test in SPSS (α = 0.05 were applied. Results: Patients with metabolic syndrome (n = 103: 63.97% presented values over average weight, height, waist circumference, body mass index, systolic blood pressure, plasma cholesterol, LDL, triglycerides and glucose. Their HDL levels were lower. A significant association between metabolic syndrome and CRP, microalbuminuria, alterations in blood sugar levels and hypertension was proved. Conclusions: The importance of characterizing the metabolic syndrome for future interventions was determined.

  8. Rare hereditary red blood cell enzymopathies associated with hemolytic anemia - pathophysiology, clinical aspects, and laboratory diagnosis. (United States)

    Koralkova, P; van Solinge, W W; van Wijk, R


    Hereditary red blood cell enzymopathies are genetic disorders affecting genes encoding red blood cell enzymes. They cause a specific type of anemia designated hereditary nonspherocytic hemolytic anemia (HNSHA). Enzymopathies affect cellular metabolism, which, in the red cell, mainly consists of anaerobic glycolysis, the hexose monophosphate shunt, glutathione metabolism, and nucleotide metabolism. Enzymopathies are commonly associated with normocytic normochromic hemolytic anemia. In contrast to other hereditary red cell disorders such as membrane disorders or hemoglobinopathies, the morphology of the red blood cell shows no specific abnormalities. Diagnosis is based on detection of reduced specific enzyme activity and molecular characterization of the defect on the DNA level. The most common enzyme disorders are deficiencies of glucose-6-phosphate dehydrogenase (G6PD) and pyruvate kinase (PK). However, there are a number of other enzyme disorders, often much less known, causing HNSHA. These disorders are rare and often underdiagnosed, and the purpose of this review. In this brief review, we provide an overview of clinically relevant enzymes, their function in red cell metabolism, and key aspects of laboratory diagnosis.

  9. Recurrent respiratory disorders in Polish Konik horses - clinical and laboratory findings

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    Niedźwiedź Artur


    Full Text Available The aim of this study was to investigate the causes of chronic respiratory disorders in Polish Konik horses maintained in a stable and pasture, under condition typical for pleasure horses in Poland. The study was conducted on 14 adult horses, consistent with regard to environment and living conditions. The horses were divided into two groups: seven horses not affected by any respiratory problem (control group and seven horses with history of lower airway disease (study group. Clinical and laboratory evaluation, endoscopic examination, bronchoalveolar lavage, tracheal wash, and lung ultrasound were performed in all horses. Median (25th and 75th percentiles for bronchoalveolar lavage fluid differential cell count in control horses was 55.8 (49.8 and 59.1 of macrophages, 41 (38.5 and 45.9 of lymphocytes, and 5.1 (4.1 and 5.3 of neutrophils, whereas in the study group they were 32.8 (25.9 and 35.7 of macrophages, 59.8 (51.3 and 64.8 of lymphocytes, and 38.1 (34.8 and 41.1 of neutrophils. It was concluded that chronic respiratory disorders in Polish Konik horses were probably caused by recurrent airway obstruction.

  10. Biochemistry in the idea of graduation students

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    D. F. Escoto et al


    Full Text Available INTRODUCTION AND OBJECTIVE: Biochemistry is an interdisciplinary area that allows us to study chemical phenomena in live organisms. That way, its study is of extreme importance, in all levels, to enlarge the comprehension of natural phenomena. However, it is barely explored in the basic education and often fragmented in the higher education, or in graduation degrees that contemplate this area. Especially in the teacher training, where the fragmentation of knowledge can contribute to form wrong concepts. Based on that, this work aims to identify the concept of Biochemistry according to the future teachers of Natural Science. MATERIALS AND METHODS: The work was developed with 3º, 5º and 9º semesters students of the natural science degree on Universidade Federal do Pampa. 50 students, from 18 to 56 years old, were interviewed. The data was obtained through a semi-structured questionnaire. The methodology of categorization and analysis of content with emergent categories of speech was chosen for the analysis. RESULTS AND CONCLUSION: Initially, 11 categories were chosen by content similarity. In descending order: chemical reactions in organisms, chemistry area, chemistry of life, cell metabolism, the study of living beings, origin of life, biology area, organic balance, chemical-biological study. The reports made possible to identify that most students do understand with clarity the goal of studying biochemistry. Although, we can see that there are some students that fragment the area, what means, they try to discriminate chemistry from biology. This way, they demonstrate a difficulty to comprehend biochemistry as interdisciplinary, what makes it hard to contextualize the built knowledge. It is important to develop strategies to overcome the fragmentation of knowledge, so that biochemistry can be comprehended in its fullness and help on the teaching processes that will be developed by the future teachers.

  11. Medical expert systems developed in j.MD, a Java based expert system shell: application in clinical laboratories. (United States)

    Van Hoof, Viviane; Wormek, Arno; Schleutermann, Sylvia; Schumacher, Theo; Lothaire, Olivier; Trendelenburg, Christian


    Growing complexity of diagnostic tests, combined with increased workload, stringent laboratory accreditation demands, continuous shortening of turn-around-time and budget restrictions have forced laboratories to automate most of their iterative tasks. Introduction of artificial intelligence by means of expert systems has gained an important place in this automation process. Different parts of clinical laboratory activity can benefit from their implementation and the present project deals with one aspect, namely the clinical interpretation of diagnostic tests. This paper describes how j.MD, a new Java based expert system shell, was used to reprogram the expert system for interpretation of amylase isoenzyme patterns that has been in use for many years in our laboratory, and that was originally programmed in Pro.MD, a Prolog based expert system shell. One of the most important advantages of the j.MD system is its bidirectional link with the laboratory information system. This project shows how expert systems for the interpretation of complex diagnostic tests that demand specific expertise can become an integrated part of the automated clinical chemistry lab.

  12. The clinical features, laboratory findings, treatment and follow-up results of patients with morphea

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    Nehir Parlak


    Full Text Available Objective: Morphea, also known as localized scleroderma, is a rare skin disease of unknown pathogenesis, characterized by fibrosis in the skin and subcutaneous tissue. In this study, we aim to evaluate the demographic features, clinical characteristics, laboratory findings, and response to treatment in patients diagnosed with morphea. Materials and Methods: The findings of fifty eight patients diagnosed with morphea were retrospectively evaluated between 1995-2011. All patients' clinical symptoms, concomitant diseases, symptoms, immunological features and presence of peripheral eosinophilia were investigated. Treatment methods, response to therapy of 40 patients whose treatment continued for 2-12 months were examined. Fourty nine patients (84.5% were female and 9 patients (15.5% were male of 58 patients who were diagnosed with morphea. The mean age of patients was 42.33±18.44 years (range: 7-75 years. Diagnosis was made histopathologically in all cases. Borrelia antibodies were negative in all patients enrolling the study. Thirty six patients (62.1% had plaque type, 17 patients (29.3% had generalized type, 3 patients (5.2% had mixed type (linear + plaque and 2 patients (3.4% had linear type of morphea. ANA was found to be positive in 12 (26.2% of 46 patients. Considering the relationship between the clinical types of morphea with ANA, 38.5% of plaque type, 53.8% of generalized type, 7.7% of mixed type patients showed ANA positivity. ANA positivity was statistically significant in patients with generalized morphea (p=0.027. Peripheral eosinophilia was detected in one case in whom lesions were generalized (2.1%. Colchicine therapy was given to 23 cases. Complete and partial response rates are 47.8% and 26.1%, respectively. However, 17.4% of patients remained stable and progression was noted in 8.7% of the cases. Conclusion: In conclusion, plaque type morphea is the most common type of morphea. ANA positivity was statistically significant in

  13. Clinical and Laboratory Features, Treatment and Prognosis in Children with Guillian-Barre Syndrome

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    N. A. Suponeva


    Full Text Available A retrospective study of 42 cases of acute flaccid paralysis (AFP in children aged between 7 months and 15 years, registered at the Municipal Clinical Hospital №1 throughout a 7 year period (2007—2014, was performed to investigate the features of pediatric Guillian-Barre Syndrome (GBS. GBS has shown to be the most common cause of AFP in children, with prevalence of 74% of all 31 cases. Clinical manifestations, functional status, laboratory and electrodiagnostic data were evaluated in group of 31 children in order to highlight particular features of childhood GBS in Russia. The highest frequency of GBS was observed in children aged between 1 to 3 with the median 6 [3; 11] years. Boys with GBS outnumbered girls by a 2,1:1 ratio. No seasonal dependence has been observed, with children equally suffering from this disease without a seasonal pattern throughout the year. According to the electrophysiological and clinical data, 24 children were diagnosed with acute inflammatory demyelinating polyradiculoneuropathy (AIDP (77%, 5 with acute motor axonal neuropathy (AMAN (16% and 2 with аcute motor-sensory axonal neuropathy (AMSAN in a total of cases (7%. Several exclusive features of GBS in children for Russia were discovered. The most common initial symptom was limb pain, with the impartial sensory disturbance found only in 13% of the patients observed, 10% of which were paresthesias and the remaining 3% belonging to hypostesias. Children reached the nadir state rapidly, the median time from onset to nadir was 9.5 [6,25; 12,5] days. Cranial nerve dysfunction at nadir was observed in a greater percentage of patients (51% compared to that of 23% cases at the onset, with the facial palsy increasing from 10 to 32% and the bulbar palsy from 12 to 19%. The patients were given intravenous immunoglobulin in various doses: from 0.2 to 1.75 mg/kg per course (0.5 [0.5; 0.8] g/kg and/or plasmapheresis with a median volume of 93 [81; 100] ml/kg per

  14. 78 FR 31560 - Medicare Program; Public Meeting in Calendar Year 2013 for New Clinical Laboratory Test Payment... (United States)


    ... auditorium of the Centers for Medicare & Medicaid Services (CMS), Central Building, 7500 Security Boulevard... [CMS-1451-N] Medicare Program; Public Meeting in Calendar Year 2013 for New Clinical Laboratory Test Payment Determinations AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION:...

  15. Using pathology-specific laboratory profiles in Clinical Pathology to reduce inappropriate test requesting: two completed audit cycles

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    Baricchi Roberto


    Full Text Available Abstract Background Systematic reviews have shown that, although well prepared, the Consensus Guidelines have failed to change clinical practice. In the healthcare district of Castelnovo né Monti (Reggio Emilia, Italy, it became necessary for the GPs and Clinical Pathologists to work together to jointly define laboratory profiles. Methods Observational study with two cycles of retrospective audit on test request forms, in a primary care setting. Objectives of the study were to develop pathology-specific laboratory profiles and to increase the number of provisional diagnoses on laboratory test request forms. A Multiprofessional Multidisciplinary Inter-hospital Work Team developed pathology-specific laboratory profiles for more effective test requesting. After 8 training sessions that used a combined strategy with multifaceted interventions, the 23 General Practitioners (GPs in the trial district (Castelnovo nè Monti tested the profiles; the 21 GPs in the Puianello district were the control group; all GPs in both districts participated in the trial. All laboratory tests for both healthcare districts are performed at the Laboratory located in the trial district. A baseline and a 1-year audit were performed in both districts on the GPs’ request forms. Results Seven pathology-specific laboratory profiles for outpatients were developed. In the year after the first audit cycle: 1 the number of tests requested in the trial district was distinctly lower than that in the previous year, with a decrease of about 5% (p  Conclusions The first audit cycle showed a significant decrease in the number of tests ordered only in the trial district. The combined strategy used in this study improved the prescriptive compliance of most of the GPs involved. The presence of the clinical pathologist is seen as an added value.

  16. Clinical immunology review series: an approach to the use of the immunology laboratory in the diagnosis of clinical allergy. (United States)

    Williams, P; Sewell, W A C; Bunn, C; Pumphrey, R; Read, G; Jolles, S


    In the last 10 years UK immunology laboratories have seen a dramatic increase in the number and range of allergy tests performed. The reasons for this have been an increase in the incidence of immunoglobulin E (IgE)-mediated allergic disease set against a background of greater public awareness and more referrals for assessment. Laboratory testing forms an integral part of a comprehensive allergy service and physicians treating patients with allergic disease need to have an up-to-date knowledge of the range of tests available, their performance parameters and interpretation as well as the accreditation status of the laboratory to which tests are being sent. The aim of this review is to describe the role of the immunology laboratory in the assessment of patients with IgE-mediated allergic disease and provide an up-to-date summary of the tests currently available, their sensitivity, specificity, interpretation and areas of future development.

  17. The Use of Case Studies in an Undergraduate Biochemistry Course (United States)

    Cornely, Kathleen


    Most college biochemistry courses are taught in a format in which the professor lectures and the student memorizes. Although this is the best method for conveying large amounts of material, it puts the student in the position of passive learner. The lecture-based format has not been abandoned, but has been supplemented with case study projects assigned to the students upon completion of the intermediary metabolism unit. The case study assignment is modeled on similar exercises carried out in medical school biochemistry courses in the US and around the world. A description of the assignment follows: a group of 4-5 students is given a case study which gives the medical history of a patient with an inherited metabolic disease. The group is asked to provide biochemical explanations for the patient's symptoms and to suggest an effective course of treatment. The evaluation consists of a short paper that the students write as a group. The assignment provides the opportunity for small group interaction within a larger class and emphasizes cooperative-collaborative learning. Students learn by researching the topic on their own and debating it in small group discussions, and in so doing, gain a sense of confidence in themselves and the material they have learned over the course of the semester. Solving a "real-life" problem helps develop analytical and higher-order thinking skills and allows the students to see how biochemical concepts they have learned apply to a clinical situation.

  18. Clinical and laboratory toxicity after intra-arterial radioembolization with (90y-microspheres for unresectable liver metastases.

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    Maarten L J Smits

    Full Text Available OBJECTIVE: To investigate clinical and laboratory toxicity in patients with unresectable liver metastases, treated with yttrium-90 radioembolization ((90Y-RE. METHODS: Patients with liver metastases treated with (90Y-RE, between February 1(st 2009 and March 31(st 2012, were included in this study. Clinical toxicity assessment was based on the reporting in patient's charts. Laboratory investigations at baseline and during a four-month follow-up were used to assess laboratory toxicity according to the Common Terminology Criteria for Adverse Events version 4.02. The occurrence of grade 3-4 laboratory toxicity was stratified according to treatment strategy (whole liver treatment in one session versus sequential sessions. Response assessment was performed at the level of target lesions, whole liver and overall response in accordance with RECIST 1.1 at 3- and 6 months post-treatment. Median time to progression (TTP and overall survival were calculated by Kaplan-Meier analysis. RESULTS: A total of 59 patients, with liver metastases from colorectal cancer (n = 30, neuroendocrine tumors (NET (n = 6 and other primary tumors (n = 23 were included. Clinical toxicity after (90Y-RE treatment was confined to grade 1-2 events, predominantly post-embolization symptoms. No grade 3-4 clinical toxicity was observed, whereas laboratory toxicity grade 3-4 was observed in 38% of patients. Whole liver treatment in one session was not associated with increased laboratory toxicity. Three-months disease control rates for target lesions, whole liver and overall response were 35%, 21% and 19% respectively. Median TTP was 6.2 months for target lesions, 3.3 months for the whole liver and 3.0 months for overall response. Median overall survival was 8.9 months. CONCLUSION: The risk of severe complications or grade 3-4 clinical toxicity in patients with liver metastases of various primary tumors undergoing (90Y-RE is low. In contrast, laboratory toxicity grade 3

  19. Effect of seasonal variation on adult clinical laboratory parameters in Rwanda, Zambia, and Uganda: implications for HIV biomedical prevention trials.

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    Eugene Ruzagira

    Full Text Available To investigate the effect of seasonal variation on adult clinical laboratory parameters in Rwanda, Zambia, and Uganda and determine its implications for HIV prevention and other clinical trials.Volunteers in a cross-sectional study to establish laboratory reference intervals were asked to return for a seasonal visit after the local season had changed from dry to rainy or vice versa. Volunteers had to be clinically healthy, not pregnant and negative for HIV, Hepatitis B and C, and syphilis infection at both visits. At each visit, blood was taken for measurement of hemoglobin, haematocrit, mean corpuscular volume, red blood cells, platelets, total white blood cells (WBC, neutrophils, lymphocytes, monocytes, eosinophils, basophils, CD4/CD8 T cells, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, direct bilirubin, total bilirubin, total immunoglobulin gamma, total protein, creatinine, total amylase, creatine phosphokinase and lactate dehydrogenase (LDH. Consensus dry season reference intervals were applied to rainy season values (and vice versa and the proportion of 'out-of-range' values determined. Percentage differences between dry and rainy season parameter mean values were estimated.In this cohort of 903 volunteers, less than 10.0% of consensus parameter (except LDH values in one season were "out-of-range" in the other. Twenty-two (22 percent of rainy season LDH values fell outside of the consensus dry season interval with the higher values observed in the rainy season. Variability between consensus seasonal means ranged from 0.0% (total WBC, neutrophils, monocytes, basophils, and direct bilirubin to 40.0% (eosinophils. Within sites, the largest seasonal variations were observed for monocytes (Masaka, 11.5%, LDH (Lusaka, 21.7%, and basophils (Kigali, 22.2%.Seasonality had minimal impact on adult clinical laboratory parameter values in Rwanda, Zambia, and Uganda. Seasonal variation may not be an important factor in the

  20. Clinical and Laboratory Findings of a Group of Iranian Patients with Oral Lichen Planus

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    Darvishpoor Kakhki H.


    Full Text Available atement of Problem: Lichen planus (LP is a chronic disease that affects skin and mucous membranes. Lesions of oral lichen planus (OLP can persist for a long time. Varying prevalence rates of oral lichen planus have been reported in different parts of the world, while information regarding the epidemiology of this disease in Iran is incomplete.Purpose: This study was designed to evaluate the characteristics of oral lichen planus in a group of Iranian patients and compare the results with similar conducted studies in other populations. Materials and Method: In this descriptive study data were collected from charts of 158 patients In Kerman, Iran (1997-2005 over 8 consecutive years. For each patient, age at presentation, gender, chief complaint, duration of chief compliant, previous treatment, current medications, skin involvement and a complete medical history has been recorded. A number of possible etiologic factors and possible presence of diabetes or liver disease also analyzed. Laboratory evaluations consisted of glucose tolerance test (GTT and liver function tests (LFT. This data were analyzed by SPSS version 12 statistical software. Results: The mean age of study population was 41.16 years. Subjects were predominantly female (65.1%. Liver function tests (LFT were abnormal in 19.6% of cases. Disturbance of glucose metabolism and fasting blood sugar was also higher than normal limit in10.8% and 2.9 % of cases respectively. Atrophic-erosive lesions were found in 17 of the cases. In 50 patients the lesions were exclusively keratotic and in 91 the lesions were atrophic-erosive and keratotic. Most oral lesions were multifocal (88.6%, with the buccal mucosa being the most common location in each clinical form (87.3%. Duration of oral lesions ranged from 0.4 to 20 years with a mean of 1.54 year. Conclusion: This study showed that epidemiological and clinical features of the disease in Kerman are similar to those mentioned in literature. Also, in

  1. Use of bar code labels on collection tubes for specimen management in the clinical laboratory. (United States)

    Tilzer, L L; Jones, R W


    A new generation in specimen handling has arrived with the introduction of bar code readers on medical laboratory equipment. The incorporation of this technology into laboratory information systems offers a streamlining of specimen workflow never before achievable in a laboratory environment. The use of evacuated collection tubes as the primary sampling container on a random-access chemistry analyzer interfaced to a laboratory information system creates a very simplified sampling/analysis system with tremendous advantages. There are significant labor savings, superior service to clinicians, and reduced chances for clerical error.

  2. The basis of clinical tribalism, hierarchy and stereotyping: a laboratory-controlled teamwork experiment (United States)

    Braithwaite, Jeffrey; Clay-Williams, Robyn; Vecellio, Elia; Marks, Danielle; Hooper, Tamara; Westbrook, Mary; Westbrook, Johanna; Blakely, Brette; Ludlow, Kristiana


    Objectives To examine the basis of multidisciplinary teamwork. In real-world healthcare settings, clinicians often cluster in profession-based tribal silos, form hierarchies and exhibit stereotypical behaviours. It is not clear whether these social structures are more a product of inherent characteristics of the individuals or groups comprising the professions, or attributable to a greater extent to workplace factors. Setting Controlled laboratory environment with well-appointed, quiet rooms and video and audio equipment. Participants Clinical professionals (n=133) divided into 35 groups of doctors, nurses and allied health professions, or mixed professions. Interventions Participants engaged in one of three team tasks, and their performance was video-recorded and assessed. Primary and secondary measures Primary: teamwork performance. Secondary, pre-experimental: a bank of personality questionnaires designed to assess participants’ individual differences. Postexperimental: the 16-item Mayo High Performance Teamwork Scale (MHPTS) to measure teamwork skills; this was self-assessed by participants and also by external raters. In addition, external, arm's length blinded observations of the videotapes were conducted. Results At baseline, there were few significant differences between the professions in collective orientation, most of the personality factors, Machiavellianism and conservatism. Teams generally functioned well, with effective relationships, and exhibited little by way of discernible tribal or hierarchical behaviours, and no obvious differences between groups (F (3, 31)=0.94, p=0.43). Conclusions Once clinicians are taken out of the workplace and put in controlled settings, tribalism, hierarchical and stereotype behaviours largely dissolve. It is unwise therefore to attribute these factors to fundamental sociological or psychological differences between individuals in the professions, or aggregated group differences. Workplace cultures are more likely to

  3. Synchrony of clinical and laboratory surveillance for influenza in Hong Kong.

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    Lin Yang

    Full Text Available BACKGROUND: Consultation rates of influenza-like illness (ILI in an outpatient setting have been regarded as a good indicator of influenza virus activity in the community. As ILI-like symptoms may be caused by etiologies other than influenza, and influenza virus activity in the tropics and subtropics is less predictable than in temperate regions, the correlation between of ILI and influenza virus activity in tropical and subtropical regions is less well defined. METHODOLOGY AND PRINCIPAL FINDINGS: In this study, we used wavelet analysis to investigate the relationship between seasonality of influenza virus activity and consultation rates of ILI reported separately by General Out-patient Clinics (GOPC and General Practitioners (GP. During the periods 1998-2000 and 2002-2003, influenza virus activity exhibited both annual and semiannual cycles, with one peak in the winter and another in late spring or early summer. But during 2001 and 2004-2006, only annual cycles could be clearly identified. ILI consultation rates in both GOPC and GP settings share a similar non-stationary seasonal pattern. We found high coherence between ILI in GOPC and influenza virus activity for the annual cycle, but this was only significant (p<0.05 during the periods 1998-1999 and 2002-2006. For the semiannual cycle high coherence (p<0.05 was also found significant during the period 1998-1999 and year 2003 when two peaks of influenza were evident. Similarly, ILI in GP setting is also associated with influenza virus activity for both the annual and semiannual cycles. On average, oscillation of ILI in GP and of ILI in GOPC preceded influenza virus isolation by approximately four and two weeks, respectively. CONCLUSIONS: Our findings suggest that consultation rates of ILI precede the oscillations of laboratory surveillance by at least two weeks and can be used as a predictor for influenza epidemics in Hong Kong. The validity of our model for other tropical regions needs to be

  4. Clinical and laboratory evaluation of thyroid function following total laryngectomy in laryngeal cancer

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    Motasaddi Zarandy M


    Full Text Available Background: Hypothyroidism is a well-documented complication after treatment of laryngeal cancer and is particularly significant among patients undergoing laryngectomy. We investigated the frequency of hypothyroidism in patients treated with total laryngectomy for laryngeal cancer. We also evaluated the effect of neck radiotherapy on thyroid function after total laryngectomy for laryngeal cancer. Methods: In a cross-sectional study, we evaluated 31 patients with laryngeal squamous cell carcinoma (mean age 53.6 years. Among these patients, 14 were treated with surgery only and 17 were treated with surgery plus radiotherapy. Laboratory evaluation included levels of thyroid stimulating hormone (TSH, free T4, free T3, and antithyroid antibodies both preoperatively and postoperatively at the first day, as well as one and six months after surgery. Results: All patients had normal thyroid function before treatment; however, after 6 months, five patients (16.1% were hypothyroid. Of these, three patients (9.6% had subclinical symptoms, including elevated thyroid-stimulating hormone with normal free T4, and two patients (6.5% showed clinical symptoms of hypothyroidism. Radiotherapy and neck dissection were significantly associated with higher incidences of hypothyroidism. Conclusion: Our data suggest that hypothyroidism occurs in a substantial proportion of patients undergoing surgery for laryngeal cancer. The results indicate that thyroid function studies should be routinely performed in the follow-up care of laryngeal cancer patients, especially if radiotherapy and neck dissection were part of the treatment. We suggest that this approach will improve the patient's quality of life and diminish the co-morbidity associated with this kind of surgery.

  5. Contribution of laboratory methods in diagnosing clinically suspected ocular toxoplasmosis in Brazilian patients. (United States)

    Mattos, Cinara C B; Meira, Cristina S; Ferreira, Ana I C; Frederico, Fábio B; Hiramoto, Roberto M; Almeida, Gildásio C; Mattos, Luiz C; Pereira-Chioccola, Vera L


    This prospective study evaluated the value of laboratorial diagnosis in ocular toxoplasmosis analyzing peripheral blood samples from a group of Brazilian patients by immunologic and molecular methods. We analyzed blood samples from 184 immunocompetent patients with ocular disorders divided into 2 groups: Group I, composed of samples from 49 patients with ocular toxoplasmosis diagnosed by clinical features; Group II, samples from 135 patients with other ocular diseases. Samples were assayed by conventional polymerase chain reaction (cnPCR), real-time PCR (qPCR) for Toxoplasma gondii, indirect immunofluorescence reaction (IF), avidity test (crude tachyzoite lysate as antigen), and excreted-secreted tachyzoite proteins as antigen (ESA-ELISA). cnPCR and qPCR profiles were concordant in all samples. Positive PCR was shown in 40.8% of group I patients. The majority of the positive blood samples (75%) were taken from patients with toxoplasmic retinochoroiditis scars, and the others (25%), from patients with retinal exudative lesions. Despite that 86 of the 135 patients from Group II had asymptomatic toxoplasmosis, all DNA blood samples had negative PCR. Concordant results were shown in the data obtained by serologic methods. Around 24% of the patients with ocular toxoplasmosis had high antibody titers determined by ESA-ELISA and IF. Anti-ESA antibodies are shown principally in patients with active infection. Collectively, these data demonstrate the presence of tachyzoites in the blood of patients with chronic infection, supporting the idea of recurrent disease. Circulating parasites in blood of immunocompetent individuals may be associated with the reactivation of the ocular disease.

  6. Reporting incidental findings in genomic scale clinical sequencing--a clinical laboratory perspective: a report of the Association for Molecular Pathology. (United States)

    Hegde, Madhuri; Bale, Sherri; Bayrak-Toydemir, Pinar; Gibson, Jane; Jeng, Linda Jo Bone; Joseph, Loren; Laser, Jordan; Lubin, Ira M; Miller, Christine E; Ross, Lainie F; Rothberg, Paul G; Tanner, Alice K; Vitazka, Patrik; Mao, Rong


    Advances in sequencing technologies have facilitated concurrent testing for many disorders, and the results generated may provide information about a patient's health that is unrelated to the clinical indication, commonly referred to as incidental findings. This is a paradigm shift from traditional genetic testing in which testing and reporting are tailored to a patient's specific clinical condition. Clinical laboratories and physicians are wrestling with this increased complexity in genomic testing and reporting of the incidental findings to patients. An enormous amount of discussion has taken place since the release of a set of recommendations from the American College of Medical Genetics and Genomics. This discussion has largely focused on the content of the incidental findings, but the laboratory perspective and patient autonomy have been overlooked. This report by the Association of Molecular Pathology workgroup discusses the pros and cons of next-generation sequencing technology, potential benefits, and harms for reporting of incidental findings, including the effect on both the laboratory and the patient, and compares those with other areas of medicine. The importance of genetic counseling to preserve patient autonomy is also reviewed. The discussion and recommendations presented by the workgroup underline the need for continued research and discussion among all stakeholders to improve our understanding of the effect of different policies on patients, providers, and laboratories.

  7. [Extended-spectrum-beta-lactamase-producing Proteus mirabilis: laboratory-based surveillance in cooperation with 12 clinical laboratories in the Kinki Region of Japan]. (United States)

    Nakamura, Tatsuya; Komatsu, Masaru; Shimakawa, Kouichi; Sueyoshi, Noriyuki; Satoh, Kaori; Toyokawa, Masahiro; Nishio, Hisaaki; Wada, Yasunao; Orita, Tamaki; Kofuku, Tomomi; Sakamoto, Masako; Okamoto, Kiyotaka; Akagi, Masahiro; Kinoshita, Shohiro


    We studied 247 strains of Proteus mirabilis collected during the 6 months from November 2003 to April 2004 from 12 clinical laboratories in the Kinki region of Japan for the production of extended-spectrum beta-lactamase (ESBL). Eighteen strains (7.3%) showed MICs for cefpodoxime of > or = 2 microg/mL and 13 strains (5.2%) were positive for the double-disk synergy test. Susceptibility depended on genotype. MICs for cefepime, cefozopran, and cefpirome were high (> or = 8 microg/mL), and that for ceftazidime was low (0.12-0.5 microg/mL). Meropenem showed the lowest MIC (ESBL genotype by the polymerase chain reaction showed that 12 of 13 strains were CTX-M2 types. CTX-M9 was detected in a single laboratory. The clinical background showed 5 strains in urine samples. Twelve of 13 strains were detected in patients with minimal devices use. No symptoms were found in most cases of established syndrome. Analysis of PCR fingerprint profiles of random amplified polymorphic DNA patterns showed that 6 of 7 strains from hospital 1 showed the same pattern, and 5 of 5 strains from hospital 13 showed the same pattern, suggesting the nosocomial spread of P. mirabilis in each hospital.

  8. [Recommendations for implementing the UNE-EN-ISO 15189 quality standard in the clinical microbiology laboratory: bacteriology and serology]. (United States)

    Rojo, María Dolores; Aguiar, Juan Manuel; Cercenado, Emilia; de Ory, Fernando; de la Rosa, Manuel


    The UNE-EN-ISO 15189:2007 standard specifies the management and technical requirements that clinical microbiology laboratories must meet to achieve optimal quality when performing microbiological analyses. With implementation of this standard, a laboratory can receive the accreditation and formal recognition of an authorized body, certifying that it is apt for performing an assay or group of assays. In Spain, laboratories that apply these standards can be accredited by the Entidad Nacional de Acreditación (ENAC, Spanish accreditation body). The purpose of this review is to familiarize clinical microbiology laboratory specialists with the UNE-EN-ISO 15189:2007 standard through a practical approach focussed on bacteriology and serology studies. We briefly define the scope and specify the requisites required for managing the quality of the procedures and processes involved in performing tests on human specimens, for document control, and for management of instruments and equipment, personnel, information systems, supply systems, and external services. Lastly, evaluation approaches are indicated to achieve continuing improvement of the processes carried out and the services the laboratory provides.

  9. Sexually transmitted infections in women: A correlation of clinical and laboratory diagnosis in cases of vaginal discharge syndrome

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    Vidyalaxmi Chauhan


    Full Text Available Aims: This study compares the clinical and laboratory diagnosis of vaginal discharge syndrome. Settings and Design: This cross-sectional study was carried out at the gynaecology outpatient department of a tertiary care hospital in Gujarat, India. Material and Methods: Total of 180 females diagnosed as vaginal discharge or cervicitis based on syndromic approach and were recruited for the study. Their clinical profile was noted and they were investigated for bacterial vaginosis, trichomoniasis, candidiasis, gonorrhoea and chlamydia infection. Results: Lower abdominal pain (35% followed by burning micturition (23.9% were the common associated complaints. Bacterial vaginosis was the most common clinical diagnosis, while trichomoniasis was least common. Upon laboratory investigation, 35.6% of cases of vaginal discharge and 12% of cases of cervicitis tested positive. Percentage of cases confirmed by laboratory investigation was 50, 27.8 and 41.7 for bacterial vaginosis, trichomoniasis and candidiasis respectively. Conclusion: Among all the females diagnosed as vaginal discharge syndrome, a very small percentage actually turned out to be positive upon laboratory testing.

  10. Clinical and Laboratory Findings in Patients with Tramadol Intoxication Referred to Razi Hospital During 2005-06

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    Morteza Rahbar Taromsari


    Full Text Available Introduction: Frequency of Tramadol intoxication is increasing as a result of its useas a drug for suppression of withdrawal symptoms by opioids abusers and its wideaccessibility of this drug. Tramadol intoxication can lead to death and, therefore, earlyidentification of its clinical manifestations is crucial since early detection of theintoxication and its treatment could improve patients' survival This study investigatedthe frequency of clinical and laboratory findings in Tramadol intoxication.Methods: In this cross-sectional study, patients with Tramadol intoxication whoreferred to Razi Hospital in Rasht, Iran, during 2005-06 were examined. Theirmedical records were surveyed for demographic data, past medical history,neurological examination, and routine laboratory tests. All data were statisticallyanalyzed by SPSS software version 14.Result: The majority of the 306 patients (83.3% male were in the age range of 20-40 years and 68.6% of them had been educated up to high school. The mean dose ofingested Tramadol was 746± 453mg (mean± SD. Agitation (25.2% and seizure(20.3% were the most frequent reported symptoms. Among laboratory abnormalities,the most common findings were prolonged PT (18.3% and increased ALT (5.6%.Conclusion: The most common clinical presentation was agitation and the mostcommon laboratory finding was prolonged PT. Of all the patients, 3 cases wereadmitted to ICU. Although Tramadol poisoning might lead to death, there was onlyone death after Tramadol poisoning in the current study.

  11. Whether western normative laboratory values used for clinical diagnosis are applicable to Indian population? An overview on reference interval. (United States)

    Malati, T


    Reference Intervals denote normative values related to laboratory parameters/analytes used by diagnostic centers for clinical diagnosis. International guidelines recommend that every country must establish reference intervals for healthy individuals belonging to a group of homogeneous population. Considering enormous racial and ethnic diversity of Indian population, it is mandatory to establish reference intervals specific to Indian population. The overview on reference interval describes why the national organizations in India need to initiate nationwide efforts to establish its own laboratory standards for apparently healthy reference individuals belonging to our polygenetic, polyethnic, polyracial, multilinguistic and multicultural predominantly rural and appreciable urban Indian population with varied dietary habits.

  12. Using Live Tissue Laboratories to Promote Clinical Reasoning in Doctor of Physical Therapy Students (United States)

    Moore, W. Allen; Noonan, Ann Cassidy


    Recently, the use of animal laboratories has decreased in medical and basic science programs due to lack of trained faculty members, student concerns about animal welfare, and the increased availability of inexpensive alternatives such as computer simulations and videos. Animal laboratories, however, have several advantages over alternative forms…

  13. Virtual Practice of Biochemistry: Ascendant Chromatography on Paper of Amino acids.


    Zanatta,G.; De Moraes, C G; E.R. Zimmer; E. Ewald; Pettenuzzo,L.F.; Salbego, C. G.; V.M.T. Trindade


    Chromatography is a method used for analyses of mixture components based on different criteria: adsorbility, solubility, molecular mass, ionic charge and affinity. It is an important subject of Biochemistry. This work reports the development and the validation of a software that simulated a laboratory activity named Ascendant Chromatography on Paper of Aminoacids. The organization and the multimedia material collection were done during the 2008/2 semester. The most representative images were ...

  14. Pracital examination in biochemistry: topics and procedures?

    Directory of Open Access Journals (Sweden)

    Vocke, Nils-Daniel


    Full Text Available Under the new revision of the German licensing regulations for physicians ("Approbationsordnung" the rules for the first national examinations (i.e. "Physikum", equivalent to medical school entrance exams have been changed. In addition to the written exam a novel "oral-practical" part is required. Here we describe the implications of this oral-practical exam on the examination procedures in the field of biochemistry/molecular biology. A strategy for its realization is proposed.

  15. Building Connecticut's clinical biodosimetry laboratory surge capacity to mitigate the health consequences of radiological and nuclear disasters: A collaborative approach between the state biodosimetry laboratory and Connecticut's medical infrastructure

    Energy Technology Data Exchange (ETDEWEB)

    Albanese, Joseph [Yale New Haven Health Center for Emergency Preparedness and Disaster Response, New Haven, CT 06510 (United States)], E-mail:; Martens, Kelly [Yale New Haven Health Center for Emergency Preparedness and Disaster Response, New Haven, CT 06510 (United States); Emergency Department, Yale-New Haven Hospital, New Haven, CT (United States); Arnold, Jeffrey L. [Emergency Department, Natividad Medical Center, Salinas, CA (United States); Kelley, Katherine [Connecticut Department of Public Health, Hartford, CT (United States); Kristie, Virginia [Hartford Hospital, Hartford, CT (United States); Forte, Elaine; Schneider, Mark [Yale New Haven Health Center for Emergency Preparedness and Disaster Response, New Haven, CT 06510 (United States); Dainiak, Nicholas [Yale New Haven Health Center for Emergency Preparedness and Disaster Response, New Haven, CT 06510 (United States); Department of Medicine, Bridgeport Hospital, Bridgeport, CT (United States); Yale University School of Medicine, New Haven, CT (United States)


    Biodosimetry, based on the analysis of dicentric chromosomes in circulating mononuclear cells, is considered the 'gold standard' for estimating radiation dose and is used to make informed decisions regarding the medical management of irradiated persons. This paper describes the development of biodosimetry laboratory surge capacity for the health consequences of radiological and nuclear disasters in Connecticut, including: (1) establishment of the Biodosimetry Laboratory for the timely assessment of radiation dosage in biodosimetry specimens; (2) identification of clinical laboratories qualified and willing to process biodosimetry specimens from a large number of victims; (3) training of clinical laboratorians in initial biodosimetry specimen processing; and (4) conducting a functional drill that evaluated the effectiveness of these elements. Descriptive information was obtained from: (1) personal observations; (2) a needs assessment of clinical laboratories in Connecticut; (3) records from a training program of clinical laboratorians in biodosimetry specimen processing that was developed and provided by the Yale New Haven Center for Emergency Preparedness and Disaster Response; and (4) records from a statewide functional drill in biodosimetry specimen processing that was developed and conducted by the State of Connecticut Biodosimetry Laboratory. A needs assessment of clinical laboratories in Connecticut identified 30 of 32 clinical laboratories qualified and willing to perform initial biodosimetry specimen processing. Currently, 79 clinical laboratorians in 19 of these qualified clinical laboratories have been trained in biodosimetry specimen processing. A functional exercise was conducted involving 37 of these trained clinical laboratorians in 18 qualified laboratories as well as the Biodosimetry Laboratory. The average turnaround time for biodosimetry specimen processing in this drill was 199 min. Exercise participants provided feedback which will be

  16. Performance of ACMG-AMP Variant-Interpretation Guidelines among Nine Laboratories in the Clinical Sequencing Exploratory Research Consortium. (United States)

    Amendola, Laura M; Jarvik, Gail P; Leo, Michael C; McLaughlin, Heather M; Akkari, Yassmine; Amaral, Michelle D; Berg, Jonathan S; Biswas, Sawona; Bowling, Kevin M; Conlin, Laura K; Cooper, Greg M; Dorschner, Michael O; Dulik, Matthew C; Ghazani, Arezou A; Ghosh, Rajarshi; Green, Robert C; Hart, Ragan; Horton, Carrie; Johnston, Jennifer J; Lebo, Matthew S; Milosavljevic, Aleksandar; Ou, Jeffrey; Pak, Christine M; Patel, Ronak Y; Punj, Sumit; Richards, Carolyn Sue; Salama, Joseph; Strande, Natasha T; Yang, Yaping; Plon, Sharon E; Biesecker, Leslie G; Rehm, Heidi L


    Evaluating the pathogenicity of a variant is challenging given the plethora of types of genetic evidence that laboratories consider. Deciding how to weigh each type of evidence is difficult, and standards have been needed. In 2015, the American College of Medical Genetics and Genomics (ACMG) and the Association for Molecular Pathology (AMP) published guidelines for the assessment of variants in genes associated with Mendelian diseases. Nine molecular diagnostic laboratories involved in the Clinical Sequencing Exploratory Research (CSER) consortium piloted these guidelines on 99 variants spanning all categories (pathogenic, likely pathogenic, uncertain significance, likely benign, and benign). Nine variants were distributed to all laboratories, and the remaining 90 were evaluated by three laboratories. The laboratories classified each variant by using both the laboratory's own method and the ACMG-AMP criteria. The agreement between the two methods used within laboratories was high (K-alpha = 0.91) with 79% concordance. However, there was only 34% concordance for either classification system across laboratories. After consensus discussions and detailed review of the ACMG-AMP criteria, concordance increased to 71%. Causes of initial discordance in ACMG-AMP classifications were identified, and recommendations on clarification and increased specification of the ACMG-AMP criteria were made. In summary, although an initial pilot of the ACMG-AMP guidelines did not lead to increased concordance in variant interpretation, comparing variant interpretations to identify differences and having a common framework to facilitate resolution of those differences were beneficial for improving agreement, allowing iterative movement toward increased reporting consistency for variants in genes associated with monogenic disease.

  17. A Phytase Enzyme-Based Biochemistry Practical Particularly Suited to Students Undertaking Courses in Biotechnology and Environmental Science (United States)

    Boyce, Angela; Casey, Anne; Walsh, Gary


    Courses in introductory biochemistry invariably encompass basic principles of enzymology, with reinforcement of lecture-based material in appropriate laboratory practicals. Students undertaking practical classes are more enthusiastic, and generally display improved performance, when the specific experiments undertaken show direct relevance to…

  18. Two-Dimensional Nuclear Magnetic Resonance Structure Determination Module for Introductory Biochemistry: Synthesis and Structural Characterization of Lyso-Glycerophospholipids (United States)

    Garrett, Teresa A.; Rose, Rebecca L.; Bell, Sidney M.


    In this laboratory module, introductory biochemistry students are exposed to two-dimensional [superscript 1]H-nuclear magnetic resonance of glycerophospholipids (GPLs). Working in groups of three, students enzymatically synthesized and purified a variety of 2-acyl lyso GPLs. The structure of the 2-acyl lyso GPL was verified using [superscript…


    Directory of Open Access Journals (Sweden)

    D. V. Bestaev


    Full Text Available Interstitial lung disease (ILD is a common extra-articular manifestation of rheumatoid arthritis (RA. Objective: to study the associations of the data of high-resolution computed tomography (HRCT and the esti- mate of diffusing lung capacity (DLC with clinical and laboratory parameters in RA patients with and without ILD. Subjects and methods. 79 RA patients fulfilling the 1987 American College of Rheumatology criteria (61 women and 18 men admitted to the Nasonova Research Institute of Rheumatology were included. Results. HRCT revealed signs of ILD in 58 (73% cases. The patients with ILD were divided into three groups: 1 18 (31% patients with ground glass opacities; 2 34 (58.6% patients with fibrosis; 3 6 (10.4% patients with the honeycomb lung. Twenty-one (27% patients with ILD were included in Group 4. In the ILD patients with ground glass opacities, the levels of anti-cyclic citrullinated peptide (ACCP antibodies and rheumatoid factor (RF were much above those in the patients without ILD (240 [166; 410.5], 480 [140; 850.5] and 73 [31; 101], 330,5 [118.5; 604.8], respectively. In the patients with ILD, the concentration of C-reactive protein (CRP (46 [35; 91] was higher than that in those without ILD (24 [18; 31]; p < 0.05. In the ILD patients with ground glass opacities, DLC was considerably below that in those with ILD – 59.2±11.2 and 79.8±12.1% of the normal value, respectively (p < 0.001. Conclusion. The associations found between ACCP antibodies and DLC, DAS28 and DLC may suggest that ACCP antibodies are implicated in the pathogenesis of ILD and the lung is involved in the immunoinflammatory process. The high percent of smokers detected in our investigation confirms the considerable role of smoking in the pathogene- sis of RA-associated ILD. In the RA patients with ILD, ground glass opacities must be an indicator of the activity of an immunopathological process in the lung.

  20. Evaluation of the Etiological, Clinical and Laboratory Findings in Patients with Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Sebahattin Vurucu


    Full Text Available AIM: In this study we aimed to discuss the etiological risk factors, clinical and laboratory findings of the patients with cerebral palsy (CP according to the literature of knowledges. METHOD: The data including sex, age, social status of families, method of delivery, type of CP, risk factors, comorbidities, brain imaging and electroencephalograpy findings were retrospectively recorded from the patients’ files. RESULTS: A total of 180 patients were included in this study. Of the patients 58.3% were boy, 41.7% were girl, and mean age at diagnosis was 8.98±5.34 months. Of the patients 77.8% had vaginal birth, 22.2% had cesarean birth. The patients who had vaginal birth had statisticaly higher ratio of comorbidity, and lower mean diagnostic age, respectively (respectively p=0,027, p=0,031. Of the patients 88.3% had spastic CP, 10.6% had ataxic-hypotonic CP and 1.2% had other CP types. Of the patients 51,1% had at least one etiological risk factors. Most common etiological risk factors were perianal asfixi (22.7%, prematurity (15.5%, small for gestational age (7.2% and others (18.9%. Of the patients 79.5% had at least one comorbidity. Most common comorbidities were lenguage disabilities (60%, eye abnormalities (56.6%, mental retardation (53.3%, epilepsy (41.1% and others (12.1%. Of the patients 85.6% had at least one brain imaging abnormality. Most common brain imaging abnormalities were cortical atrophy (34.4%, abnormalities of corpus callosum (20%, periventricular leukomalacia (16.6%, encephalomalasia (10.5%, cerebral infarction (10%, hypoxic ischemic encephalopaty (6.6% and others (11.9%. CONCLUSION: Most of the our patients had spastic type CP, comorbidities including lenguage disabilities, eye abnormalities, mental retardation, and epilepsy and brain imaging abnormalities including cortical atrophy, abnormalities of corpus callosum, and periventricular leukomalacia. Therefore we consider that there may be a relationship between brain imaging

  1. Effect of vitamin B/sub 6/ on the neurotoxicity and pharmacology of desmethylmisonidazole and misonidazole: clinical and laboratory studies

    Energy Technology Data Exchange (ETDEWEB)

    Coleman, C.N.; Hirst, V.K.; Brown, D.M.; Halsey, J.


    The clinical usefulness of misonidazole (MISO) and desmethylmisonidazole (DMM) is severely limited by neurotoxicity. Based on theoretical considerations and on laboratory data suggesting that pyridoxine (PN) decreased MISO toxicity in mice. The authors attempted to ameliorate the clinical neuropathy of DMM using oral PN. Pharmacokinetic analysis suggested interaction of PN and DMM but no protection against neuropathy was observed. Serial experiments with C3H and BALB/c mice were done using various forms of vitamin B/sub 6/ (PN, pyridoxal, pyridoxal phosphate) administered orally and i.p. No consistent protection was observed. Dexamethasone did not alter MISO toxicity in mice, contrary to the clinical findings. They conclude that vitamin B/sub 6/ is not useful in preventing clinical neurotoxicity of MISO or DMM.

  2. Functions and activities of the Area Committee on Microbiology of the National Committee for Clinical Laboratory Standards. (United States)

    Washington, J A


    The Area Committee on Microbiology of the National Committee for Clinical Laboratory Standards has responsibility for the development of guidelines and standards in the field of clinical microbiology. Through the consensus process, representatives from government, industry, and professional societies have developed standards on antibacterial susceptibility testing (M2, M7, and M11), antimycobacterial susceptibility testing (M24), quality assurance on commercially prepared microbiological culture media (M22), evaluation of production lots of dehydrated Mueller-Hinton agar (M6), and preparation and testing of fetal bovine serum for use as cell culture growth supplement (M25) and guidelines on bactericidal tests (M26), protection of laboratory workers from infections transmitted by blood, body fluids, and tissue (M29), blood film examination for parasites (M15), and development of in vitro susceptibility testing criteria and quality control parameters (M23). PMID:2070343

  3. Validation of antibiotic susceptibility testing guidelines in a routine clinical microbiology laboratory exemplifies general key challenges in setting clinical breakpoints. (United States)

    Hombach, Michael; Courvalin, Patrice; Böttger, Erik C


    This study critically evaluated the new European Committee for Antimicrobial Susceptibility Testing (EUCAST) antibiotic susceptibility testing guidelines on the basis of a large set of disk diffusion diameters determined for clinical isolates. We report several paradigmatic problems that illustrate key issues in the selection of clinical susceptibility breakpoints, which are of general importance not only for EUCAST but for all guidelines systems, i.e., (i) the need for species-specific determinations of clinical breakpoints/epidemiological cutoffs (ECOFFs), (ii) problems arising from pooling data from various sources, and (iii) the importance of the antibiotic disk content for separating non-wild-type and wild-type populations.

  4. Mould routine identification in the clinical laboratory by matrix-assisted laser desorption ionization time-of-flight mass spectrometry.

    Directory of Open Access Journals (Sweden)

    Carole Cassagne

    Full Text Available BACKGROUND: MALDI-TOF MS recently emerged as a valuable identification tool for bacteria and yeasts and revolutionized the daily clinical laboratory routine. But it has not been established for routine mould identification. This study aimed to validate a standardized procedure for MALDI-TOF MS-based mould identification in clinical laboratory. MATERIALS AND METHODS: First, pre-extraction and extraction procedures were optimized. With this standardized procedure, a 143 mould strains reference spectra library was built. Then, the mould isolates cultured from sequential clinical samples were prospectively subjected to this MALDI-TOF MS based-identification assay. MALDI-TOF MS-based identification was considered correct if it was concordant with the phenotypic identification; otherwise, the gold standard was DNA sequence comparison-based identification. RESULTS: The optimized procedure comprised a culture on sabouraud-gentamicin-chloramphenicol agar followed by a chemical extraction of the fungal colonies with formic acid and acetonitril. The identification was done using a reference database built with references from at least four culture replicates. For five months, 197 clinical isolates were analyzed; 20 were excluded because they were not identified at the species level. MALDI-TOF MS-based approach correctly identified 87% (154/177 of the isolates analyzed in a routine clinical laboratory activity. It failed in 12% (21/177, whose species were not represented in the reference library. MALDI-TOF MS-based identification was correct in 154 out of the remaining 156 isolates. One Beauveria bassiana was not identified and one Rhizopus oryzae was misidentified as Mucor circinelloides. CONCLUSIONS: This work's seminal finding is that a standardized procedure can also be used for MALDI-TOF MS-based identification of a wide array of clinically relevant mould species. It thus makes it possible to identify moulds in the routine clinical laboratory setting

  5. Current status of matrix-assisted laser desorption ionisation-time of flight mass spectrometry in the clinical microbiology laboratory. (United States)

    Kok, Jen; Chen, Sharon C A; Dwyer, Dominic E; Iredell, Jonathan R


    The integration of matrix-assisted laser desorption ionisation-time of flight mass spectrometry (MALDI-TOF MS) into many clinical microbiology laboratories has revolutionised routine pathogen identification. MALDI-TOF MS complements and has good potential to replace existing phenotypic identification methods. Results are available in a more clinically relevant timeframe, particularly in bacteraemic septic shock. Novel applications include strain typing and the detection of antimicrobial resistance, but these are not widely used. This review discusses the technical aspects, current applications, and limitations of MALDI-TOF MS.

  6. Clinical laboratory, virologic, and pathologic changes in hamsters experimentally infected with Pirital virus (Arenaviridae): a rodent model of Lassa fever. (United States)

    Sbrana, Elena; Mateo, Rosa I; Xiao, Shu-Yuan; Popov, Vsevolod L; Newman, Patrick C; Tesh, Robert B


    The clinical laboratory, virologic, and pathologic changes occurring in hamsters after infection with Pirital virus (Arenaviridae) are described. Pirital virus infection in the hamsters was characterized by high titered viremia, leukocytosis, coagulopathy, pulmonary hemorrhage and edema, hepatocellular and splenic necrosis, and marked elevation of serum transaminase levels. All of the animals died within 9 days. The clinical and histopathological findings in the Pirital virus-infected hamsters were very similar to those reported in severe human cases of Lassa fever, suggesting that this new animal model could serve as a low-cost and relatively safe alternative for studying the pathogenesis and therapy of Lassa fever.

  7. External Quality Assessment for Detection of Fetal Trisomy 21, 18, and 13 by Massively Parallel Sequencing in Clinical Laboratories. (United States)

    Zhang, Rui; Zhang, Hongyun; Li, Yulong; Han, Yanxi; Xie, Jiehong; Li, Jinming


    An external quality assessment for detection of trisomy 21, 18, and 13 by massively parallel sequencing was implemented by the National Center for Clinical Laboratories of People's Republic of China in 2014. Simulated samples were prepared by mixing fragmented abnormal DNA with plasma from non-pregnant women. The external quality assessment panel, comprising 5 samples from pregnant healthy women, 2 samples with sex chromosome aneuploidies, and 13 samples with different concentrations of fetal fractions positive for trisomy 21, 18, and 13, was then distributed to participating laboratories. In total, 55.6% (47 of 84) of respondents correctly identified each of the samples in the panel. Seventeen false-negative and 87 gray zone results were reported, most [102 of 104 (98.1%)] of which were derived from for trisomy samples with effective fetal fractions trisomy sample generated by BGISEQ-100. Overall, most clinical laboratories detected samples containing effective fetal fractions >4%. Our study shows need for further laboratory training in the management of samples with low fetal fractions. For some assays, precision of Z values needs to be improved.

  8. Management of stress and stress-related diseases: Emerging computer-based technologies and the rationale for clinical laboratory assessment

    Directory of Open Access Journals (Sweden)

    Ezekiel Uba Nwose


    Full Text Available Background : Over the years, the issue of stress management in mental health has been discussed without reference to the clinical laboratory perspectives. Translational research and the vast array of emerging diagnostic technologies in alternative medical practice are now bridging the gap. While it would be scientific arrogance for the clinical practitioner and scientist to ignore the trend, the new technologies seeking clinical acceptability necessarily require expatiation of the scientific aspects of their products. Aims : This commentary builds on a comparative critical review to further our hypothesis that oxidative stress is the biochemical basis of the emerging computer-based diagnostic technologies. Materials & Method : The available information on Computer Meridian Diagnostics, Neuropattern and Virtual Scanning technologies were critically reviewed. The differences and similarities were articulated. Results : The technologies seem different, but have similarities that have not been articulated before. The seemingly different theories are traceable to Russian scientists and are based upon stress-induced adrenal secretions and the associated effect on glucose metabolism. The therapeutic effects of antioxidant nutrition, exercise or relaxation that are inherent in the technologies are highlighted. Conclusion : This commentary furthers explanation of the alterations in antioxidant activities as a result of biofeedback, oxidative stress and/or physiological effects as the biochemical basis of the technologies. The place for antioxidant indices and whole blood viscosity are also highlighted. This provides a rationale for the evaluation of available clinical diagnostic tests both to validate the technologies and as clinical laboratory correlates in stress management.

  9. Microfluidics: applications for analytical purposes in chemistry and biochemistry. (United States)

    Ohno, Ken-ichi; Tachikawa, Kaoru; Manz, Andreas


    In this review, we present recent advancements and novel developments in fluidic systems for applied analytical purposes in chemistry, biochemistry, and life science in general that employ and reflect the full benefits of microfluidics. A staggering rise in publications related to integrated, all-in-one microfluidic chips capable of separation, reaction, and detection have been observed, all of which realise the principal of micro total analysis systems or lab-on-a-chip. These integrated chips actively adopt the scaling law concepts, utilising the highly developed fabrication techniques. Their aim is to multi-functionalise and fully automate devices believed to assist the future advancements of point-of-care, clinical, and medical diagnostics.

  10. Clinical characteristics, laboratory identification, and in vitro antifungal susceptibility of Trichomonascus (Candida) ciferrii isolates associated with granular myringitis


    Chan, JFW; Tsang, CC; Yang, J.; Xing, F.; LEUNG, SM; Ngan, AHY; Lau, SKP; Woo, PCY; Yuen, KY


    BACKGROUND: Trichomonascus (Candida) ciferrii is an emerging opportunistic yeast pathogen that has been increasingly recognised in human infections. T. ciferrii has previously been implicated as the cause of tinea pedis, tinea cruris, onchychomycosis, and less commonly, fungaemia. Recently, we diagnosed four unusual cases of T. ciferrii-associated granular myringitis in Chinese patients in Hong Kong and Shenzhen, China. In this study, we report the clinical characteristics, laboratory identif...

  11. 应用六西格玛质量管理方法评价实验室质量水平%Evaluation of quality level in clinical laboratory by six sigma quality management method

    Institute of Scientific and Technical Information of China (English)

    靳冰; 赵强元; 刘敏; 马志家


    Objective To apply the six sigma(6σ) quality management method to quantitatively analyze the quality control data of the detection items from different groups and conduct the comparison for analyzing the evaluation performance and improving the laboratory quality .Methods The data of the internal quality control and the external quality assessment were collected from35 de‐tection items in the clinical chemistry laboratory group and the hematology laboratory group during 2013 ,the σ value of every item was calculated and the analytical performance of the detection item was analyzed .Results Among 23 clinical detection items in the biochemistry group ,there were 10 items of σ ≥ 6 ,6 items of 5 ≤ σ < 6 ,3 items of 4 ≤ σ < 5 ,3 items of 3 ≤ σ < 4 and 1 item of σ < 3 , the average σ was 5 .962 .Among 12 clinical detection items in the hematology group ,there were 8 items of σ ≥ 6 ,2 items of 5 ≤ σ <6 ,2 items of 4 ≤ σ < 5 ,the average σ value was 7 .38 .The detection items in which the analytic performance did not reach 6σ in the biochemistry group accounted for 37% of the total items ,which in the hematology group accounted for 11% ,the differences in theσ quality level of detection items between the biochemistry group and the hematology group had statistical significance(P< 0 .05) , the differences in the σ quality level of detection items between the matched reagent and the non‐matched reagent had statistical sig‐nificance (P< 0 .05) .Conclusion The 6σ quality management method can be used used in the quality evaluation of clinical detection items and can be widely used in the quality management of clinical laboratory .%目的:应用六西格玛(6σ)质量管理方法定量分析临床实验室不同组别检验项目的质量控制数据并进行比较,分析评价性能,改进实验室质量。方法收集2013年度生化组与血液组共35个检验项目的室内质量控制及室间质量评价的数据,计算检

  12. The Alcohol Dehydrogenase Kinetics Laboratory: Enhanced Data Analysis and Student-Designed Mini-Projects (United States)

    Silverstein, Todd P.


    A highly instructive, wide-ranging laboratory project in which students study the effects of various parameters on the enzymatic activity of alcohol dehydrogenase has been adapted for the upper-division biochemistry and physical biochemistry laboratory. Our two main goals were to provide enhanced data analysis, featuring nonlinear regression, and…

  13. Evaluation of Student-made Blogs in Basicand Advanced Biochemistry Classes

    Directory of Open Access Journals (Sweden)

    E. Cubas


    Full Text Available Preliminary results of the experience of student-made clinical biochemistry blogs were reported at SBBq-2010 (abstract K-5. Herein, five teaching-semesters and the opinion of former students were evaluated. Since the teaching-semester of 2008-1, Basic Biochemistry (BioBio students should prepare blog-assignments on clinical issues. Students' acceptance was evaluated through 6-point Likert-type questionnaires. Positive responses were those marking 4 to 6. A total of 348 BioBio students from five teaching-semesters answered the questionnaire; 77% of them agreed that preparing blogs was enjoyable, having a positive effect on their formation. Moreover, 81% of students agreed that BioBio blogs are relevant learning tools and 78% believedthat BioBio blogs boosted interest for biochemistry. Moreover, students' acceptance 1 year after taking BioBio was evaluated. Students (n=50 were dividedin (i those who had attended BioBio only, and (ii those who had also taken Advanced Biochemistry, together with blog tutoring. In the first group, 72% agreed that the information acquired during blog elaboration was useful atthe time of interview; 76% judged that blog elaboration boosted interest for the discipline. For thosein the second group evaluations were 100% and 82%, respectively. Results show maintenance of acceptance over 1 year and effective interest for blog-assignment for thosein basic and advanced biochemistry classes.

  14. Non-clinical studies in the process of new drug development - Part II: Good laboratory practice, metabolism, pharmacokinetics, safety and dose translation to clinical studies

    Directory of Open Access Journals (Sweden)

    E.L. Andrade

    Full Text Available The process of drug development involves non-clinical and clinical studies. Non-clinical studies are conducted using different protocols including animal studies, which mostly follow the Good Laboratory Practice (GLP regulations. During the early pre-clinical development process, also known as Go/No-Go decision, a drug candidate needs to pass through several steps, such as determination of drug availability (studies on pharmacokinetics, absorption, distribution, metabolism and elimination (ADME and preliminary studies that aim to investigate the candidate safety including genotoxicity, mutagenicity, safety pharmacology and general toxicology. These preliminary studies generally do not need to comply with GLP regulations. These studies aim at investigating the drug safety to obtain the first information about its tolerability in different systems that are relevant for further decisions. There are, however, other studies that should be performed according to GLP standards and are mandatory for the safe exposure to humans, such as repeated dose toxicity, genotoxicity and safety pharmacology. These studies must be conducted before the Investigational New Drug (IND application. The package of non-clinical studies should cover all information needed for the safe transposition of drugs from animals to humans, generally based on the non-observed adverse effect level (NOAEL obtained from general toxicity studies. After IND approval, other GLP experiments for the evaluation of chronic toxicity, reproductive and developmental toxicity, carcinogenicity and genotoxicity, are carried out during the clinical phase of development. However, the necessity of performing such studies depends on the new drug clinical application purpose.

  15. Non-clinical studies in the process of new drug development - Part II: Good laboratory practice, metabolism, pharmacokinetics, safety and dose translation to clinical studies. (United States)

    Andrade, E L; Bento, A F; Cavalli, J; Oliveira, S K; Schwanke, R C; Siqueira, J M; Freitas, C S; Marcon, R; Calixto, J B


    The process of drug development involves non-clinical and clinical studies. Non-clinical studies are conducted using different protocols including animal studies, which mostly follow the Good Laboratory Practice (GLP) regulations. During the early pre-clinical development process, also known as Go/No-Go decision, a drug candidate needs to pass through several steps, such as determination of drug availability (studies on pharmacokinetics), absorption, distribution, metabolism and elimination (ADME) and preliminary studies that aim to investigate the candidate safety including genotoxicity, mutagenicity, safety pharmacology and general toxicology. These preliminary studies generally do not need to comply with GLP regulations. These studies aim at investigating the drug safety to obtain the first information about its tolerability in different systems that are relevant for further decisions. There are, however, other studies that should be performed according to GLP standards and are mandatory for the safe exposure to humans, such as repeated dose toxicity, genotoxicity and safety pharmacology. These studies must be conducted before the Investigational New Drug (IND) application. The package of non-clinical studies should cover all information needed for the safe transposition of drugs from animals to humans, generally based on the non-observed adverse effect level (NOAEL) obtained from general toxicity studies. After IND approval, other GLP experiments for the evaluation of chronic toxicity, reproductive and developmental toxicity, carcinogenicity and genotoxicity, are carried out during the clinical phase of development. However, the necessity of performing such studies depends on the new drug clinical application purpose.

  16. Clinical and laboratory profile of HIV-positive patients at the moment of diagnosis in Bahia, Brazil

    Directory of Open Access Journals (Sweden)

    Márcia Sampaio Sá


    Full Text Available In Brazil, current trends of the AIDS epidemic include an increase in transmission through heterosexual contact, predominantly from men to women, with more cases of AIDS in women and more children contaminated by vertical transmission. There is also a high proportion of cases in poor people or people living in small towns. HIV-infected patients with high levels of immunodeficiency are frequently hospitalized after their first visit to the clinic due to opportunistic infections, characteristic of advanced disease. This study characterized the clinical and laboratory pattern of AIDS in a sample of patients attended for the first time in the AIDS clinic of the Federal University of Bahia Hospital (HUPES in Salvador, Brazil. We revised medical charts of cases of subjects registered at the outpatient AIDS clinic from January 1997 to December 2003. The demographics, clinical data, and laboratory characteristics were analyzed to determine the degree of immunodeficiency at the time of admission. A total of 377 patients were evaluated (58.6% were male, with a mean sample age of 33.4 years. The most frequent clinical manifestations were asthenia, weight loss, fever, anemia, dermatitis, oral thrush and diarrhea. CDC criteria were not adequate to define the initial cases. After admission to the outpatient clinic, nearly 25% of the patients were hospitalized immediately, indicating delay in the diagnosis. In Bahia, the initial presentation of HIV-infected patients to health care assistance is occurring at a late stage of the disease, when signs and symptoms of immunodeficiency are already established. Efforts are necessary to construct strategies to make an early diagnosis of these patients, improve the quality of care, and guarantee the benefits of antiretroviral therapy, when it is indicated.

  17. Reliability of clinical diagnosis and laboratory testing techniques currently used for identification of canine parvovirus enteritis in clinical settings (United States)

    FAZ, Mirna; MARTÍNEZ, José Simón; QUIJANO-HERNÁNDEZ, Israel; FAJARDO, Raúl


    Canine parvovirus type 2 (CPV-2) is the main etiological agent of viral enteritis in dogs. Actually in literature, CPV-2 has been reported with clinical signs that vary from the classical disease, and immunochromatography test and PCR technique have been introduced to veterinary hospitals to confirm CPV-2 diagnosis and other infections. However, the reliability of these techniques has been poorly analyzed. In this study, we evaluated the sensitivity and specificity of veterinary clinical diagnosis, immunochromatography test and PCR technique. Our data indicate that variations in the clinical signs of CPV-2 complicate the gathering of an appropriate diagnosis; and immunochromatography test and PCR technique do not have adequate sensitivity to diagnose positive cases. PMID:27818461

  18. A Changing Research and Publication Landscape for Biochemistry

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    Gabor Mocz


    Full Text Available This introductory editorial hopes to convey three points to its audience. First, it provides an overview of the new, peer-reviewed, open access journal Biochemistry Insights published by Libertas Academica. Second, it summarizes the benefits of open access publishing concepts to the biochemistry community. And third, it takes a brief look at the near future of biochemistry as a fundamental molecular science whose continued advances and latest developments will be the focus of the new journal. Biochemistry Insights looks forward to receiving research articles, review papers, commentaries and letters from all disciplines and specialties of the field.

  19. Population-based biochemistry, immunologic and hematological reference values for adolescents and young adults in a rural population in Western Kenya.

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    Clement Zeh

    Full Text Available BACKGROUND: There is need for locally-derived age-specific clinical laboratory reference ranges of healthy Africans in sub-Saharan Africa. Reference values from North American and European populations are being used for African subjects despite previous studies showing significant differences. Our aim was to establish clinical laboratory reference values for African adolescents and young adults that can be used in clinical trials and for patient management. METHODS AND FINDINGS: A panel of 298, HIV-seronegative individuals aged 13-34 years was randomly selected from participants in two population-based cross-sectional surveys assessing HIV prevalence and other sexually transmitted infections in western Kenya. The adolescent (<18 years-to-adults (≥ 18 years ratio and the male-to-female ratio was 1∶1. Median and 95% reference ranges were calculated for immunohematological and biochemistry values. Compared with U.S-derived reference ranges, we detected lower hemoglobin (HB, hematocrit (HCT, red blood cells (RBC, mean corpuscular volume (MCV, neutrophil, glucose, and blood urea nitrogen values but elevated eosinophil and total bilirubin values. Significant gender variation was observed in hematological parameters in addition to T-bilirubin and creatinine indices in all age groups, AST in the younger and neutrophil, platelet and CD4 indices among the older age group. Age variation was also observed, mainly in hematological parameters among males. Applying U.S. NIH Division of AIDS (DAIDS toxicity grading to our results, 40% of otherwise healthy study participants were classified as having an abnormal laboratory parameter (grade 1-4 which would exclude them from participating in clinical trials. CONCLUSION: Hematological and biochemistry reference values from African population differ from those derived from a North American population, showing the need to develop region-specific reference values. Our data also show variations in hematological


    Directory of Open Access Journals (Sweden)

    G. B. Lazzarotto


    Full Text Available This work presents a game like educational software (courseware to study metabolic pathways, calledDiagrama Metabolico Din^amico Virtual (DMDV of Krebs Cycle. The experience acquired teachingwith the logical sequence tray games in the FFFCMPAs Biochemistry Course provides the beddingswith the use of this model as education method. With DMDV, students can assembly the sequenceof reactions that describe the desired metabolic pathway, create situational models which can guidehis/her choices, reduce the subject complexity of the scheme in knowledge construction presentingin a graphical way the current interrelations. Biochemistry teachers can use the present software inclassroom as well as distance classes. This product integrates multimedia resources extensively andis distributed in CD-ROM format. The virtual environment will make possible interaction of thestudent with the environment and with colleagues and teachers, through tools as chats and forum.Experience with the use of this method was carried through with two distinct groups of students.The rst group was composed by 11 students, who were more familiar with the content and answereda specic questionnaire to previously evaluate the software. The second group was formed by 24students regularly registered in the FFFCMPAs Biochemistry Course, who used the software as astudy method. The rst group considered DMDV of easy and pleasant navigation. The knowledgeevaluation of the second group students was made by a written test and the analysis of three conceptualmaps constructed by each one of them: one map before initiating the study with the DMDV, thesecond just after the study and the third one two months later. Every conceptual maps producedafter DMDV method showed an expansion of valid concepts if compared with the rst maps. Simplevisual comparison of maps shows that new elements where added. All students who passed throughthe experiment reached a greater than ve grade in the subjects written