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Sample records for clinical chemistry tests

  1. Interference of cationic polymeric nanoparticles with clinical chemistry tests--clinical relevance.

    Science.gov (United States)

    Shcharbin, Dzmitry; Shcharbina, Natallia; Milowska, Katarzyna; de la Mata, Francisco Javier; Muñoz-Fernandez, Maria Angeles; Mignani, Serge; Gomez-Ramirez, Rafael; Majoral, Jean-Pierre; Bryszewska, Maria

    2014-10-01

    The development of medical nanosystems requires knowledge of their behavior in vivo. Clinical chemistry tests are widely used to estimate the systemic toxicity of nanoparticles. In this paper we have explored the impact of small positively charged nanoparticles-poly(amidoamine), phosphorous and carbosilane dendrimers - on biochemical parameters of standardized serum in vitro. All the dendrimers could shift the main biochemical parameters. Thus, in the case of patients having the normal, but 'boundary', values of biochemical parameters, nanoparticle-induced changes can be wrongly interpreted as evidence of some dysfunctions (hepatic, renal, etc.). Moreover, the effects of nanoparticles of metals, carbon nanotubes, quantum dots, fullerenes, dendrimers having been sized up to 4000 nm and the hundreds of reactive groups, can be significantly higher. Thus, preliminary evaluation of any nanomaterial in vitro is required in clinical chemistry tests before its application in vivo to draw the correct conclusions and benefit animals.

  2. Utility and necessity of repeat testing of critical values in the clinical chemistry laboratory.

    Directory of Open Access Journals (Sweden)

    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

  3. Chemistry Testing on Plasma Versus Serum Samples in Dialysis Patients: Clinical and Quality Improvement Implications.

    Science.gov (United States)

    Carey, Roger Neill; Jani, Chinu; Johnson, Curtis; Pearce, Jim; Hui-Ng, Patricia; Lacson, Eduardo

    2016-09-01

    Plasma samples collected in tubes containing separator gels have replaced serum samples for most chemistry tests in many hospital and commercial laboratories. Use of plasma samples for blood tests in the dialysis population eliminates delays in sample processing while waiting for clotting to complete, laboratory technical issues associated with fibrin formation, repeat sample collection, and patient care issues caused by delay of results because of incompletely clotted specimens. Additionally, a larger volume of plasma is produced than serum for the same amount of blood collected. Plasma samples are also acceptable for most chemical tests involved in the care of patients with ESRD. This information becomes very important when United States regulatory requirements for ESRD inadvertently limit the type of sample that can be used for government reporting, quality assessment, and value-based payment initiatives. In this narrative, we summarize the renal community experience and how the subsequent resolution of the acceptability of phosphorus levels measured from serum and plasma samples may have significant implications in the country's continued development of a value-based Medicare ESRD Quality Incentive Program.

  4. Teaching Techniques in Clinical Chemistry.

    Science.gov (United States)

    Wilson, Diane

    This master's thesis presents several instructional methods and techniques developed for each of eleven topics or subject areas in clinical chemistry: carbohydrate metabolism, lipid metabolism, diagnostic enzymology, endocrinology, toxicology, quality control, electrolytes, acid base balance, hepatic function, nonprotein nitrogenous compounds, and…

  5. American Association for Clinical Chemistry

    Science.gov (United States)

    ... The Journal of Applied Laboratory Medicine Clinical and Forensic Toxicology News Clinical Laboratory Marketplace Books and Multimedia ... Global Health Outreach Global Lab Quality Initiative Lab Tests Online Harmonization Membership Grants Travel Grants International Travelers ... On the Path to Improved Blood Glucose Monitoring A new mathematical model uses hemoglobin ...

  6. Continuing Education Instrumentation Training in Clinical Chemistry.

    Science.gov (United States)

    LeBlanc, Jacqueline; Frankel, Saundra

    1980-01-01

    Describes the continuing education program for clinical chemistry instrumentation training established at The College of Staten Island, New York. A course consisting of 14 sessions is outlined and discussed. (CS)

  7. Predictors of sudden death and death from pump failure in congestive heart failure are different. Analysis of 24 h Holter monitoring, clinical variables, blood chemistry, exercise test and radionuclide angiography

    DEFF Research Database (Denmark)

    Madsen, B K; Rasmussen, Verner; Hansen, J F

    1997-01-01

    One hundred and ninety consecutive patients discharged with congestive heart failure were examined with clinical evaluation, blood chemistry, 24 h Holter monitoring, exercise test and radionuclide angiography. Median left ventricular ejection fraction was 0.30, 46% were in New York Heart Associat......One hundred and ninety consecutive patients discharged with congestive heart failure were examined with clinical evaluation, blood chemistry, 24 h Holter monitoring, exercise test and radionuclide angiography. Median left ventricular ejection fraction was 0.30, 46% were in New York Heart...

  8. Using Clinical Cases to Teach General Chemistry

    Science.gov (United States)

    Dewprashad, Brahmadeo; Kosky, Charles; Vaz, Geraldine S.; Martin, Charlotte L.

    2004-01-01

    A clinical study was designed and used to show the relationship of health and medicine, in a typical clinical scenario, where many chemical principles are involved and that an integrated knowledge of chemistry and biology is essential to the understanding, diagnosing and treating of illnesses. A case study would be a positive learning experience…

  9. Evaluation of the Olympus AU 400 clinical chemistry analyzer.

    Science.gov (United States)

    Bilić, A; Alpeza, I; Rukavina, A S

    2000-01-01

    The performance of the Olympus AU 400 clinical chemistry analyzer was evaluated according to the guidelines of the European Committee for Clinical Laboratory Standards. The following analytes were tested: glucose, urea, creatinine, calcium, AST, ALT, CK, LDH, ALP and amylase. The Olympus AU 400 was compared with the Olympus AU 800. Coefficients of correlation showed high correlation between the compared analyzers. Other performances (intra- and inter-assay variation, carry-over and interferences) of the analyzer were satisfactory.

  10. Interferences from blood collection tube components on clinical chemistry assays.

    Science.gov (United States)

    Bowen, Raffick A R; Remaley, Alan T

    2014-01-01

    Improper design or use of blood collection devices can adversely affect the accuracy of laboratory test results. Vascular access devices, such as catheters and needles, exert shear forces during blood flow, which creates a predisposition to cell lysis. Components from blood collection tubes, such as stoppers, lubricants, surfactants, and separator gels, can leach into specimens and/or adsorb analytes from a specimen; special tube additives may also alter analyte stability. Because of these interactions with blood specimens, blood collection devices are a potential source of pre-analytical error in laboratory testing. Accurate laboratory testing requires an understanding of the complex interactions between collection devices and blood specimens. Manufacturers, vendors, and clinical laboratorians must consider the pre-analytical challenges in laboratory testing. Although other authors have described the effects of endogenous substances on clinical assay results, the effects/impact of blood collection tube additives and components have not been well systematically described or explained. This review aims to identify and describe blood collection tube additives and their components and the strategies used to minimize their effects on clinical chemistry assays.

  11. Laboratory evaluation of the Beckman Synchron CX3 clinical chemistry analyzer.

    Science.gov (United States)

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

    1988-02-01

    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.

  12. Evaluation of the Konelab 20XT clinical chemistry analyzer.

    Science.gov (United States)

    Stojanović, Natasa; Rogić, Dunja; Stavljenić-Rukavina, Ana

    2005-01-01

    The Konelab 20XT (Thermo Electron Oy, Finland) is a clinical chemistry analyzer for colorimetric, immunoturbidimetric and ion-selective electrode measurements. The aim of our work was to evaluate the analytical performances of the Konelab 20XT according to the European Clinical Chemistry Laboratory Standards Guidelines. A total of 30 analytes including substrates, enzymes, electrolytes and specific proteins were tested. Investigation results showed low imprecision (within-run coefficient of variation was below 3.5% and between-day coefficient of variation was less than 2.5% for most analytes at all three levels studied) and acceptable accuracy of the analyzer. No significant sample- or reagent-related carry-over was found. It was demonstrated that the analytical system operates within the claimed linearity ranges. The results compared well with those obtained by instruments routinely used in our laboratory (Olympus AU2700, Behring Nephelometer II). In general, the data on interference by hemoglobin, hyperbilirubinemia and turbidity are in accordance with known facts. However, slight hemolysis was found to interfere with the alkaline phosphatase (ALP) assay and mild lipemia affected the glucose assay. The Konelab 20XT is an easy-to-use analyzer that is suitable for routine and emergency analyses in small laboratories.

  13. 78 FR 13347 - Clinical Chemistry and Clinical Toxicology Devices Panel of the Medical Devices Advisory...

    Science.gov (United States)

    2013-02-27

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Clinical Chemistry and Clinical Toxicology Devices Panel of... Chemistry and Clinical Toxicology Devices Panel of the Medical Devices Advisory Committee. General...

  14. Contributions of Analytical Chemistry to the Clinical Laboratory.

    Science.gov (United States)

    Skogerboe, Kristen J.

    1988-01-01

    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…

  15. Clinical chemistry: challenges for analytical chemistry and the nanosciences from medicine.

    Science.gov (United States)

    Durner, Jürgen

    2010-02-01

    Clinical chemistry and laboratory medicine can look back over more than 150 years of eventful history. The subject encompasses all the medicinal disciplines as well as the remaining natural sciences. Clinical chemistry demonstrates how new insights from basic research in biochemical, biological, analytical chemical, engineering, and information technology can be transferred into the daily routine of medicine to improve diagnosis, therapeutic monitoring, and prevention. This Review begins with a presentation of the development of clinical chemistry. Individual steps between the drawing of blood and interpretation of laboratory data are then illustrated; here not only are pitfalls described, but so are quality control systems. The introduction of new methods and trends into medicinal analysis is explored, along with opportunities and problems associated with personalized medicine.

  16. Oligonucleotide therapeutics: chemistry, delivery and clinical progress.

    Science.gov (United States)

    Sharma, Vivek K; Watts, Jonathan K

    2015-01-01

    Oligonucleotide therapeutics have the potential to become a third pillar of drug development after small molecules and protein therapeutics. However, the three approved oligonucleotide drugs over the past 17 years have not proven to be highly successful in a commercial sense. These trailblazer drugs have nonetheless laid the foundations for entire classes of drug candidates to follow. This review will examine further advances in chemistry that are earlier in the pipeline of oligonucleotide drug candidates. Finally, we consider the possible effect of delivery systems that may provide extra footholds to improve the potency and specificity of oligonucleotide drugs. Our overview focuses on strategies to imbue antisense oligonucleotides with more drug-like properties and their applicability to other nucleic acid therapeutics.

  17. Comparing Recent Organizing Templates for Test Content between ACS Exams in General Chemistry and AP Chemistry

    Science.gov (United States)

    Holme, Thomas

    2014-01-01

    Two different versions of "big ideas" rooted content maps have recently been published for general chemistry. As embodied in the content outline from the College Board, one of these maps is designed to guide curriculum development and testing for advanced placement (AP) chemistry. The Anchoring Concepts Content Map for general chemistry…

  18. 21 CFR 862.2170 - Micro chemistry analyzer for clinical use.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Micro chemistry analyzer for clinical use. 862... SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Laboratory Instruments § 862.2170 Micro chemistry analyzer for clinical use. (a) Identification. A micro...

  19. Selenium in oncology: from chemistry to clinics.

    Science.gov (United States)

    Micke, Oliver; Schomburg, Lutz; Buentzel, Jens; Kisters, Klaus; Muecke, Ralph

    2009-01-01

    The essential trace element selenium, which is a crucial cofactor in the most important endogenous antioxidative systems of the human body, is attracting more and more the attention of both laypersons and expert groups. The interest of oncologists mainly focuses in the following clinical aspects: radioprotection of normal tissues, radiosensitizing in malignant tumors, antiedematous effect, prognostic impact of selenium, and effects in primary and secondary cancer prevention. Selenium is a constituent of the small group of selenocysteine-containing selenoproteins and elicits important structural and enzymatic functions. Selenium deficiency has been linked to increased infection risk and adverse mood states. It has been shown to possess cancer-preventive and cytoprotective activities in both animal models and humans. It is well established that Se has a key role in redox regulation and antioxidant function, and hence in membrane integrity, energy metabolism and protection against DNA damage. Recent clinical trials have shown the importance of selenium in clinical oncology. Our own clinical study involving 48 patients suggest that selenium has a positive effect on radiation-associated secondary lymphedema in patients with limb edemas, as well as in the head and neck region, including endolaryngeal edema. Another randomized phase III study of our group was performed to examine the cytoprotective properties of selenium in radiation oncology. The aim was to evaluate whether sodium selenite is able to compensate a preexisting selenium deficiency and to prevent radiation induced diarrhea in adjuvant radiotherapy for pelvic gynecologic malignancies. Through this study, the significant benefits of sodium selenite supplementation with regards to selenium deficiency and radiotherapy induced diarrhea in patients with cervical and uterine cancer has been shown for the first time in a prospective randomized trial. Survival data imply that supplementation with selenium does not

  20. Selenium in Oncology: From Chemistry to Clinics

    Directory of Open Access Journals (Sweden)

    Oliver Micke

    2009-10-01

    Full Text Available The essential trace element selenium, which is a crucial cofactor in the most important endogenous antioxidative systems of the human body, is attracting more and more the attention of both laypersons and expert groups. The interest of oncologists mainly focuses in the following clinical aspects: radioprotection of normal tissues, radiosensitizing in malignant tumors, antiedematous effect, prognostic impact of selenium, and effects in primary and secondary cancer prevention. Selenium is a constituent of the small group of selenocysteine-containing selenoproteins and elicits important structural and enzymatic functions. Selenium deficiency has been linked to increased infection risk and adverse mood states. It has been shown to possess cancer-preventive and cytoprotective activities in both animal models and humans. It is well established that Se has a key role in redox regulation and antioxidant function, and hence in membrane integrity, energy metabolism and protection against DNA damage. Recent clinical trials have shown the importance of selenium in clinical oncology. Our own clinical study involving 48 patients suggest that selenium has a positive effect on radiation-associated secondary lymphedema in patients with limb edemas, as well as in the head and neck region, including endolaryngeal edema. Another randomized phase III study of our group was performed to examine the cytoprotective properties of selenium in radiation oncology. The aim was to evaluate whether sodium selenite is able to compensate a preexisting selenium deficiency and to prevent radiation induced diarrhea in adjuvant radiotherapy for pelvic gynecologic malignancies. Through this study, the significant benefits of sodium selenite supplementation with regards to selenium deficiency and radiotherapy induced diarrhea in patients with cervical and uterine cancer has been shown for the first time in a prospective randomized trial. Survival data imply that supplementation with

  1. Selenium in Oncology: From Chemistry to Clinics

    OpenAIRE

    Oliver Micke; Lutz Schomburg; Jens Buentzel; Klaus Kisters; Ralph Muecke

    2009-01-01

    The essential trace element selenium, which is a crucial cofactor in the most important endogenous antioxidative systems of the human body, is attracting more and more the attention of both laypersons and expert groups. The interest of oncologists mainly focuses in the following clinical aspects: radioprotection of normal tissues, radiosensitizing in malignant tumors, antiedematous effect, prognostic impact of selenium, and effects in primary and secondary cancer prevention. Selenium is a con...

  2. Specialized Gas Chromatography--Mass Spectrometry Systems for Clinical Chemistry.

    Science.gov (United States)

    Gochman, Nathan; And Others

    1979-01-01

    A discussion of the basic design and characteristics of gas chromatography-mass spectrometry systems used in clinical chemistry. A comparison of three specific systems: the Vitek Olfax IIA, Hewlett-Packard HP5992, and Du Pont DP-102 are included. (BB)

  3. Clinical Genetic Testing in Gastroenterology

    Science.gov (United States)

    Goodman, Russell P; Chung, Daniel C

    2016-01-01

    Rapid advances in genetics have led to an increased understanding of the genetic determinants of human disease, including many gastrointestinal (GI) disorders. Coupled with a proliferation of genetic testing services, this has resulted in a clinical landscape where commercially available genetic tests for GI disorders are now widely available. In this review, we discuss the current status of clinical genetic testing for GI illnesses, review the available testing options, and briefly discuss indications for and practical aspects of such testing. Our goal is to familiarize the practicing gastroenterologist with this rapidly changing and important aspect of clinical care. PMID:27124700

  4. Performance testing of a mid-infrared spectroscopic system for clinical chemistry applications utilising an ultra-broadband tunable EC-QCL radiation source

    Science.gov (United States)

    Grafen, M.; Nalpantidis, K.; Ihrig, D.; Heise, H. M.; Ostendorf, A.

    2016-03-01

    Mid-infrared (MIR) spectroscopy is a valuable analytical method for patient monitoring within point-of-care diagnostics. For implementation, quantum cascade lasers (QCL) appear to be most suited regarding miniaturization, complexity and eventually also costs. External cavity (EC) - QCLs offer broad tuning ranges and recently, ultra-broadly tunable systems covering spectral ranges around the mid-infrared fingerprint region became commercially available. Using such a system, transmission spectra from the wavenumber interval of 780 to 1920 cm-1, using a thermoelectrically cooled MCT-detector, were recorded while switching the aqueous glucose concentrations between 0, 50 and 100 mg/dL. In order to optimize the system performance, a multi-parameter study was carried out, varying laser pulse width, duty cycle, sweep speed and the optical sample pathlength for scoring the absorbance noise. Exploratory factor analysis with pattern recognition tools (PCA, LDA) was used for the raw data, providing more than 10 significantly contributing factors. With the glucose signal causing 20 % of the total variance, further factors include short-term drift possibly related to thermal effects, long-term drift due to varying atmospheric water vapour in the lab, as well as wavenumber shifts and drifts of the single tuners. For performance testing, the noise equivalent concentration was estimated based on cross-validated Partial-Least Squares (PLS) predictions and the a-posteriori obtained scores of the factor analysis. Based on the optimized parameters, a noise equivalent glucose concentration of 1.5 mg/dL was achieved.

  5. Chemistry and radiochemistry tests of N.S.MUTSU

    International Nuclear Information System (INIS)

    The power-up test of N.S.MUTSU started in March 1990 and finished in December. The chemistry test and radiochemistry test were performed during the power-up tests. This paper discribes the methods and the results of the chemistry and radiochemistry tests performed during the power-up tests of N.S.MUTSU. The N.S.MUTSU is equipped with a PWR type reactor having a thermal power output of 36 MW. The chemical and radiochemical characteristics of the reactor are fuel rod cladding tubes made of stainless steel and reactivity control without chemical shim. The chemistry test yielded the good results in quality of the primary cooling water and the secondary cooling water. The radiochemistry test confirmed that there is no leakages from fuel rod tubes, SG U-tubes and reactor component cooling systems. (author)

  6. Chemistry inside an epistemological community box! Discursive exclusions and inclusions in Swedish National tests in Chemistry

    Science.gov (United States)

    Ståhl, Marie; Hussénius, Anita

    2016-04-01

    This study examined the Swedish national tests in chemistry for implicit and explicit values. The chemistry subject is understudied compared to biology and physics and students view chemistry as their least interesting science subject. The Swedish national science assessments aim to support equitable and fair evaluation of students, to concretize the goals in the chemistry syllabus and to increase student achievement. Discourse and multimodal analyses, based on feminist and critical didactic theories, were used to examine the test's norms and values. The results revealed that the chemistry discourse presented in the tests showed a traditional view of science from the topics discussed (for example, oil and metal), in the way women, men and youth are portrayed, and how their science interests are highlighted or neglected. An elitist view of science emerges from the test, with distinct gender and age biases. Students could interpret these biases as a message that only "the right type" of person may come into the chemistry epistemological community, that is, into this special sociocultural group that harbours a common view about this knowledge. This perspective may have an impact on students' achievement and thereby prevent support for an equitable and fair evaluation. Understanding the underlying evaluative meanings that come with science teaching is a question of democracy since it may affect students' feelings of inclusion or exclusion. The norms and values harboured in the tests will also affect teaching since the teachers are given examples of how the goals in the syllabus can be concretized.

  7. Colloidal oatmeal: history, chemistry and clinical properties.

    Science.gov (United States)

    Kurtz, Ellen S; Wallo, Warren

    2007-02-01

    Oatmeal has been used for centuries as a soothing agent to relieve itch and irritation associated with various xerotic dermatoses. In 1945, a ready to use colloidal oatmeal, produced by finely grinding the oat and boiling it to extract the colloidal material, became available. Today, colloidal oatmeal is available in various dosage forms from powders for the bath to shampoos, shaving gels, and moisturizing creams. Currently, the use of colloidal oatmeal as a skin protectant is regulated by the U.S. Food and Drug Administration (FDA) according to the Over-The-Counter Final Monograph for Skin Protectant Drug Products issued in June 2003. Its preparation is also standardized by the United States Pharmacopeia. The many clinical properties of colloidal oatmeal derive from its chemical polymorphism. The high concentration in starches and beta-glucan is responsible for the protective and water-holding functions of oat. The presence of different types of phenols confers antioxidant and anti-inflammatory activity. Some of the oat phenols are also strong ultraviolet absorbers. The cleansing activity of oat is mostly due to saponins. Its many functional properties make colloidal oatmeal a cleanser, moisturizer, buffer, as well as a soothing and protective anti-inflammatory agent.

  8. The use of hirudin as universal anticoagulant in haematology, clinical chemistry and blood grouping.

    Science.gov (United States)

    Menssen, H D; Melber, K; Brandt, N; Thiel, E

    2001-12-01

    Undesirable interactions between anticoagulants and diagnostic test kit procedures so far have prevented the development of a single uniform blood sampling tube. Contrary to K2-EDTA, heparin and other anticoagulants, hirudin only minimally alters blood cells and dissolved blood constituents, thus qualifying as a universal anticoagulant for diagnostic purposes. Automated complete blood counts, automated analyses of clinical chemistry analytes and immunohaematology were performed from hirudinised and routinely processed blood obtained from healthy volunteers (n=35) and hospitalised patients (n=45). Hirudin (400 ATU/ml blood) sufficiently anticoagulated blood for diagnostic purposes. The measurements of automated complete blood counts obtained from K2-EDTA-anticoagulated and hirudinised blood correlated significantly as did the measurements of 24 clinical chemistry analytes from hirudinised plasma and serum. Regression analysis revealed that the results of complete blood counts and clinical chemistry tests were predictable from the respective measurements from hirudinised blood (p=0.001). Immunohaematological tests and cross-matching from hirudinised and native blood of the same donors gave identical results. Single clotting factors, but not global coagulation analytes, could be measured from hirudinised blood. Therefore, a universal hirudin-containing blood sampling tube could be designed for automated analysis of haematological, serological and clinical chemistry analytes. PMID:11798089

  9. 21 CFR 862.2160 - Discrete photometric chemistry analyzer for clinical use.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Discrete photometric chemistry analyzer for... Clinical Laboratory Instruments § 862.2160 Discrete photometric chemistry analyzer for clinical use. (a) Identification. A discrete photometric chemistry analyzer for clinical use is a device intended to...

  10. The use of enzyme test kits for teaching lipid chemistry

    Science.gov (United States)

    Many methods are available for the analysis of lipids and other natural products. Although they are rarely used in research laboratories, enzyme-based assays are used extensively for routine analyses in the clinical chemistry and in food analysis laboratories. Many of these enzymatic methods can b...

  11. 78 FR 19717 - Clinical Chemistry and Clinical Toxicology Devices Panel of the Medical Devices Advisory...

    Science.gov (United States)

    2013-04-02

    ... notice that appeared in the Federal Register of Wednesday, February 27, 2013 (78 FR 13347). The meeting... for up-to-date information on this meeting. SUPPLEMENTARY INFORMATION: In FR doc. 2013-04543... HUMAN SERVICES Food and Drug Administration Clinical Chemistry and Clinical Toxicology Devices Panel...

  12. Immunoassays in clinical chemistry (principles of immunoradiometric assays)

    International Nuclear Information System (INIS)

    The use of antibodies as reagents in clinical chemistry for the quantitation of a wide range of analytes has now become widely established. Initially antibodies were employed in precipitation techniques, usually for the analysis of serum proteins, in solution or in the form of antibody containing gels, e.g. immunoprecipitation, immunodiffusion, and immunoelectrophoresis. Further developments have led to the highly sensitive techniques of radioimmunoassay and recently immunometric assay for the measurement of drugs, tumour markers and hormones. In general, those techniques without the addition of a label e.g. immunoprecipitation, immunodiffusion and immunoturbidimetry are the older techniques used for the measurement of serum proteins. These techniques are relatively insensitive, measuring at the g/L. level, and in the case of immunodiffusion are generally slow. Automation coupled with the development of chemistries to enhance precipitation has, however, reduced measurement times to minutes in modern laboratories. Nevertheless these methods have detection limits of the order of 1 g/L

  13. Evaluation of the Dade Behring Dimension RxL clinical chemistry analyzer.

    Science.gov (United States)

    Cuka, S; Dvornik, S; Drazenović, K; Mihić, J

    2001-01-01

    The performance of the Dade Behring Dimension RxL clinical chemistry analyzer was evaluated according to the guidelines of the European Committee for Clinical Laboratory Standards. The following analytes were tested: glucose, urea, creatinine, albumin, phosphorus, cholesterol, triglyceride, uric acid, magnesium, sodium, potassium, chloride, calcium, iron and total bilirubin. The Dade Behring Dimension RxL was compared with the Hitachi 704, Bayer RA-1000, Ektachem 250 and Chiron 865 depending on available tests on these analyzers. Coefficients of correlation showed high correlation between compared analyzers. Other performances (intra- and inter-assay variation, carry-over and interferences) of the analyzer were satisfactory.

  14. Preparedness for Tertiary Chemistry: Multiple Applications of the Chemistry Competence Test for Diagnostic and Prediction Purposes

    Science.gov (United States)

    Potgieter, Marietjie; Davidowitz, Bette

    2011-01-01

    The development of the Chemistry Competence Test was prompted by the extensive curriculum changes in the South African school system after democracy was established in 1994. As chemists, we were concerned that there might be a lack of articulation between secondary and tertiary levels, since we anticipated that curriculum changes would have an…

  15. Mathematical SAT Test Scores and College Chemistry Grades.

    Science.gov (United States)

    Spencer, Harry E.

    1996-01-01

    Explores the comparative performance of various segments of the student sample in general chemistry courses relative to their scores on the mathematical SAT test. Results indicate that mathematical skill measured by the SAT scores is an important factor in determining grades while factors that are not important in determining grades are gender…

  16. Clinical Genetic Testing in Epilepsy

    OpenAIRE

    Mefford, Heather C.

    2015-01-01

    New technologies for mutation detection in the human genome have greatly increased our understanding of epilepsy genetics. Application of genomic technologies in the clinical setting allows for more efficient genetic diagnosis in some patients; therefore, it is important to understand the types of tests available and the types of mutations that can be detected. Making a genetic diagnosis improves overall patient care by enhancing prognosis and recurrence risk counseling and informing treatmen...

  17. Chemistry

    International Nuclear Information System (INIS)

    The chemical research and development efforts related to the design and ultimate operation of molten-salt breeder reactor systems are concentrated on fuel- and coolant-salt chemistry, including the development of analytical methods for use in these systems. The chemistry of tellurium in fuel salt is being studied to help elucidate the role of this element in the intergranular cracking of Hastelloy N. Studies were continued of the effect of oxygen-containing species on the equilibrium between dissolved UF3 and dissolved UF4, and, in some cases, between the dissolved uranium fluorides and graphite, and the UC2. Several aspects of coolant-salt chemistry are under investigation. Hydroxy and oxy compounds that could be formed in molten NaBF4 are being synthesized and characterized. Studies of the chemistry of chromium (III) compounds in fluoroborate melts were continued as part of a systematic investigation of the corrosion of structural alloys by coolant salt. An in-line voltammetric method for determining U4+/U3+ ratios in fuel salt was tested in a forced-convection loop over a six-month period. (LK)

  18. Differential interferences with clinical chemistry assays by gold nanorods, and gold and silica nanospheres.

    Science.gov (United States)

    Hinkley, Georgia K; Carpinone, Paul L; Munson, John W; Powers, Kevin W; Roberts, Stephen M

    2015-02-01

    Nanomaterials are known to cause interference with several standard toxicological assays. As part of an in vivo study of PEG-coated gold nanorods in mice, nanorods were added to reference serum, and results for standard clinical chemistry parameters were compared with serum analyzed without nanorods. PEG-coated gold nanorods produced several concentration-dependent interferences. Comparisons were then made with PEG-coated gold and silica nanospheres. Interferences were observed for both materials that differed from gold nanorods. Removal of the particles from serum by centrifugation prior to analysis resolved most, but not all of the interferences. Additional clinical chemistry analyzers were used to further investigate trends in assay interference. We conclude that PEG-coated gold and silica nanoparticles can interfere with standard clinical chemistry tests in ways that vary depending upon material, shape, and specific assay methodology employed. Assay interferences by nanomaterials cannot always be predicted, underscoring the need to verify that nanomaterials under study do not interfere with methods used to evaluate potential biological effects.

  19. The European Register for Clinical Chemists. (European Communities Confederation of Clinical Chemistry, Working Group on Registration).

    Science.gov (United States)

    Sanders, G T; Kelly, A M; Breuer, J; Kohse, K P; Mocarelli, P; Sachs, C

    1997-10-01

    To ensure freedom of movement in the European Union, a limited number of professions is regulated by a so-called Sectorial Directive; all other disciplines, including clinical chemistry, fall under a General Directive. However, clinical chemists in the EU wish their specialty to be more specifically regulated; this means that common standards of education, training, experience and compliance with continuing professional developments must be guaranteed. Therefore, the European Communities Confederation of Clinical Chemistry (EC4) is about to implement the European Register for clinical chemists, and has composed a guide to this Register. The document describes the conditions for entry to specialty training, the minimum standards for registration (university education and postgraduate vocational training with a minimum total of eight years), the competencies of those qualifying for registration, and the operation of the register. Registration guarantees professional and managerial competencies; the title conferred is "European Clinical Chemist". EC4 recognises the existing national registers as far as they are based on the minimal requirements as indicated. An EC4 Register Commission (EC4RC) will maintain and control the European Register, supported by National Clinical Chemistry Registration Committees (NCCRC). An NCCRC controls the quality of the education in each country and assesses candidates. An individual (EU citizen or non-EU citizen trained in an EU country) applies privately for the European Register to EC4RC and, where applicable, the application is accompanied by a document from the NCCRC of the country of registration, stating that the applicant has the necessary qualifications. For EU citizens trained outside the EU the final decision is with EC4RC; non-EU citizens not trained in an EU country are not eligible for registration. Registration is renewed once every five years. PMID:9368800

  20. 21 CFR 862.2140 - Centrifugal chemistry analyzer for clinical use.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Centrifugal chemistry analyzer for clinical use. 862.2140 Section 862.2140 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... Instruments § 862.2140 Centrifugal chemistry analyzer for clinical use. (a) Identification. A...

  1. 21 CFR 862.2150 - Continuous flow sequential multiple chemistry analyzer for clinical use.

    Science.gov (United States)

    2010-04-01

    ... analyzer for clinical use. (a) Identification. A continuous flow sequential multiple chemistry analyzer for... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Continuous flow sequential multiple chemistry analyzer for clinical use. 862.2150 Section 862.2150 Food and Drugs FOOD AND DRUG...

  2. Lead - a preanalytical/analytical variable in clinical chemistry

    Directory of Open Access Journals (Sweden)

    Rašić-Mišić Ivana

    2014-01-01

    Full Text Available Lead is one of the most studied clinically important metals due its high toxicity and a high number of workers exposed to it. The interest toward Pb is elevated by the fact that children are especially susceptible to lead poisoning. Research regarding lead poisoning requires a complex, multi-disciplinary (clinical medical and clinical chemical approach. Monitoring human exposure to lead (intake, i.e. poisoning may be achieved by quantification of Pb in tissues and body fluids. For that reason, a number of accurate and reliable analytical methods for the determination of Pb (analytical/preanalytical variable were developed. An objective of this review paper is to provide key information necessary for proper interpretation of results of lead related clinical/laboratory tests. [Projekat Ministarstva nauke Republike Srbije, br. 172061

  3. Establishment of an indocyanine green test using an automatic chemistry analyzer.

    Science.gov (United States)

    Seong, Moon-Woo; Song, Sang-Hoon; Oh, Joo-Young; Park, Joong-Won; Lee, Do-Hoon

    2006-01-01

    The indocyanine green (ICG) clearance test has been used to assess the reserve of hepatic function. This method is based on the spectrometric measurement of its plasma concentration at maximum wavelength of 805 nm, which requires a spectrophotometer and associated maintenance. We established an ICG clearance test using a Toshiba 200FR automatic chemistry analyzer that can be tuned to a wavelength of approximately 805 nm. Five pooled sera spiked from 0 to 4.0 mg/dL were analyzed for linearity test and precision was determined at five levels in the range 0.1-2.0 mg/dL. The ICG retention rate at 15 min (R15) was determined for 38 patients using a conventional method and our method. The ICG clearance test using the automatic chemistry analyzer showed good linearity, and precision ranged from 0.3% to 1.0% for within-run CVs and from 0.6% to 4.7% for total CVs. The degree of agreement between the two methods was also acceptable (mean difference of 1.5%). It is expected that the ICG test using the automatic chemistry analyzer can replace the conventional ICG clearance test, considering the excellent agreement, good precision and linearity over a clinically relevant range.

  4. Baseline hematology and clinical chemistry results from captive-raised trumpeter swans

    Science.gov (United States)

    Olsen, G.H.; Rininger, D.L.; Ets, M.K.; Sladen, William J. L.; Rees, Eileen C.; Earnst, Susan L.; Coulson, John C.

    2002-01-01

    Results from hematology and clinical chemistry tests are presented for healthy captive-raised Trumpeter Swans (Cygnus buccinator) to help establish baseline data. Blood samples were obtained from 14 cygnets between the ages of three to four and seven to eight months that were the subjects of a study to teach migration routes to swans. Males and females differed significantly in asparatate aminotransferase, alanine aminotransferase and total protein. Age categories differed significantly in hematocrit, white blood cell counts, alkaline phosphatase, aspar-rate aminotransferase, glucose, cholesterol and uric acid. There were no significant differences among age categories in values of alanine aminotransferase, calcium, triglycerides and total protein.

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

    Directory of Open Access Journals (Sweden)

    Matthew D Krasowski

    2014-01-01

    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

  6. 21 CFR 862.1187 - Conjugated sulfolithocholic acid (SLCG) test system.

    Science.gov (United States)

    2010-04-01

    ... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems § 862.1187 Conjugated sulfolithocholic acid (SLCG) test system. (a) Identification....

  7. 21 CFR 862.1163 - Cardiac allograft gene expression profiling test system.

    Science.gov (United States)

    2010-04-01

    ... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems § 862.1163 Cardiac allograft gene expression profiling test system....

  8. 21 CFR 862.1113 - Bilirubin (total and unbound) in the neonate test system.

    Science.gov (United States)

    2010-04-01

    ... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems § 862.1113 Bilirubin (total and unbound) in the neonate test system....

  9. 21 CFR 862.1360 - Gamma-glutamyl transpeptidase and isoenzymes test system.

    Science.gov (United States)

    2010-04-01

    ... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems § 862.1360 Gamma-glutamyl transpeptidase and isoenzymes test system....

  10. 21 CFR 862.1245 - Dehydroepiandrosterone (free and sulfate) test system.

    Science.gov (United States)

    2010-04-01

    ... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems § 862.1245 Dehydroepiandrosterone (free and sulfate) test system. (a)...

  11. 21 CFR 862.1315 - Galactose-1-phosphate uridyl transferase test system.

    Science.gov (United States)

    2010-04-01

    ... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems § 862.1315 Galactose-1-phosphate uridyl transferase test system. (a)...

  12. 湖北省临床化学常规检验项目不精密度分析%Analysis of the Imprecision of Clinical Routine Chemistry Analysis Tests in Hubei Province

    Institute of Scientific and Technical Information of China (English)

    潘莉兰; 邓盼; 祝卫平

    2015-01-01

    laboratories which participated the project of interlaboratory comparisons of clinical chemistry indoor quality control data in Hubei Province.This paper was to analyze the variation coefficient of indoor quality control for 21 routine clinical chemistry examination items which were K,Na,Cl,TCa,P,GLu,Urea,UA,Cr,TP,Alb,TC,TG,ALT,AST,TBil,ALP,AMS,CK,LDH andγ-GT.The other objec-tive was to learn how well these items of Hubei Province meet the quality standards of allowed imprecision.Then took the 1/3 TEa,1/4 TEa,WS/T-403-2012 and minimum imprecision derived from biological variation as quality specification.And an-alyzed the percentage of laboratories in meeting the quality standards.Results The TG,ALT,CK and TBil in more than 50% of the participated laboratories could meet the quality standards of the 1/3 TEa,1/4 TEa,WS/T-403-2012 and the low-est appropriate imprecision derived from biological variation.The Cl and Cr in more than 50% of laboratories couldn’t meet the all above quality standards.The Na and TCa in all laboratories couldn’t meet the quality standards of best imprecision derived from biological variation.The evaluation criterion for qualified items setted was that the variation coefficient in more than 80% laboratories was less than the quality standard.Thus,the percentage of the items which meet the lowest quality standard of biological variation and the all 21 items was the most (66.7%).While the percentage of the items which met the quality standards of the WS/T403-2012 and the best biological variation was the least (14.3%).Conclusion In short,the values of indoor variation coefficient of the 21 items in laboratories which participated the project of interlaboratory compari-sons of clinical chemistry indoor quality control data generally met the requirements.But some items had a little higher de-gree of dispersion.The laboratories should set the appropriate imprecision levels based on the detection capability and quality standards and improve the quality of

  13. Reporting unit size and measurement uncertainty: current Australian practice in clinical chemistry and haematology.

    Science.gov (United States)

    Hawkins, Robert C; Badrick, Tony

    2015-08-01

    In this study we aimed to compare the reporting unit size used by Australian laboratories for routine chemistry and haematology tests to the unit size used by learned authorities and in standard laboratory textbooks and to the justified unit size based on measurement uncertainty (MU) estimates from quality assurance program data. MU was determined from Royal College of Pathologists of Australasia (RCPA) - Australasian Association of Clinical Biochemists (AACB) and RCPA Haematology Quality Assurance Program survey reports. The reporting unit size implicitly suggested in authoritative textbooks, the RCPA Manual, and the General Serum Chemistry program itself was noted. We also used published data on Australian laboratory practices.The best performing laboratories could justify their chemistry unit size for 55% of analytes while comparable figures for the 50% and 90% laboratories were 14% and 8%, respectively. Reporting unit size was justifiable for all laboratories for red cell count, >50% for haemoglobin but only the top 10% for haematocrit. Few, if any, could justify their mean cell volume (MCV) and mean cell haemoglobin concentration (MCHC) reporting unit sizes.The reporting unit size used by many laboratories is not justified by present analytical performance. Using MU estimates to determine the reporting interval for quantitative laboratory results ensures reporting practices match local analytical performance and recognises the inherent error of the measurement process.

  14. A Bridge between Two Cultures: Uncovering the Chemistry Concepts Relevant to the Nursing Clinical Practice

    Science.gov (United States)

    Brown, Corina E.; Henry, Melissa L. M.; Barbera, Jack; Hyslop, Richard M.

    2012-01-01

    This study focused on the undergraduate course that covers basic topics in general, organic, and biological (GOB) chemistry at a mid-sized state university in the western United States. The central objective of the research was to identify the main topics of GOB chemistry relevant to the clinical practice of nursing. The collection of data was…

  15. 21 CFR 862.1720 - Triose phosphate isomerase test system.

    Science.gov (United States)

    2010-04-01

    ... (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test... (the energy-yielding conversion of glucose to lactic acid in various tissues). Measurements obtained...

  16. 21 CFR 862.1775 - Uric acid test system.

    Science.gov (United States)

    2010-04-01

    ...) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems § 862..., psoriasis, starvation or other wasting conditions, and of patients receiving cytotoxic drugs....

  17. 21 CFR 862.1680 - Testosterone test system.

    Science.gov (United States)

    2010-04-01

    ...) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems § 862... hirsutism (excessive hair) and virilization (masculinization) due to tumors, polycystic ovaries,...

  18. 21 CFR 862.1265 - Estriol test system.

    Science.gov (United States)

    2010-04-01

    ...) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems § 862.... (b) Classification. Class I (general controls). The device is exempt from the premarket...

  19. 21 CFR 862.1475 - Lipoprotein test system.

    Science.gov (United States)

    2010-04-01

    ...) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems § 862.... (b) Classification. Class I (general controls). The device is exempt from the premarket...

  20. 21 CFR 862.1470 - Lipid (total) test system.

    Science.gov (United States)

    2010-04-01

    ...) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems § 862.... (b) Classification. Class I (general controls). The device is exempt from the premarket...

  1. 21 CFR 862.1260 - Estradiol test system.

    Science.gov (United States)

    2010-04-01

    ...) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems § 862.... (b) Classification. Class I (general controls). The device is exempt from the premarket...

  2. Developing computational model-based diagnostics to analyse clinical chemistry data

    NARCIS (Netherlands)

    Schalkwijk, D.B. van; Bochove, K. van; Ommen, B. van; Freidig, A.P.; Someren, E.P. van; Greef, J. van der; Graaf, A.A. de

    2010-01-01

    This article provides methodological and technical considerations to researchers starting to develop computational model-based diagnostics using clinical chemistry data.These models are of increasing importance, since novel metabolomics and proteomics measuring technologies are able to produce large

  3. 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;

    2010-01-01

    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...

  4. Mass spectrometry in clinical chemistry: the case of newborn screening.

    Science.gov (United States)

    la Marca, Giancarlo

    2014-12-01

    Newborn screening (NBS) program is a complex and organized system consisting of family and personnel education, biochemical tests, confirmatory biochemical and genetic tests, diagnosis, therapy, and patient follow up. The program identifies treatable metabolic disorders possibly when asymptomatic by using dried blood spot (DBS). During the last 20 years tandem mass spectrometry (TMS) has become the leading technology in NBS programs demonstrating to be versatile, sensitive and specific. There is consistent evidence of benefits from NBS for many disorders detected by TMS as well as for congenital hypothyroidism, cystic fibrosis, congenital adrenal hyperplasia by immune-enzymatic methods. Real time PCR tests have more recently been proposed for the detection of some severe combined immunodeficiences (SCID) along with the use of TMS for ADA and PNP SCID; a first evaluation of their cost-benefit ratio is still ongoing. Avoiding false negative results by using specific biomarkers and reducing the false positive rate by using second tier tests, is fundamental for a successful NBS program. The fully integration of NBS and diagnostic laboratories with clinical service is crucial to have the best effectiveness in a comprehensive NBS system.

  5. Applications of monolithic solid-phase extraction in chromatography-based clinical chemistry assays.

    Science.gov (United States)

    Bunch, Dustin R; Wang, Sihe

    2013-04-01

    Complex matrices, for example urine, serum, plasma, and whole blood, which are common in clinical chemistry testing, contain many non-analyte compounds that can interfere with either detection or in-source ionization in chromatography-based assays. To overcome this problem, analytes are extracted by protein precipitation, solid-phase extraction (SPE), and liquid-liquid extraction. With correct chemistry and well controlled material SPE may furnish clean specimens with consistent performance. Traditionally, SPE has been performed with particle-based adsorbents, but monolithic SPE is attracting increasing interest of clinical laboratories. Monoliths, solid pieces of stationary phase, have bimodal structures consisting of macropores, which enable passage of solvent, and mesopores, in which analytes are separated. This structure results in low back-pressure with separation capabilities similar to those of particle-based adsorbents. Monoliths also enable increased sample throughput, reduced solvent use, varied support formats, and/or automation. However, many of these monoliths are not commercially available. In this review, application of monoliths to purification of samples from humans before chromatography-based assays will be critically reviewed.

  6. Chemistry

    International Nuclear Information System (INIS)

    Research and development activities dealing with the chemical problems related to design and ultimate operation of molten-salt reactor systems are described. An experimental test stand was constructed to expose metallurgical test specimens to Te2 vapor at defined temperatures and deposition rates. To better define the chemistry of fluoroborate coolant, several aspects are being investigated. The behavior of hydroxy and oxy compounds in molten NaBF4 is being investigated to define reactions and compounds that may be involved in corrosion and/or could be involved in methods for trapping tritium. Two corrosion products of Hastelloy N, Na3CrF6 and Na5Cr3F14, were identified from fluoroborate systems. The evaluation of fluoroborate and alternate coolants continued. Research on the behavior of hydrogen and its isotopes is summarized. The solubilities of hydrogen, deuterium, and helium in Li2BeF4 are very low. The sorption of tritium on graphite was found to be significant (a few milligrams of tritium per kilogram of graphite), possibly providing a means of sequestering a portion of the tritium produced. Development of analytical methods continued with emphasis on voltammetric and spectrophotometric techniques for the in-line analysis of corrosion products such as Fe2+ and Cr3+ and the determination of the U3+/U4+ ratio in MSBR fuel salt. Similar studies were conducted with the NaBF4--NaF coolant salt. Information developed during the previous operation of the CSTF has been assessed and used to formulate plans for evaluation of in-line analytical methods in future CSTF operations. Electroanalytical and spectrophotometric research suggests that an electroactive protonic species is present in molten NaBF4--NaF, and that this species rapidly equilibrates with a volatile proton-containing species. Data obtained from the CSTF indicated that tritium was concentrated in the volatile species. (JGB)

  7. ASVCP quality assurance guidelines: control of preanalytical, analytical, and postanalytical factors for urinalysis, cytology, and clinical chemistry in veterinary laboratories.

    Science.gov (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

    2012-03-01

    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.

  8. Simulation of ISTP-EPICUR Iodine Chemistry Tests with RAIM

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Han-Chul; Cho, Yeong-Hun; Jang, Dong-Ju; Ryu, Myung-Hyun [Nuclear Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

    2014-10-15

    The amount of iodine release largely depends on its volatility in the containment. Iodine has several chemical forms including aerosols, vapor, and gas. Among them gaseous iodine such as I{sub 2} and organic iodide are dominating due to their high volatility. Therefore, such iodine behavior has been extensively examined. Korea Institute of Nuclear Safety (KINS) has been joining the relevant international programs such as ISTP-EPICUR, OECD-BIP and OECD-STEM. In the course of this study, a simple iodine model, RAIM (Radio-Active Iodine chemistry Model) has been developed, based on the IMOD methodology and other previous studies. This model deals with chemical reactions associated with formation and destruction of iodine species in the containment atmosphere and the sump in a simple manner, as shown in Fig. 1. It also treats adsorption and desorption of volatile iodine on the paint surface. The iodine species modeled are inorganic volatile iodine, organic iodides of high volatility (HVRI) and low volatility (LVRI), non-volatiles, non-aqueous iodine, and iodine oxide aerosols (IO{sub x}). Many other material participating in the iodine reactions, e.g., air radiolysis products (ARP) such as ozone, are also modeled. This paper especially shows the analysis results after addition of gaseous reaction model to RAIM, which was further accompanied by adjustments of the existing reaction rate constants even for the aqueous reactions. After integration of iodine reaction models for gas and aqueous phase, RAIM was applied the S1-9 and S1-11 tests which were carried out in aqueous phase. In addition, re-analysis of the S2-6-5-2 test, for which iodine-loaded coupons were tested in gas phase, was also performed.

  9. Important options available--from start to finish--for translating proteomics results to clinical chemistry.

    Science.gov (United States)

    Heegaard, Niels H H; Østergaard, Ole; Bahl, Justyna M C; Overgaard, Martin; Beck, Hans C; Rasmussen, Lars Melholt; Larsen, Martin R

    2015-02-01

    In the realm of clinical chemistry, the field of clinical proteomics, that is, the application of proteomic methods for understanding mechanisms and enabling diagnosis, prediction, measurement of activity, and treatment response in disease, is first and foremost a discovery and research tool that feeds assay development downstream. Putative new assay candidates generated by proteomics discovery projects compete with well-established assays with known indications, well-described performance, and of known value in specific clinical settings. Careful attention to the many options available in the design, execution, and interpretation of clinical proteomics studies is thus necessary for translation into clinical practice. We here review and discuss important options associated with clinical proteomics endeavors stretching from the planning phases to the final use in clinical chemistry.

  10. Important options available - from start to finish -for translating proteomics results to clinical chemistry

    DEFF Research Database (Denmark)

    Heegaard, Niels H H; Ostergaard, Ole; Bahl, Justyna M C;

    2015-01-01

    In the realm of clinical chemistry the field of clinical proteomics, i.e., the application of proteomic methods for understanding mechanisms and enabling diagnosis, prediction, measurement of activity, and treatment response in disease, is first and foremost a discovery and research tool that feed...... assay development downstream. Putative new assay candidates generated by proteomics discovery projects compete with well-established assays with known indications, well-described performance, and of known value in specific clinical settings. Careful attention to the many options available in the design......, execution, and interpretation of clinical proteomics studies is thus necessary for translation into clinical practice. We here review and discuss important options associated with clinical proteomics endeavors stretching from the planning phases to the final use in clinical chemistry. This article...

  11. An Enzymatic Clinical Chemistry Laboratory Experiment Incorporating an Introduction to Mathematical Method Comparison Techniques

    Science.gov (United States)

    Duxbury, Mark

    2004-01-01

    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…

  12. History of the water chemistry for the few tube test model

    International Nuclear Information System (INIS)

    The water chemistry activities carried out in support of the Few Tube Test are described. This test was conducted to provide design confirmation data for the Clinch River Breeder Reactor Project (CRBRP) steam generators. Proposed CRBRP chemistry was followed; all volatile treatment (AVT) of water was carried out with on-line monitoring capability

  13. European multicentre evaluation of the ABBOTT Spectrum clinical chemistry analyzer.

    Science.gov (United States)

    Blijenberg, B G; Braconnier, F; Vallez, J M; Burlina, A; Plebani, M; Celadin, M; Haeckel, R; Römer, M; Hänseler, E; De Schrijver, G

    1989-06-01

    The analytical performance of the selective multitest ABBOTT Spectrum analyser was studied according to the ECCLS guidelines and partly the CERMAB protocol in a multicentre evaluation involving laboratories from six European countries. Fifteen analytes, including the electrolytes sodium, potassium and chloride, were measured each in at least 3 laboratories, all at 37 degrees C, except the electrolytes, which are measured at room temperature. The trial lasted approximately three months and involved the collection of over 60,000 data points. It yielded the following results: 1. The precision was at least as good as the precision obtained with the comparison instruments. The majority of the coefficients of variation were between 1 and 4%. 2. The recovery for method assigned control sera values was, with few exceptions, within 10%. 3. Good agreement with respect to the method assigned values of control materials and method comparison with patient specimens to different instruments (e.g. SMAC, Hitachi 737, RA 1000) was found. 4. No drift was observed. 5. Reagent-related carry-over was not found. Specimen-related carry-over was detected in some cases, the deviation being of little or no clinical significance. 6. The manufacturer's claims regarding method linearity were as stated or exceeded. 7. The open system capability was tested and rated as very convenient. 8. The practicability of the instrument was very good.

  14. 21 CFR 862.1115 - Urinary bilirubin and its conjugates (nonquantitative) test system.

    Science.gov (United States)

    2010-04-01

    ... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems § 862.1115 Urinary bilirubin and its conjugates (nonquantitative)...

  15. 21 CFR 862.1255 - 2,3-Diphosphoglyceric acid test system.

    Science.gov (United States)

    2010-04-01

    ... (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test... the quality of stored blood. (b) Classification. Class I (general controls). The device is exempt...

  16. Implementation of External Quality Assessment Scheme in Clinical Chemistry for District Laboratories in Bhutan.

    Science.gov (United States)

    Jamtsho, Rixin; Nuchpramool, Wilairat

    2012-07-01

    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. Recent activities of EC4 in the harmonization of clinical chemistry in the European Union.

    Science.gov (United States)

    Sanders, G T; Jansen, R T; Beastall, G; Gurr, E; Kenny, D; Kohse, K P; Zérah, S

    1999-04-01

    This article describes the recent activities of the European Communities Confederation of Clinical Chemistry (EC4). Main goal of EC4 is harmonization of clinical chemistry in the European Union and Europe. EC4's actions connected to that are training and registration of professionals, and accreditation of laboratories. The 35000 professionals practising clinical chemistry in the EU have different backgrounds (medical, pharmaceutical, science-oriented, veterinary, or microbiological). Thus, for the harmonization of training of clinical chemists, EC4 has published a European Syllabus for Postgraduate Training, and instituted a European Union Register for Clinical Chemists. The Syllabus is an indication of the level of requirements in postgraduate training. The EC4 initiative to implement the European Register for Clinical Chemists is based on the 8 years vocational training necessary to obtain sufficient knowledge in clinical chemistry according to the European Syllabus. A guide to the EC4 Register has been published; registration leads to the title European Clinical Chemist (EurClinChem). The accreditation of laboratories must be based on a total quality management system. EC4 has described guidelines (essential criteria) which it judges appropriate for establishing the quality of medical laboratory service; it does not wish to fulfil the role of an accrediting body. Moreover, a working group has been set up to seek to harmonize the work of national accrediting bodies. Therefore, it is logical that EC4 monitors the activities of the different standardizing bodies that might influence the practice of clinical chemistry in the EU. Finally, some aspects concerning the future strategy of EC4 are brought forward. PMID:10369121

  18. Clinical chemistry: a professional field for physicians and natural scientists in Europe.

    Science.gov (United States)

    Büttner, J

    1991-01-01

    1. Clinical chemistry is definitely an interdisciplinary subject between natural science and medicine. The major part of clinical chemistry is natural science and therefore theoretical science. To a lesser extent, however, clinical chemistry is practical science or "action science" which is aimed at a certain action. 2. The question "Is clinical chemistry a professional field for physicians, for scientists or for both?" can be answered with the statement: It follows from its historical development and its characteristic theory and practice, and is de facto true throughout the world, that clinical chemistry is a professional field for physicians and natural scientists. 3. The broad scope of the technical field and the challenges to be expected in future within the framework of the European Community will require the recruiting aspiring clinical chemists both from medicine and from the natural sciences. 4. Qualified postgraduate training is more important than the nature of the initial study course. 5. Apart from providing special knowledge and particular abilities, postgraduate training must make the younger generation familiar with the ways of thought of the physician and of the natural scientist. 6. Successful work as a clinical chemist requires "extra-functional" qualifications, such as the ability to conduct dialogue and teamwork with the clinician. 7. The national differences which exist in the definition of the professional pattern "clinical chemist" are a hindrance to the future development of the discipline in the European Community. The starting point for recognition of the profession must be an agreed definition among the professionals of the countries of the European Community of the professional field of the clinical chemist. PMID:2049472

  19. Design, Development, and Psychometric Analysis of a General, Organic, and Biological Chemistry Topic Inventory Based on the Identified Main Chemistry Topics Relevant to Nursing Clinical Practice

    Science.gov (United States)

    Brown, Corina E.

    2013-01-01

    This two-stage study focused on the undergraduate nursing course that covers topics in general, organic, and biological (GOB) chemistry. In the first stage, the central objective was to identify the main concepts of GOB chemistry relevant to the clinical practice of nursing. The collection of data was based on open-ended interviews of both nursing…

  20. Integration of clinical chemistry, expression, and metabolite data leads to better toxicological class separation

    DEFF Research Database (Denmark)

    Spicker, Jeppe; Brunak, Søren; Frederiksen, K.S.;

    2008-01-01

    A large number of databases are currently being implemented within toxicology aiming to integrate diverse biological data, such as clinical chemistry, expression, and other types of data. However, for these endeavors to be successful, tools for integration, visualization, and interpretation...... are needed. This paper presents a method for data integration using a hierarchical model based on either principal component analysis or partial least squares discriminant analysis of clinical chemistry, expression, and nuclear magnetic resonance data using a toxicological study as case. The study includes...

  1. Diagnosis of brain death: confirmatory tests after clinical test

    Institute of Scientific and Technical Information of China (English)

    Su Yingying; Yang Qinglin; Liu Gang; Zhang Yan; Ye Hong; Gao Daiquan; Zhang Yunzhou

    2014-01-01

    Background The brain death confirmation tests occupy a different position in each country's diagnostic criteria (or guideline); the choices of tests are also different.China brain death criteria include clinical judgment and confirmation tests.This study aimed to confirm the preferred confirmatory test and complementary confirmatory tests.Methods We did a clinical brain death determination on deep coma patients,and then divided them into brain death group and non-brain death group.According to the Chinese standards for determining brain death,both the groups accepted confirmatory tests including electroencephalograph (EEG),somatosensory evoked potentials (SEP),and transcranial Doppler (TCD).The sensitivity,specificity,false positive rate,and false negative rate were calculated to evaluate the accuracy of the confirmatory tests.Results Among the 131 cases of patients,103 patients met the clinical criteria of brain death.Respiratory arrest provocation test was performed on 44 cases and 32 cases (73%) successfully completed and confirmed that they have no spontaneous breathing.Of the three confirmation tests,EEG had the highest completion rate (98%) and good sensitivity (83%) and specificity (97%); TCD had followed completion rate (54%) and not good sensitivity (73%) and specificity (75%); SEP had the lowest completion rate (49%),good sensitivity (100%),and not good specificity (78%).After the combination of SEP or TCD with EEG,the specificity can increase to 100%.Conclusions The completion rate of respiratory arrest provocation test remains a problem in the clinical diagnosis of brain death.If the test cannot be completed,whether to increase a confirmatory test is debatable.SEP had an ideal sensitivity,and the specificity will reach 100% after combining with TCD or EEG.When a confirmed test was uncertain,we suggest increasing another confirmatory test.

  2. Testing Grain Surface Chemistry in Star Forming Regions

    Science.gov (United States)

    Keane, Jacqueline; Boogert, Adwin

    2008-03-01

    The key chemical reactions that produce the first generation ice mantles in dense molecular clouds are still poorly known. Within cold, dense clouds, species formed in the gas and on the grain surfaces will stick to the grains and form icy mantles. However, during star-formation, materials in the general cloud medium are subjected to numerous chemical and physical processes that are driven mostly by thermal and energetic radiation. The comparison between background stars and protostars is a proven excellent tool for this purpose. By comparing observed interstellar solid state abundances with models of grain surface chemistry it is possible to elucidate the efficiency and hence relevancy of a number of chemical reactions, in particular the CO_2 formation pathways. In part because of Spitzer, significant progress has been made towards understanding the various effects of these radiation processes on the ices around a large sample of high- and low-mass protostars. First results suggest that two different CO2 formation pathways play a role in these harsh environments. Though which reaction initially dominated the chemistry is unknown due to the numerous physical processes. Unfortunately, only a small sample of background field stars have been observed, most notably Taurus. In Taurus, only one reaction pathway appears to be efficient in quiescent regions, but this result is sample limited. We propose to take low resolution spectra from 5 to 22 microns along the line of sight toward 31 field stars behind the LDN 673 molecular cloud. Differences in near-IR ice chemistry have already been observed and we will use these mid-infrared data to provide more stringent constraints on chemical models of grain surface chemistry. With this sample it is possible to address fundamental questions in astrochemistry: what are the dominant grain surface chemistry pathways? What is the composition of the first generation ice mantles in molecular clouds?

  3. Quality Assurance in Clinical Chemistry: A Touch of Statistics and A Lot of Common Sense

    Directory of Open Access Journals (Sweden)

    Theodorsson Elvar

    2016-04-01

    Full Text Available Working in laboratories of clinical chemistry, we risk feeling that our personal contribution to quality is small and that statistical models and manufacturers play the major roles. It is seldom sufficiently acknowledged that personal knowledge, skills and common sense are crucial for quality assurance in the interest of patients. The employees, environment and procedures inherent to the laboratory including its interactions with the clients are crucial for the overall result of the total testing chain. As the measurement systems, reagents and procedures are gradually improved, work on the preanalytical, postanalytical and clinical phases is likely to pay the most substantial dividends in accomplishing further quality improvements. This means changing attitudes and behaviour, especially of the users of the laboratory. It requires understanding people and how to engage them in joint improvement processes. We need to use our knowledge and common sense expanded with new skills e.g. from the humanities, management, business and change sciences in order to bring this about together with the users of the laboratory.

  4. Implementation of Scheduling Algorithm with Robotic Arm and Analytical Plate for Clinical Chemistry Analyzer

    Directory of Open Access Journals (Sweden)

    Sudha Ramasamy

    2013-02-01

    Full Text Available Complete automation is the ultimate goal in health care industry and this is of utmost importance in clinical laboratories. Processor based bio robots are involved in all these automation procedures. In this study, the indigenous robotic platform, used in clinical chemistry analyzers, which is highly flexible and user friendly for small or medium sized hospitals, is designed. A microcontroller based robotic arm is put forth as the robotic platform and this is capable of handling blood samples, reagents, etc. The basic design is of a compact, three circular analytical plates, placed one inside the other. The samples and reagents are loaded onto the analytical plate; the arm then transfers the blood samples and reagents successively to the reaction cell and if required, next to an incubating unit. Two different arms perform all the different tasks based on the controlling algorithm. The circuit manipulating the path of the robot arm, along with other controlling circuitry of the arm is embedded within the arm itself. By automating this unit, the flexibility and throughput of the tests will be increased. Controlled and precise use of reagents and high accuracy of results are additional advantages. Data handling is also simplified. The robotic arm and analytical plate has been designed, a prototype model has been made and synchronization between the two has been achieved. The clear description of arm and analytical plate movement along with the synchronization algorithms are presented in this study.

  5. Test Plan: Sludge Treatment Project Corrosion Process Chemistry Follow-on Testing

    Energy Technology Data Exchange (ETDEWEB)

    Delegard, Calvin H.; Schmidt, Andrew J.; Poloski, Adam P.

    2007-08-17

    This test plan was prepared by the Pacific Northwest National Laboratory (PNNL) under contract with Fluor Hanford (FH). The test plan describes the scope and conditions to be used to perform laboratory-scale testing of the Sludge Treatment Project (STP) hydrothermal treatment of K Basin sludge. The STP, managed for the U. S. Department of Energy (DOE) by FH, was created to design and operate a process to eliminate uranium metal from the sludge prior to packaging for Waste Isolation Pilot Plant (WIPP) by using high temperature liquid water to accelerate the reaction, produce uranium dioxide from the uranium metal, and safely discharge the hydrogen. The proposed testing builds on the approach and laboratory test findings for both K Basin sludge and simulated sludge garnered during prior testing from September 2006 to March 2007. The outlined testing in this plan is designed to yield further understanding of the nature of the chemical reactions, the effects of compositional and process variations and the effectiveness of various strategies to mitigate the observed high shear strength phenomenon observed during the prior testing. These tests are designed to provide process validation and refinement vs. process development and design input. The expected outcome is to establish a level of understanding of the chemistry such that successful operating strategies and parameters can be implemented within the confines of the existing STP corrosion vessel design. In July 2007, the DOE provided direction to FH regarding significant changes to the scope of the overall STP. As a result of the changes, FH directed PNNL to stop work on most of the planned activities covered in this test plan. Therefore, it is unlikely the testing described here will be performed. However, to preserve the test strategy and details developed to date, the test plan has been published.

  6. 我国人群多中心参考区间研究-生化检验项目分析质量保证%Quality assurance of clinical biochemistry testing:a mualti-center study based reference interval for clinical chemistry tests in the Chinese population

    Institute of Scientific and Technical Information of China (English)

    张传宝; 黄亨建; 马越云; 于小鸥; 郭玮; 乔蕊; 尚红; 黄宪章; 王兰兰; 郝晓柯; 穆润清; 潘柏申; 张捷; 陈文祥; 庄俊华

    2015-01-01

    Objective To verify and monitor the performance of accuracy, precision and comparability of 26 clinical biochemical analytes (29 methods) in the six centers involved in multi-centers reference intervals research, and to ensure the reliability of theirmeasurement results.Methods During the period of the systems evaluating, two levels of commercial quality control materials and fresh frozen human serum reference materials were applied to verify the performance of inter-laboratory precision and accuracy of analysis systems. During the period of samples testing, the commercial quality control materials were measured whenever samples were analysed, the fresh frozen serum reference materials were measured once a month.The coefficient of variations (CVs), bias and total errors were calculated to assess the precision, accuracy and comparability.Results Verification of precision and accuracy: ( 1 ) the ranges of CVs of 29 methods in the six laboratory laboratories were 0.4%-6.0%, the CVs of all 29 methods met the criterion . (2) The overall average bias of the analysis systems of 21 analytes (24 methods) ranged from -5.15%( ALT) to 4.46% ( Ur ) .Among 24 methods the overall average bias of TP, Glu-GOD, Ur, Cl, Ca exceeded the acceptable range.The quality assessment during the period of samples testing:(1) The overall average bias ranged from -1.95%(Ca) to 2.92%(Ur), median 1.26%, they all met the requirements of relevant standards.( 2 ) When commercial control materials were tested, the requirements of CVs were fulfilled for most methods in the six laboratories,and the CVs of TP, Alb, Cl, Ca exceeded the acceptable range.The overall average TE of all methods met the quality specification for the C-N controls material.For the C-P control material, only the overall average TE of TP (5.05%) exceeded thearceptable range while the other methods met the requirement in criterion.Conclusions The performance of precision and accuracy of the analysis systems used in the six

  7. 50th anniversary of Clinical Chemistry and Laboratory Medicine--a historical overview.

    Science.gov (United States)

    Körber, Friedrich; Plebani, Mario

    2013-01-01

    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.

  8. Bedside clinical chemistry: from catheter tip sensor chips towards micro total analysis systems

    NARCIS (Netherlands)

    Bergveld, P.

    2000-01-01

    With the start of the development of tiny chip chemical sensors in the seventies and eighties, which can easily be mounted in the tip of a catheter, it was thought that clinical chemistry would enter the operating theatre, the intensive care unit, etc. Continuous in vivo monitoring of many important

  9. Lipidomics applications for discovering biomarkers of diseases in clinical chemistry.

    Science.gov (United States)

    Zhao, Ying-Yong; Cheng, Xian-long; Lin, Rui-Chao

    2014-01-01

    Lipids are the fundamental components of biological membranes as well as the metabolites of organisms. Lipids play diverse and important roles in biologicals. The lipid imbalance is closely associated with numerous human lifestyle-related diseases, such as atherosclerosis, obesity, diabetes, and Alzheimer's disease. Lipidomics or lipid profiling is a system-based study of all lipids aiming at comprehensive analysis of lipids in the biological system. Lipidomics has been accepted as a lipid-related research tool in lipid biochemistry, clinical biomarker discovery, disease diagnosis, and in understanding disease pathology. Lipidomics will not only provide insights into the specific functions of lipid species in health and disease, but will also identify potential biomarkers for establishing preventive or therapeutic programs for human diseases. This review presents an overview of lipidomics followed by in-depth discussion of its application to the study of human diseases, including extraction methods of lipids, analytical technologies, data analysis, and clinical research in cancer, neuropsychiatric disease, cardiovascular disease, kidney disease, and respiratory disease. We describe the current status of the identification of metabolic biomarkers in different diseases. We also discuss the lipidomics for the future perspectives and their potential problems. The application of lipidomics in clinical studies may provide new insights into lipid profiling and pathophysiological mechanisms.

  10. Chemistry

    International Nuclear Information System (INIS)

    Research progress is reported in programs on fuel-salt chemistry, properties of compounds in the Li--Te system, Te spectroscopy UF4--H equilibria, porous electrode studies of molten salts, fuel salt-coolant salt reactions, thermodynamic properties of transition-metal fluorides, and properties of sodium fluoroborate. Developmental work on analytical methods is summarized including in-line analysis of molten MSBR fuel, analysis of coolant-salts for tritium, analysis of molten LiF--BeF2--ThF4 for Fe and analysis of LiF--BeF--ThF4 for Te

  11. 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;

    2010-01-01

    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...

  12. Current status and future developments of LC-MS/MS in clinical chemistry for quantification of biogenic amines

    NARCIS (Netherlands)

    de Jong, Wilhelmina H. A.; de Vries, Elisabeth G. E.; Kema, Ido P.

    2011-01-01

    Liquid chromatography-tandem mass spectrometry (LC-MS/MS) is rapidly gaining ground in special clinical chemistry laboratories. It significantly increases the analytic potential in clinical chemistry, especially in the field of low molecular weight biomarker analysis. This review overviews current L

  13. Identification of Misconceptions through Multiple Choice Tasks at Municipal Chemistry Competition Test

    OpenAIRE

    Milenković, Dušica; Hrin, Tamara; Segedinac, Mirjana; HORVAT, Saša; Stanisavljević, Ljubiša; Stanisavljević, Jelena, 1981-

    2016-01-01

    Abstract In this paper, the level of conceptual understanding of chemical contents among seventh grade students who participated in the municipal Chemistry competition in Novi Sad, Serbia, in 2013 have been examined. Tests for the municipal chemistry competition were used as a measuring instrument, wherein only multiple choice tasks were considered and analyzed. Determination of the level of conceptual understanding of the tested chemical contents was based on the calculation of the freque...

  14. A clinical evaluation of the Cobas Fara clinical chemistry analyzer for some routine serum enzymes and glucose.

    Science.gov (United States)

    Moses, G C; Lightle, G O; Tuckerman, J F; Henderson, A R

    1987-11-01

    The authors evaluated the Cobas FARA centrifugal analyzer with respect to pipetting precision and accuracy, instrument temperature, spectrophotometric response, and analytic performance for the assay of five serum enzymes and glucose. Spectrophotometric response, temperature response, pipetting precision, and accuracy were satisfactory. However, sufficient time must be allowed for cuvet contents to reach a stable temperature before measurements are made. Total day-to-day imprecision (within plus between run) was less than 5% (coefficient of variation) for aspartate and alanine aminotransferases (AST; Enzyme Commission classification number [EC] EC 2.6.1.1; and ALT; EC 2.6.1.2); alkaline phosphatase (AP; EC 3.1.3.1); gamma-glutamyltransferase (GGT; EC 2.3.1.2); lactate dehydrogenase (LD; EC 1.1.1.17); creatine kinase (CK; EC 2.7.3.1); and glucose assays. Results compare well with those obtained with other current clinical chemistry analyzers; correlation coefficients were greater than 0.993. Sample-to-sample carryover was negligible, and method linearity was satisfactory for all tests.

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

    LENUS (Irish Health Repository)

    McMurray, Janet

    2010-07-01

    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.

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

    LENUS (Irish Health Repository)

    McMurray, Janet

    2009-01-01

    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.

  17. Hypothesis Formation and Testing in Clinical Judgment.

    Science.gov (United States)

    Strohmer, Douglas C.; And Others

    1983-01-01

    Examined the influence of cognitive complexity and client observation on the quality of clinical hypotheses counselors develop and the number of questions generated to test them. Results showed no effect of these variables on hypothesis quality; but a significant interaction between client observations on the number of questions developed. (LLL)

  18. Axon clinical chemistry analyzer evaluated according to ECCLS protocol.

    Science.gov (United States)

    Brenna, S; Prencipe, L

    1992-10-01

    We assessed the analytical performance of the Axon system (Bayer Diagnostici), according to the European Committee for Clinical Laboratory Standards guidelines, for assay of 12 analytes: cholesterol, creatinine, glucose, total protein, urea, uric acid, alkaline phosphatase, alpha-amylase, aspartate aminotransferase, creatine kinase, sodium, and potassium. The field evaluation lasted approximately 5 months and involved the collection of approximately 10,000 data points with the Axon. The following results were obtained: The highest CVs for controls and human sera at different concentration/activity values were 2.2% for within-run imprecision (n = 60; 3 days, pooled estimate) and 3.5% for the between-day imprecision (n = 20 days). Close correlation was found with results for patients' specimens assayed with comparative instruments (Hitachi 717 for substrates and enzymes, Beckman Synchron EL/E4A for electrolytes). No drift was observed during 8 h of operation. The linearity range was broad, sometimes exceeding the manufacturer's claims. No sample-, reagent-, or cuvette-related carryover was found. Measurement of control sera gave results within +/- 5% of the assigned values. We conclude that good reliability and practicability make the Axon system suitable for laboratories with various needs.

  19. Pre-analytical phase in clinical chemistry laboratory

    Directory of Open Access Journals (Sweden)

    Neogi SS

    2016-07-01

    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.

  20. Comparison of plastic vs. glass evacuated serum-separator (SST) blood-drawing tubes for common clinical chemistry determinations.

    Science.gov (United States)

    Hill, B M; Laessig, R H; Koch, D D; Hassemer, D J

    1992-08-01

    We evaluated a plastic evacuated blood-drawing tube containing an integral serum-separating barrier gel, by direct comparison with a glass counterpart. The plastic tube demonstrated no differences when compared for common clinical chemistry analytes with multiple types of instruments and systems. A total of 260 such different combinations were studied with emphasis on tests sensitive to drawing and handling indexes such as lactate dehydrogenase and potassium. A total of six separate blood drawings were tested with no significant differences noted in these tests. The total study included subjective evaluations of the plastic tube's use as a blood-drawing device and objective studies based on quantitative test results from normal and hospitalized patients and use of the primary sampling tubes (both plastic and glass) for 48-h storage. PMID:1643717

  1. Effects of a test taking strategy on postsecondary computer assisted chemistry assessments

    Science.gov (United States)

    Manco, Sharon Ann

    Metacognitive test taking strategies have proven advantageous in improving content-based test scores in a wide variety of disciplines and age/grade levels using traditional paper-and-pencil tests. However, despite the increase in computer assisted assessment (CAA), little research has examined whether these test taking strategies are effective for computer assisted tests. Research was conducted to determine if learning a proven test taking strategy would improve the online quiz scores of six university students in an introductory chemistry course intended for science, technology, engineering and math majors. Participants completed six to ten chemistry quizzes prior to intervention---learning the test taking strategy---and four to eight chemistry quizzes after intervention. Results indicated that, while students learned the strategy, it had little effect on their online chemistry quiz scores. Additionally, at the end of the semester, participants completed a satisfaction survey indicating general satisfaction with having learned the test taking strategy and generalization to other courses and types of tests. Furthermore, results suggest that adaptations to the on-line delivery method of the quizzes and to the test taking strategies may improve the robustness of the effect. Due to the increased use of computer assisted assessment, additional research is warranted to determine appropriate test taking strategies for online tests.

  2. Satiety testing: Ready for the clinic?

    Institute of Scientific and Technical Information of China (English)

    Michael P Jones

    2008-01-01

    Drink tests are advocated as an inexpensive,nonivesive technique to assess gastric function in patients with a variety of upper digestive symptoms.Many patients with dyspeptic complaints will achieve satiation or develop symptoms at ingested volumes below those typically required to achieve these endpoints in controls.Substantial variation in test performance exists and a greater degree of standardization is required.Additionally,it remains unclear exactly what drink tests measure as correlations with measures of gastric sensation,accomodation and emptying are modest at best.Finally,results of drink tests do not guide therpay.At present,these tests are best reserved for research studies and are not advocated for use in clinical practice.(C)2008 The W.1G Press.All rights reserved.

  3. Effect of repeated freezing and thawing on 18 clinical chemistry analytes in rat serum.

    Science.gov (United States)

    Kale, Vijay P; Patel, Sweta G; Gunjal, Prashant S; Wakchaure, Santosh U; Sundar, Rajesh S; Ranvir, Ramchandra K; Jain, Mukul R

    2012-07-01

    In a preclinical research laboratory, using serum samples that have been frozen and thawed repeatedly is sometimes unavoidable when needing to confirm previous results or perform additional analysis. Here we determined the effects of multiple cycles of refrigeration or freezing and thawing of rat serum at 3 temperature conditions for different storage times on clinical chemistry analytes. Serum samples obtained from adult Wistar rats were stored at 2 to 8 °C and -10 to -20 °C for as long as 72 h and at -70 °C for as long as 30 d. At different time points (24, 48, and 72 h for samples stored at 2 to 8 °C or -10 to -20 °C and 1, 7, and 30 d for samples stored at -70 °C), the samples were brought to room temperature, analyzed, and then stored again at the designated temperature. The results obtained after each storage cycle were compared with those obtained from the initial analysis of fresh samples. Of the 18 serum analytes evaluated, 14 were stable without significant changes, even after 3 freeze-thaw cycles at the tested temperature ranges. Results from this study will help researchers working with rat serum to interpret the biochemical data obtained from serum samples that have been frozen and thawed repeatedly. PMID:23043814

  4. Probability, clinical decision making and hypothesis testing

    Directory of Open Access Journals (Sweden)

    A Banerjee

    2009-01-01

    Full Text Available Few clinicians grasp the true concept of probability expressed in the ′P value.′ For most, a statistically significant P value is the end of the search for truth. In fact, the opposite is the case. The present paper attempts to put the P value in proper perspective by explaining different types of probabilities, their role in clinical decision making, medical research and hypothesis testing.

  5. Feline genetics: clinical applications and genetic testing.

    Science.gov (United States)

    Lyons, Leslie A

    2010-11-01

    DNA testing for domestic cat diseases and appearance traits is a rapidly growing asset for veterinary medicine. Approximately 33 genes contain 50 mutations that cause feline health problems or alterations in the cat's appearance. A variety of commercial laboratories can now perform cat genetic diagnostics, allowing both the veterinary clinician and the private owner to obtain DNA test results. DNA is easily obtained from a cat via a buccal swab with a standard cotton bud or cytological brush, allowing DNA samples to be easily sent to any laboratory in the world. The DNA test results identify carriers of the traits, predict the incidence of traits from breeding programs, and influence medical prognoses and treatments. An overall goal of identifying these genetic mutations is the correction of the defect via gene therapies and designer drug therapies. Thus, genetic testing is an effective preventative medicine and a potential ultimate cure. However, genetic diagnostic tests may still be novel for many veterinary practitioners and their application in the clinical setting needs to have the same scrutiny as any other diagnostic procedure. This article will review the genetic tests for the domestic cat, potential sources of error for genetic testing, and the pros and cons of DNA results in veterinary medicine. Highlighted are genetic tests specific to the individual cat, which are a part of the cat's internal genome. PMID:21147473

  6. Feline genetics: clinical applications and genetic testing.

    Science.gov (United States)

    Lyons, Leslie A

    2010-11-01

    DNA testing for domestic cat diseases and appearance traits is a rapidly growing asset for veterinary medicine. Approximately 33 genes contain 50 mutations that cause feline health problems or alterations in the cat's appearance. A variety of commercial laboratories can now perform cat genetic diagnostics, allowing both the veterinary clinician and the private owner to obtain DNA test results. DNA is easily obtained from a cat via a buccal swab with a standard cotton bud or cytological brush, allowing DNA samples to be easily sent to any laboratory in the world. The DNA test results identify carriers of the traits, predict the incidence of traits from breeding programs, and influence medical prognoses and treatments. An overall goal of identifying these genetic mutations is the correction of the defect via gene therapies and designer drug therapies. Thus, genetic testing is an effective preventative medicine and a potential ultimate cure. However, genetic diagnostic tests may still be novel for many veterinary practitioners and their application in the clinical setting needs to have the same scrutiny as any other diagnostic procedure. This article will review the genetic tests for the domestic cat, potential sources of error for genetic testing, and the pros and cons of DNA results in veterinary medicine. Highlighted are genetic tests specific to the individual cat, which are a part of the cat's internal genome.

  7. Characterization of Rheumatoid Arthritis Subtypes Using Symptom Profiles, Clinical Chemistry and Metabolomics Measurements

    OpenAIRE

    van Wietmarschen, Herman A.; Weidong Dai; van der Kooij, Anita J.; Theo H Reijmers; Yan Schroën; Mei Wang; Zhiliang Xu; Xinchang Wang; Hongwei Kong; Guowang Xu; Thomas Hankemeier; Meulman, Jacqueline J.; Jan van der Greef

    2012-01-01

    Objective: The aim is to characterize subgroups or phenotypes of rheumatoid arthritis (RA) patients using a systems biology approach. The discovery of subtypes of rheumatoid arthritis patients is an essential research area for the improvement of response to therapy and the development of personalized medicine strategies. Methods: In this study, 39 RA patients are phenotyped using clinical chemistry measurements, urine and plasma metabolomics analysis and symptom profiles. In addition, a Chine...

  8. A clinical chemistry analyzer evaluated by NCCLS guidelines for use in a military field laboratory unit.

    Science.gov (United States)

    Sullinger, J; Garrett, P E

    1989-11-01

    In a previous comparison study of "dry chemistry" desktop analyzers, the ChemPro 1000 (Arden Medical Systems) was one of several instruments found suitable for field use. We have now evaluated the linearity, accuracy, and precision of the ChemPro 1000, according to NCCLS Document EP 10-P. We also compared results with those by the SMAC (Technicon) and the Nova 9 (Nova Biomedical) for electrolytes, serum urea nitrogen, and ionized calcium in field and laboratory environments. The precision (CV) of the ChemPro was within acceptable ranges for dry chemistry desktop analyzers for all analytes tested. This instrument is a suitable and reasonable alternative to manual chemistry or to large, automated instrumentation in a field environment.

  9. Development and Analysis of an Instrument to Assess Student Understanding of GOB Chemistry Knowledge Relevant to Clinical Nursing Practice

    Science.gov (United States)

    Brown, Corina E.; Hyslop, Richard M.; Barbera, Jack

    2015-01-01

    The General, Organic, and Biological Chemistry Knowledge Assessment (GOB-CKA) is a multiple-choice instrument designed to assess students' understanding of the chemistry topics deemed important to clinical nursing practice. This manuscript describes the development process of the individual items along with a psychometric evaluation of the…

  10. Identification of metabolites, clinical chemistry markers and transcripts associated with hepatotoxicity.

    Science.gov (United States)

    Buness, Andreas; Roth, Adrian; Herrmann, Annika; Schmitz, Oliver; Kamp, Hennicke; Busch, Kristina; Suter, Laura

    2014-01-01

    Early and accurate pre-clinical and clinical biomarkers of hepatotoxicity facilitate the drug development process and the safety monitoring in clinical studies. We selected eight known model compounds to be administered to male Wistar rats to identify biomarkers of drug induced liver injury (DILI) using transcriptomics, metabolite profiling (metabolomics) and conventional endpoints. We specifically explored early biomarkers in serum and liver tissue associated with histopathologically evident acute hepatotoxicity. A tailored data analysis strategy was implemented to better differentiate animals with no treatment-related findings in the liver from animals showing evident hepatotoxicity as assessed by histopathological analysis. From the large number of assessed parameters, our data analysis strategy allowed us to identify five metabolites in serum and five in liver tissue, 58 transcripts in liver tissue and seven clinical chemistry markers in serum that were significantly associated with acute hepatotoxicity. The identified markers comprised metabolites such as taurocholic acid and putrescine (measured as sum parameter together with agmatine), classical clinical chemistry markers like AST (aspartate aminotransferase), ALT (alanine aminotransferase), and bilirubin, as well as gene transcripts like Igfbp1 (insulin-like growth factor-binding protein 1) and Egr1 (early growth response protein 1). The response pattern of the identified biomarkers was concordant across all types of parameters and sample matrices. Our results suggest that a combination of several of these biomarkers could significantly improve the robustness and accuracy of an early diagnosis of hepatotoxicity.

  11. Identification of metabolites, clinical chemistry markers and transcripts associated with hepatotoxicity.

    Directory of Open Access Journals (Sweden)

    Andreas Buness

    Full Text Available Early and accurate pre-clinical and clinical biomarkers of hepatotoxicity facilitate the drug development process and the safety monitoring in clinical studies. We selected eight known model compounds to be administered to male Wistar rats to identify biomarkers of drug induced liver injury (DILI using transcriptomics, metabolite profiling (metabolomics and conventional endpoints. We specifically explored early biomarkers in serum and liver tissue associated with histopathologically evident acute hepatotoxicity. A tailored data analysis strategy was implemented to better differentiate animals with no treatment-related findings in the liver from animals showing evident hepatotoxicity as assessed by histopathological analysis. From the large number of assessed parameters, our data analysis strategy allowed us to identify five metabolites in serum and five in liver tissue, 58 transcripts in liver tissue and seven clinical chemistry markers in serum that were significantly associated with acute hepatotoxicity. The identified markers comprised metabolites such as taurocholic acid and putrescine (measured as sum parameter together with agmatine, classical clinical chemistry markers like AST (aspartate aminotransferase, ALT (alanine aminotransferase, and bilirubin, as well as gene transcripts like Igfbp1 (insulin-like growth factor-binding protein 1 and Egr1 (early growth response protein 1. The response pattern of the identified biomarkers was concordant across all types of parameters and sample matrices. Our results suggest that a combination of several of these biomarkers could significantly improve the robustness and accuracy of an early diagnosis of hepatotoxicity.

  12. Observational tests for grain chemistry: posterior isotopic labelling

    NARCIS (Netherlands)

    S.B. Charnley; P. Ehrenfreund; T.J. Millar; A.C.A. Boogert; A.J. Markwick; H.M. Butner; R. Ruiterkamp; S.D. Rodgers

    2004-01-01

    We propose a series of detailed observations that should allow current ideas concerning the important catalytic pathways to interstellar molecules on interstellar dust grains to be tested. The atoms and molecules that accrete on cold grains and take part in surface reactions will be selectively frac

  13. Preliminary evaluation of an experimental clinical chemistry analyzer developed for space medicine.

    Science.gov (United States)

    Wu, A H; Gornet, T G; Schenkel, O; Smith-Cronin, L; Graham, G A; Tonnesen, A S; McKinley, B A

    1993-01-01

    An experimental clinical chemistry analyzer system was designed and built to demonstrate the feasibility of clinical chemistry as part of a medical-care system at NASA's planned space station Freedom. We report the performance of the experimental analyzer, called a medical development unit (MDU), for selected analytes in a laboratory setting in preparation for a preliminary clinical trial at patients' bedsides in an intensive-care unit. Within-run CVs ranged from 0.7% for sodium to 7.1% for phosphorus; day-to-day CVs ranged from 1.0% for chloride to 23.4% for calcium. Correlation of patients' blood sample analyses compared well with those by Ektachem E700 and other high-volume central laboratory analyzers (r ranged from 0.933 for creatine kinase MB isoenzyme to 0.997 for potassium), except for hemoglobin (r = 0.901) and calcium (r = 0.823). Although several CVs obtained in this study exceeded theoretical desired precision limits based on biological variations, performance was adequate for clinical laboratory diagnosis. We examined the effect of potentially interfering concentrations of hemoglobin, bilirubin, and lipids: the only effect was negative interference with calcium analyses by high concentrations of bilirubin. We also examined the effects of preanalytical variables and the performance of experimental sample-transfer cups designed to retain sample and reference liquid in microgravity. Continued development of the MDU system is recommended, especially automation of sample processing.

  14. Analytical Chemistry Laboratory (ACL) procedure compendium. Volume 6, Physical testing

    Energy Technology Data Exchange (ETDEWEB)

    1993-08-01

    This volume contains the interim change notice for physical testing. Covered are: properties of solutions, slurries, and sludges; rheological measurement with cone/plate viscometer; % solids determination; particle size distribution by laser scanning; penetration resistance of radioactive waste; operation of differential scanning calorimeter, thermogravimetric analyzer, and high temperature DTA and DSC; sodium rod for sodium bonded fuel; filling SP-100 fuel capsules; sodium filling of BEATRIX-II type capsules; removal of alkali metals with ammonia; specific gravity of highly radioactive solutions; bulk density of radioactive granular solids; purification of Li by hot gettering/filtration; and Li filling of MOTA capsules.

  15. The terminator "toy"-chemistry test: a simple tool to assess errors in transport schemes

    Directory of Open Access Journals (Sweden)

    P. H. Lauritzen

    2014-12-01

    Full Text Available This test extends the evaluation of transport schemes from prescribed advection of inert scalars to reactive species. The test consists of transporting two reacting chlorine-like species (Cl and Cl2 in the Nair and Lauritzen 2-D idealized flow field. The sources and sinks for the two species are given by a simple, but non-linear, "toy" chemistry. This chemistry mimics photolysis-driven processes near the solar terminator. As a result, strong gradients in the spatial distribution of the species develop near the edge of the terminator. Despite the large spatial variations in Cl and Cl2 the weighted sum Cly = Cl +2 Cl2 should always be preserved. The terminator test demonstrates how well the advection/transport scheme preserves linear correlations. Physics-dynamics coupling can also be studied with this test. Examples of the consequences of this test are shown for illustration.

  16. Hanford low-level waste process chemistry testing data package

    International Nuclear Information System (INIS)

    Recently, the Tri-Party Agreement (TPA) among the State of Washington Department of Ecology, U.S. Department of Energy (DOE) and the US Environmental Protection Agency (EPA) for the cleanup of the Hanford Site was renegotiated. The revised agreement specifies vitrification as the encapsulation technology for low level waste (LLW). A demonstration, testing, and evaluation program underway at Westinghouse Hanford Company to identify the best overall melter-system technology available for vitrification of Hanford Site LLW to meet the TPA milestones. Phase I is a open-quotes proof of principleclose quotes test to demonstrate that a melter system can process a simulated highly alkaline, high nitrate/nitrite content aqueous LLW feed into a glass product of consistent quality. Seven melter vendors were selected for the Phase I evaluation: joule-heated melters from GTS Duratek, Incorporated (GDI); Envitco, Incorporated (EVI); Penberthy Electomelt, Incorporated (PEI); and Vectra Technologies, Incorporated (VTI); a gas-fired cyclone burner from Babcock ampersand Wilcox (BCW); a plasma torch-fired, cupola furnace from Westinghouse Science and Technology Center (WSTC); and an electric arc furnace with top-entering vertical carbon electrodes from the U.S. Bureau of Mines (USBM)

  17. Clinical chemistry and laboratory medicine in Croatia: regulation of the profession.

    Science.gov (United States)

    Simundic, Ana-Maria; Topic, Elizabeta; Cvoriscec, Dubravka; Cepelak, Ivana

    2011-01-01

    Heterogeneity exists across Europe in the definition of the profession of clinical chemistry and laboratory medicine and also in academic background of specialists in this discipline. This article provides an overview of the standards of education and training of laboratory professionals and quality regulations in Croatia. Clinical chemistry in Croatia is almost exclusively practiced by medical biochemists. Although term Medical biochemist often relates to medical doctors in other European countries, in Croatia medical biochemists are not medical doctors, but university degree professionals who are qualified scientifically. Practicing the medical biochemistry is regulated by The Health Care Law, The Law of the Medical Biochemistry Profession and The Law of the State and Private Health Insurance. According to the law, only medical biochemists are entitled to run and work in the medical biochemistry laboratory. University degree is earned after the 5 years of the studies. Register for medical biochemists is kept by the Croatian Chamber of Medical Biochemists. Licensing is mandatory, valid for 6 years and regulated by the government (Law on the Health Care, 1993). Vocational training for medical biochemists lasts 44 months and is regulated by the national regulatory document issued by the Ministry of Health. Accreditation is not mandatory and is provided by an independent, non-commercial national accreditation body. The profession has interdisciplinary character and a level of required competence and skills comparable to other European countries. PMID:22141201

  18. Quantitative Clinical Chemistry Proteomics (qCCP) using mass spectrometry: general characteristics and application.

    Science.gov (United States)

    Lehmann, Sylvain; Hoofnagle, Andrew; Hochstrasser, Denis; Brede, Cato; Glueckmann, Matthias; Cocho, José A; Ceglarek, Uta; Lenz, Christof; Vialaret, Jérôme; Scherl, Alexander; Hirtz, Christophe

    2013-05-01

    Proteomics studies typically aim to exhaustively detect peptides/proteins in a given biological sample. Over the past decade, the number of publications using proteomics methodologies has exploded. This was made possible due to the availability of high-quality genomic data and many technological advances in the fields of microfluidics and mass spectrometry. Proteomics in biomedical research was initially used in 'functional' studies for the identification of proteins involved in pathophysiological processes, complexes and networks. Improved sensitivity of instrumentation facilitated the analysis of even more complex sample types, including human biological fluids. It is at that point the field of clinical proteomics was born, and its fundamental aim was the discovery and (ideally) validation of biomarkers for the diagnosis, prognosis, or therapeutic monitoring of disease. Eventually, it was recognized that the technologies used in clinical proteomics studies [particularly liquid chromatography-tandem mass spectrometry (LC-MS/MS)] could represent an alternative to classical immunochemical assays. Prior to deploying MS in the measurement of peptides/proteins in the clinical laboratory, it seems likely that traditional proteomics workflows and data management systems will need to adapt to the clinical environment and meet in vitro diagnostic (IVD) regulatory constraints. This defines a new field, as reviewed in this article, that we have termed quantitative Clinical Chemistry Proteomics (qCCP).

  19. Effects of PBBs on cattle. I. Clinical evaluations and clinical chemistry.

    Science.gov (United States)

    Durst, H I; Willett, L B; Schanbacher, F L; Moorhead, P D

    1978-04-01

    Toxicosis was induced in pregnant heifers by feeding 25,000 mg/head/day of FireMaster BP-6, a commercial blend of polybrominated biphenyls (PBB). The PBB feeding decreased dry matter intake approximately 50% by 4 days exposure. Emaciated animals became anorexic a few days prior to death at 33 to 66 days. Weight losses of heifers average 80 kg. Other clinical signs observed were dehydration, diarrhea, excessive salivation and lacrimation, fetal death, abortion, and general depression as evidenced by depressed heart and respiratory rates. Clinical signs were apparent after 10 days exposure and progressively intensified along with loss of condition until death. Clinicopathologic changes included significantly increased serum glutamic-oxaloacetic transaminase and decreased serum calcium by 30 days exposure. Lactate dehydrogenase, urea nitrogen, and bilirubin were elevated, and serum albumin decreased by 36 to 40 days. Principal urine changes were decreased specific gravity and moderate proteinuria. Pregnant heifers fed 0.25 or 250 mg/head/day for 60 days and nonpregnant heifers fed 250 mg/head/day for 180 days displayed neither clinical signs nor clinicopathologic changes indicating adverse effects from PBB exposure. Post-exposure, all heifers exposed to PBB for 60 days calved normally with zero calf mortality and were successfully rebred. Milk production was not different from control animals. Birth weights of calves from dams exposed to 250 mg PBB/head/day were significantly greater than calves of dams exposed to 0 mg or 0.25 mg/head/day. PBB exposure of dams produced no detrimental effects on calves as indicated by clinical signs, clinicopathologic changes, or performance.

  20. Paragangliomas/Pheochromocytomas: Clinically Oriented Genetic Testing

    Directory of Open Access Journals (Sweden)

    Rute Martins

    2014-01-01

    Full Text Available Paragangliomas are rare neuroendocrine tumors that arise in the sympathetic or parasympathetic nervous system. Sympathetic paragangliomas are mainly found in the adrenal medulla (designated pheochromocytomas but may also have a thoracic, abdominal, or pelvic localization. Parasympathetic paragangliomas are generally located at the head or neck. Knowledge concerning the familial forms of paragangliomas has greatly improved in recent years. Additionally to the genes involved in the classical syndromic forms: VHL gene (von Hippel-Lindau, RET gene (Multiple Endocrine Neoplasia type 2, and NF1 gene (Neurofibromatosis type 1, 10 novel genes have so far been implicated in the occurrence of paragangliomas/pheochromocytomas: SDHA, SDHB, SDHC, SDHD, SDHAF2, TMEM127, MAX, EGLN1, HIF2A, and KIF1B. It is currently accepted that about 35% of the paragangliomas cases are due to germline mutations in one of these genes. Furthermore, somatic mutations of RET, VHL, NF1, MAX, HIF2A, and H-RAS can also be detected. The identification of the mutation responsible for the paraganglioma/pheochromocytoma phenotype in a patient may be crucial in determining the treatment and allowing specific follow-up guidelines, ultimately leading to a better prognosis. Herein, we summarize the most relevant aspects regarding the genetics and clinical aspects of the syndromic and nonsyndromic forms of pheochromocytoma/paraganglioma aiming to provide an algorithm for genetic testing.

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

    Directory of Open Access Journals (Sweden)

    Usha S. Adiga

    2015-10-01

    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.

  2. Clinical Applications of CO2 and H2 Breath Test

    OpenAIRE

    ZHAO Si-qian; Chen, Bao-Jun; LUO Zhi-fu

    2016-01-01

    Breath test is non-invasive, high sensitivity and high specificity. In this article, CO2 breath test, H2 breath test and their clinical applications were elaborated. The main applications of CO2 breath test include helicobacter pylori test, liver function detection, gastric emptying test, insulin resistance test, pancreatic exocrine secretion test, etc. H2 breath test can be applied in the diagnosis of lactose malabsorption and detecting small intestinal bacterial overgrowth. With further res...

  3. How do video-based demonstration assessment tasks affect problem-solving process, test anxiety, chemistry anxiety and achievement in general chemistry students?

    Science.gov (United States)

    Terrell, Rosalind Stephanie

    2001-12-01

    Because paper-and-pencil testing provides limited knowledge about what students know about chemical phenomena, we have developed video-based demonstrations to broaden measurement of student learning. For example, students might be shown a video demonstrating equilibrium shifts. Two methods for viewing equilibrium shifts are changing the concentration of the reactants and changing the temperature of the system. The students are required to combine the data collected from the video and their knowledge of chemistry to determine which way the equilibrium shifts. Video-based demonstrations are important techniques for measuring student learning because they require students to apply conceptual knowledge learned in class to a specific chemical problem. This study explores how video-based demonstration assessment tasks affect problem-solving processes, test anxiety, chemistry anxiety and achievement in general chemistry students. Several instruments were used to determine students' knowledge about chemistry, students' test and chemistry anxiety before and after treatment. Think-aloud interviews were conducted to determine students' problem-solving processes after treatment. The treatment group was compared to a control group and a group watching video demonstrations. After treatment students' anxiety increased and achievement decreased. There were also no significant differences found in students' problem-solving processes following treatment. These negative findings may be attributed to several factors that will be explored in this study.

  4. Inter-rater-agreement in clinical tests of subacromial impingement

    OpenAIRE

    2003-01-01

    Introduction: Shoulder pain is a common complain in the population. Subacromial impingement syndrome(SIS) is cause of many of these. SIS is a clinical diagnosis, mainly based on impingement signs. Clinical tests used for diagnosing specific disease, must be valid and reliable and have as high sensitivity and specificity as possible. They should be easy to learn and to reproduce. Material and method: Tests included were Neers test, Hawkins test, painful arch and isometric test of the sup...

  5. 21 CFR 862.1678 - Tacrolimus test system.

    Science.gov (United States)

    2010-04-01

    ...) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems § 862... Controls Guidance Document: Cyclosporine and Tacrolimus Assays; Guidance for Industry and FDA.” See §...

  6. 21 CFR 862.1190 - Copper test system.

    Science.gov (United States)

    2010-04-01

    ... DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems § 862.1190... primarily of the lymph system). (b) Classification. Class I (general controls). The device is exempt...

  7. The terminator "toy" chemistry test: a simple tool to assess errors in transport schemes

    Directory of Open Access Journals (Sweden)

    P. H. Lauritzen

    2015-05-01

    Full Text Available This test extends the evaluation of transport schemes from prescribed advection of inert scalars to reactive species. The test consists of transporting two interacting chemical species in the Nair and Lauritzen 2-D idealized flow field. The sources and sinks for these two species are given by a simple, but non-linear, "toy" chemistry that represents combination (X + X → X2 and dissociation (X2 → X + X. This chemistry mimics photolysis-driven conditions near the solar terminator, where strong gradients in the spatial distribution of the species develop near its edge. Despite the large spatial variations in each species, the weighted sum XT = X + 2X2 should always be preserved at spatial scales at which molecular diffusion is excluded. The terminator test demonstrates how well the advection–transport scheme preserves linear correlations. Chemistry–transport (physics–dynamics coupling can also be studied with this test. Examples of the consequences of this test are shown for illustration.

  8. Design study of water chemistry control system for IASCC irradiation test

    Energy Technology Data Exchange (ETDEWEB)

    Mori, Yuichiro; Ide, Hiroshi; Nabeya, Hideaki [Japan Atomic Energy Research Inst., Oarai, Ibaraki (Japan). Oarai Research Establishment; Tsukada, Takashi [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment

    2002-02-01

    In relation to the aging of Light Water Reactor (LWR), the Irradiation Assisted Stress Corrosion Cracking (IASCC) has been regarded as a significant and urgent issue for the reliability of in-core components of LWR, and the irradiation research on the IASCC is now under schedule. With the progress of the irradiation research on reactor materials, well-controlled environment conditions during irradiation testing are required. Especially for irradiation testing of IASCC studies, water chemistry control is essential in addition to the control of neutron fluence and irradiation temperature. According to these requirements, at the Japan Atomic Energy Research Institute (JAERI), an irradiation testing facility that simulates in-core environment of Boiling Water Reactor (BWR) has been designed to be installed in the Japan Materials Testing Reactor (JMTR). This facility is composed of the Saturated Temperature Capsules (SATCAP) that are installed into the JMTR's core to irradiate material specimens, the Water Control Unit that is able to supply high-temperature and high-pressure chemical controlled water to SATCAP, and other components. This report describes the design study of water chemistry control system of the Water Control Unit. The design work has been performed in the fiscal year 1999. (author)

  9. A Genetically Optimized Predictive System for Success in General Chemistry Using a Diagnostic Algebra Test

    Science.gov (United States)

    Cooper, Cameron I.; Pearson, Paul T.

    2012-02-01

    In higher education, many high-enrollment introductory courses have evolved into "gatekeeper" courses due to their high failure rates. These courses prevent many students from attaining their educational goals and often become graduation roadblocks. At the authors' home institution, general chemistry has become a gatekeeper course in which approximately 25% of students do not pass. This failure rate in chemistry is common, and often higher, at many other institutions of higher education, and mathematical deficiencies are perceived to be a large contributing factor. This paper details the development of a highly accurate predictive system that identifies students at the beginning of the semester who are "at-risk" for earning a grade of C- or below in chemistry. The predictive accuracy of this system is maximized by using a genetically optimized neural network to analyze the results of a diagnostic algebra test designed for a specific population. Once at-risk students have been identified, they can be helped to improve their chances of success using techniques such as concurrent support courses, online tutorials, "just-in-time" instructional aides, study skills, motivational interviewing, and/or peer mentoring.

  10. Autonomic testing: common techniques and clinical applications.

    Science.gov (United States)

    Weimer, Louis H

    2010-07-01

    Laboratories able to test autonomic function are increasingly available and rely on batteries of well-accepted, noninvasive tests. Tests of parasympathetic cardiovagal, sympathetic vasoconstriction, and sudomotor (sweating) function are most commonly employed. Common examples include heart rate variability to various challenges, Valsalva maneuver, standing and tilt-table studies, and various sudomotor methods. New techniques and technical refinements continue to be described. Most studies rely on perturbations of complex systems and not direct assessment. Testing has helped to improve disease recognition and prompted advances in classification, pathophysiology, and treatment. Major areas impacted include hereditary and immune-mediated autonomic neuropathy, diabetic autonomic neuropathy, distal symmetric polyneuropathy, Parkinson disease and other autonomic failure syndromes, orthostatic intolerance, and unexplained syncope. PMID:20592565

  11. Clinical use of pharmacogenomic tests in 2009.

    Science.gov (United States)

    Sheffield, Leslie J; Phillimore, Hazel E

    2009-05-01

    Pharmacogenomics is a new field where testing an individual can define either a risk status for an adverse event, or the rate of metabolism of a drug. This is achieved by the categorisation of the enzyme activity or documenting genetic polymorphisms of a metabolising enzyme. The best example of risk status assessment is the recent finding that HLA-B typing a person can predict whether they are at risk of a severe skin reaction from the drug abacavir. Those patients showing HLA-B*5701, who are being considered for abacavir therapy, can be prevented from developing potentially toxic epidermal necrosis (TEN) or Stevens-Johnson Syndrome by avoiding abacavir. The evidence for HLA-B typing for allopurinol and carbamazepine has also been described. Most other pharmacogenomic tests are of drug metabolising enzymes, which can either be assessed using "probe" drugs and measuring a ratio of parent drug to metabolite, or, by genetic testing for polymorphisms of the genes. In practice, testing is usually done by molecular testing, but this typically does not detect all polymorphisms. This article briefly reviews the evidence for the utilisation of pharmacogenomics for antidepressant drugs, tamoxifen, codeine, warfarin, azathioprine, clopidogrel, omeprazole, tacrolimus and irinotecan. There are few pharmacogenomics tests being carried out in practice, as there has not been a wide appreciation of their use, and only limited evidence exists for many individual drugs. It is expected that utilisation will increase as more evidence becomes available and there is a wider understanding of the existing evidence by the medical profession. PMID:19565025

  12. Clinical Genetic Testing of Periodic Fever Syndromes

    Directory of Open Access Journals (Sweden)

    Annalisa Marcuzzi

    2013-01-01

    Full Text Available Periodic fever syndromes (PFSs are a wide group of autoinflammatory diseases. Due to some clinical overlap between different PFSs, differential diagnosis can be a difficult challenge. Nowadays, there are no universally agreed recommendations for most PFSs, and near half of patients may remain without a genetic diagnosis even after performing multiple-gene analyses. Molecular analysis of periodic fevers’ causative genes can improve patient quality of life by providing early and accurate diagnosis and allowing the administration of appropriate treatment. In this paper we focus our discussion on effective usefulness of genetic diagnosis of PFSs. The aim of this paper is to establish how much can the diagnostic system improve, in order to increase the success of PFS diagnosis. The mayor expectation in the near future will be addressed to the so-called next generation sequencing approach. Although the application of bioinformatics to high-throughput genetic analysis could allow the identification of complex genotypes, the complexity of this definition will hardly result in a clear contribution for the physician. In our opinion, however, to obtain the best from this new development a rule should always be kept well in mind: use genetics only to answer specific clinical questions.

  13. Irradiation capability of Japanese materials test reactor for water chemistry experiments

    International Nuclear Information System (INIS)

    Appropriate understanding of water chemistry in the core of LWRs is essential as chemical species generated due to water radiolysis by neutron and gamma-ray irradiation govern corrosive environment of structural materials in the core and its periphery, causing material degradation such as stress corrosion cracking. Theoretical model calculation such as water radiolysis calculation gives comprehensive understanding of water chemistry at irradiation field where we cannot directly monitor. For enhancement of the technology, accuracy verification of theoretical models under wide range of irradiation conditions, i.e. dose rate, temperature etc., with well quantified in-pile measurement data is essential. Japan Atomic Energy Agency (JAEA) has decided to launch water chemistry experiments for obtaining data that applicable to model verification as well as model benchmarking, by using an in-pile loop which will be installed in the Japan Materials Testing Reactor (JMTR). In order to clarify the irradiation capability of the JMTR for water chemistry experiments, preliminary investigations by water radiolysis / ECP model calculations were performed. One of the important irradiation conditions for the experiments, i.e. dose rate by neutron and gamma-ray, can be controlled by selecting irradiation position in the core. In this preliminary study, several representative irradiation positions that cover from highest to low absorption dose rate were chosen and absorption dose rate at the irradiation positions were evaluated by MCNP calculations. As a result of the calculations, it became clear that the JMTR could provide the irradiation conditions close to the BWR. The calculated absorption dose rate at each irradiation position was provided to water radiolysis calculations. The radiolysis calculations were performed under various conditions by changing absorption dose rate, water chemistry of feeding water etc. parametrically. Qualitatively, the concentration of H2O2, O2 and H2 at

  14. The significance of indirect costs—application to clinical laboratory test economics using computer facilities

    OpenAIRE

    Hindriks, F. R.; Bosman, A.; Rademaker, P. F.

    1989-01-01

    The significance of indirect costs in the cost price calculation of clinical chemistry laboratory tests by way of the production centres method has been investigated. A cost structure model based on the ‘production centres’ method, the Academisch Ziekenhuis Groningen (AZG) 1-2-3 model, is used for the calculation of cost and cost prices as an add-in tool to the spreadsheet program Lotus 1-2-3. The system specifications of the AZG 1-2-3 cost structure model have been extended with facilities t...

  15. Effects of fenbendazole administration on hematology, clinical chemistries and selected hormones in the white Pekin duck.

    Science.gov (United States)

    Pedersoli, W M; Spano, J S; Krista, L M; Whitesides, J F; Ravis, W R; Kemppainen, R J; Young, D W

    1989-06-01

    The effects of single i.v. and p.o. doses (5 mg/kg) of fenbendazole, were evaluated on thyroxine, tri-iodothyronine, corticosterone, hematology, clinical chemistries, and serum proteins in 10 white Pekin ducks. Fenbendazole was administered i.v. (n = 5) as a 3% dimethyl sulfoxide solution and p.o. (n = 5) as a 10% commercial suspension. Serum enzyme concentrations, total protein and protein fractions, glucose, cholesterol, uric acid, sodium, and potassium were unchanged from baseline values. Serum triglycerides decreased consistently in the i.v.-treated group but remained unchanged in the p.o.-treated group. Serum chloride was consistently elevated above baseline values for both i.v.- and p.o.-treated ducks, while inorganic phosphate was consistently decreased only in the i.v.-treated group. Hemoglobin and hematocrit values generally were below baseline values. Leukocyte values varied considerably and were not significantly different from baseline values. Serum thyroxine and tri-iodothyronine values in both the i.v.- and p.o.-treated groups were not changed significantly from baseline values. Serum corticosterone values were not changed in the i.v.-treated groups but they were decreased at various times in the p.o.-treated group. Although there were some sporadic significant changes in the parameters measured versus baseline values all values remained within the physiologic limits for ducks. The safety of fenbendazole has been previously demonstrated for several species.

  16. Characterization of rheumatoid arthritis subtypes using symptom profiles, clinical chemistry and metabolomics measurements.

    Directory of Open Access Journals (Sweden)

    Herman A van Wietmarschen

    Full Text Available OBJECTIVE: The aim is to characterize subgroups or phenotypes of rheumatoid arthritis (RA patients using a systems biology approach. The discovery of subtypes of rheumatoid arthritis patients is an essential research area for the improvement of response to therapy and the development of personalized medicine strategies. METHODS: In this study, 39 RA patients are phenotyped using clinical chemistry measurements, urine and plasma metabolomics analysis and symptom profiles. In addition, a Chinese medicine expert classified each RA patient as a Cold or Heat type according to Chinese medicine theory. Multivariate data analysis techniques are employed to detect and validate biochemical and symptom relationships with the classification. RESULTS: The questionnaire items 'Red joints', 'Swollen joints', 'Warm joints' suggest differences in the level of inflammation between the groups although c-reactive protein (CRP and rheumatoid factor (RHF levels were equal. Multivariate analysis of the urine metabolomics data revealed that the levels of 11 acylcarnitines were lower in the Cold RA than in the Heat RA patients, suggesting differences in muscle breakdown. Additionally, higher dehydroepiandrosterone sulfate (DHEAS levels in Heat patients compared to Cold patients were found suggesting that the Cold RA group has a more suppressed hypothalamic-pituitary-adrenal (HPA axis function. CONCLUSION: Significant and relevant biochemical differences are found between Cold and Heat RA patients. Differences in immune function, HPA axis involvement and muscle breakdown point towards opportunities to tailor disease management strategies to each of the subgroups RA patient.

  17. Chemokine receptor CCR5 antagonist maraviroc: medicinal chemistry and clinical applications.

    Science.gov (United States)

    Xu, Guoyan G; Guo, Jia; Wu, Yuntao

    2014-01-01

    The human immunodeficiency virus (HIV) causes acquired immumodeficiency syndrome (AIDS), one of the worst global pandemic. The virus infects human CD4 T cells and macrophages, and causes CD4 depletion. HIV enters target cells through the binding of the viral envelope glycoprotein to CD4 and the chemokine coreceptor, CXCR4 or CCR5. In particular, the CCR5-utilizing viruses predominate in the blood during the disease course. CCR5 is expressed on the surface of various immune cells including macrophages, monocytes, microglia, dendric cells, and active memory CD4 T cells. In the human population, the CCR5 genomic mutation, CCR5Δ32, is associated with relative resistance to HIV. These findings paved the way for the discovery and development of CCR5 inhibitors to block HIV transmission and replication. Maraviroc, discovered as a CCR5 antagonist, is the only CCR5 inhibitor that has been approved by both US FDA and the European Medicines Agency (EMA) for treating HIV/AIDS patients. In this review, we summarize the medicinal chemistry and clinical studies of Maraviroc.

  18. Clinical Use of Pharmacogenomic Tests in 2009

    OpenAIRE

    Sheffield, Leslie J; Phillimore, Hazel E

    2009-01-01

    Pharmacogenomics is a new field where testing an individual can define either a risk status for an adverse event, or the rate of metabolism of a drug. This is achieved by the categorisation of the enzyme activity or documenting genetic polymorphisms of a metabolising enzyme. The best example of risk status assessment is the recent finding that HLA-B typing a person can predict whether they are at risk of a severe skin reaction from the drug abacavir. Those patients showing HLA-B*5701, who are...

  19. [Clinical trial data validation and user acceptance testing].

    Science.gov (United States)

    Sun, Hua-long; Dai, Nan

    2015-11-01

    For pharmaceutical industries, clinical data is one of the most valuable deliverables. It is also the basis of analysis, submission, approval, labeling and marketing of a drug product. To ensure the integrity and reliability of clinical data, a scientific standardized quality control (QC) has to be established at each step of a clinical trial. Data validation is conducted to ensure the reasonability and compliance of clinical data by checking data quality before the data is statistically analyzed. This paper focuses on purpose of data validation, creation of data validation plan, rationale of data validation, types of data validation and performance of user acceptance testing on clinical database. PMID:26911047

  20. Best practices for clinical pathology testing in carcinogenicity studies.

    Science.gov (United States)

    Young, Jamie K; Hall, Robert L; O'Brien, Peter; Strauss, Volker; Vahle, John L

    2011-02-01

    The Society of Toxicologic Pathology (STP) and American Society for Veterinary Clinical Pathology (ASCVP) convened a Clinical Pathology in Carcinogenicity Studies Working Group to recommend best practices for inclusion of clinical pathology testing in carcinogenicity studies. Regulatory guidance documents and literature were reviewed, and veterinary pathologists from North America, Japan, and Europe were surveyed regarding current practices, perceived value, and recommendations for clinical pathology testing in carcinogenicity studies. For two-year rodent carcinogenicity studies, the Working Group recommends that clinical pathology testing be limited to collection of blood smears at scheduled and unscheduled sacrifices to be examined only if indicated to aid in the diagnosis of possible hematopoietic neoplasia following histopathologic evaluation. Additional clinical pathology testing is most appropriately used to address specific issues from prior toxicity studies or known test article-related class effects. Inadequate data were available to make a recommendation concerning clinical pathology testing for alternative six-month carcinogenicity assays using genetically modified mice, although the Working Group suggests that it may be appropriate to use the same approach as for two-year carcinogenicity studies since the study goal is the same.

  1. Characterisation of liver chemistry abnormalities associated with pazopanib monotherapy: a systematic review and meta-analysis of clinical trials in advanced cancer patients.

    Science.gov (United States)

    Powles, Thomas; Bracarda, Sergio; Chen, Mei; Norry, Elliot; Compton, Natalie; Heise, Mark; Hutson, Thomas; Harter, Philipp; Carpenter, Christopher; Pandite, Lini; Kaplowitz, Neil

    2015-07-01

    Drug-induced liver chemistry abnormalities, primarily transaminase elevations, are commonly observed in pazopanib-treated patients. This meta-analysis characterises liver chemistry abnormalities associated with pazopanib. Data of pazopanib-treated patients from nine prospective trials were integrated (N=2080). Laboratory datasets were used to characterise the incidence, timing, recovery and patterns of liver events, and subsequent rechallenge with pazopanib. Severe cases of liver chemistry abnormalities were clinically reviewed. Multivariate analyses identified predisposing factors. Twenty percent of patients developed elevated alanine aminotransferase (ALT) >3×ULN. Incidence of peak ALT >3-5×ULN, >5-8×ULN, >8-20×ULN and >20×ULN was 8%, 5%, 5% and 1%, respectively. Median time to onset for all events was 42days; 91% of events were observed within 18weeks. Recovery rates based on peak ALT >3-5×ULN, >5-8×ULN, >8-20×ULN and >20×ULN were 91%, 90%, 90% and 64%, respectively. Median time from onset to recovery was 30days, but longer in patients without dose interruption. Based on clinical review, no deaths were associated with drug-induced liver injury. Overall, 38% of rechallenged patients had ALT elevation recurrence, with 9-day median time to recurrence. Multivariate analysis showed that older age was associated with development of ALT >8×ULN. There was no correlation between hypertension and transaminitis. Our data support the current guidelines on regular liver chemistry tests after initiation of pazopanib, especially during the first 9 or 10weeks, and also demonstrate the safety of rechallenge with pazopanib.

  2. Lifestyle and Clinical Health Behaviors and PSA Tests

    Science.gov (United States)

    Norris, Cynthia; McFall, Stephanie

    2006-01-01

    This study assessed the association of lifestyle and clinical health behaviors with prostate specific antigen (PSA) tests. The study used cross-sectional data from the 2002 Behavioral Risk Factor Surveillance System (BRFSS). We used Stata 8.0 to take into account the complex sample design in analyses. Both lifestyle and clinical health behaviors…

  3. Current Clinical Trials Testing Combinations of Immunotherapy and Radiation

    OpenAIRE

    Crittenden, M.; Kohrt, H.; Levy, R.; Jones, J.; Camphausen, K.; Dicker, A.; Demaria, S.; Formenti, S.

    2015-01-01

    Preclinical evidence of successful combinations of ionizing radiation with immunotherapy has inspired testing the translation of these results to the clinic. Interestingly, the preclinical work has consistently predicted the responses encountered in clinical trials. The first example came from a proof-of-principle trial started in 2001 that tested the concept that growth factors acting on antigen-presenting cells improve presentation of tumor antigens released by radiation and induce an absco...

  4. Selected clinical chemistry analytes correlate with the pathogenesis of inclusion body hepatitis experimentally induced by fowl aviadenoviruses.

    Science.gov (United States)

    Matos, Miguel; Grafl, Beatrice; Liebhart, Dieter; Schwendenwein, Ilse; Hess, Michael

    2016-10-01

    In the present study, clinical chemistry was applied to assess the pathogenesis and progression of experimentally induced inclusion body hepatitis (IBH). For this, five fowl aviadenovirus (FAdV) strains from recent IBH field outbreaks were used to orally inoculate different groups of day-old specific pathogen-free chickens, which were weighed, sampled and examined during necropsy by sequential killing. Mortalities of 50% and 30% were recorded in two groups between 6 and 9 days post-infection (dpi), along with a decreased weight of 23% and 20%, respectively, compared to the control group. Macroscopical changes were seen in the liver and kidney between 6 and 10 dpi, with no lesions being observed in the other organs. Histological lesions were observed in the liver and pancreas during the same period. Plasma was collected from killed birds of each group at each time point and the following clinical chemistry analytes were investigated: aspartate aminotransferase (AST), glutamate dehydrogenase (GLDH), bile acids, total protein, albumin, uric acid and lipase. Plasma protein profile, AST and GLDH, together with bile acids values paralleled the macroscopical and histopathological lesions in the liver, while plasma lipase activity levels coincided with lesions observed in pancreas. In agreement with the histology and clinical chemistry, viral load in the target organs, liver and pancreas, was highest at 7 dpi. Thus, clinical chemistry was found to be a valuable tool in evaluating and monitoring the progression of IBH in experimentally infected birds, providing a deeper knowledge of the underlying pathophysiological mechanisms of a FAdV infection in chickens.

  5. Gender Fair Efficacy of Concept Mapping Tests in Identifying Students' Difficulties in High School Organic Chemistry

    Science.gov (United States)

    Gafoor, Kunnathodi Abdul; Shilna, V.

    2014-01-01

    In view of the perceived difficulty of organic chemistry unit for high schools students, this study examined the usefulness of concept mapping as a testing device to assess students' difficulty in the select areas. Since many tests used for identifying students misconceptions and difficulties in school subjects are observed to favour one or…

  6. Accreditation and postgraduate training in European countries: an FESCC survey. Federation of European Societies of Clinical Chemistry.

    Science.gov (United States)

    Blaton, V

    2001-07-20

    The mission of the Federation of European Societies of Clinical Chemistry is to support and promote clinical chemistry and laboratory medicine in Europe, to aid communication between the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) and National Scientific Societies, to develop education and quality in the discipline, and to encourage young scientists to take an active role in these activities. One recent initiative of the Federation was a survey on accreditation of medical laboratories and training in laboratory medicine in Europe. Among European countries, three promote accreditation according to EN 45001, several countries apply systems based on professional and nationally defined standards (e.g. CPA in the UK) and other countries are moving to define accreditation standards at a national level. Data on vocational training demonstrate that this is based on a postgraduate education with duration ranging from 6 months to 11 years; in most countries the average length of university education is 5 years and that of postgraduate training is 4 years. A great difference, moreover, exists regarding the polyvalent versus monovalent training. Taken together, these data indicate that a great effort should be made by the Federation for promoting harmonization and coordination in Europe. PMID:11438289

  7. Usefulness of factor V Leiden mutation testing in clinical practice

    Science.gov (United States)

    Blinkenberg, Ellen Ø; Kristoffersen, Ann-Helen; Sandberg, Sverre; Steen, Vidar M; Houge, Gunnar

    2010-01-01

    We have investigated the clinical usefulness of the activated protein C resistance (APCR)/factor V Leiden mutation (FVL) test by sending out questionnaires to all Norwegian physicians who ordered these tests from our publicly funded service laboratory during a 3-month period, and of whom 70% (267/383) responded. Indications for testing, patient follow-up, the use of APCR versus FVL tests and differences in practice between hospital doctors and GPs were examined. We found that 46% of the tests were predictive, ordered for risk assessment in healthy individuals with no previous history of venous thromboembolism (VTE). Among these, 42% of the tests were taken on the initiative of the patient and 24% were screening tests before prescription of oral contraceptives. In total, 54% of the tests were classified as diagnostic, among which 42% were ordered owing to a previous history of VTE and 22% to a history of brain stroke or myocardial infarction. The prevalence of FVL heterozygotes was not significantly different between the predictive and diagnostic test groups, that is, 26 and 20%, respectively. Only the predictive tests influenced patient follow-up. Here, the physician's advice to patients depended on the test result. In general, the clinical usefulness of APCR/FVL testing was low. Many tests were performed on unsubstantiated or vague indications. Furthermore, normal test results led to unwarranted refrain from giving advice about antithrombotic measures, leading to potential harm to the patient. PMID:20332812

  8. Core Stability: Inter- and Intraobserver Reliability of 6 Clinical Tests

    NARCIS (Netherlands)

    A. Weir; J. Darby; H. Inklaar; B. Koes; E. Bakker; J.L. Tol

    2010-01-01

    Objective: Core stability is a complex concept within sports medicine and is thought to play a role in sports injuries. There is a lack of reliable and valid clinical tests for core stability. The inter- and intraobserver reliability of 6 tests commonly used to assess core stability was determined.

  9. Mining the Swedish clinical archives to develop pharmacogenomic tests.

    Science.gov (United States)

    Sanders, R

    1999-12-01

    Eurona Medical is a Swedish company that develops diagnostic tests to predict response to drugs or treatment. Sweden offers unparalleled retrospective clinical data resources, with epidemiological registers and collections of tissue samples built up over decades. Efficient pharmacogenomic research can be performed using these registers and sample collections in collaboration with experienced medical researchers. Eurona's tests are based on Genetic Signatures, groups of polymorphic, polygenic genomic positions linked to and therefore predictive of drug response. These are elucidated from complex data sets using unique applications of multivariate and combinatorial statistics and a multigenic approach. The company develops tests applicable to current medical practice and is preparing to launch its first within the hypertension field. Quality control (including ISO9001 certification) and clinical regulatory compliance are applied throughout all programs to produce data that can be directly translated into clinical tests. PMID:10671642

  10. Skin signs in Ehlers-Danlos syndrome: clinical tests and para-clinical methods

    DEFF Research Database (Denmark)

    Remvig, Lars; Duhn, Ph; Ullman, S;

    2010-01-01

    extensibility. The present study aimed to assess skin signs by means of clinical and para-clinical methods. Methods: A total of 31 EDS patients and 28 healthy controls were examined blinded and in random order. Inter-examiner analysis of clinical tests for skin extensibility, consistency, scarring, and bruising...... was performed, followed by analyses of extensibility with the suction cup (SC), consistency with a soft tissue stiffness meter (STSM), and thickness with ultrasonography (US). Semi-quantitative assessment of skin extensibility in healthy controls was incorporated in the tests. Results: The clinical analyses...... with classical-type EDS and controls with respect to skin extensibility by SC (4.91 vs. 12.52 kPa/mm) and skin consistency by STSM (0.59 vs. 0.76 N). We found no difference in skin thickness. Conclusion: The reproducibility of the clinical skin tests was substantial to good, apart from the consistency...

  11. Platelet function testing: methods of assessment and clinical utility.

    LENUS (Irish Health Repository)

    Mylotte, Darren

    2012-02-01

    Platelets play a central role in the regulation of both thrombosis and haemostasis yet tests of platelet function have, until recently, been exclusively used in the diagnosis and management of bleeding disorders. Recent advances have demonstrated the clinical utility of platelet function testing in patients with cardiovascular disease. The ex vivo measurement of response to antiplatelet therapies (aspirin and clopidogrel), by an ever-increasing array of platelet function tests, is with some assays, predictive of adverse clinical events and thus, represents an emerging area of interest for both the clinician and basic scientist. This review article will describe the advantages and disadvantages of the currently available methods of measuring platelet function and discuss both the limitations and emerging data supporting the role of platelet function studies in clinical practice.

  12. Platelet function testing: methods of assessment and clinical utility.

    LENUS (Irish Health Repository)

    Mylotte, Darren

    2011-01-01

    Platelets play a central role in the regulation of both thrombosis and haemostasis yet tests of platelet function have, until recently, been exclusively used in the diagnosis and management of bleeding disorders. Recent advances have demonstrated the clinical utility of platelet function testing in patients with cardiovascular disease. The ex vivo measurement of response to antiplatelet therapies (aspirin and clopidogrel), by an ever-increasing array of platelet function tests, is with some assays, predictive of adverse clinical events and thus, represents an emerging area of interest for both the clinician and basic scientist. This review article will describe the advantages and disadvantages of the currently available methods of measuring platelet function and discuss both the limitations and emerging data supporting the role of platelet function studies in clinical practice.

  13. Lumping, testing, tuning: The invention of an artificial chemistry in atmospheric transport modeling

    Science.gov (United States)

    Heymann, Matthias

    Since the late 1950s computer simulation has been used to investigate the transport of pollutants in the atmosphere. About 20 years later also the chemical transformation of atmospheric pollutants was included in computer models of photochemical smog formation. Due to limited knowledge of atmospheric chemistry and due to limited computer capacity, chemical processes in the atmosphere were modeled with the help of simplified chemical models. In these models chemical substances are lumped together forming artificial virtual compounds with virtual characteristics. The paper aims at studying the practices developed in chemical model building and the creation of confidence in these models. Core of the paper will be the analysis of the Urban Airshed Model (UAM) for the Los Angeles region, a pioneering development in the early 1970s. The construction of the UAM involved the "lumping" of chemical processes and extensive testing and tuning. These practices led to a consistent model representation, in which diverse pieces of information fitted and were mutually stabilized. The pragmatic achievement of consistency created confidence, even though empirical tests of the models remained ambiguous and problematic.

  14. Clinical and para-clinical tests in the routine examination of headache patients

    DEFF Research Database (Denmark)

    Friberg, L; Sandrini, G; Jänig, W;

    2000-01-01

    Para-clinical examinations in the diagnosis and treatment control of headache patients vary considerably between clinics and headache centers. Among the neurological societies in Europe there has been a consensus that some common procedures and recommendations should be created. In the Fall of 1998......) autonomic nervous system and clinical tests and 3) imaging and cerebrovascular tests (X-ray, CT, MR, fMRI, PET, SPECT and transcranial Doppler). The literature was carefully evaluated with respect to validity and strength of the data. The task was to reach conclusions about each technique in the form...

  15. Good chemistry

    OpenAIRE

    Petsko, Gregory A

    2004-01-01

    The subject matter in chemistry courses reflects almost nothing of the issues that chemists are interested in. It is important to formulate a set of topics - and a Medical College Admissions Test reflecting them - that would leave chemistry departments no choice but to change their teaching.

  16. Secondary side cracking at Saint-Laurent unit B1: investigations, operating chemistry and corrosion tests

    International Nuclear Information System (INIS)

    Among the similar steam generators (SG) in EDF plants (equipped with mill annealed Alloy 600, drilled tube-support plates TSP), one of the SG of SAINT-LAURENT B1 was found particularly affected by cracking at TSP level. Eddy current indications lead to pull one tube after 30 000 h of operation: investigations revealed that corrosion was involved. In 1991, after 58 000 h, numerous indications with axial probe were beyond the recording threshold. A few heats were concerned, the examination of 11 pulled tubes evidenced an important axial intergranular stress corrosion cracking (IGSCC), with bands of intergranular attack (IGA) in front of the edge of TSPs. This investigation has qualified a new probe (STL 10). A new plugging criterion was also defined. In the same time, the results from hideout return tests and the operating chemistry were examined. They did not provide a satisfactory explanation of the observed damage. The degradations have affected only one out of three SG and the pH-calculations using MULTEQ code have shown that the environment in restricted-flow areas has not always been strongly alkaline (pH270: 5.7 to 10.2). Moreover, pH-values were decreasing after successive hideout return shutdowns. Corrosion tests were then performed in laboratory conditions (sodium hydroxide, 350 deg C) in order to study the sensitivity of the pulled tubes. They demonstrated the greatest sensitivity to cracking of these tubes, among various mill-annealed tubes in Alloy 600. The worst behaviour in caustic environment of SAINT-LAURENT tubes is apparently not connected with their metallurgical structure; moreover, they are not sensitized (no intergranular chromium depletion). The sensitivity in caustic environment seems to be in accordance with a low value of the yield stress. Studies are still in progress in order to examine if it is the right explanation for the sensitivity of Saint-Laurent tubes (the composition at the grain boundaries is also investigated...). The knowledge

  17. Histopathology and serum clinical chemistry evaluation of broilers with femoral head separation disorder

    Science.gov (United States)

    Femoral head disarticulation (FHD) and necrosis is a sporadic leg problem of unknown etiology in broiler breeders. To determine the underlying physiology of FHD, the blood chemistry and the histopathology of the femoral heads of the affected chickens were compared with their age matched controls. Ch...

  18. Learning Nuclear Chemistry through Practice: A High School Student Project Using PET in a Clinical Setting

    Science.gov (United States)

    Liguori, Lucia; Adamsen, Tom Christian Holm

    2013-01-01

    Practical experience is vital for promoting interest in science. Several aspects of chemistry are rarely taught in the secondary school curriculum, especially nuclear and radiochemistry. Therefore, we introduced radiochemistry to secondary school students through positron emission tomography (PET) associated with computer tomography (CT). PET-CT…

  19. The Stice model of overeating: Tests in clinical and non-clinical samples

    NARCIS (Netherlands)

    Strien, T. van; Engels, R.C.M.E.; Leeuwe, J.F.J. van; Snoek, H.M.

    2005-01-01

    The present study tested the dual pathway model of Stice [Stice, E (1994). A review of the evidence for a sociocultural model of bulimia nervosa and an exploration of the mechanisms of action. Clinical Psychology Review, 14, 633-661 and Stice, E. (2001). A prospective test of the dual-pathway model

  20. Biological variation in 32 clinical laboratory routine tests

    Institute of Scientific and Technical Information of China (English)

    陈政君

    2012-01-01

    Objective To set quality goals of conventional biochemical tests through the research of biological variation of the 32 routine items in Chinese population to provide the basis for Chinese clinical and laboratory standards. Methods According to the experimental designs and computing methods

  1. Application to cows and horses of Spotchem, a dry-chemistry blood analyzer for use in veterinary clinics.

    Science.gov (United States)

    Hoshi, F; Satho, M; Koyama, S; Nakadaka, K; Chiba, M; Ikeda, N; Hakamada, R; Higuchi, S; Kawamura, S

    1994-02-01

    The usefulness of a dry-chemistry blood analyzer, Spotchem SP-4410 (SP-4410) in a veterinary clinic for analysis of bovine and equine blood chemistry was studied. We quantitated total protein (TP), albumin (Alb), total bilirubin (T-Bil), blood urea nitrogen (BUN), total cholesterol (T-Cho), glucose (Glu), calcium (Ca), aspartate aminotransferase (AST), gamma-glutamyltransferase (GGT), creatinine phosphokinase (CPK), and alkaline phosphatase (ALP) in bovine sera. Each sample was assayed with both the SP-4410 and an automated blood analyzer which served as a wet-chemistry reference system, and the data were analyzed with regression analysis. The correlation coefficient for AST was 0.997 being the highest for all the parameters, and all the correlation coefficients were 0.93 or higher. The coefficients of variation were lower than 5.0 except in the case of bovine T-Bil where it was 5,756. The ranges of normal reference values measured by SP-4410 were the same as those reported by other investigators in most cases, but those for GGT and CPK were slightly higher. The strongest interference was observed with hemoglobin. It seems that dry-chemical-analysis of blood serum using the SP-4410 is useful for analysis of bovine and equine blood. PMID:8085395

  2. Current practices and challenges in the standardization and harmonization of clinical laboratory tests.

    Science.gov (United States)

    Vesper, Hubert W; Myers, Gary L; Miller, W Greg

    2016-09-01

    Effective patient care, clinical research, and public health efforts require comparability of laboratory results independent of time, place, and measurement procedure. Comparability is achieved by establishing metrological traceability, which ensures that measurement procedures measure the same quantity and that the calibration of measurement procedures is traceable to a common reference system consisting of reference methods and materials. Whereas standardization ensures traceability to the International System of Units, harmonization ensures traceability to a reference system agreed on by convention. This article provides an overview of standardization and harmonization with an emphasis on commutability as an important variable that affects testing accuracy. Commutability of reference materials is required to ensure that traceability is established appropriately and that laboratory results are comparable. The use of noncommutable reference materials leads to inaccurate results. Whereas procedures and protocols for standardizing measurements are established and have been successfully applied in efforts such as the Hormones Standardization Program of the CDC, harmonization activities require new, more complex procedures and approaches. The American Association for Clinical Chemistry, together with its domestic and international partners, formed the International Consortium for Harmonization of Clinical Laboratory Results to coordinate harmonization efforts. Reference systems, as well as procedures and protocols to establish traceability of clinical laboratory tests, have been established and continue to be developed by national and international groups and organizations. Serum tests of thyroid function, including those for the thyroid hormones thyroxine and triiodothyronine, are among the clinical procedures for which standardization efforts are well under way. Approaches to the harmonization of measurement procedures for serum concentrations of thyroid

  3. Useful tests for hepatic encephalopathy in clinical practice.

    Science.gov (United States)

    Nabi, Eiman; Bajaj, Jasmohan S

    2014-01-01

    Hepatic encephalopathy (HE) is a serious complication of liver disease and portosystemic shunting that represents a continuum of neuropsychiatric changes and altered consciousness. It is classified as overt HE (OHE) when clinically apparent or as covert HE (CHE) in its mildest form. Progression of CHE to OHE and its impact of quality of life make its early diagnosis imperative. Several diagnostic techniques ranging from simple clinical scales to sophisticated computerized tests exist, yet diagnosis remains a challenge, due to the time, cost, and personnel involved. Psychometric tests appear promising due to their high sensitivity and low cost, but results are variable depending on age and education. The pros and cons of current diagnostic methods for OHE and CHE are reviewed, along with strategy for CHE testing. PMID:24357348

  4. 75 FR 63188 - Draft Guidance for Industry: Early Clinical Trials With Live Biotherapeutic Products: Chemistry...

    Science.gov (United States)

    2010-10-14

    ... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry: Early Clinical Trials With Live... availability of a draft document entitled ``Guidance for Industry: Early Clinical Trials with Live... submission of INDs for early clinical trials with live biotherapeutic products (LBPs). DATES: Although...

  5. 77 FR 9947 - Guidance for Industry: Early Clinical Trials With Live Biotherapeutic Products: Chemistry...

    Science.gov (United States)

    2012-02-21

    ... HUMAN SERVICES Food and Drug Administration Guidance for Industry: Early Clinical Trials With Live... availability of a document entitled ``Guidance for Industry: Early Clinical Trials With Live Biotherapeutic... submission of INDs for early clinical trials with live biotherapeutic products (LBPs). The guidance...

  6. 21 CFR 862.1130 - Blood volume test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Blood volume test system. 862.1130 Section 862...) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems § 862.1130 Blood volume test system. (a) Identification. A blood volume test system is a device intended...

  7. Platelet Function Tests: A Review of Progresses in Clinical Application

    Directory of Open Access Journals (Sweden)

    Jae-Lim Choi

    2014-01-01

    Full Text Available The major goal of traditional platelet function tests has been to screen and diagnose patients who present with bleeding problems. However, as the central role of platelets implicated in the etiology of arterial thrombotic diseases such as myocardial infarction and stroke became widely known, platelet function tests are now being promoted to monitor the efficacy of antiplatelet drugs and also to potentially identify patients at increased risk of thrombosis. Beyond hemostasis and thrombosis, an increasing number of studies indicate that platelets play an integral role in intercellular communication, are mediators of inflammation, and have immunomodulatory activity. As new potential biomarkers and technologies arrive at the horizon, platelet functions testing appears to take on a new aspect. This review article discusses currently available clinical application of platelet function tests, placing emphasis on essential characteristics.

  8. Translating biological parameters into clinically useful diagnostic tests.

    Science.gov (United States)

    Arfken, Cynthia L; Carney, Stuart; Boutros, Nash N

    2009-08-01

    Psychiatry has lagged behind other specialties in developing diagnostic laboratory tests for the purpose of confirming or ruling out a diagnosis. Biological research into the pathophysiology of psychiatric disorders has, however, yielded some highly replicable abnormalities that have the potential for development into clinically useful diagnostic tests. To achieve this goal, a process for systematic translation must be developed and implemented. Building on our previous work, we review a proposed process using four clearly defined steps. We conclude that biological parameters currently face challenges in their pathways to becoming diagnostic tests because of both the premature release and premature abandonment of tests. Attention to a systematic translation process aided by these principles may help to avoid these problems.

  9. Combined clinical and genetic testing algorithm for cervical cancer diagnosis

    OpenAIRE

    Liou, Yu-Ligh; Zhang, Tao-Lan; Yan, Tian; Yeh, Ching-Tung; Kang, Ya-Nan; Cao, Lanqin; Wu, Nayiyuan; Chang, Chi-Feng; Wang, Huei-Jen; Yen, Carolyn; Chu, Tang-Yuan; Zhang, Yi; Zhang, Yu; Zhou, Honghao

    2016-01-01

    Background Opportunistic screening in hospitals is widely used to effectively reduce the incidence rate of cervical cancer in China and other developing countries. This study aimed to identify clinical risk factor algorithms that combine gynecologic examination and molecular testing (paired box gene 1 (PAX1) or zinc finger protein 582 (ZNF582) methylation or HPV16/18) results to improve diagnostic accuracy. Methods The delta Cp of methylated PAX1 and ZNF582 was obtained via quantitative methy...

  10. The UK clinical aptitude test and clinical course performance at Nottingham: a prospective cohort study

    OpenAIRE

    Yates, Janet; James, David

    2013-01-01

    Background The UK Clinical Aptitude Test (UKCAT) was introduced in 2006 as an additional tool for the selection of medical students. It tests mental ability in four distinct domains (Verbal Reasoning, Quantitative Reasoning, Abstract Reasoning, and Decision Analysis), and the results are available to students and admission panels in advance of the selection process. Our first study showed little evidence of any predictive validity for performance in the first two years of the Nottingham un...

  11. A critique of statistical hypothesis testing in clinical research

    Directory of Open Access Journals (Sweden)

    Somik Raha

    2011-01-01

    Full Text Available Many have documented the difficulty of using the current paradigm of Randomized Controlled Trials (RCTs to test and validate the effectiveness of alternative medical systems such as Ayurveda. This paper critiques the applicability of RCTs for all clinical knowledge-seeking endeavors, of which Ayurveda research is a part. This is done by examining statistical hypothesis testing, the underlying foundation of RCTs, from a practical and philosophical perspective. In the philosophical critique, the two main worldviews of probability are that of the Bayesian and the frequentist. The frequentist worldview is a special case of the Bayesian worldview requiring the unrealistic assumptions of knowing nothing about the universe and believing that all observations are unrelated to each other. Many have claimed that the first belief is necessary for science, and this claim is debunked by comparing variations in learning with different prior beliefs. Moving beyond the Bayesian and frequentist worldviews, the notion of hypothesis testing itself is challenged on the grounds that a hypothesis is an unclear distinction, and assigning a probability on an unclear distinction is an exercise that does not lead to clarity of action. This critique is of the theory itself and not any particular application of statistical hypothesis testing. A decision-making frame is proposed as a way of both addressing this critique and transcending ideological debates on probability. An example of a Bayesian decision-making approach is shown as an alternative to statistical hypothesis testing, utilizing data from a past clinical trial that studied the effect of Aspirin on heart attacks in a sample population of doctors. As a big reason for the prevalence of RCTs in academia is legislation requiring it, the ethics of legislating the use of statistical methods for clinical research is also examined.

  12. A critique of statistical hypothesis testing in clinical research.

    Science.gov (United States)

    Raha, Somik

    2011-07-01

    Many have documented the difficulty of using the current paradigm of Randomized Controlled Trials (RCTs) to test and validate the effectiveness of alternative medical systems such as Ayurveda. This paper critiques the applicability of RCTs for all clinical knowledge-seeking endeavors, of which Ayurveda research is a part. This is done by examining statistical hypothesis testing, the underlying foundation of RCTs, from a practical and philosophical perspective. In the philosophical critique, the two main worldviews of probability are that of the Bayesian and the frequentist. The frequentist worldview is a special case of the Bayesian worldview requiring the unrealistic assumptions of knowing nothing about the universe and believing that all observations are unrelated to each other. Many have claimed that the first belief is necessary for science, and this claim is debunked by comparing variations in learning with different prior beliefs. Moving beyond the Bayesian and frequentist worldviews, the notion of hypothesis testing itself is challenged on the grounds that a hypothesis is an unclear distinction, and assigning a probability on an unclear distinction is an exercise that does not lead to clarity of action. This critique is of the theory itself and not any particular application of statistical hypothesis testing. A decision-making frame is proposed as a way of both addressing this critique and transcending ideological debates on probability. An example of a Bayesian decision-making approach is shown as an alternative to statistical hypothesis testing, utilizing data from a past clinical trial that studied the effect of Aspirin on heart attacks in a sample population of doctors. As a big reason for the prevalence of RCTs in academia is legislation requiring it, the ethics of legislating the use of statistical methods for clinical research is also examined.

  13. Clinical Testing for Extra-Articular Lateral Knee Pain. A Modification and Combination of Traditional Tests

    Science.gov (United States)

    2008-01-01

    Knee pain is one of the most common problems encountered by recreational and competitive athletes. Pain over the lateral aspect of the knee can be the result of intra or extra articular conditions. The purpose of this clinical suggestion is to present the modification of a traditional clinical test to aide in the differential diagnosis of lateral knee pain. This method has not been described elsewhere and anecdotally has been helpful in the evaluation of patients with lateral knee pain. PMID:21509133

  14. Clinical utility of antinuclear antibody tests in children

    Directory of Open Access Journals (Sweden)

    Kickingbird Lauren M

    2004-07-01

    Full Text Available Abstract Background Antinuclear antibody (ANA tests are frequently used to screen children for chronic inflammatory diseases such as systemic lupus erythematosus (SLE. However, the diagnostic utility of this test is limited because of the large number of healthy children who have low-titer positive tests. We sought to determine the clinical utility of ANA tests in screening children for rheumatic disease and to determine whether there are specific signs or symptoms that enhance the clinical utility of ANA tests in children. Methods We undertook a retrospective analysis of 509 new patient referrals. Charts of patients referred because of results of ANA testing were selected for further analysis. Children with JRA, SLE, and other conditions were compared using demographic data, chief complaints at the time of presentation, and ANA titers. Results One hundred ten patients were referred because of an ANA test interpreted as positive. Ten patients were subsequently diagnosed with SLE. In addition, we identified one patient with mixed connective tissue disease, and an additional child with idiopathic Raynaud's phenomenon. Eighteen children of the children referred for a positive ANA test had juvenile rheumatoid arthritis (JRA. Another 80 children with positive ANA tests were identified, the majority of whom (n = 39, 49% had musculoskeletal pain syndromes. Neither the presence nor the titer of ANA served to distinguish children with JRA from children with other musculoskeletal conditions. Children with JRA were readily identified on the basis of the history and physical examination. Children with SLE were therefore compared with children with positive ANA tests who did not have JRA, designated the "comparison group." Non-urticarial rash was more common in children with SLE than in children without chronic inflammatory disease (p = 0.007. Children with SLE were also older (mean ± sd = 14.2 ± 2.5 years than the comparison group (11.0 ± 3.6 years; p

  15. Echinacea species (Echinacea angustifolia (DC.) Hell., Echinacea pallida (Nutt.) Nutt.,Echinacea purpurea (L.) Moench): a review of their chemistry, pharmacology and clinical properties.

    Science.gov (United States)

    Barnes, Joanne; Anderson, Linda A; Gibbons, Simon; Phillipson, J David

    2005-08-01

    This paper reviews the chemistry, pharmacology and clinical properties of Echinacea species used medicinally. The Echinacea species Echinacea angustifolia, Echinacea pallida and Echinacea purpurea have a long history of medicinal use for a variety of conditions, particularly infections, and today echinacea products are among the best-selling herbal preparations in several developed countries. Modern interest in echinacea is focused on its immunomodulatory effects, particularly in the prevention and treatment of upper respiratory tract infections. The chemistry of Echinacea species is well documented, and several groups of constituents, including alkamides and caffeic acid derivatives, are considered important for activity. There are, however, differences in the constituent profile of the three species. Commercial echinacea samples and marketed echinacea products may contain one or more of the three species, and analysis of samples of raw material and products has shown that some do not meet recognized standards for pharmaceutical quality. Evidence from preclinical studies supports some of the traditional and modern uses for echinacea, particularly the reputed immunostimulant (or immunomodulatory) properties. Several, but not all, clinical trials of echinacea preparations have reported effects superior to those of placebo in the prevention and treatment of upper respiratory tract infections. However, evidence of efficacy is not definitive as studies have included different patient groups and tested various different preparations and dosage regimens of echinacea. On the basis of the available limited safety data, echinacea appears to be well tolerated. However, further investigation and surveillance are required to establish the safety profiles of different echinacea preparations. Safety issues include the possibility of allergic reactions, the use of echinacea by patients with autoimmune diseases and the potential for echinacea preparations to interact with

  16. Preanalytical quality improvement. In pursuit of harmony, on behalf of European Federation for Clinical Chemistry and Laboratory Medicine (EFLM) Working group for Preanalytical Phase (WG-PRE).

    Science.gov (United States)

    Lippi, Giuseppe; Banfi, Giuseppe; Church, Stephen; Cornes, Michael; De Carli, Gabriella; Grankvist, Kjell; Kristensen, Gunn B; Ibarz, Mercedes; Panteghini, Mauro; Plebani, Mario; Nybo, Mads; Smellie, Stuart; Zaninotto, Martina; Simundic, Ana-Maria

    2015-02-01

    Laboratory diagnostics develop through different phases that span from test ordering (pre-preanalytical phase), collection of diagnostic specimens (preanalytical phase), sample analysis (analytical phase), results reporting (postanalytical phase) and interpretation (post-postanalytical phase). Although laboratory medicine seems less vulnerable than other clinical and diagnostic areas, the chance of errors is not negligible and may adversely impact on quality of testing and patient safety. This article, which continues a biennial tradition of collective papers on preanalytical quality improvement, is aimed to provide further contributions for pursuing quality and harmony in the preanalytical phase, and is a synopsis of lectures of the third European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)-Becton Dickinson (BD) European Conference on Preanalytical Phase meeting entitled 'Preanalytical quality improvement. In pursuit of harmony' (Porto, 20-21 March 2015). The leading topics that will be discussed include unnecessary laboratory testing, management of test request, implementation of the European Union (EU) Directive on needlestick injury prevention, harmonization of fasting requirements for blood sampling, influence of physical activity and medical contrast media on in vitro diagnostic testing, recent evidence about the possible lack of necessity of the order of draw, the best practice for monitoring conditions of time and temperature during sample transportation, along with description of problems emerging from inappropriate sample centrifugation. In the final part, the article includes recent updates about preanalytical quality indicators, the feasibility of an External Quality Assessment Scheme (EQAS) for the preanalytical phase, the results of the 2nd EFLM WG-PRE survey, as well as specific notions about the evidence-based quality management of the preanalytical phase.

  17. Can clinical tests help monitor human papillomavirus vaccine impact?

    Science.gov (United States)

    Meites, Elissa; Lin, Carol; Unger, Elizabeth R; Steinau, Martin; Patel, Sonya; Markowitz, Lauri E; Hariri, Susan

    2013-09-01

    As immunization programs for human papillomavirus (HPV) are implemented more widely around the world, interest is increasing in measuring their impact. One early measurable impact of HPV vaccine is on the prevalence of specific HPV types in a population. In low-resource settings, a potentially attractive strategy would be to monitor HPV prevalence using clinical cervical cancer screening test results to triage specimens for HPV typing. We assessed this approach in a nationally representative population of U.S. females aged 14-59 years. Using self-collected cervico-vaginal swab specimens from 4,150 women participating in the National Health and Nutrition Examination Survey during 2003-2006, we evaluated type-specific HPV prevalence detected by the Roche linear array (LA) research test on all specimens, compared with type-specific HPV prevalence detected by LA conducted only on specimens positive by the digene hybrid capture 2 (HC-2) clinical test. We calculated weighted prevalence estimates and their 95% confidence intervals (CIs), and examined relative type-specific HPV prevalence according to the two testing approaches. The population prevalence of oncogenic HPV vaccine types 16/18 was 6.2% (CI:5.4-7.1) by LA if all specimens were tested, and 2.4% (CI:1.9-3.0) if restricted to positive HC-2. Relative prevalence of individual HPV types was similar for both approaches. Compared with typing all specimens, a triage approach would require testing fewer specimens, but a greater reduction in HPV prevalence or a larger group of specimens would be needed to detect vaccine impact. Further investigation is warranted to inform type-specific HPV monitoring approaches around the world.

  18. A Genetically Optimized Predictive System for Success in General Chemistry Using a Diagnostic Algebra Test

    Science.gov (United States)

    Cooper, Cameron I.; Pearson, Paul T.

    2012-01-01

    In higher education, many high-enrollment introductory courses have evolved into "gatekeeper" courses due to their high failure rates. These courses prevent many students from attaining their educational goals and often become graduation roadblocks. At the authors' home institution, general chemistry has become a gatekeeper course in which…

  19. Using an Online, Self-Diagnostic Test for Introductory General Chemistry at an Open University

    Science.gov (United States)

    Kennepohl, Dietmar; Guay, Matthew; Thomas, Vanessa

    2010-01-01

    A simple, online, self-diagnostic tool has been developed to allow students to independently and quickly measure their potential of success in a first-year general chemistry course. The online tool employs well-established performance predictors in areas such as student educational background, conceptual basics, critical thinking, mathematical…

  20. The Testing Effect: An Intervention on Behalf of Low-Skilled Comprehenders in General Chemistry

    Science.gov (United States)

    Pyburn, Daniel T.; Pazicni, Samuel; Benassi, Victor A.; Tappin, Elizabeth M.

    2014-01-01

    Past work has demonstrated that language comprehension ability correlates with general chemistry course performance with medium effect sizes. We demonstrate here that language comprehension's strong cognitive grounding can be used to inform effective and equitable pedagogies, namely, instructional interventions that differentially aid…

  1. Genomic Testing and Therapies for Breast Cancer in Clinical Practice

    Science.gov (United States)

    Haas, Jennifer S.; Phillips, Kathryn A.; Liang, Su-Ying; Hassett, Michael J.; Keohane, Carol; Elkin, Elena B.; Armstrong, Joanne; Toscano, Michele

    2011-01-01

    Purpose: Given the likely proliferation of targeted testing and treatment strategies for cancer, a better understanding of the utilization patterns of human epidermal growth factor receptor 2 (HER2) testing and trastuzumab and newer gene expression profiling (GEP) for risk stratification and chemotherapy decision making are important. Study Design: Cross-sectional. Methods: We performed a medical record review of women age 35 to 65 years diagnosed between 2006 and 2007 with invasive localized breast cancer, identified using claims from a large national health plan (N = 775). Results: Almost all women received HER2 testing (96.9%), and 24.9% of women with an accepted indication received GEP. Unexplained socioeconomic differences in GEP use were apparent after adjusting for age and clinical characteristics; specifically, GEP use increased with income. For example, those in the lowest income category (< $40,000) were less likely than those with an income of $125,000 or more to receive GEP (odds ratio, 0.34; 95% CI, 0.16 to 0.73). A majority of women (57.7%) with HER2-positive disease received trastuzumab; among these women, differences in age and clinical characteristics were not apparent, although surprisingly, those in the lowest income category were more likely than those in the high-income category to receive trastuzumab (P = .02). Among women who did not have a positive HER2 test, 3.9% still received trastuzumab. Receipt of adjuvant chemotherapy increased as GEP score indicated greater risk of recurrence. Conclusion: Identifying and eliminating unnecessary variation in the use of these expensive tests and treatments should be part of quality improvement and efficiency programs. PMID:21886507

  2. Clinical Evaluation of Heart Failure: Agreement among Tests.

    Science.gov (United States)

    Pandey, Amit K; Penny, William F; Bhargava, Valmik; Lai, N Chin; Xu, Ronghui; Hammond, H Kirk

    2016-01-01

    Methods commonly used clinically to assess cardiac function in patients with heart failure include ejection fraction (EF), exercise treadmill testing (ETT), and symptom evaluation. Although these approaches are useful in evaluating patients with heart failure, there are at times substantial mismatches between individual assessments. For example, ETT results are often discordant with EF, and patients with minimal symptoms sometimes have surprisingly low EFs. To better define the relationship of these methods of assessment, we studied 56 patients with heart failure with reduced EF (HFrEF) who underwent measurement of ETT duration, EF by echocardiography, quantitative symptom evaluation, and LV peak dP/dt (rate of left ventricular pressure development and decline, measured invasively). Correlations were determined among these four tests in order to assess the relationship of EF, ETT, and symptoms against LV peak dP/dt. In addition, we sought to determine whether EF, ETT, and symptoms correlated with each other. Overall, correlations were poor. Only 15 of 63 total correlations (24%) were significant (p < 0.05). EF correlated most closely with LV peak -dP/dt. Linear regression analysis indicated that EF, ETT, and symptoms taken together predicted LV peak dP/dt better than any one measure alone. We conclude that clinical tests used to assess LV function in patients with HFrEF may not be as accurate or correlate as well as expected. All three clinical measures considered together may be the best representation of cardiac function in HFrEF patients currently available. PMID:27537778

  3. Diagnostic values of clinical diagnostic tests in subacromial impingement syndrome

    OpenAIRE

    Calis, M.; Akgun, K; Birtane, M; Karacan, I; Calis, H.; Tuzun, F.

    2000-01-01

    OBJECTIVE—Subacromial impingement syndrome (SIS) is a frequent cause of shoulder pain. The aim of this study was to investigate the diagnostic values of clinical diagnostic tests, in patients with SIS.
METHODS—72 female, 48 male patients with shoulder pain were included in the study. Five had bilateral shoulder pain, so 125 painful shoulders were evaluated. Details were recorded about the patients' ages and sexes, as well as characteristics of pain and related problems. Detailed physical exam...

  4. Non-invasive prenatal chromosomal aneuploidy testing--clinical experience: 100,000 clinical samples.

    Directory of Open Access Journals (Sweden)

    Ron M McCullough

    Full Text Available OBJECTIVE: As the first laboratory to offer massively parallel sequencing-based noninvasive prenatal testing (NIPT for fetal aneuploidies, Sequenom Laboratories has been able to collect the largest clinical population experience data to date, including >100,000 clinical samples from all 50 U.S. states and 13 other countries. The objective of this study is to give a robust clinical picture of the current laboratory performance of the MaterniT21 PLUS LDT. STUDY DESIGN: The study includes plasma samples collected from patients with high-risk pregnancies in our CLIA-licensed, CAP-accredited laboratory between August 2012 to June 2013. Samples were assessed for trisomies 13, 18, 21 and for the presence of chromosome Y-specific DNA. Sample data and ad hoc outcome information provided by the clinician was compiled and reviewed to determine the characteristics of this patient population, as well as estimate the assay performance in a clinical setting. RESULTS: NIPT patients most commonly undergo testing at an average of 15 weeks, 3 days gestation; and average 35.1 years of age. The average turnaround time is 4.54 business days and an overall 1.3% not reportable rate. The positivity rate for Trisomy 21 was 1.51%, followed by 0.45% and 0.21% rate for Trisomies 18 and 13, respectively. NIPT positivity rates are similar to previous large clinical studies of aneuploidy in women of maternal age ≥ 35 undergoing amniocentesis. In this population 3519 patients had multifetal gestations (3.5% with 2.61% yielding a positive NIPT result. CONCLUSION: NIPT has been commercially offered for just over 2 years and the clinical use by patients and clinicians has increased significantly. The risks associated with invasive testing have been substantially reduced by providing another assessment of aneuploidy status in high-risk patients. The accuracy and NIPT assay positivity rate are as predicted by clinical validations and the test demonstrates improvement in the

  5. 42 CFR 414.508 - Payment for a new clinical diagnostic laboratory test.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Payment for a new clinical diagnostic laboratory... SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.508 Payment for a new clinical diagnostic laboratory test. For a new clinical diagnostic laboratory test that is assigned a new...

  6. Evaluation of the Beckman Synchron CX4 clinical chemistry analyzer in a hospital laboratory.

    Science.gov (United States)

    Ambus, T; Korogyi, N; DeCampos, F; Groom, B; Innanen, V T

    1990-01-01

    The Beckman Synchron CX4 random-access multianalyzer was evaluated in a medium sized hospital laboratory. The instrument does end-point, rate, and multipoint assays and carries on-board reagents for 24 tests. In addition to predefined tests, the instrument can be programmed for 100 user-defined tests; these are stored on the hard disk and can utilize up to three component reagents each. The throughput is 200 tests per hour. There is stat testing capability. In our evaluation, within-run and between-run precision and linearity were good, and no reagent carryover was detected. There was good correlation with the in-house methodology for the 19 tests evaluated. A disadvantage at the time of evaluation was interference by elevated bilirubin on creatinine, phosphorus, uric acid, and triglycerides. This problem of interference is being addressed by the manufacturer.

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

    DEFF Research Database (Denmark)

    Wieringa, Gijsbert; Zerah, Simone; Jansen, Rob;

    2012-01-01

    and competencies' division embracing all laboratory medicine disciplines is described. For the first time the syllabus identifies the competencies required to meet clinical leadership demands for defining, directing and assuring the efficiency and effectiveness of laboratory services as well as expectations...

  8. Filtering Medline for a clinical discipline: diagnostic test assessment framework

    Science.gov (United States)

    Iansavichus, Arthur V; Wilczynski, Nancy L; Kastner, Monika; Baier, Leslie A; Shariff, Salimah Z; Rehman, Faisal; Weir, Matthew; McKibbon, K Ann; Haynes, R Brian

    2009-01-01

    Objective To develop and test a Medline filter that allows clinicians to search for articles within a clinical discipline, rather than searching the entire Medline database. Design Diagnostic test assessment framework with development and validation phases. Setting Sample of 4657 articles published in 2006 from 40 journals. Reviews Each article was manually reviewed, and 19.8% contained information relevant to the discipline of nephrology. The performance of 1 155 087 unique renal filters was compared with the manual review. Main outcome measures Sensitivity, specificity, precision, and accuracy of each filter. Results The best renal filters combined two to 14 terms or phrases and included the terms “kidney” with multiple endings (that is, truncation), “renal replacement therapy”, “renal dialysis”, “kidney function tests”, “renal”, “nephr” truncated, “glomerul” truncated, and “proteinuria”. These filters achieved peak sensitivities of 97.8% and specificities of 98.5%. Performance of filters remained excellent in the validation phase. Conclusions Medline can be filtered for the discipline of nephrology in a reliable manner. Storing these high performance renal filters in PubMed could help clinicians with their everyday searching. Filters can also be developed for other clinical disciplines by using similar methods. PMID:19767336

  9. Validation of a clinical critical thinking skills test in nursing

    Directory of Open Access Journals (Sweden)

    Sujin Shin

    2015-01-01

    Full Text Available Purpose: The purpose of this study was to develop a revised version of the clinical critical thinking skills test (CCTS and to subsequently validate its performance. Methods: This study is a secondary analysis of the CCTS. Data were obtained from a convenience sample of 284 college students in June 2011. Thirty items were analyzed using item response theory and test reliability was assessed. Test-retest reliability was measured using the results of 20 nursing college and graduate school students in July 2013. The content validity of the revised items was analyzed by calculating the degree of agreement between instrument developer intention in item development and the judgments of six experts. To analyze response process validity, qualitative data related to the response processes of nine nursing college students obtained through cognitive interviews were analyzed. Results: Out of initial 30 items, 11 items were excluded after the analysis of difficulty and discrimination parameter. When the 19 items of the revised version of the CCTS were analyzed, levels of item difficulty were found to be relatively low and levels of discrimination were found to be appropriate or high. The degree of agreement between item developer intention and expert judgments equaled or exceeded 50%. Conclusion: From above results, evidence of the response process validity was demonstrated, indicating that subjects respondeds as intended by the test developer. The revised 19-item CCTS was found to have sufficient reliability and validity and will therefore represents a more convenient measurement of critical thinking ability.

  10. Reliability, construct and discriminative validity of clinical testing in subjects with and without chronic neck pain

    DEFF Research Database (Denmark)

    Jørgensen, René; Ris Hansen, Inge; Juul-Kristensen, Birgit;

    2014-01-01

    Abstract BACKGROUND: The reliability of clinical tests for the cervical spine has not been adequately evaluated. Six cervical clinical tests, which are low cost and easy to perform in clinical settings, were tested for intra- and inter-examiner reliability, and two performance tests were assessed...

  11. A Competency-Based Clinical Chemistry Course for the Associate Degree Medical Laboratory Technician Graduate in a Medical Technology Baccalaureate Program.

    Science.gov (United States)

    Buccelli, Pamela

    Presented is a project that developed a competency-based clinical chemistry course for associate degree medical laboratory technicians (MLT) in a medical technology (MT) baccalaureate program. Content of the course was based upon competencies expected of medical technologists at career-entry as defined in the statements adopted in 1976 by the…

  12. Can clinical colour vision tests be used to predict the results of the Farnsworth lantern test?

    Science.gov (United States)

    Cole, B L; Maddocks, J D

    1998-11-01

    Clinicians usually do not have access to a lantern test when making an occupational assessment of the ability of a person with defective colour vision to recognise signal light colours: they must rely on the results of ordinary clinical tests. While all colour vision defectives fail the Holmes Wright Type B lantern test and most fail the Holmes Wright Type A lantern, 35% of colour vision defectives pass the Farnsworth lantern. Can clinical tests predict who will pass and fail the Farnsworth lantern? We find that a pass (less than two or more diametrical crossings) at the Farnsworth Panel D 15 Dichotomous test has a sensitivity of 0.67 and specificity of 0.94 in predicting a pass or fail at the Farnsworth lantern test: a Nagel range of > 10 has a sensitivity of 0.87 and a specificity of 0.57. We conclude that neither the D 15 nor the Nagel Anomaloscope matching range are satisfactory predictors of performance on the Farnsworth Lantern.

  13. Statistical validation of reagent lot change in the clinical chemistry laboratory can confer insights on good clinical laboratory practice.

    Science.gov (United States)

    Cho, Min-Chul; Kim, So Young; Jeong, Tae-Dong; Lee, Woochang; Chun, Sail; Min, Won-Ki

    2014-11-01

    Verification of new lot reagent's suitability is necessary to ensure that results for patients' samples are consistent before and after reagent lot changes. A typical procedure is to measure results of some patients' samples along with quality control (QC) materials. In this study, the results of patients' samples and QC materials in reagent lot changes were analysed. In addition, the opinion regarding QC target range adjustment along with reagent lot changes was proposed. Patients' sample and QC material results of 360 reagent lot change events involving 61 analytes and eight instrument platforms were analysed. The between-lot differences for the patients' samples (ΔP) and the QC materials (ΔQC) were tested by Mann-Whitney U tests. The size of the between-lot differences in the QC data was calculated as multiples of standard deviation (SD). The ΔP and ΔQC values only differed significantly in 7.8% of the reagent lot change events. This frequency was not affected by the assay principle or the QC material source. One SD was proposed for the cutoff for maintaining pre-existing target range after reagent lot change. While non-commutable QC material results were infrequent in the present study, our data confirmed that QC materials have limited usefulness when assessing new reagent lots. Also a 1 SD standard for establishing a new QC target range after reagent lot change event was proposed.

  14. International Congress on Analytical Chemistry. Abstracts. V. 2

    International Nuclear Information System (INIS)

    The collection of materials of the international congress on analytical chemistry taken place in Moscow in June 1997 is presented. The main directs of investigations are elucidated in such regions of analytical chemistry as quantitative and qualitative chemical analysis, sample preparation, express test methods of environmental and biological materials, clinical analysis, analysis of food and agricultural products

  15. A blood chemistry profile for lake trout

    Science.gov (United States)

    Edsall, Carol Cotant

    1999-01-01

    A blood chemistry profile for lake trout Salvelinus namaycush was developed by establishing baseline ranges for several clinical chemistry tests (glucose, total protein, amylase, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, creatine kinase, calcium, and magnesium). Measurements were made accurately and rapidly with a Kodak Ektachem DT60 Analyzer and the Ektachem DTSC Module. Blood serum was collected from both laboratory-reared lake trout (1978 and 1986 year-classes) and feral spawning trout from Lake Michigan and then analyzed in the laboratory. No clinically significant differences were found between samples analyzed fresh and those frozen for 1 or 6 weeks. The ranges in chemistry variables for feral lake trout were generally wider than those for laboratory-reared lake trout, and significant differences existed between male and female feral lake trout for several tests. Blood chemistry profiles also varied seasonally on fish sampled repeatedly.

  16. Evolution of Clinical Enzymology

    OpenAIRE

    Büttner, J

    1981-01-01

    The evolution of clinical enzymology is discussed in relation to the history of general enzymology and clinical chemistry. The discussion is limited to the period from 1835 (definition of catalysis by Berzelius) to 1935 (description of the optical test by Warburg). In conclusion, a general account is given of the introduction of the concept of quantitative enzyme activity determination into clinical medicine.

  17. 42 CFR 493.1453 - Condition: Laboratories performing high complexity testing; clinical consultant.

    Science.gov (United States)

    2010-10-01

    ... Condition: Laboratories performing high complexity testing; clinical consultant. The laboratory must have a... testing; clinical consultant. 493.1453 Section 493.1453 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION...

  18. 21 CFR 862.1320 - Gastric acidity test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gastric acidity test system. 862.1320 Section 862.1320 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  19. 21 CFR 862.1325 - Gastrin test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gastrin test system. 862.1325 Section 862.1325 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  20. 21 CFR 862.1195 - Corticoids test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Corticoids test system. 862.1195 Section 862.1195 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  1. 21 CFR 862.1310 - Galactose test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Galactose test system. 862.1310 Section 862.1310 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  2. 21 CFR 862.1170 - Chloride test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Chloride test system. 862.1170 Section 862.1170 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  3. 21 CFR 862.1035 - Albumin test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Albumin test system. 862.1035 Section 862.1035 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  4. 21 CFR 862.1330 - Globulin test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Globulin test system. 862.1330 Section 862.1330 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  5. 21 CFR 862.1210 - Creatine test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Creatine test system. 862.1210 Section 862.1210 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  6. 21 CFR 862.1045 - Aldosterone test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Aldosterone test system. 862.1045 Section 862.1045 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  7. 21 CFR 862.1400 - Hydroxyproline test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hydroxyproline test system. 862.1400 Section 862.1400 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  8. 21 CFR 862.1285 - Etiocholanolone test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Etiocholanolone test system. 862.1285 Section 862.1285 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  9. 21 CFR 862.1335 - Glucagon test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Glucagon test system. 862.1335 Section 862.1335 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  10. 21 CFR 862.1240 - Cystine test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cystine test system. 862.1240 Section 862.1240 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  11. 21 CFR 862.1075 - Androstenedione test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Androstenedione test system. 862.1075 Section 862.1075 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  12. 21 CFR 862.1235 - Cyclosporine test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cyclosporine test system. 862.1235 Section 862.1235 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  13. 21 CFR 862.1080 - Androsterone test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Androsterone test system. 862.1080 Section 862.1080 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  14. 21 CFR 862.1290 - Fatty acids test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Fatty acids test system. 862.1290 Section 862.1290 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  15. 21 CFR 862.1225 - Creatinine test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Creatinine test system. 862.1225 Section 862.1225 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  16. 21 CFR 862.1280 - Estrone test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Estrone test system. 862.1280 Section 862.1280 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  17. 21 CFR 862.1177 - Cholylglycine test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cholylglycine test system. 862.1177 Section 862.1177 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  18. 21 CFR 862.1145 - Calcium test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Calcium test system. 862.1145 Section 862.1145 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  19. 21 CFR 862.1118 - Biotinidase test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Biotinidase test system. 862.1118 Section 862.1118 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  20. 21 CFR 862.1140 - Calcitonin test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Calcitonin test system. 862.1140 Section 862.1140 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  1. 21 CFR 862.1095 - Ascorbic acid test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ascorbic acid test system. 862.1095 Section 862.1095 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  2. 21 CFR 862.1365 - Glutathione test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Glutathione test system. 862.1365 Section 862.1365 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  3. 21 CFR 862.1040 - Aldolase test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Aldolase test system. 862.1040 Section 862.1040 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  4. 21 CFR 862.1070 - Amylase test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Amylase test system. 862.1070 Section 862.1070 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  5. 21 CFR 862.1465 - Lipase test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Lipase test system. 862.1465 Section 862.1465 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  6. Increasing fetal ovine number per gestation alters fetal plasma clinical chemistry values.

    Science.gov (United States)

    Zywicki, Micaela; Blohowiak, Sharon E; Magness, Ronald R; Segar, Jeffrey L; Kling, Pamela J

    2016-08-01

    Intrauterine growth restriction (IUGR) is interconnected with developmental programming of lifelong pathophysiology. IUGR is seen in human multifetal pregnancies, with stepwise rises in fetal numbers interfering with placental nutrient delivery. It remains unknown whether fetal blood analyses would reflect fetal nutrition, liver, and excretory function in the last trimester of human or ovine IUGR In an ovine model, we hypothesized that fetal plasma biochemical values would reflect progressive placental, fetal liver, and fetal kidney dysfunction as the number of fetuses per gestation rose. To determine fetal plasma biochemical values in singleton, twin, triplet, and quadruplet/quintuplet ovine gestation, we investigated morphometric measures and comprehensive metabolic panels with nutritional measures, liver enzymes, and placental and fetal kidney excretory measures at gestational day (GD) 130 (90% gestation). As anticipated, placental dysfunction was supported by a stepwise fall in fetal weight, fetal plasma glucose, and triglyceride levels as fetal number per ewe rose. Fetal glucose and triglycerides were directly related to fetal weight. Plasma creatinine, reflecting fetal renal excretory function, and plasma cholesterol, reflecting placental excretory function, were inversely correlated with fetal weight. Progressive biochemical disturbances and growth restriction accompanied the rise in fetal number. Understanding the compensatory and adaptive responses of growth-restricted fetuses at the biochemical level may help explain how metabolic pathways in growth restriction can be predetermined at birth. This physiological understanding is important for clinical care and generating interventional strategies to prevent altered developmental programming in multifetal gestation.

  7. Increasing fetal ovine number per gestation alters fetal plasma clinical chemistry values.

    Science.gov (United States)

    Zywicki, Micaela; Blohowiak, Sharon E; Magness, Ronald R; Segar, Jeffrey L; Kling, Pamela J

    2016-08-01

    Intrauterine growth restriction (IUGR) is interconnected with developmental programming of lifelong pathophysiology. IUGR is seen in human multifetal pregnancies, with stepwise rises in fetal numbers interfering with placental nutrient delivery. It remains unknown whether fetal blood analyses would reflect fetal nutrition, liver, and excretory function in the last trimester of human or ovine IUGR In an ovine model, we hypothesized that fetal plasma biochemical values would reflect progressive placental, fetal liver, and fetal kidney dysfunction as the number of fetuses per gestation rose. To determine fetal plasma biochemical values in singleton, twin, triplet, and quadruplet/quintuplet ovine gestation, we investigated morphometric measures and comprehensive metabolic panels with nutritional measures, liver enzymes, and placental and fetal kidney excretory measures at gestational day (GD) 130 (90% gestation). As anticipated, placental dysfunction was supported by a stepwise fall in fetal weight, fetal plasma glucose, and triglyceride levels as fetal number per ewe rose. Fetal glucose and triglycerides were directly related to fetal weight. Plasma creatinine, reflecting fetal renal excretory function, and plasma cholesterol, reflecting placental excretory function, were inversely correlated with fetal weight. Progressive biochemical disturbances and growth restriction accompanied the rise in fetal number. Understanding the compensatory and adaptive responses of growth-restricted fetuses at the biochemical level may help explain how metabolic pathways in growth restriction can be predetermined at birth. This physiological understanding is important for clinical care and generating interventional strategies to prevent altered developmental programming in multifetal gestation. PMID:27565903

  8. An innovative method to assess clinical reasoning skills: Clinical reasoning tests in the second national medical science Olympiad in Iran

    Directory of Open Access Journals (Sweden)

    Shafaghi Afshin

    2011-10-01

    Full Text Available Abstract Background Clinical reasoning plays a major role in the ability of doctors to make a diagnosis and reach treatment decisions. This paper describes the use of four clinical reasoning tests in the second National Medical Science Olympiad in Iran: key features (KF, script concordance (SCT, clinical reasoning problems (CRP and comprehensive integrative puzzles (CIP. The purpose of the study was to design a multi instrument for multiple roles approach in clinical reasoning field based on the theoretical framework, KF was used to measure data gathering, CRP was used to measure hypothesis formation, SCT and CIP were used to measure hypothesis evaluation and investigating the combined use of these tests in the Olympiad. A bank of clinical reasoning test items was developed for emergency medicine by a scientific expert committee representing all the medical schools in the country. These items were pretested by a reference group and the results were analyzed to select items that could be omitted. Then 135 top-ranked medical students from 45 medical universities in Iran participated in the clinical domain of the Olympiad. The reliability of each test was calculated by Cronbach's alpha. Item difficulty and the correlation between each item and the total score were measured. The correlation between the students' final grade and each of the clinical reasoning tests was calculated, as was the correlation between final grades and another measure of knowledge, i.e., the students' grade point average. Results The combined reliability for all four clinical reasoning tests was 0.91. Of the four clinical reasoning tests we compared, reliability was highest for CIP (0.91. The reliability was 0.83 for KF, 0.78 for SCT and 0.71 for CRP. Most of the tests had an acceptable item difficulty level between 0.2 and 0.8. The correlation between the score for each item and the total test score for each of the four tests was positive. The correlations between scores

  9. Polymer Chemistry

    Science.gov (United States)

    Williams, Martha; Roberson, Luke; Caraccio, Anne

    2010-01-01

    This viewgraph presentation describes new technologies in polymer and material chemistry that benefits NASA programs and missions. The topics include: 1) What are Polymers?; 2) History of Polymer Chemistry; 3) Composites/Materials Development at KSC; 4) Why Wiring; 5) Next Generation Wiring Materials; 6) Wire System Materials and Integration; 7) Self-Healing Wire Repair; 8) Smart Wiring Summary; 9) Fire and Polymers; 10) Aerogel Technology; 11) Aerogel Composites; 12) Aerogels for Oil Remediation; 13) KSC's Solution; 14) Chemochromic Hydrogen Sensors; 15) STS-130 and 131 Operations; 16) HyperPigment; 17) Antimicrobial Materials; 18) Conductive Inks Formulations for Multiple Applications; and 19) Testing and Processing Equipment.

  10. Hematology and Clinical Chemistry Measures During and After Pregnancy and Age- and Sex-Specific Reference Intervals in African Green Monkeys (Chlorocebus aethiops sabaeus).

    Science.gov (United States)

    Chichester, Lee; Gee, Melaney K; Jorgensen, Matthew J; Kaplan, Jay R

    2015-07-01

    Clinical decisions and experimental analyses often involve the assessment of hematology and clinical chemistry. Using clinical pathology to assess the health status of NHP in breeding colonies or data from studies than involve pregnancy can often be complicated by pregnancy status. This study had 2 objectives regarding the hematology and clinical chemistry of African green monkeys (AGM, Chlorocebus aethiops sabaeus): 1) to compare pregnant or recently postpartum animals with nonpregnant, nonlactating animals and 2) to create age- and sex-specific reference intervals. Subjects in this study were 491 AGM from the Vervet Research Colony of the Wake Forest University Primate Center. Results indicated that changes in BUN, serum total protein, albumin, ALP, GGT, calcium, phosphorus, sodium, potassium, cholesterol, total CO2, globulins, lipase, amylase, WBC, neutrophils, lymphocytes, platelets, RBC, Hgb, and Hct occur during pregnancy and the postpartum period. Age- and sex-specific reference intervals consistent with guidelines from the American Society for Veterinary Clinical Pathology were established and further expand the understanding of how to define health in AGM on the basis of clinical pathology. The combination of understanding the changes that occur in pregnancy and postpartum and expansive reference intervals will help guide clinical and experimental decisions.

  11. [Vasculitic Peripheral Neuropathies: Clinical Features and Diagnostic Laboratory Tests].

    Science.gov (United States)

    Ogata, Katsuhisa

    2016-03-01

    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.

  12. Permeability and fluid chemistry studies of the Topopah Spring Member of the Paintbrush Tuff, Nevada Test Site: Part II

    International Nuclear Information System (INIS)

    The Topopah Spring Member of the Paintbrush Tuff is being considered as a possible emplacement horizon for the disposal of nuclear waste. The permeability and pore-fluid chemistry of the Topopah Spring Member have been investigated experimentally. The work reported here represents a continuation of previous permeability studies on the Topopah Spring Member. Three experiments were run, to test the effect of pore pressure, sample orientation, and flow direction on permeability and pore fluid chemistry. In the experiments, water flowed either up or down a temperature gradient established across the tuff sample in response to a small pore pressure gradient. The maximum temperature of the gradient was 1500C, and the minimum was 43 to 450C. The confining pressure was 100 bars, corresponding to a disposal depth of 400 meters. J13 water was the starting pore fluid. The heated tuff samples showed few changes in permeability from their initial, room-temperature values. In addition, the fluids discharged from both the low and high-temperature sides of the tuff samples were dilute, nearly neutral solutions whose compositions did not differ greatly from the starting J13 compositions. 16 refs., 14 figs., 4 tabs

  13. How tests of lubricating and transformer oils became part of power plant chemistry in Denmark

    Energy Technology Data Exchange (ETDEWEB)

    Moeller, H. [I/S Nordjyllandsvaerket, Vodskov (Denmark)

    1996-12-01

    Lubricating, hydraulic and transformer oils based on refined crude oil are used in nearly all power station components, such as gear, turbines, hydraulic stations, feed pumps and transformers. The function of these components totally depends on the condition of the oils and their properties. Seen from this point one may wonder why examination and evaluation of oils did not become part of the power station chemistry within the ELSAM utility area until during the middle of the eighties. We started to examine the properties of lubricating oils at the time when several steam turbines experienced serious problems with formation of deposits in their hydraulic control circuits. This work was intensified in connection with the significant number of CHPs and wind turbines erected within the Danish electricity sector during the past 10 years or so. The majority of the CHPs are natural gas fired turbines or motors, equipment which severely stresses the lubricating oil. In collaboration with KEMA, the Netherlands, we have carried through with a large examination of lubricating oils in gas turbines and we have found suitable oil types. The objectives of our work with lubricating and transformer oils have been to link together the laboratory measurements with operational experience. Only by doing this is it possible to utilize the laboratory measurements in a correct way. It must be remembered that the main part of all oil specifications concerns the properties of new oils. Only very little is published about the requirements concerning used oils. (EG)

  14. Language Preferences of Freshman Chemistry Students: An Exploratory Study.

    Science.gov (United States)

    Hill, Douglas M.; And Others

    1980-01-01

    Ascertained whether chemistry instructors have a consistent preference for particular ways of idea expression by chemistry students. Comparisons of responses on a chemistry preference test were made among chemistry instructors, chemistry majors and nonscience majors. (CS)

  15. Application of sigma metrics for the assessment of quality control in clinical chemistry laboratory in Ghana: A pilot study

    Directory of Open Access Journals (Sweden)

    Justice Afrifa

    2015-01-01

    Full Text Available Background: Sigma metrics provide a uniquely defined scale with which we can assess the performance of a laboratory. The objective of this study was to assess the internal quality control (QC in the clinical chemistry laboratory of the University of Cape Cost Hospital (UCC using the six sigma metrics application. Materials and Methods: We used commercial control serum [normal (L1 and pathological (L2] for validation of quality control. Metabolites (glucose, urea, and creatinine, lipids [triglycerides (TG, total cholesterol, high-density lipoprotein cholesterol (HDL-C], enzymes [alkaline phosphatase (ALP, alanine aminotransferase (AST], electrolytes (sodium, potassium, chloride and total protein were assessed. Between-day imprecision (CVs, inaccuracy (Bias and sigma values were calculated for each control level. Results: Apart from sodium (2.40%, 3.83%, chloride (2.52% and 2.51% for both L1 and L2 respectively, and glucose (4.82%, cholesterol (4.86% for L2, CVs for all other parameters (both L1 and L2 were >5%. Four parameters (HDL-C, urea, creatinine and potassium achieved sigma levels >1 for both controls. Chloride and sodium achieved sigma levels >1 for L1 but 1 for L2. Glucose and ALP achieved a sigma level >1 for both control levels whereas TG achieved a sigma level >2 for both control levels. Conclusion: Unsatisfactory sigma levels (<3 where achieved for all parameters using both control levels, this shows instability and low consistency of results. There is the need for detailed assessment of the analytical procedures and the strengthening of the laboratory control systems in order to achieve effective six sigma levels for the laboratory.

  16. Use of clinical movement screening tests to predict injury in sport.

    Science.gov (United States)

    Chimera, Nicole J; Warren, Meghan

    2016-04-18

    Clinical movement screening tests are gaining popularity as a means to determine injury risk and to implement training programs to prevent sport injury. While these screens are being used readily in the clinical field, it is only recently that some of these have started to gain attention from a research perspective. This limits applicability and poses questions to the validity, and in some cases the reliability, of the clinical movement tests as they relate to injury prediction, intervention, and prevention. This editorial will review the following clinical movement screening tests: Functional Movement Screen™, Star Excursion Balance Test, Y Balance Test, Drop Jump Screening Test, Landing Error Scoring System, and the Tuck Jump Analysis in regards to test administration, reliability, validity, factors that affect test performance, intervention programs, and usefulness for injury prediction. It is important to review the aforementioned factors for each of these clinical screening tests as this may help clinicians interpret the current body of literature. While each of these screening tests were developed by clinicians based on what appears to be clinical practice, this paper brings to light that this is a need for collaboration between clinicians and researchers to ensure validity of clinically meaningful tests so that they are used appropriately in future clinical practice. Further, this editorial may help to identify where the research is lacking and, thus, drive future research questions in regards to applicability and appropriateness of clinical movement screening tools. PMID:27114928

  17. Hydrologic and water-chemistry data from the Cretaceous-aquifers test well (BFT-2055), Beaufort County, South Carolina

    Science.gov (United States)

    Landmeyer, J.E.; Bradley, P.M.

    1998-01-01

    Test well BFT-2055 was drilled through the entire thickness of Coastal Plain sediments beneath central Hilton Head Island, South Carolina, and terminated in bedrock at a depth of 3833 feet. The well was drilled to evaluate the hydraulic properties of the Cretaceous formations beneath Hilton Head Island as a potential source of supplemental water to supplies currently withdrawn from the Upper Floridan aquifer. The intervals tested include sediments of the Cape Fear and Middendorf Formations. Results from aquifer tests indicate that the transmissivity of the formations screened ranges from 1300 to 3000 feet squared per day and an average hydraulic conductivity of about 15 feet per day. Formation-fluid pressure tests indicate that the potential exists for upward ground-water flow from higher fluid pressures in the deeper Cape Fear and Middendorf Formations to lower fluid pressures in the Black Creek Formation and shallower units. A flowmeter test indicated that greater than 75 percent of the natural, unpumped flow in the well is from the screened intervals no deeper than 3100 feet. Water-chemistry analyses indicate that the water sampled from the Middendorf and Cape Fear has about 1450 milligrams per liter dissolved solids, 310 to 1000 milligrams per liter sodium, and 144 to 1600 milligrams per liter chloride. Because these chloride concentrations would render water pumped from these aquifers as nonpotable, it is unlikely that these aquifers will be used as a supplemental source of water for island residents without some form of pretreatment. Similar chloride concentrations are present in some wells in the Upper Floridan aquifer adjacent to Port Royal Sound, and these chloride concentrations were the primary reason for drilling the test well in the Cretaceous formations as a possible source of more potable water.

  18. Chemistry of the sea surface microlayer. 1. Fabrication and testing of the sampler

    Digital Repository Service at National Institute of Oceanography (India)

    Singbal, S.Y.S.; Narvekar, P.V.

    A screen sampler fabricated to study the sea surface microlayer (SML) has been described. The screen sampler was tested in the Mandovi estuary and adjacent waters. Physico-chemical parameters of the subsurface waters from a depth of 25 cm was also...

  19. Differential Reinforcement of Alternative Behavior Increases Resistance to Extinction: Clinical Demonstration, Animal Modeling, and Clinical Test of One Solution

    OpenAIRE

    Mace, F. Charles; McComas, Jennifer J; Mauro, Benjamin C.; Progar, Patrick R; Taylor, Bridget; Ervin, Ruth; Zangrillo, Amanda N

    2010-01-01

    Basic research with pigeons on behavioral momentum suggests that differential reinforcement of alternative behavior (DRA) can increase the resistance of target behavior to change. This finding suggests that clinical applications of DRA may inadvertently increase the persistence of target behavior even as it decreases its frequency. We conducted three coordinated experiments to test whether DRA has persistence-strengthening effects on clinically significant target behavior and then tested the ...

  20. Modelling of turbulent hydrocarbon combustion. Test of different reactor concepts for describing the interactions between turbulence and chemistry

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, C.; Kremer, H. [Ruhr-Universitaet Bochum, Lehrstuhl fuer Energieanlagentechnik, Bochum (Germany); Kilpinen, P.; Hupa, M. [Aabo Akademi, Turku (Finland). Combustion Chemistry Research Group

    1997-12-31

    The detailed modelling of turbulent reactive flows with CFD-codes is a major challenge in combustion science. One method of combining highly developed turbulence models and detailed chemistry in CFD-codes is the application of reactor based turbulence chemistry interaction models. In this work the influence of different reactor concepts on methane and NO{sub x} chemistry in turbulent reactive flows was investigated. Besides the classical reactor approaches, a plug flow reactor (PFR) and a perfectly stirred reactor (PSR), the Eddy-Dissipation Combustion Model (EDX) and the Eddy Dissipation Concept (EDC) were included. Based on a detailed reaction scheme and a simplified 2-step mechanism studies were performed in a simplified computational grid consisting of 5 cells. The investigations cover a temperature range from 1273 K to 1673 K and consider fuel-rich and fuel-lean gas mixtures as well as turbulent and highly turbulent flow conditions. All test cases investigated in this study showed a strong influence of the reactor residence time on the species conversion processes. Due to this characteristic strong deviations were found for the species trends resulting from the different reactor approaches. However, this influence was only concentrated on the `near burner region` and after 4-5 cells hardly any deviation and residence time dependence could be found. The importance of the residence time dependence increased when the species conversion was accelerated as it is the case for overstoichiometric combustion conditions and increased temperatures. The study focused furthermore on the fine structure in the EDC. Unlike the classical approach this part of the cell was modelled as a PFR instead of a PSR. For high temperature conditions there was hardly any difference between both reactor types. However, decreasing the temperature led to obvious deviations. Finally, the effect of the selective species transport between the cells on the conversion process was investigated

  1. Radiopharmaceutical Chemistry of Targeted Radiopharmaceutics. Synthesis of 211At-Labeled Radiopharmaceuticals at High Activities for Clinical Use

    International Nuclear Information System (INIS)

    Targeted α-particle radiotherapy is an appealing approach to cancer treatment because of the potential for delivering curative doses of radiation to tumor with minimal damage to normal tissue due to a range equivalent to only a few cell diameters. Compared with β-emitters they have significant advantages from a radiobiological perspective. The LET of 211At α-particles is more than 400 times higher than the β-particles emitted by 90Y, in addition the distance between ionizing events is almost the same as that between the two strands of DNA, yielding a high probability of creating non-repairable DNA damage. It gives the ability to kill cancer cells not compromised by hypoxia, dose rate effects or cell cycle position, enhancing their attractiveness for targeted radiotherapy. However, translation of the concept to the clinic has been slow, many obstacles had to be surmounted before clinical studies could be initiated, the first clinical evaluation of a 211At- labeled mAb was made in 2001. This study circumvents many of the challenges to entering clinical studies with 211At. But several problems were encountered in maintaining efficient labeling with escalating radiation dose of alpha-particle likely related to radiolysis. The impact of the radiolysis produced by the α-particle over the labeling chemistry is much higher in comparison with typical β-emitters due to a deposition of energy in the solvent in a highly localized manner two orders of magnitude per unit volume higher than 90Y or 131I. Due to these difficulties a comprehensive basic science study about the radiolytic effects of astatine alpha-particles over the synthesis of 211At-labeled radiopharmaceuticals was carried out. Its main goal was overcoming the problem of the synthesis of 211At-labeled radiopharmaceuticals at the high activities necessaries for therapy and also to extend the shelf life of astatine elutions. Briefly this study held several steps, the first one was to study the role of solvent

  2. Useful Tests for Hepatic Encephalopathy in Clinical Practice

    OpenAIRE

    Nabi, Eiman; Bajaj, Jasmohan S

    2014-01-01

    Hepatic encephalopathy (HE) is a serious complication of liver disease and portosystemic shunting that represents a continuum of neuropsychiatric changes and altered consciousness. It is classified as overt hepatic encephalopathy (OHE) when clinically apparent or as covert hepatic encephalopathy (CHE) in its mildest form. Progression of CHE to OHE and its impact of quality of life make its early diagnosis imperative. Several diagnostic techniques ranging from simple clinical scales to sophist...

  3. Field testing of lake water chemistry with a portable and an AUV-based mass spectrometer.

    Science.gov (United States)

    Hemond, Harry F; Mueller, Amy V; Hemond, Michael

    2008-10-01

    Two mass spectrometers (MS) are tested for the measurement of volatile substances, such as hydrocarbons and metabolic gases, in natural waters. KOALA is a backpackable MS operated from above the water surface, in which samples are pumped through a flow cell using a syringe. NEREUS is an underwater instrument hosted by an autonomous underwater vehicle (AUV) that is linked to a communications network to provide chemical data in real time. The mass analyzers of the two MS are nearly identical cycloids, and both use flat-plate membrane inlets. Testing took place in an eutrophic, thermally stratified lake exhibiting steep chemical gradients and significant levels of methane. KOALA provided rapid multispecies analysis of dissolved gases, with a detection limit for methane of 0.1 ppm (readily extendable to 0.01 ppm) and savings of time of at least a factor of 10 compared to that of conventional analysis. The AUV-mounted NEREUS additionally provided rapid spatial coverage and the capability of performing chemical surveys autonomously. Tests demonstrated the need for temperature control of a membrane inlet when steep thermal gradients are present in a water body, as well as the benefits of co-locating all sensors on the AUV to avoid interference from chemically different waters entering and draining from the free-flooding outer hull. The ability to measure dissolved volatiles provided by MS offers potential for complementarity with ionic sensors in the study of natural waters, such as in the case of the carbonate system.

  4. A benchmark test suite for proton transfer energies and its use to test electronic structure model chemistries

    International Nuclear Information System (INIS)

    Highlights: ► We present benchmark calculations of energies of complexation and barriers for proton transfer to water. ► Benchmark calculations are used to test methods suitable for application to large and complex systems. ► Methods tested include hybrid meta-GGAs, M06-L, PW6B95, SOGGA11, MP2, SCC-DFTB, PMO, and NDDO. - Abstract: We present benchmark calculations of nine selected points on potential energy surfaces describing proton transfer processes in three model systems, H5O2+, CH3OH…H+…OH2, and CH3COOH…OH2. The calculated relative energies of these geometries are compared to those calculated by various wave function and density functional methods, including the polarized molecular orbital (PMO) model recently developed in our research group and other semiempirical molecular orbital methods. We found that the SCC-DFTB and PMO methods (the latter available so far only for molecules consisting of only O and H and therefore only for the first of the three model systems) give results that are, on average, within 2 kcal/mol of the benchmark results. Other semiempirical molecular orbital methods have mean unsigned errors (MUEs) of 3–8 kcal/mol, local density functionals have MUEs in the range 0.7–3.7 kcal/mol, and hybrid density functionals have MUEs of only 0.3–1.0 kcal/mol, with the best density functional performance obtained by hybrid meta-GGAs, especially M06 and PW6B95.

  5. Six-minute stepper test: a valid clinical exercise tolerance test for COPD patients

    Directory of Open Access Journals (Sweden)

    Grosbois JM

    2016-03-01

    .005. Performances on the 6MST and 6MWT were significantly improved after PR (570 vs 488 steps, P=0.001 and 448 vs 406 m, respectively; P<0.0001. Improvements of the 6MST and 6MWT after PR were significantly correlated (r=0.34; P=0.03.Conclusion: The results of this study show that the 6MST is a valid test to evaluate exercise tolerance in COPD patients. The use of this test in clinical practice appears to be particularly relevant for the assessment of patients managed by home PR. Keywords: 6-minute stepper test, 6-minute walk test, exercise tolerance, pulmonary rehabilitation, cardiopulmonary exercise testing, validity

  6. Ant Colony Algorithm and Optimization of Test Conditions in Analytical Chemistry

    Institute of Scientific and Technical Information of China (English)

    丁亚平; 吴庆生; 苏庆德

    2003-01-01

    The research for the new algorithm is in the forward position and an issue of general interest in chemometrics all along.A novel chemometrics method,Chemical Ant Colony Algorithm,has first been developed.In this paper,the basic principle,theevaluation function,and the parameter choice were discussed.This method has been successfully applied to the fitting of nonlinear multivariate function and the optimization of test conditions in chrome-azure-S-Al spctrophotometric system.The sum of residual square of the results is 0.0009,which has reached a good convergence result.

  7. Testing the Potential for Computational Chemistry to Quantify Biophysical Properties of the Non-Proteinaceous Amino Acids

    Science.gov (United States)

    Lu, Yi; Freeland, Stephen

    2006-08-01

    Although most proteins of most living organisms are constructed from the same set of 20 amino acids, all indications are that this standard alphabet represents a mere subset of what was available to life during early evolution. However, we currently lack an appropriate quantitative framework with which to test the qualitative hypotheses that have been offered to date as explanations for nature's "choices." Specifically, although many indices have been developed to describe the 20 standard amino acids, few or no comparable data extend to prebiotically plausible alternatives because of the costly and time-consuming bench experiments that would be required. Computational chemistry (specifically quantitative structure property relationship methods) offers a potentially fast, cost-effective remedy for this knowledge gap by predicting such molecular properties in silico. Thus, we investigated the use of various freely accessible programs to predict three key amino acid properties (hydrophobicity, charge, and size). We assessed the accuracy of these predictions by comparisons with experimentally determined counterparts for appropriate test data sets. In light of these results, and factors of software accessibility and transparency, we suggest a method for further computational assessments of prebiotically plausible amino acids. The results serve as a starting point for future quantitative analysis of amino acid alphabet evolution.

  8. 21 CFR 862.1405 - Immunoreactive insulin test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Immunoreactive insulin test system. 862.1405 Section 862.1405 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry...

  9. 21 CFR 862.1165 - Catecholamines (total) test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Catecholamines (total) test system. 862.1165 Section 862.1165 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry...

  10. 21 CFR 862.1175 - Cholesterol (total) test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cholesterol (total) test system. 862.1175 Section 862.1175 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry...

  11. 21 CFR 862.1435 - Ketones (nonquantitative) test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ketones (nonquantitative) test system. 862.1435 Section 862.1435 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry...

  12. 21 CFR 862.1420 - Isocitric dehydrogenase test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Isocitric dehydrogenase test system. 862.1420 Section 862.1420 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry...

  13. 21 CFR 862.1370 - Human growth hormone test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Human growth hormone test system. 862.1370 Section 862.1370 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry...

  14. 21 CFR 862.1440 - Lactate dehydrogenase test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Lactate dehydrogenase test system. 862.1440 Section 862.1440 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry...

  15. 21 CFR 862.1395 - 17-Hydroxyprogesterone test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false 17-Hydroxyprogesterone test system. 862.1395 Section 862.1395 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry...

  16. 21 CFR 862.1250 - Desoxycorticosterone test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Desoxycorticosterone test system. 862.1250 Section 862.1250 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry...

  17. 21 CFR 862.1380 - Hydroxybutyric dehydrogenase test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hydroxybutyric dehydrogenase test system. 862.1380 Section 862.1380 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry...

  18. The role of European Federation of Clinical Chemistry and Laboratory Medicine Working Group for Preanalytical Phase in standardization and harmonization of the preanalytical phase in Europe.

    Science.gov (United States)

    Cornes, Michael P; Church, Stephen; van Dongen-Lases, Edmée; Grankvist, Kjell; Guimarães, João T; Ibarz, Mercedes; Kovalevskaya, Svetlana; Kristensen, Gunn Bb; Lippi, Giuseppe; Nybo, Mads; Sprongl, Ludek; Sumarac, Zorica; Simundic, Ana-Maria

    2016-09-01

    Patient safety is a leading challenge in healthcare and from the laboratory perspective it is now well established that preanalytical errors are the major contributor to the overall rate of diagnostic and therapeutic errors. To address this, the European Federation of Clinical Chemistry and Laboratory Medicine Working Group for Preanalytical Phase (EFLM WG-PRE) was established to lead in standardization and harmonization of preanalytical policies and practices at a European level. One of the key activities of the WG-PRE is the organization of the biennial EFLM-BD conference on the preanalytical phase to provide a forum for National Societies (NS) to discuss their issues. Since 2012, a year after the first Preanalytical phase conference, there has been a rapid growth in the number of NS with a working group engaged in preanalytical phase activities and there are now at least 19 countries that have one. As a result of discussions with NS at the third conference held in March 2015 five key areas were identified as requiring harmonisation. These were test ordering, sample transport and storage, patient preparation, sampling procedures and management of unsuitable specimens. The article below summarises the work that has and will be done in these areas. The goal of this initiative is to ensure the EFLM WG-PRE produces work that meets the needs of the European laboratory medicine community. Progress made in the identified areas will be updated at the next preanalytical phase conference and show that we have produced guidance that has enhanced standardisation in the preanalytical phase and improved patient safety throughout Europe.

  19. Strategies for the Simulation of Sea Ice Organic Chemistry: Arctic Tests and Development

    CERN Document Server

    Elliott, S; Hunke, E; Deal, C; Jin, M; Wang, S; Smith, E Elliott; Oestreicher, S

    2016-01-01

    A mechanism connecting ice algal ecodynamics with the buildup of organic macromolecules in brine channels is tested offline in a reduced model of pack geochemistry. Driver physical quantities are extracted from the global sea ice dynamics code CICE, including snow height, column thickness and internal temperature. The variables are averaged at the regional scale over ten Arctic biogeographic zones and treated as input matrices at four vertical habitat levels. Nutrient-light-salt limited ice algal growth is computed along with the associated grazing plus mortality. Vertical transport is diffusive but responds to pore structure. Simulated bottom layer chlorophyll maxima are reasonable, though delayed by about a month relative to observations. This highlights major uncertainties deriving from snow thickness variability. Upper level biota are generated intermittently through flooding. Macromolecular injections are represented by the compound classes humics, proteins, polysaccharides and lipids. The fresh biopolym...

  20. 21 CFR 862.1410 - Iron (non-heme) test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Iron (non-heme) test system. 862.1410 Section 862.1410 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  1. Counseling for HIV Prevention: Clinical Interventions and HIV Antibody Testing.

    Science.gov (United States)

    Craig, Donald H.; And Others

    1996-01-01

    Describes some developmental foundations for HIV counseling. Asserts that, in both formal sessions and moments of opportunity, educators, clinicians, and counselors can use the counseling relationship to promote healthy behavior change. This clinical process depends on careful self-appraisal, good counseling skills, and responsiveness to the…

  2. Clinical Teaching Effectiveness Instrument: Development and Psychometric Testing.

    Science.gov (United States)

    Copeland, H. Liesel; Hewson, Mariana

    This report describes the development and psychometric qualities of a new instrument to assess clinical teaching effectiveness in medical education. The strength of the instrument is seen to lie in the qualitative development process involving iterative checking with key stakeholders; its high reliability, validity, and feasibility; and its ease…

  3. New PCR Test That Recognizes All Human Prototypes of Enterovirus: Application for Clinical Diagnosis

    OpenAIRE

    Bourlet, Thomas; Caro, Valerie; Minjolle, Sophie; Jusselin, Isabelle; Pozzetto, Bruno; Crainic, Radu; Colimon, Ronald

    2003-01-01

    We describe a new PCR test (Penter RT-PCR) that recognizes all 64 prototypes of enterovirus. Sixty clinical samples were analyzed in parallel with this Penter RT-PCR and previously described PCR tests: 34 and 32 samples tested positive, respectively. This assay is suitable for use in clinical diagnosis, and its ability to amplify all known serotypes makes it more useful than other consensus PCR tests.

  4. Interpretation of friction and wear in DLC film: role of surface chemistry and test environment

    Science.gov (United States)

    Polaki, S. R.; Kumar, N.; Madapu, K.; Ganesan, K.; Krishna, N. G.; Srivastava, S. K.; Abhaya, S.; Kamruddin, M.; Dash, S.; Tyagi, A. K.

    2016-11-01

    In spite of the large amount of tribological work carried out to explain the friction and wear mechanism in diamond-like carbon (DLC) films, some of the core issues relating to the evolution of reactive species across sliding interfaces and their role on the friction and wear mechanism remain unclear. The phase composition, film density and hydrogen content present in a DLC film can be tailored by substrate biasing during film deposition to achieve a nearly vanishing friction coefficient. Furthermore, nitrogen doping in DLC films significantly improves wear resistance, and sliding occurs in a nearly wearless regime. Undoped and nitrogen-doped DLC films exhibit a nearly frictionless value with ultra-low wear behavior when tests are performed in argon, nitrogen and methane atmospheres. The antifriction and antiwear properties of the DLC films were improved with the reduction of adsorbed oxygen impurities on the film surface. This behavior was understood by correlating the oxygen impurities present at the surface/subsurface region of the DLC film while using x-ray photoelectron spectroscopy and depth-resolved Auger electron spectroscopy.

  5. Clinical value of exercise testing in elderly patients

    NARCIS (Netherlands)

    J. Pool (Jan); M.G. Scheffer; M.L. Simoons (Maarten); N. Patijn

    1984-01-01

    textabstractBetween 1978 and 1983, 1391 exercise tests were performed by 1083 males and 308 females over 64 years of age. This represents 17% of the total number of 8213 exercise tests. A history of myocardial infarction was present in 53% of the males and 30% of the females, while 12% of patients h

  6. Application of Six Sigma Quality Management method in Quality Control of Clinical Chemistry Laboratory%6σ质量标准在临床生化检验室内质量控制中的应用研究

    Institute of Scientific and Technical Information of China (English)

    刘忠民; 高月亭; 肖洪广; 刘利东; 伍众文

    2010-01-01

    目的 应用6σ质量标准分析临床生化检验质量控制数据,评价检验项目质量水平,改进检验质量.方法 收集2007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;按照美国临床实验室改进修正法案中允许总误差(Tea)标准.采用公式σ=(Tea-bias)/CV,计算各检验项目的σ值,绘制6σ性能决定图,评价分析性能,并设计质量控制方案.结果 28个临床生化常规检验项目中,检验项目总分析性能σ≥6、5、4和3者.分别占25%、35.7%、57.1%和71.4%,所有检验项目的平均σ=4.77;当σ≥5时,采用l_(3S)(n=2)质量控制规则能满足质量要求.结论 6σ质量标准的应用.有助于提高临床生化检验质量水平,6σ管理是一项有效的质量管理工具.%Objective To assess and improve the performance of clinical chemistry laboratory by applying the six sigma(6σ)quality management criterion. Methods Data were collected from routine internal quality control and external quality assessment inclinical chemistry laboratory during 2007. Allowable analytical error was defined according to the Clinical Laboratory ImprovementAmendments. The sigma value was calculated according the equation σ= (TEa-bias)/Coefficient of variation (CV),and 6σ decisionchart was made. The quality control strategy based on 6σ was also designed and used for evaluation of the clinical chemical tests. Re-sults 25%.35. 71%,57. 1% and 71.4% of all 28 tests were over 6,5,4 and 3 sigma metrics respectively with the averaged 4. 77.The results met the requirement with the rule of _(13S)(n=2) when the s metric values have been over 5. 0. Conclusion Six Sigmamethodology is an effective tool for quality management in clinical chemistry laboratory.

  7. GA(2)LEN skin test study II: clinical relevance of inhalant allergen sensitizations in Europe

    DEFF Research Database (Denmark)

    Burbach, G J; Heinzerling, L M; Edenharter, G;

    2009-01-01

    BACKGROUND: Skin prick testing is the standard for diagnosing IgE-mediated allergies. A positive skin prick reaction, however, does not always correlate with clinical symptoms. A large database from a Global Asthma and Allergy European Network (GA(2)LEN) study with data on clinical relevance...... the clinical relevance of positive skin prick test reactions against inhalant allergens considering the predominating type of symptoms in a pan-European population of patients presenting with suspected allergic disease. METHODS: Clinical relevance of skin prick tests was recorded with regard to patient history...

  8. What is the role of clinical tests and ultrasound in acetabular labral tear diagnostics?

    DEFF Research Database (Denmark)

    Troelsen, Anders; Mechlenburg, Inger; Gelineck, John;

    2009-01-01

    BACKGROUND AND PURPOSE: An acetabular labral tear is a diagnostic challenge. Various clinical tests have been described, but little is known about their diagnostic sensitivity and specificity. We investigated the diagnostic validity of clinical tests and ultrasound as compared with MR arthrograph...

  9. 42 CFR 493.1415 - Condition: Laboratories performing moderate complexity testing; clinical consultant.

    Science.gov (United States)

    2010-10-01

    ... laboratory must have a clinical consultant who meets the qualification requirements of § 493.1417 of this... complexity testing; clinical consultant. 493.1415 Section 493.1415 Public Health CENTERS FOR MEDICARE... LABORATORY REQUIREMENTS Personnel for Nonwaived Testing Laboratories Performing Moderate Complexity...

  10. Quality assessment in in vivo NMR spectroscopy: III. Clinical test objects: design, construction, and solutions

    DEFF Research Database (Denmark)

    Leach, M.O.; Collins, D.J.; Keevil, S;

    1995-01-01

    Based on the requirements of test protocols developed to evaluate clinical MRS single slice and volume localisation sequences, two clinical test objects, STO1 and STO2 have been developed. The properties of a range of potential construction materials have been assessed, demonstrating that the water...

  11. On masculinities, technologies, and pain: the testing of male contraceptives in the clinic and the media

    NARCIS (Netherlands)

    Oudshoorn, Nelly

    1999-01-01

    In the last fifteen years, testing has attracted much attention in science and technology studies. Most researchers have focused almost exclusively on testing in the laboratory, specifically designed test locations, and, for medical technologies, the clinic. What counts as testing has largely been d

  12. Use of clinical movement screening tests to predict injury in sport

    OpenAIRE

    Chimera, Nicole J.; Warren, Meghan

    2016-01-01

    Clinical movement screening tests are gaining popularity as a means to determine injury risk and to implement training programs to prevent sport injury. While these screens are being used readily in the clinical field, it is only recently that some of these have started to gain attention from a research perspective. This limits applicability and poses questions to the validity, and in some cases the reliability, of the clinical movement tests as they relate to injury prediction, intervention,...

  13. Clinical Performance of Roche Cobas 4800 HPV Test

    Science.gov (United States)

    Cui, Miao; Chan, Nicholas; Liu, Momo; Thai, Khanh; Malaczynska, Joanna; Singh, Ila; Zhang, David

    2014-01-01

    Evaluation of the Cobas 4800 test demonstrated that Cobas had a low rate of cross-reactivity with low-risk human papillomavirus (lrHPV), a 3.74% disconcordance rate between prealiquots and postaliquots, and failure rates of 4.57% and 1.16%, respectively, after vortexing and swirling. This study demonstrated that the Cobas test has good sensitivity, accuracy, and reproducibility for detecting 14 high-risk HPV (hrHPV) genotypes. PMID:24719443

  14. A Low-order Coupled Chemistry Meteorology Model for Testing Online and Offline Advanced Data Assimilation Schemes

    Science.gov (United States)

    Bocquet, M.; Haussaire, J. M.

    2015-12-01

    Bocquet and Sakov have recently introduced a low-order model based on the coupling of thechaotic Lorenz-95 model which simulates winds along a mid-latitude circle, with thetransport of a tracer species advected by this wind field. It has been used to testadvanced data assimilation methods with an online model that couples meteorology andtracer transport. In the present study, the tracer subsystem of the model is replacedwith a reduced photochemistry module meant to emulate reactive air pollution. Thiscoupled chemistry meteorology model, the L95-GRS model, mimics continental andtranscontinental transport and photochemistry of ozone, volatile organic compounds andnitrogen dioxides.The L95-GRS is specially useful in testing advanced data assimilation schemes, such as theiterative ensemble Kalman smoother (IEnKS) that combines the best of ensemble andvariational methods. The model provides useful insights prior to any implementation ofthe data assimilation method on larger models. For instance, online and offline dataassimilation strategies based on the ensemble Kalman filter or the IEnKS can easily beevaluated with it. It allows to document the impact of species concentration observationson the wind estimation. The model also illustrates a long standing issue in atmosphericchemistry forecasting: the impact of the wind chaotic dynamics and of the chemical speciesnon-chaotic but highly nonlinear dynamics on the selected data assimilation approach.

  15. Bad chemistry

    OpenAIRE

    Petsko, Gregory A

    2004-01-01

    General chemistry courses haven't changed significantly in forty years. Because most basic chemistry students are premedical students, medical schools have enormous influence and could help us start all over again to create undergraduate chemistry education that works.

  16. Clinical Chemistry Reference Intervals for C57BL/6J, C57BL/6N, and C3HeB/FeJ Mice (Mus musculus).

    Science.gov (United States)

    Otto, Gordon P; Rathkolb, Birgit; Oestereicher, Manuela A; Lengger, Christoph J; Moerth, Corinna; Micklich, Kateryna; Fuchs, Helmut; Gailus-Durner, Valérie; Wolf, Eckhard; Hrabě de Angelis, Martin

    2016-01-01

    Although various mouse inbred strains are widely used to investigate disease mechanisms and to establish new therapeutic strategies, sex-specific reference intervals for laboratory diagnostic analytes that are generated from large numbers of animals have been unavailable. In this retrospective study, we screened data from more than 12,000 mice phenotyped in the German Mouse Clinic from January 2006 through June 2014 and selected animals with the genetic background of C57BL/6J, C57BL/6N, or C3HeB/FeJ. In addition, we distinguished between the C57BL/6NTac substrain and C57BL/6N mice received from other vendors. The corresponding data sets of electrolytes (sodium, potassium, calcium, chloride, inorganic phosphate), lipids (cholesterol, triglyceride), and enzyme activities (ALT, AST, ALP, α-amylase) and urea, albumin, and total protein levels were analyzed. Significant effects of age and sex on these analytes were identified, and strain- or substrain- and sex-specific reference intervals for 90- to 135-d-old mice were calculated. In addition, we include an overview of the literature that reports clinical chemistry values for wild-type mice of different strains. Our results support researchers interpreting clinical chemistry values from various mouse mutants and corresponding wild-type controls based on the examined strains and substrains.

  17. [Clinical testing of a new local corticoid: desoximethasone].

    Science.gov (United States)

    Camarasa, G

    1975-01-01

    In a double-blind comparative trial on 37 patients with symetric dermatoses, the clinical effect of desoximetasone (0.25%) has been compared to fluocinolone acetonide (0.2%). After 7 days of treatment an improvement or cure of the lesions could be seen in 34 patients treated with desoximetasone, and only on 22 patients treated with fluocinolone acetonide (0.2%). The better effect of desoximetasone was especially evident on erythema and pruritus. Differences between the drugs were statistically significant. PMID:132780

  18. Clinical 13CO2 breath tests: methodology and limitations

    International Nuclear Information System (INIS)

    Methods were developed to perform 13CO2 breath tests and the limitations and sources of error in these tests were explored. The random error introduced during each step of the analysis was determined and it was found that the precision was limited by the fluctuations in the isotope ratio of the patient's endogenous CO2. The detection limit was a 1.4 percent increase in the isotope ratio. This corresponds to an oxidation rate of 140 nmoles/kg-hr of singly labeled substrate to CO2. The use of stable isotope 13C provides a safe and sensitive alternative to the use of the radionuclide 14C and extends the utility of CO2 breath tests to the previously exempted populations of children and pregnant women

  19. Apnoea testing to confirm brain death in clinical practice.

    Science.gov (United States)

    van Donselaar, C A; Meerwaldt, J D; van Gijn, J

    1986-09-01

    In six patients an apnoea test was carried out to confirm brain death according to a protocol recommended in the USA. After ten minutes' apnoea the pCO2 did not reach the target value of 7.98 kPa (60 mm Hg) in any of these patients. This was caused by the low initial value and the slow increase of the pCO2. Moreover, we could not confirm the belief that the necessary duration of the apnoea test can be predicted by assuming a rise of the pCO2 of 0.33 kPa (2.5 mm Hg) per minute.

  20. Apnoea testing to confirm brain death in clinical practice.

    Science.gov (United States)

    van Donselaar, C A; Meerwaldt, J D; van Gijn, J

    1986-01-01

    In six patients an apnoea test was carried out to confirm brain death according to a protocol recommended in the USA. After ten minutes' apnoea the pCO2 did not reach the target value of 7.98 kPa (60 mm Hg) in any of these patients. This was caused by the low initial value and the slow increase of the pCO2. Moreover, we could not confirm the belief that the necessary duration of the apnoea test can be predicted by assuming a rise of the pCO2 of 0.33 kPa (2.5 mm Hg) per minute. PMID:3093640

  1. Genetic counselors' (GC) knowledge, awareness, understanding of clinical next-generation sequencing (NGS) genomic testing.

    Science.gov (United States)

    Boland, P M; Ruth, K; Matro, J M; Rainey, K L; Fang, C Y; Wong, Y N; Daly, M B; Hall, M J

    2015-12-01

    Genomic tests are increasingly complex, less expensive, and more widely available with the advent of next-generation sequencing (NGS). We assessed knowledge and perceptions among genetic counselors pertaining to NGS genomic testing via an online survey. Associations between selected characteristics and perceptions were examined. Recent education on NGS testing was common, but practical experience limited. Perceived understanding of clinical NGS was modest, specifically concerning tumor testing. Greater perceived understanding of clinical NGS testing correlated with more time spent in cancer-related counseling, exposure to NGS testing, and NGS-focused education. Substantial disagreement about the role of counseling for tumor-based testing was seen. Finally, a majority of counselors agreed with the need for more education about clinical NGS testing, supporting this approach to optimizing implementation.

  2. A Clinical Perspective on Ethical Issues in Genetic Testing

    NARCIS (Netherlands)

    Sijmons, R. H.; Van Langen, I. M.; Sijmons, J. G.

    2011-01-01

    Genetic testing is traditionally preceded by counselling to discuss its advantages and disadvantages with individuals so they can make informed decisions. The new technique of whole genome or exome sequencing, which is currently only used in research settings, can identify many gene mutations, inclu

  3. Pros and Cons of Clinical Basophil Testing (BAT)

    DEFF Research Database (Denmark)

    Hoffmann, Hans Jürgen; Knol, Edward F; Ferrer, Martha;

    2016-01-01

    PURPOSE OF REVIEW: We review basophil testing by flow cytometry with an emphasis on advantages and disadvantages. RECENT FINDINGS: There are many tools available to assess the presence and severity of allergic diseases in patients. For 50 years, peripheral blood basophils have been used as tools ...

  4. CLINICAL APPLICATION AND EVALUATION OF SALIVAFERNING TEST IN SJOGREN'S SYNDROME

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective To evaluate the saliva ferning test (SFT) as diagnostic test for xerostomia in patients with Sjogren 's Syndrome (SS). Methods In this study, dried samples of freshly produced saliva from 78 patients with established SS according to European Community criteria and 80 healthy controls were examined by light microscopy. The crystallization was classified into 4 types according to the ferning phenomenon: uniformity, branching, spreading and integrity (type Ⅰ normal and type Ⅱ ,III ,Ⅳ abnormal ). Then , the 78 patients underwent labial salivary gland biopsy. According to Tarpley' s classifica tion, minor salivary gland biopsy (≥2+) was considered to be positive. Results 1. The sensitivity of SFT was high (70/ 78 = 89.74% ). And the specificity was also high (67/80 = 83.75% ). 2. Abnormal SFT was observed in 70/78(89.74%) samples from patients group and in 13/80 ( 16.25% ) samples from healthy controls. The differences of SFT in patients group versus controls were statistically significant (P0.05) as diagnostic tests in SS. Conclusion SFT was simple , sensitive and specific as diagnostic test in SS suspect patients just as mini labial gland biopsy.

  5. Clinical genetic testing for familial melanoma in Italy: a cooperative study

    OpenAIRE

    W.Bruno, P.Ghiorzo, L.Battistuzzi, P.A.Ascierto, M.Barile, S.Gargiulo, F.Gensini, S.Gliori, M.Guida, M.Lombardo, S.Manoukian, C.Menin, S.Nasti, P.Origone, B.Pasini,L. Pastorino, B.Peissel, M.A.Pizzichetta, P.Queirolo, M.Rodolfo, A.Romanini, M.C.Scaini, A.Testori, M.G.Tibiletti, D.Turchetti, S.A.Leachman, G.Bianchi Scarrà; IMI, Italian Melanoma Intergroup

    2009-01-01

    Background: The Italian Society of Human Genetics’ (SIGU) recommendations on genetic counseling and testing for hereditary melanoma state that clinical genetic testing can be offered to Italian melanoma families with at least two affected members. Objective: In the framework of a cooperative study, we sought to establish the frequency of cyclindependent kinase inhibitor 2A mutations in melanoma families that underwent clinical genetic counseling and testing in accordance with t...

  6. [Familial Mediterranean fever--from gene test to clinical aspects].

    Science.gov (United States)

    Sudeck, H

    2000-10-26

    Familial Mediterranean Fever (FMF) is a genetically defined disease affecting mostly families of jewish, turkish or armenian origin whose ancestors originate from the mediterranean basin. The first officially acknowledged description was given by SIEGAL in 1945 but previous cases were reported since 1908. The main clinical signs which are very varying in intensity and appearance are periodic attacks of fever with peritonitis, pleurisy and arthritis. The classical but not always found complication is amyloidosis with renal failure which is preventable by lifelong colchicine therapy. By using a novel genetest it is now possible to definitely diagnose FMF instead of relying on a diagnosis made merely by exclusion. This will emphasize the use of colchicine and should bring us nearer to the pathophysiology of this interesting disease. PMID:11103618

  7. Diagnostic Accuracy of Clinical Tests for Morton's Neuroma Compared With Ultrasonography.

    Science.gov (United States)

    Mahadevan, Devendra; Venkatesan, Muralidharan; Bhatt, Raj; Bhatia, Maneesh

    2015-01-01

    The aim of the present study was to assess the diagnostic accuracy of 7 clinical tests for Morton's neuroma (MN) compared with ultrasonography (US). Forty patients (54 feet) were diagnosed with MN using predetermined clinical criteria. These patients were subsequently referred for US, which was performed by a single, experienced musculoskeletal radiologist. The clinical test results were compared against the US findings. MN was confirmed on US at the site of clinical diagnosis in 53 feet (98%). The operational characteristics of the clinical tests performed were as follows: thumb index finger squeeze (96% sensitivity, 96% accuracy), Mulder's click (61% sensitivity, 62% accuracy), foot squeeze (41% sensitivity, 41% accuracy), plantar percussion (37% sensitivity, 36% accuracy), dorsal percussion (33% sensitivity, 26% accuracy), and light touch and pin prick (26% sensitivity, 25% accuracy). No correlation was found between the size of MN on US and the positive clinical tests, except for Mulder's click. The size of MN was significantly larger in patients with a positive Mulder's click (10.9 versus 8.5 mm, p = .016). The clinical assessment was comparable to US in diagnosing MN. The thumb index finger squeeze test was the most sensitive screening test for the clinical diagnosis of MN. PMID:25432459

  8. Tilt table testing in neurology and clinical neurophysiology.

    Science.gov (United States)

    Saal, D P; Thijs, R D; van Dijk, J G

    2016-02-01

    Reflex syncope is responsible for 1-6% of hospital admissions and the economic burden of syncope is huge. A considerable part of these high costs is still spent on tests that are not indicated. Till now few neurologists have taken an interest in syncope and tilt table testing (TTT). However, reflex syncope and epilepsy are often in each other's differential diagnosis and require a similar emphasis on history taking and deductive reasoning. A TTT can be helpful for diagnosis and treatment. The pathophysiological rationale behind the TTT is the fact that it uses gravity to provoke a downwards shift of blood that in turn triggers syncope. Various indications and methods of the TTT are discussed in this paper. PMID:26404035

  9. Porphyrin Tests

    Science.gov (United States)

    ... attack Table adapted from: "Iron and porphyrin metabolism," Clinical Chemistry: Theory, Analysis and Correlation , courtesy of William E. ... For Health Professionals ©2001 - by American Association for Clinical Chemistry • Contact Us | Terms of Use | Privacy We comply ...

  10. Potential clinical impact of normal-tissue intrinsic radiosensitivity testing

    International Nuclear Information System (INIS)

    A critical appraisal is given of the possible benefit from a reliable pre-treatment knowledge of individual normal-tissue sensitivity to radiotherapy. The considerations are in part, but not exclusively, based on the recent experience with in vitro colony-forming assays of the surviving fraction at 2 Gy, the SF2. Three strategies are reviewed: (1) to screen for rare cases with extreme radiosensitivity, so-called over-reactors, and treat these with reduced total dose, (2) to identify the sensitive tail of the distribution of 'normal' radiosensitivities, refer these patients to other treatment, and to escalate the dose to the remaining patients, or (3) to individualize dose prescriptions based on individual radiosensitivity, i.e. treating to isoeffect rather than to a specific dose-fractionation schedule. It is shown that these strategies will have a small, if any, impact on routine radiotherapy. Screening for over-reactors is hampered by the low prevalence of these among otherwise un-selected patients that leads to a low positive predictive value of in vitro radiosensitivity assays. It is argued, that this problem may persist even if the noise on current assays could be reduced to (the unrealistic value of) zero, simply because of the large biological variation in SF2. Removing the sensitive tail of the patient population, will only have a minor effect on the dose that could be delivered to the remaining patients, because of the sigmoid shape of empirical dose-response relationships. Finally, individualizing dose prescriptions based exclusively on information from a normal-tissue radiosensitivity assay, leads to a nearly symmetrical distribution of dose-changes that would produce a very small gain, or even a loss, of tumor control probability if implemented in the clinic. From a theoretical point of view, other strategies could be devised and some of these are considered in this review. Right now the most promising clinical use of in vitro radiosensitivity assays

  11. Evaluation of new oxidation methods for the measurement of bilirubin on the aeroset clinical chemistry analyzer and comparison with methods on the Hitachi 717.

    Science.gov (United States)

    Sturm, Ernhard; Albrecht-Groos, Ragnhild; Seyfarth, Michael

    2002-01-01

    We evaluated analytical and performance quality of the new oxidation methods for direct and total bilirubin on the Abbott Aeroset clinical chemistry analyzer. Within-day imprecisions for Abbott Aeroset assays ranged from 0.7 to 2.9% and between-day imprecisions from 2.1 to 7.3%. Inaccuracies as compared with the control "target values" for the Jendrassik-Gróf method showed deviations of -18.2 to +4.2%. Limits of detection were determined and showed very low values of 300 micromol/l. A method comparison for 100 patient samples with established Jendrassik-Gróf and DPD methods on the Roche Hitachi 717 showed good linearities between the investigated methods (r > or = 0.995). Due to slopes that ranged from 0.829 to 0.950, reference ranges for the oxidation methods differ slightly from those of established Roche Jendrassik-Gróf methods, but results can be adapted by the introduction of converting factors. In conclusion, the oxidation bilirubin assays revealed convincing analytical and performance qualities for medical needs that were similar or even better than for established methods. Application of the oxidation methods on the Aeroset clinical chemistry analyzer also improves laboratory efficiency by increasing throughput, speed of obtaining results and lowered sample and reagent volumes compared to established methods.

  12. Performance of genotype-MTBDR test directly on clinical specimens

    Directory of Open Access Journals (Sweden)

    Gülden Yılmaz

    2012-12-01

    Full Text Available Objectives: Most important point for the control and effective treatment of multidrug resistant tuberculosis (MDR-TBis early diagnosis and rapid determination of the resistance. The aim of this study is to assess the performance of theGenotype-MTBDR assay applied directly on sputum samples and compare the results with those obtained by DNA sequencingand phenotypic susceptibility testing.Materials and methods: Between November 2005 and February 2006, 93 smear and culture positive sputum sampleswere included in the study. Drug susceptibility results for rifampin (RIF and isoniazid (INH, obtained by proportionmethod on L-J medium, Genotype-MTBDR and DNA sequencing were compared.Results: The rate of concordance between the results of the Genotype-MTBDR and DNA sequencing was 93.5% and96.7% for RIF and INH, respectively. Moreover, Genotype-MTBDR detected all the RIF (24 and INH (18 resistant strainsobtained by sequencing (100%. Compared to the DNA sequencing method; the sensitivity, specificity, positive predictiveand negative predictive value for RIF and INH were 100%, 91.3%, 80%, 100% and 100%, 96%, 85.7%, 100% respectively.Conclusion: Genotype-MTBDR, one of molecular assays, distinctly shortens the time for diagnosis and detection of resistanceto INH and RIF, essential for management of MDR-TB. The test appears to have good sensitivity and specificitywhen also used directly on sputum specimens. J Microbiol Infect Dis 2012; 2(4: 135-141Key words: Mycobacterium tuberculosis; drug resistance; genotype-MTBDR.

  13. Mathematical Chemistry

    OpenAIRE

    Trinajstić, Nenad; Gutman, Ivan

    2002-01-01

    A brief description is given of the historical development of mathematics and chemistry. A path leading to the meeting of these two sciences is described. An attempt is made to define mathematical chemistry, and journals containing the term mathematical chemistry in their titles are noted. In conclusion, the statement is made that although chemistry is an experimental science aimed at preparing new compounds and materials, mathematics is very useful in chemistry, among other things, to produc...

  14. The next controversy in genetic testing: clinical data as trade secrets?

    OpenAIRE

    Cook-Deegan, Robert; Conley, John M.; Evans, James P.; Vorhaus, Daniel

    2012-01-01

    Sole-source business models for genetic testing can create private databases containing information vital to interpreting the clinical significance of human genetic variations. But incomplete access to those databases threatens to impede the clinical interpretation of genomic medicine. National health systems and insurers, regulators, researchers, providers and patients all have a strong interest in ensuring broad access to information about the clinical significance of variants discovered th...

  15. Medical Physics: Forming and testing solutions to clinical problems.

    Science.gov (United States)

    Tsapaki, Virginia; Bayford, Richard

    2015-11-01

    According to the European Federation of Organizations for Medical Physics (EFOMP) policy statement No. 13, "The rapid advance in the use of highly sophisticated equipment and procedures in the medical field increasingly depends on information and communication technology. In spite of the fact that the safety and quality of such technology is vigorously tested before it is placed on the market, it often turns out that the safety and quality is not sufficient when used under hospital working conditions. To improve safety and quality for patient and users, additional safeguards and related monitoring, as well as measures to enhance quality, are required. Furthermore a large number of accidents and incidents happen every year in hospitals and as a consequence a number of patients die or are injured. Medical Physicists are well positioned to contribute towards preventing these kinds of events". The newest developments related to this increasingly important medical speciality were presented during the 8th European Conference of Medical Physics 2014 which was held in Athens, 11-13 September 2014 and hosted by the Hellenic Association of Medical Physicists (HAMP) in collaboration with the EFOMP and are summarized in this issue.

  16. Neurophysiological testing correlates with clinical examination according to fibre type involvement and severity in sensory neuropathy

    OpenAIRE

    Lefaucheur, J.; Creange, A.

    2004-01-01

    Objective: To investigate a comprehensive battery of neurophysiological tests for objective evaluation of sensory neuropathies including fibre type involvement and severity, and to determine the relation between neurophysiological data and clinical examination.

  17. Clinical utility and validity of minoxidil response testing in androgenetic alopecia.

    Science.gov (United States)

    Goren, Andy; Shapiro, Jerry; Roberts, Janet; McCoy, John; Desai, Nisha; Zarrab, Zoulikha; Pietrzak, Aldona; Lotti, Torello

    2015-01-01

    Clinical response to 5% topical minoxidil for the treatment of androgenetic alopecia (AGA) is typically observed after 3-6 months. Approximately 40% of patients will regrow hair. Given the prolonged treatment time required to elicit a response, a diagnostic test for ruling out nonresponders would have significant clinical utility. Two studies have previously reported that sulfotransferase enzyme activity in plucked hair follicles predicts a patient's response to topical minoxidil therapy. The aim of this study was to assess the clinical utility and validity of minoxidil response testing. In this communication, the present authors conducted an analysis of completed and ongoing studies of minoxidil response testing. The analysis confirmed the clinical utility of a sulfotransferase enzyme test in successfully ruling out 95.9% of nonresponders to topical minoxidil for the treatment of AGA. PMID:25112173

  18. Clinical experience from Thailand noninvasive prenatal testing as screening tests for trisomies 21, 18 and 13 in 4736 pregnancies

    DEFF Research Database (Denmark)

    Manotaya, S.; Uerpairojkit, B.; Chen, F.;

    2016-01-01

    PurposeThe purpose of this article is to report the clinical experience and performance of massively parallel sequencing-based noninvasive prenatal testing (NIPT) as a screening method in detecting trisomy 21, 18, and 13 (T21/T18/T13) in a mixed-risk population in Thailand. MethodsIn a 30-month...... as the screening test in a large-scale mixed-risk population in Thailand for the first time. It provides the experience of implementing NIPT in a developing country with patient-funded prenatal screening system and continuous quests for applicable nationwide uptake of prenatal screening and diagnosis....... period, 121 medical centers in Thailand offered NIPT as clinical screening tests for fetal T21, T18, and T13 in the mixed-risk population. All NIPT-positive cases were recommended to undergo invasive prenatal diagnosis. ResultsA total of 4736 participants received the NIPT test, including 2840 high...

  19. A standardized framework for the validation and verification of clinical molecular genetic tests.

    NARCIS (Netherlands)

    Mattocks, C.J.; Morris, M.A.; Matthijs, G.; Swinnen, E.; Corveleyn, A.; Dequeker, E.; Muller, C.R.; Pratt, V.; Wallace, A.

    2010-01-01

    The validation and verification of laboratory methods and procedures before their use in clinical testing is essential for providing a safe and useful service to clinicians and patients. This paper outlines the principles of validation and verification in the context of clinical human molecular gene

  20. Catheter-based flow measurements in hemodialysis fistulas - Bench testing and clinical performance

    DEFF Research Database (Denmark)

    Heerwagen, Søren T; Lönn, Lars; Schroeder, Torben V;

    2012-01-01

    Purpose: The purpose of this study was to perform bench and clinical testing of a catheter-based intravascular system capable of measuring blood flow in hemodialysis vascular accesses during endovascular procedures. Methods: We tested the Transonic ReoCath Flow Catheter System which uses the ther......Purpose: The purpose of this study was to perform bench and clinical testing of a catheter-based intravascular system capable of measuring blood flow in hemodialysis vascular accesses during endovascular procedures. Methods: We tested the Transonic ReoCath Flow Catheter System which uses...

  1. [Importance of realistic tests for drug allergy: apropos of a clinical case].

    Science.gov (United States)

    Hassoun, S

    1998-11-01

    Drug allergy is the most difficult area in Allergology because: Clinical polymorphism and specially physiopathology (IgE-dependent hypersensibility reaction, cyclo-oxygenase inhibitor, etc.). Feeble specificity and sensitivity in the basic immunoallergic investigation (Skin tests, specific IgE). Very frequently his necessitates recourse to REALISTIC TESTS of drug re-introduction under clinical and biological surveillance (HSI mediators: histamine/tryptase/urinary methyl histamine) to produce a diagnosis. PMID:9887987

  2. Optimisation and Assessment of Three Modern Touch Screen Tablet Computers for Clinical Vision Testing

    OpenAIRE

    Tahir, Humza J.; Murray, Ian J.; Parry, Neil R. A.; Aslam, Tariq M

    2014-01-01

    Technological advances have led to the development of powerful yet portable tablet computers whose touch-screen resolutions now permit the presentation of targets small enough to test the limits of normal visual acuity. Such devices have become ubiquitous in daily life and are moving into the clinical space. However, in order to produce clinically valid tests, it is important to identify the limits imposed by the screen characteristics, such as resolution, brightness uniformity, contrast line...

  3. Implementation of quality control performance criteria and approved guidelines for upgrading of clinical chemistry laboratory procedures in Alexandria University hospitals.

    Science.gov (United States)

    Rizk, Mohamed Moustafa M; el-Badawi, Nashwa A; Moez, Pacint E; Khattab, Azza A

    2009-03-01

    The aim of the present work was to assess the quality of work in Clinical Pathology Department, Alexandria Main University Hospital, Egypt; as regards the pre-analytical and analytical phases of testing; for later accreditation. This evaluation was performed using inspection sheets that were designed according to the CAP 2006 recommendations. All checklist questions that could not be answered "yes" were considered deficiencies and had to be corrected before being accredited. The questions were classified into ten groups; each group contained a number of questions concerning one of the pre-analytical and analytical assessment activities. We ranked our results into 4 categories according to the degree of fulfillment. The total number of questions that were answered "no" at the start and the end of the study accounted for 64/101 (63.4%) and 34/101 (33.7%) questions respectively. Most of the deficiencies were detected in the pre-analytical phase of the testing process; the first two checklists were used for the evaluation of this phase. At the start of the study, the degree of requirements fulfillment in checklist I and II were 0% and 21.1% respectively. By the end of the study the degree of fulfillment became, 85.7% and 63.2% respectively. Average number of sample rejection due to different causes was evaluated before and after implementing CAP recommendations; these causes include haemolysis, clotted serum, quantity not sufficient, and lost samples; the percentage of rejected samples before implementing CAP recommendations was 15.8%, 1.81%, 0.70%, and 0.51% respectively, while after implementing CAP recommendations it was 7%, 0.77%, 0.08%, and 0.05%, respectively. We concluded that the presence of standardized protocol for the pre-analytical activities had improved the quality of samples received by the lab, and we also concluded that accreditation allows laboratories to evaluate their performance, their compliance with the requirements of the accrediting association

  4. The ANA-reflex test as a model for improving clinical appropriateness in autoimmune diagnostics.

    Science.gov (United States)

    Tonutti, Elio; Bizzaro, Nicola; Morozzi, Gabriella; Radice, Antonella; Cinquanta, Luigi; Villalta, Danilo; Tozzoli, Renato; Tampoia, Marilina; Porcelli, Brunetta; Fabris, Martina; Brusca, Ignazio; Alessio, Maria Grazia; Barberio, Giuseppina; Sorrentino, Maria Concetta; Antico, Antonio; Bassetti, Danila; Fontana, Desré Ethel; Imbastaro, Tiziana; Visentini, Daniela; Pesce, Giampaola; Bagnasco, Marcello

    2016-12-01

    Reflex tests are widely used in clinical laboratories, for example, to diagnose thyroid disorders or in the follow-up of prostate cancer. Reflex tests for antinuclear antibodies (ANA) have recently gained attention as a way to improve appropriateness in the immunological diagnosis of autoimmune rheumatic diseases and avoid waste of resources. However, the ANA-reflex test is not as simple as other consolidated reflex tests (the TSH-reflex tests or the PSA-reflex tests) because of the intrinsic complexity of the ANA test performed by the indirect immunofluorescence method on cellular substrates. The wide heterogeneity of the ANA patterns, which need correct interpretation, and the subsequent choice of the most appropriate confirmatory test (ANA subserology), which depend on the pattern feature and on clinical information, hinder any informatics automation, and require the pathologist's intervention. In this review, the Study Group on Autoimmune Diseases of the Italian Society of Clinical Pathology and Laboratory Medicine provides some indications on the configuration of the ANA-reflex test, using two different approaches depending on whether clinical information is available or not. We further give some suggestions on how to report results of the ANA-reflex test. PMID:27423928

  5. CLINICAL BIOCHEMISTRY

    Science.gov (United States)

    Assessment of the health status of animals through measurement of cellular, biochemical, and macromolecular constituents in blood, secretions, and excretions has been variously referred to as clinical chemistry, clinical biochemistry, or clinical pathology. he genesis of this dis...

  6. Importance of head thrust test like bedside test in ENT outpatient clinic

    Directory of Open Access Journals (Sweden)

    Batuecas-Caletrio A, Muñoz Herrera A

    2012-11-01

    Full Text Available Head thrust test is a simple test that provides great information in the studyof patients with vestibular pathology. Despite a relatively low sensitivity, thespecificity is very high so it can be helpful in diagnosing severe vestibulardeficit as in the differential diagnosis of acute vestibular disorders such asneuritis vestibular. In this paper we review the physiology vestibulooculomotorreflex, performing the test, the interpretation of the results andthe advantages of its realization

  7. 21 CFR 862.1085 - Angiotensin I and renin test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Angiotensin I and renin test system. 862.1085 Section 862.1085 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry...

  8. 21 CFR 862.1135 - C-peptides of proinsulin test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false C-peptides of proinsulin test system. 862.1135 Section 862.1135 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry...

  9. 21 CFR 862.1110 - Bilirubin (total or direct) test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Bilirubin (total or direct) test system. 862.1110 Section 862.1110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry...

  10. 21 CFR 862.1160 - Bicarbonate/carbon dioxide test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Bicarbonate/carbon dioxide test system. 862.1160 Section 862.1160 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry...

  11. 21 CFR 862.1300 - Follicle-stimulating hormone test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Follicle-stimulating hormone test system. 862.1300 Section 862.1300 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry...

  12. 21 CFR 862.1117 - B-type natriuretic peptide test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false B-type natriuretic peptide test system. 862.1117 Section 862.1117 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry...

  13. 21 CFR 862.1060 - Delta-aminolevulinic acid test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Delta-aminolevulinic acid test system. 862.1060 Section 862.1060 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry...

  14. 21 CFR 862.1415 - Iron-binding capacity test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Iron-binding capacity test system. 862.1415 Section 862.1415 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry...

  15. Skin signs in Ehlers-Danlos syndrome: clinical tests and para-clinical methods

    DEFF Research Database (Denmark)

    Remvig, L; Duhn, Ph; Ullman, S;

    2010-01-01

    The criteria for Ehlers-Danlos syndrome (EDS) and the hypermobility syndrome (HMS) should be reliable. Examination for general joint hypermobility has high reliability but there is only sparse information on the reliability of skin tests, and no information on the level of normal skin extensibility...

  16. 42 CFR 493.839 - Condition: Chemistry.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Chemistry. 493.839 Section 493.839... These Tests § 493.839 Condition: Chemistry. The specialty of chemistry includes for the purposes of proficiency testing the subspecialties of routine chemistry, endocrinology, and toxicology....

  17. Thoracic outlet syndrome: do we have clinical tests as predictors for the outcome after surgery?

    Directory of Open Access Journals (Sweden)

    Sadeghi-Azandaryani M

    2009-09-01

    Full Text Available Abstract Objective Thoracic outlet syndrome (TOS is a clinical phenomenon resulting from compression of the neurovascular structures at the superior aperture of the thorax which presents with varying symptoms. Regarding to the varying symptoms, the diagnosis of TOS seems to be a challenge and predictors for the outcome are rare. The purpose of this study was therefore to analyze the different clinical examinations and tests relative to their prediction of the clinical outcome subsequent to surgery. Methods During a period of five years, 56 patients were diagnosed with TOS. Medical history, clinical tests, operative procedure and complications were recorded and analysed. Mean follow-up of the patients was 55.6 ± 45.5 months, median age of the patients was 36.4 ± 12.5 years. Results Different clinical tests for TOS showed an acceptable sensitivity overall, but a poor specificity. A positive test was not associated with a poor outcome. Analyses of the systolic blood pressure before and after exercise showed, that a distinct decrease in blood pressure of the affected side after exercises was associated with a poor outcome (p = 0.0027. Conclusions Clinical tests for TOS show a good sensitivity, but a poor specificity and cannot be used as predictors for the outcome. A distinct decrease in blood pressure of the affected side after exercises was associated with poor outcome and might be useful to predict the patients' outcome.

  18. Lack of Correlation between Severity of Clinical Symptoms, Skin Test Reactivity, and Radioallergosorbent Test Results in Venom-Allergic Patients

    Directory of Open Access Journals (Sweden)

    Warrington RJ

    2006-06-01

    Full Text Available Abstract Purpose To retrospectively examine the relation between skin test reactivity, venom-specific immunoglobulin E (IgE antibody levels, and severity of clinical reaction in patients with insect venom allergy. Method Thirty-six patients (including 15 females who presented with a history of allergic reactions to insect stings were assessed. The mean age at the time of the reactions was 33.4 ± 15.1 years (range, 4-76 years, and patients were evaluated 43.6 ± 90 months (range, 1-300 months after the reactions. Clinical reactions were scored according to severity, from 1 (cutaneous manifestations only to 3 (anaphylaxis with shock. These scores were compared to scores for skin test reactivity (0 to 5, indicating the log increase in sensitivity from 1 μg/mL to 0.0001 μg/mL and radioallergosorbent test (RAST levels (0 to 4, indicating venom-specific IgE levels, from undetectable to >17.5 kilounits of antigen per litre [kUA/L]. Results No correlation was found between skin test reactivity (Spearman's coefficient = 0.15, p = .377 or RAST level (Spearman's coefficient = 0.32, p = .061 and the severity of reaction. Skin test and RAST scores both differed significantly from clinical severity (p p = .042. There was no correlation between skin test reactivity and time since reaction (Spearman's coefficient = 0.18, p = .294 nor between RAST and time since reaction (r = 0.1353, p = .438. Elimination of patients tested more than 12 months after their reaction still produced no correlation between skin test reactivity (p = .681 or RAST score (p = .183 and the severity of the clinical reaction. Conclusion In venom-allergic patients (in contrast to reported findings in cases of inhalant IgE-mediated allergy, there appears to be no significant correlation between the degree of skin test reactivity or levels of venom-specific IgE (determined by RAST and the severity of the clinical reaction.

  19. HIV Rapid Testing in Substance Abuse Treatment: Implementation Following a Clinical Trial

    Science.gov (United States)

    Haynes, L. F.; Korte, J. E.; Holmes, B. E.; Gooden, L.; Matheson, T.; Feaster, D. J.; Leff, J. A.; Wilson, L.; Metsch, L. R.; Schackman, B. R.

    2011-01-01

    The Substance Abuse Mental Health Services Administration has promoted HIV testing and counseling as an evidence-based practice. Nevertheless, adoption of HIV testing in substance abuse treatment programs has been slow. This article describes the experience of a substance abuse treatment agency where, following participation in a clinical trial,…

  20. Bile acid malabsorption in patients with chronic diarrhoea: clinical value of SeHCAT test

    DEFF Research Database (Denmark)

    Wildt, Signe; Nørby Rasmussen, S; Madsen, Jan Lysgård;

    2003-01-01

    BACKGROUND: Bile acid malabsorption (BAM), a cause of chronic diarrhoea, can be diagnosed by the SeHCAT test. The purpose of this study was to evaluate the usefulness of SeHCAT testing by assessing the extent of BAM and describing the clinical characteristics in a group of patients with chronic...

  1. Chemistry Notes

    Science.gov (United States)

    School Science Review, 1976

    1976-01-01

    Described are eight chemistry experiments and demonstrations applicable to introductory chemistry courses. Activities include: measure of lattice enthalpy, Le Chatelier's principle, decarboxylation of soap, use of pocket calculators in pH measurement, and making nylon. (SL)

  2. Colour Chemistry

    Science.gov (United States)

    Griffiths, J.; Rattee, I. D.

    1973-01-01

    Discusses the course offerings in pure color chemistry at two universities and the three main aspects of study: dyestuff chemistry, color measurement, and color application. Indicates that there exists a constant challenge to ingenuity in the subject discipline. (CC)

  3. The role of European Federation of Clinical Chemistry and Laboratory Medicine Working Group for Preanalytical Phase in standardization and harmonization of the preanalytical phase in Europe

    DEFF Research Database (Denmark)

    Cornes, Michael P; Church, Stephen; van Dongen-Lases, Edmée;

    2016-01-01

    and Laboratory Medicine Working Group for Preanalytical Phase (EFLM WG-PRE) was established to lead in standardization and harmonization of preanalytical policies and practices at a European level. One of the key activities of the WG-PRE is the organization of the biennial EFLM-BD conference on the preanalytical......Patient safety is a leading challenge in healthcare and from the laboratory perspective it is now well established that preanalytical errors are the major contributor to the overall rate of diagnostic and therapeutic errors. To address this, the European Federation of Clinical Chemistry...... summarises the work that has and will be done in these areas. The goal of this initiative is to ensure the EFLM WG-PRE produces work that meets the needs of the European laboratory medicine community. Progress made in the identified areas will be updated at the next preanalytical phase conference and show...

  4. Positronium chemistry

    CERN Document Server

    Green, James

    1964-01-01

    Positronium Chemistry focuses on the methodologies, reactions, processes, and transformations involved in positronium chemistry. The publication first offers information on positrons and positronium and experimental methods, including mesonic atoms, angular correlation measurements, annihilation spectra, and statistical errors in delayed coincidence measurements. The text then ponders on positrons in gases and solids. The manuscript takes a look at the theoretical chemistry of positronium and positronium chemistry in gases. Topics include quenching, annihilation spectrum, delayed coincidence

  5. Combinatorial chemistry

    DEFF Research Database (Denmark)

    Nielsen, John

    1994-01-01

    An overview of combinatorial chemistry is presented. Combinatorial chemistry, sometimes referred to as `irrational drug design,' involves the generation of molecular diversity. The resulting chemical library is then screened for biologically active compounds.......An overview of combinatorial chemistry is presented. Combinatorial chemistry, sometimes referred to as `irrational drug design,' involves the generation of molecular diversity. The resulting chemical library is then screened for biologically active compounds....

  6. EVALUATION OF VITEK 2 SYSTEM FOR CLINICAL IDENTIFICATION OF CANDIDA SPECIES AND THEIR ANTIFUNGAL SUSCEPTIBILITY TEST

    OpenAIRE

    Mohan,, V.; Ram Murugan

    2016-01-01

    BJECTIVES 1. To evaluate the Vitek 2 system for clinical identification of Candida species and their antifungal susceptibility test; 2. To study the incidence of various types of Candida species in this part of Tamilnadu. METHODS Samples collected from different wards were subjected for culture, isolation and identification of Candida Species and Antifungal Susceptibility testing by Vitek System. Vitek 2 test was carried out in Apollo Specialty Hospital Lab Services, Madurai....

  7. Similar clinical features among patients with severe adult growth hormone deficiency diagnosed with insulin tolerance test or arginine or glucagon stimulation tests

    DEFF Research Database (Denmark)

    Toogood, Andrew; Brabant, Georg; Maiter, Dominique;

    2012-01-01

    To determine whether insulin tolerance tests (ITTs), arginine stimulation tests (ASTs), and glucagon stimulation tests (GST) identify patients who have similar clinical features of growth hormone (GH) deficiency when a diagnostic GH threshold of 3 μg/L is used.......To determine whether insulin tolerance tests (ITTs), arginine stimulation tests (ASTs), and glucagon stimulation tests (GST) identify patients who have similar clinical features of growth hormone (GH) deficiency when a diagnostic GH threshold of 3 μg/L is used....

  8. Vestibular Function Tests for Vestibular Migraine: Clinical Implication of Video Head Impulse and Caloric Tests

    Science.gov (United States)

    Kang, Woo Seok; Lee, Sang Hun; Yang, Chan Joo; Ahn, Joong Ho; Chung, Jong Woo; Park, Hong Ju

    2016-01-01

    Vestibular migraine (VM) is one of the most common causes of episodic vertigo. We reviewed the results of multiple vestibular function tests in a cohort of VM patients who were diagnosed with VM according to the diagnostic criteria of the Barany Society and the International Headache Society and assessed the efficacy of each for predicting the prognosis in VM patients. A retrospective chart analysis was performed on 81 VM patients at a tertiary care center from June 2014 to July 2015. Patients were assessed by the video head impulse test (vHIT), caloric test, vestibular-evoked myogenic potentials (VEMPs), and sensory organization test (SOT) at the initial visit and then evaluated for symptomatic improvement after 6 months. Complete response (CR) was defined as no need for continued medication, partial response (PR) as improved symptoms but need for continued medication, and no response (NR) as no symptomatic improvement and requiring increased dosage or change in medications. At the initial evaluation, 9 of 81 patients (11%) exhibited abnormal vHIT results, 14 of 73 (19%) exhibited abnormal caloric test results, 25 of 65 (38%) exhibited abnormal SOT results, 8 of 75 (11%) exhibited abnormal cervical VEMP results, and 20 of 75 (27%) exhibited abnormal ocular VEMP results. Six months later, 63 of 81 patients (78%) no longer required medication (CR), while 18 (22%) still required medication, including 7 PR and 11 NR patients. Abnormal vHIT gain and abnormal caloric results were significantly related to the necessity for continued medication at 6-month follow-up (OR = 5.67 and 4.36, respectively). Abnormal vHIT and caloric test results revealed semicircular canal dysfunction in VM patients and predicted prolonged preventive medication requirement. These results suggest that peripheral vestibular abnormalities are closely related to the development of vertigo in VM patients.

  9. Clinical relevance is associated with allergen-specific wheal size in skin prick testing

    DEFF Research Database (Denmark)

    Haahtela, T.; Burbach, G. J.; Bachert, C.;

    2014-01-01

    BackgroundWithin a large prospective study, the Global Asthma and Allergy European Network (GA(2)LEN) has collected skin prick test (SPT) data throughout Europe to make recommendations for SPT in clinical settings. ObjectiveTo improve clinical interpretation of SPT results for inhalant allergens...... by providing quantitative decision points. MethodsThe GA(2)LEN SPT study with 3068 valid data sets was used to investigate the relationship between SPT results and patient-reported clinical relevance for each of the 18 inhalant allergens as well as SPT wheal size and physician-diagnosed allergy (rhinitis......) to 87-89% (grass, mites) of the positive SPT reactions (wheal size3mm) were associated with patient-reported clinical symptoms when exposed to the respective allergen. The risk of allergic symptoms increased significantly with larger wheal sizes for 17 of the 18 allergens tested. Children with positive...

  10. Rotational laxity after anterior cruciate ligament injury by kinematic evaluation of clinical tests.

    Science.gov (United States)

    Zaffagnini, S; Martelli, S; Falcioni, B; Motta, M; Marcacci, M

    2000-01-01

    Despite the numerous studies on anterior cruciate ligament biomechanics and clinical tests, some disagreements still exist in the literature on the role of ACL in restraining rotations and which kinematic test after ACL injuries is the most suitable to evaluate this instability. This work analyses the capability of passive clinical and stress tests to detect an ACL state quantifying rotational instability. The study was conducted on animal knees with a new protocol. We found that an internal-external stress test can give a useful indication on the ACL state when used to estimate the side to side differences while varus-valgus laxity and secondary motions in standard kinematic tests did not seem to be affected by ACL injury. The kinematic protocol performed could be used intra-operatively to quantify rotations, allowing a more accurate evaluation of knee instability to guide surgical reconstruction and improve its final outcome. PMID:11204247

  11. Current practices and guidelines for clinical next-generation sequencing oncology testing

    Institute of Scientific and Technical Information of China (English)

    Samuel P. Strom

    2016-01-01

    Next-generation sequencing (NGS) has been rapidly integrated into molecular pathology, dramatically increasing the breadth genomic of information available to oncologists and their patients. This review will explore the ways in which this new technology is currently applied to bolster care for patients with solid tumors and hematological malignancies, focusing on practices and guidelines for assessing the technical validity and clinical utility of DNA variants identified during clinical NGS oncology testing.

  12. Unexplained exertional dyspnea caused by low ventricular filling pressures: results from clinical invasive cardiopulmonary exercise testing

    OpenAIRE

    Oldham, William M.; Lewis, Gregory D.; Opotowsky, Alexander R.; Waxman, Aaron B.; Systrom, David M.

    2016-01-01

    To determine whether low ventricular filling pressures are a clinically relevant etiology of unexplained dyspnea on exertion, a database of 619 consecutive, clinically indicated invasive cardiopulmonary exercise tests (iCPETs) was reviewed to identify patients with low maximum aerobic capacity (V̇o2max) due to inadequate peak cardiac output (Qtmax) with normal biventricular ejection fractions and without pulmonary hypertension (impaired: n = 49, V̇o2max = 53% predicted [interquartile range (I...

  13. Role of clinical neurophysiological tests in evaluation of erectile dysfunction in people with spinal cord disorders

    OpenAIRE

    Ashraf V; Taly Arun Kumar; Sivaraman Nair K; Rao Shivaji; Sridhar

    2005-01-01

    BACKGROUND: While erectile dysfunction is frequent among people with disorders of the spinal cord, the role of various clinical neurophysiological tests in assessment is not clear. AIMS: To study the role of clinical neurophysiological investigations in assessing erectile dysfunction among men with spinal cord disorders. SETTING: National Institute of Mental Health and Neurosciences, India. DESIGN: Survey. MATERIALS AND METHODS: Subjects with a score of 21 or less on the International Index ...

  14. The modification of the thrombin generation test for the clinical assessment of dabigatran etexilate efficiency

    OpenAIRE

    Gribkova, Irina V.; Lipets, Elena N; Rekhtina, Irina G.; Alex I. Bernakevich; Ayusheev, Dorzho B.; Ruzanna A. Ovsepyan; Ataullakhanov, Fazoil I.; Elena I Sinauridze

    2016-01-01

    A new oral anticoagulant, dabigatran etexilate (DE, a prodrug of direct thrombin inhibitor (DTI) dabigatran), has been used clinically to prevent thrombosis. The assessment of dabigatran efficiency is necessary in some clinical cases, such as renal insufficiency, risk of bleeding, and drug interactions. However, a specific thrombin generation test (TGT) that is one of the most informative and sensitive to anticoagulant therapy (calibrated automated thrombinography (САТ)) shows a paradoxical i...

  15. What every clinical geneticist should know about testing for osteogenesis imperfecta in suspected child abuse cases.

    Science.gov (United States)

    Pepin, Melanie G; Byers, Peter H

    2015-12-01

    Non-accidental injury (NAI) is a major medical concern in the United States. One of the challenges in evaluation of children with unexplained fractures is that genetic forms of bone fragility are one of the differential diagnoses. Infants who present with fractures with mild forms of osteogenesis imperfecta (OI) (OI type I or OI type IV), the most common genetic form of bone disease leading to fractures might be missed if clinical evaluation alone is used to make the diagnosis. Diagnostic clinical features (blue sclera, dentinogenesis imperfecta, Wormian bones on X-rays or positive family history) may not be present or apparent at the age of evaluation. The evaluating clinician faces the decision about whether genetic testing is necessary in certain NAI cases. In this review, we outline clinical presentations of mild OI and review the history of genetic testing for OI in the NAI versus OI setting. We summarize our data of molecular testing in the Collagen Diagnostic Laboratory (CDL) from 2008 to 2014 where NAI was noted on the request for DNA sequencing of COL1A1 and COL1A2. We provide recommendations for molecular testing in the NAI versus OI setting. First, DNA sequencing of COL1A1, COL1A2, and IFITM5 simultaneously and duplication/deletion testing is recommended. If a causative variant is not identified, in the absence of a pathologic clinical phenotype, no additional gene testing is indicated. If a VUS is found, parental segregation studies are recommended.

  16. Clinical Characteristics of Patients Who Test Positive for Clostridium difficile by Repeat PCR

    Science.gov (United States)

    Stotler, Brie; Jackman, Dana; Whittier, Susan; Della-Latta, Phyllis

    2014-01-01

    The high sensitivity of PCR assays for diagnosing Clostridium difficile infection (CDI) has greatly reduced the need for repeat testing after a negative result. Nevertheless, a small subset of patients do test positive within 7 days of a negative test. The aim of this study was to evaluate the clinical characteristics of these patients to determine when repeat testing may be appropriate. The results of all Xpert C. difficile PCR (Cepheid, Sunnyvale CA) tests performed in the clinical microbiology laboratory at New York-Presbyterian Hospital, Columbia University Medical Center (NYPH/CUMC) from 1 May 2011 through 6 September 2013, were reviewed. A retrospective case-control study was performed, comparing patients who tested positive within 7 days of a negative test result to a random selection of 50 controls who tested negative within 7 days of a negative test result. During the study period, a total of 14,875 tests were performed, of which 1,066 were repeat tests (7.2%). Eleven of these repeat tests results were positive (1.0%). The only risk factor independently associated with repeat testing positive was history of a prior CDI (odds ratio [OR], 19.6 [95% confidence interval {CI}, 4.0 to 19.5], P < 0.001). We found that patients who test positive for C. difficile by PCR within 7 days of a negative test are more likely to have a history of CDI than are patients who test negative with repeat PCR. This finding may be due to the high rate of disease relapse or the increased likelihood of empirical therapy leading to false-negative results in these patients. PMID:25122866

  17. Prediction of the hematocrit of dried blood spots via potassium measurement on a routine clinical chemistry analyzer.

    Science.gov (United States)

    Capiau, Sara; Stove, Veronique V; Lambert, Willy E; Stove, Christophe P

    2013-01-01

    The potential of dried blood spot (DBS) sampling as an alternative for classical venous sampling is increasingly recognized, with multiple applications in, e.g., therapeutic drug monitoring and toxicology. Although DBS sampling has many advantages, it is associated with several issues, the hematocrit (Hct) issue being the most widely discussed challenge, given its possible strong impact on DBS-based quantitation. Hitherto, no approaches allow Hct prediction from nonvolumetrically applied DBS. Following a simple and rapid extraction protocol, K(+) levels from 3 mm DBS punches were measured via indirect potentiometry, using the Roche Cobas 8000 routine chemistry analyzer. The extracts' K(+) concentrations were used to calculate the approximate Hct of the blood used to generate DBS. A linear calibration line was established, with a Hct range of 0.19 to 0.63 (lower limit of quantification, LLOQ, to upper limit of quantification, ULOQ). The procedure was fully validated; the bias and imprecision of quality controls (QCs) at three Hct levels and at the LLOQ and ULOQ was less than 5 and 12%, respectively. In addition, the influence of storage (pre- and postextraction), volume spotted, and punch homogeneity was evaluated. Application on DBS from patient samples (n = 111), followed by Bland and Altman, Passing and Bablok, and Deming regression analysis, demonstrated a good correlation between the "predicted Hct" and the "actual Hct". After correcting for the observed bias, limits of agreement of ±0.049 were established. Incurred sample reanalysis demonstrated assay reproducibility. In conclusion, potassium levels in extracts from 3 mm DBS punches can be used to get a good prediction of the Hct, one of the most important "unknowns" in DBS analysis.

  18. Nowadays Full-automatic Clinical Chemistry Analyzers Measurement Method Problem and Improvement%现阶段全自动生化分析仪计量方法的问题与改进

    Institute of Scientific and Technical Information of China (English)

    李晓丽; 刘志成

    2012-01-01

      Object:The present stage JJG464-1996"Clinical Chemistry Analyzers Verification regulation"is not ful y applicable to the Clinical Chemistry Analyzers measurement. Methods:In the HITACHI 7080 type Ful-automatic Clinical Chemistry Analyzers for example, respectively using the general method and the improved method on the absorbance of a measuring accuracy. Results:Method for improving the detection accuracy is higher than the general method. Conclusion:The use of general methods of Clinical Chemistry Analyzers measurement has the inevitable error.%  目的:判别现阶段JJG464-1996《生化分析仪检定规程》是否适用于全自动生化分析仪计量检定的要求。方法:以HITACHI 7080型全自动生化分析仪为例,分别使用普通方法和改进方法对其吸光度准确度一项进行计量检测。结果:改进方法的检测结果准确度高于普通方法。结论:使用普通检测方法对全自动生化分析仪的计量检测存在不可避免的误差,导致计量结果的不合格。

  19. The intra- and inter-rater reliability of five clinical muscle performance tests in patients with and without neck pain

    DEFF Research Database (Denmark)

    Juul, Tina; Langberg, Henning; Enoch, Flemming;

    2013-01-01

    This study investigates the reliability of muscle performance tests using cost- and time-effective methods similar to those used in clinical practice. When conducting reliability studies, great effort goes into standardising test procedures to facilitate a stable outcome. Therefore, several test...... trials are often performed. However, when muscle performance tests are applied in the clinical setting, clinicians often only conduct a muscle performance test once as repeated testing may produce fatigue and pain, thus variation in test results. We aimed to investigate whether cervical muscle...... performance tests, which have shown promising psychometric properties, would remain reliable when examined under conditions similar to those of daily clinical practice....

  20. Clinical characteristics of patients who test positive for Clostridium difficile by repeat PCR.

    Science.gov (United States)

    Green, Daniel A; Stotler, Brie; Jackman, Dana; Whittier, Susan; Della-Latta, Phyllis

    2014-11-01

    The high sensitivity of PCR assays for diagnosing Clostridium difficile infection (CDI) has greatly reduced the need for repeat testing after a negative result. Nevertheless, a small subset of patients do test positive within 7 days of a negative test. The aim of this study was to evaluate the clinical characteristics of these patients to determine when repeat testing may be appropriate. The results of all Xpert C. difficile PCR (Cepheid, Sunnyvale CA) tests performed in the clinical microbiology laboratory at New York-Presbyterian Hospital, Columbia University Medical Center (NYPH/CUMC) from 1 May 2011 through 6 September 2013, were reviewed. A retrospective case-control study was performed, comparing patients who tested positive within 7 days of a negative test result to a random selection of 50 controls who tested negative within 7 days of a negative test result. During the study period, a total of 14,875 tests were performed, of which 1,066 were repeat tests (7.2%). Eleven of these repeat tests results were positive (1.0%). The only risk factor independently associated with repeat testing positive was history of a prior CDI (odds ratio [OR], 19.6 [95% confidence interval {CI}, 4.0 to 19.5], P PCR within 7 days of a negative test are more likely to have a history of CDI than are patients who test negative with repeat PCR. This finding may be due to the high rate of disease relapse or the increased likelihood of empirical therapy leading to false-negative results in these patients.

  1. Annual, seasonal and individual variation in hematology and clinical blood chemistry profiles in bottlenose dolphins (Tursiops truncatus) from Sarasota Bay, Florida.

    Science.gov (United States)

    Hall, Ailsa J; Wells, Randall S; Sweeney, Jay C; Townsend, Forrest I; Balmer, Brian C; Hohn, Aleta A; Rhinehart, Howard L

    2007-10-01

    Hematology and clinical blood chemistry (HCBC) profiles in free-living bottlenose dolphins from Sarasota Bay, Florida have been monitored over a 14-year period. This long-term dataset includes samples from recaptured dolphins, enabling individual variation to be accounted for when investigating seasonal and annual variability. Four different laboratories carried out the assays and inter-laboratory comparisons found significant differences in 31 of 39 parameters measured. However, variability in comparable HCBCs by sex, age, condition, season and year could be investigated. Significant relationships with the independent variables were found for the majority of the HCBCs. Notable consistent seasonal differences included significantly elevated glucose and significantly lower creatinine concentrations in winter compared to summer. These differences may be due to energetic or thermoregulatory fluctuations in the animals by season and do not necessarily have any clinical significance. Erythrocyte counts were significantly lower in the winter, possibly also due to nutritional differences. Albumin and calcium levels in this population have increased significantly over the years of monitoring and consistently across seasons, being higher in the winter than the summer. Again, nutritional and thermal constraints seem to be the most likely environmental factors influencing these patterns. PMID:17524692

  2. Contribution of a Real Depth Distance Stereoacuity Test to Clinical Management

    Directory of Open Access Journals (Sweden)

    B. J. Young

    2009-01-01

    Full Text Available Measurement of Stereopsis forms an important part of the clinical assessment of patients with disorders of ocular motility. The introduction of a real depth distance stereoacuity test (FD2 was evaluated in clinical practice and to what extent the introduction affected clinical management. Seventy-three patients under evaluation before and following the introduction of the test were included. Combined thresholds were measured at near using the Frisby and TNO test and at distance using the FD2. Fifty healthy controls were included. Forty-five patients demonstrated Stereopsis using the FD2 and 23 of these had a change in their management based in part on their responses using the FD2. Patients with evidence of Stereopsis using the FD2 were significantly more likely to have change in their management than expected from the whole sample (=.02. The introduction of a real depth distance stereoacuity test into clinical practice contributed to a change in management when used in conjunction with other tests. The usefulness of the FD2 is limited by its range at 6 m. Use at closer distances necessitates the calculation of binocular threshold from the combined and monocular threshold.

  3. International Federation of Clinical Chemistry and International Union of Pure and Applied Chemistry 2. Properties and Units in the Clinical Laboratory Sciences. VI. Properties and Units in IOC Prohibited Drugs (IFCC-IUPAC Recommendations 1997).

    Science.gov (United States)

    Olesen, H; Cowan, D; Bruunshuus, I; Klempel, K; Hill, G

    1997-12-10

    The term designating a substance being an active ingredient of a drug may be a generic name, a nonproprietary name, a registered trade name, a fantasy name or other. This causes difficulties in the transmission of request and report on such substances to and from the clinical laboratories, and in the collating of this information from different sources. The document comprises a list of properties of drugs of abuse in biological fluids as defined by the International Olympic Committee Medical Code for use in electronic transmission systems. Standard systematic names are presented with a code value for each. The coding schemes thus prepared are accessible on Internet from C-NPU Home page address: http://inet.uni-c.dk/ qukb7642. PMID:9495577

  4. Introduction and Administration of the Clinical Skill Test of the Medical Licensing Examination, Republic of Korea (2009)

    OpenAIRE

    Kun Sang Kim

    2010-01-01

    The first trial of the clinical skill test as part of the Korean Medical Licensing Examination was done from September 23 to December 1, 2009, in the clinical skill test center located in the National Health Personnel Licensing Examination Board (NHPLEB) building, Seoul. Korea is the first country to introduce the clinical skill test as part of the medical licensing examination in Asia. It is a report on the introduction and administration of the test. The NHPLEB launched researches on the va...

  5. Bile acid malabsorption in patients with chronic diarrhoea: clinical value of SeHCAT test

    DEFF Research Database (Denmark)

    Wildt, Signe; Nørby Rasmussen, S; Madsen, Jan Lysgård;

    2003-01-01

    BACKGROUND: Bile acid malabsorption (BAM), a cause of chronic diarrhoea, can be diagnosed by the SeHCAT test. The purpose of this study was to evaluate the usefulness of SeHCAT testing by assessing the extent of BAM and describing the clinical characteristics in a group of patients with chronic...... diarrhoea. Clinical outcome after treatment with cholestyramine was also evaluated. METHODS: During a 5-year period (1997-2001) the SeHCAT test was performed in 135 patients in whom a primary programme for diagnostic evaluation of chronic diarrhoea had not revealed a cause. File data from 133 patients could...... as a second-line investigation with a high diagnostic yield. The only a priori parameter to predict BAM was the existence of ileocaecal resections. The result of the SeHCAT test seems to predict the benefit of treatment with cholestyramine....

  6. 10 CFR 31.11 - General license for use of byproduct material for certain in vitro clinical or laboratory testing.

    Science.gov (United States)

    2010-01-01

    ... in vitro clinical or laboratory testing. 31.11 Section 31.11 Energy NUCLEAR REGULATORY COMMISSION... certain in vitro clinical or laboratory testing. (a) A general license is hereby issued to any physician, veterinarian in the practice of veterinary medicine, clinical laboratory or hospital to receive,...

  7. 42 CFR 414.509 - Reconsideration of basis for and amount of payment for a new clinical diagnostic laboratory test.

    Science.gov (United States)

    2010-10-01

    ... for a new clinical diagnostic laboratory test. 414.509 Section 414.509 Public Health CENTERS FOR... FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.509 Reconsideration of basis for and amount of payment for a new clinical diagnostic...

  8. 77 FR 31620 - Medicare Program; Public Meeting in Calendar Year 2012 for New Clinical Laboratory Tests Payment...

    Science.gov (United States)

    2012-05-29

    ... Year 2012 for New Clinical Laboratory Tests Payment Determinations AGENCY: Centers for Medicare... for Medicare payment under the clinical laboratory fee schedule (CLFS) for calendar year (CY) 2013... determinations for new clinical diagnostic laboratory tests under Part B of title XVIII of the Social...

  9. 42 CFR 414.506 - Procedures for public consultation for payment for a new clinical diagnostic laboratory test.

    Science.gov (United States)

    2010-10-01

    ... a new clinical diagnostic laboratory test. 414.506 Section 414.506 Public Health CENTERS FOR... FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.506 Procedures for public consultation for payment for a new clinical diagnostic laboratory...

  10. 76 FR 10600 - Medicare Program; Public Meeting in Calendar Year 2011 for New Clinical Laboratory Tests Payment...

    Science.gov (United States)

    2011-02-25

    ... Year 2011 for New Clinical Laboratory Tests Payment Determinations AGENCY: Centers for Medicare... Procedural Terminology (CPT) codes for clinical laboratory tests in calendar year (CY) 2012. The meeting... that will be included in Medicare's Clinical Laboratory Fee Schedule for CY 2012, which will...

  11. 78 FR 31560 - Medicare Program; Public Meeting in Calendar Year 2013 for New Clinical Laboratory Test Payment...

    Science.gov (United States)

    2013-05-24

    ... Year 2013 for New Clinical Laboratory Test Payment Determinations AGENCY: Centers for Medicare... clinical laboratory fee schedule (CLFS) for calendar year (CY) 2014. DATES: Meeting Date: The public... clinical diagnostic laboratory tests under Part B of title XVIII of the Social Security Act (the Act)...

  12. Need for an Ethical Framework for Testing for Systemic Diseases in Dental Clinics

    OpenAIRE

    Silveira, Marushka Leanne; Chattopadhyay, Amit

    2011-01-01

    Testing for systemic diseases in dental clinics is a potentially attractive avenue for oral health professionals and may be viewed as an opportunity to increase professional reach, expand practice, and improve financial returns. However, several ethical questions arise that must be addressed before such activities are adopted. (1) What should be the level of training dentists must acquire to deal with challenges associated with testing? (2) How well are dental practices aware of and compliant...

  13. Intraocular pressure dynamics with prostaglandin analogs: a clinical application of water-drinking test

    OpenAIRE

    Özyol P; Özyol E; Baldemir E

    2016-01-01

    Pelin Özyol,1 Erhan Özyol,1 Ercan Baldemir2 1Ophthalmology Department, 2Biostatistics Department, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey Aim: To evaluate the clinical applicability of the water-drinking test in treatment-naive primary open-angle glaucoma patients. Methods: Twenty newly diagnosed primary open-angle glaucoma patients and 20 healthy controls were enrolled in this prospective study. The water-drinking test was performed at baseline and 6&nbs...

  14. PSA testing without clinical indication for prostate cancer in relation to socio-demographic and clinical characteristics in the Danish Diet, Cancer and Health Study

    DEFF Research Database (Denmark)

    Karlsen, Randi V; Larsen, Signe B; Christensen, Jane;

    2013-01-01

    associations between socio-demographic or clinical characteristics and PSA testing without clinical indication. Material and methods. In the Danish Diet, Cancer and Health Cohort, we identified 1051 men with PC diagnosed in 1993-2008. Diagnostic and clinical characteristics were obtained from medical records......, and socio-demographic information was retrieved from administrative registers. We used general logistic regression analysis to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between socio-demographic or clinical characteristics and PSA testing without clinical indication. Cox......Background. Social differences in prostate cancer (PC) incidence and mortality might be related to testing for prostate-specific antigen (PSA). Although routine PSA screening is not recommended in Denmark, testing without clinical indication increased during the past decade. We evaluated...

  15. Bioinorganic Chemistry

    OpenAIRE

    Bertini, Ivano; Gray, Harry B.; Lippard, Stephen J.; Valentine, Joan Selverstone

    1994-01-01

    This book covers material that could be included in a one-quarter or one-semester course in bioinorganic chemistry for graduate students and advanced undergraduate students in chemistry or biochemistry. We believe that such a course should provide students with the background required to follow the research literature in the field. The topics were chosen to represent those areas of bioinorganic chemistry that are mature enough for textbook presentation. Although each chapter presents material...

  16. Organic chemistry

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2003-08-15

    This book with sixteen chapter explains organic chemistry on linkage isomerism such as alkane, cycloalkane, alkene, aromatic compounds, stereo selective isomerization, aromatic compounds, stereo selective isomerization, organic compounds, stereo selective isomerization, organic halogen compound, alcohol, ether, aldehyde and ketone, carboxylic acid, dicarboxylic acid, fat and detergent, amino, carbohydrate, amino acid and protein, nucleotide and nucleic acid and spectroscopy, a polymer and medical chemistry. Each chapter has introduction structure and characteristic and using of organic chemistry.

  17. Social Chemistry

    OpenAIRE

    Lichtfouse, Eric; Schwarzbauer, Jan; Robert, Didier

    2012-01-01

    International audience This article is both an essay to propose social chemistry as a new scientific discipline, and a preface of the book Environmental Chemistry for a Sustainable World. Environmental chemistry is a fast emerging discipline aiming at the understanding the fate of pollutants in ecosystems and at designing novel processes that are safe for ecosystems. Past pollution should be cleaned, future pollution should be predicted and avoided (Lichtfouse et al., 2005a). Such advices ...

  18. Computational chemistry

    OpenAIRE

    Truhlar, Donald G.; McKoy, Vincent

    2000-01-01

    Computational chemistry has come of age. With significant strides in computer hardware and software over the last few decades, computational chemistry has achieved full partnership with theory and experiment as a tool for understanding and predicting the behavior of a broad range of chemical, physical, and biological phenomena. The Nobel Prize award to John Pople and Walter Kohn in 1998 highlighted the importance of these advances in computational chemistry. With massively parallel computers ...

  19. 42 CFR 493.929 - Chemistry.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Chemistry. 493.929 Section 493.929 Public Health... Proficiency Testing Programs by Specialty and Subspecialty § 493.929 Chemistry. The subspecialties under the specialty of chemistry for which a proficiency testing program may offer proficiency testing are...

  20. [Clinical Application of Non-invasive Diagnostic Tests for Liver Fibrosis].

    Science.gov (United States)

    Shin, Jung Woo; Park, Neung Hwa

    2016-07-25

    The diagnostic assessment of liver fibrosis is an important step in the management of patients with chronic liver diseases. Liver biopsy is considered the gold standard to assess necroinflammation and fibrosis. However, recent technical advances have introduced numerous serum biomarkers and imaging tools using elastography as noninvasive alternatives to biopsy. Serum markers can be direct or indirect markers of the fibrosis process. The elastography-based studies include transient elastography, acoustic radiation force imaging, supersonic shear wave imaging and magnetic resonance elastography. As accumulation of clinical data shows that noninvasive tests provide prognostic information of clinical relevance, non-invasive diagnostic tools have been incorporated into clinical guidelines and practice. Here, the authors review noninvasive tests for the diagnosis of liver fibrosis. PMID:27443617

  1. Patch test results of hand eczema patients : relation to clinical types

    NARCIS (Netherlands)

    Boonstra, M B; Christoffers, W A; Coenraads, P J; Schuttelaar, M L A

    2015-01-01

    BACKGROUND: Allergic contact dermatitis is a well-known cause of hand eczema, although the influence of contact allergens on different clinical types of hand eczema remains still unclear. OBJECTIVE: To identify most common positive tested allergens among hand eczema patients and to define the relati

  2. Relationship Between Upper Respiratory Tract Influenza Test Result and Clinical Outcomes Among Critically Ill Influenza Patients

    OpenAIRE

    Reddy, Krishna P.; Bajwa, Ednan K.; Parker, Robert A.; Andrew B Onderdonk; Walensky, Rochelle P.

    2016-01-01

    Among critically ill patients with lower respiratory tract (LRT)-confirmed influenza, we retrospectively observed worse 28-day clinical outcomes in upper respiratory tract (URT)-negative versus URT-positive subjects. This finding may reflect disease progression and highlights the need for influenza testing of both URT and LRT specimens to improve diagnostic yield and possibly inform prognosis.

  3. 78 FR 53773 - Select Updates for Non-Clinical Engineering Tests and Recommended Labeling for Intravascular...

    Science.gov (United States)

    2013-08-30

    ... HUMAN SERVICES Food and Drug Administration Select Updates for Non-Clinical Engineering Tests and... Food and Drug Administration Staff; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing the availability of the...

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

    NARCIS (Netherlands)

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

    2009-01-01

    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

  5. Medicare Program; Medicare Clinical Diagnostic Laboratory Tests Payment System. Final rule.

    Science.gov (United States)

    2016-06-23

    This final rule implements requirements of section 216 of the Protecting Access to Medicare Act of 2014 (PAMA), which significantly revises the Medicare payment system for clinical diagnostic laboratory tests. This final rule also announces an implementation date of January 1, 2018 for the private payor rate-based fee schedule required by PAMA.

  6. Knowledge of the D-dimer test result influences clinical probability assessment of pulmonary embolism

    NARCIS (Netherlands)

    R.A. Douma; J.B.F. Kessels; H.R. Büller; V.E.A. Gerdes

    2010-01-01

    Background: In patients with suspected pulmonary embolism (PE), an unlikely or non-high probability assessment combined with a normal D-dimer test can safely exclude the diagnosis. We studied the influence of early D-dimer knowledge on clinical probability assessment. Methods: A questionnaire was se

  7. Clinical evaluation of a dynamic test for lateral ankle ligament laxity

    NARCIS (Netherlands)

    J.S. de Vries; G.M.M.J. Kerkhoffs; L. Blankevoort; C.N. van Dijk

    2010-01-01

    The dynamic anterior ankle tester (DAAT) has shown a good reliability in testing anterior talar translation in earlier studies. The goal of the present study was first to evaluate the reliability of the DAAT in a clinical setting and second to analyze its ability to detect increased ligament laxity.

  8. The role of KRAS rs61764370 in invasive epithelial ovarian cancer: implications for clinical testing

    NARCIS (Netherlands)

    Pharoah, P.D.; Palmieri, R.T.; Ramus, S.J.; Gayther, S.A.; Andrulis, I.L.; Anton-Culver, H.; Antonenkova, N.; Antoniou, A.C.; Goldgar, D.; Beattie, M.S.; Beckmann, M.W.; Birrer, M.J.; Bogdanova, N.; Bolton, K.L.; Brewster, W.; Brooks-Wilson, A.; Brown, R.; Butzow, R.; Caldes, T.; Caligo, M.A.; Campbell, I.; Chang-Claude, J.; Chen, Y.A.; Cook, L.S.; Couch, F.J.; Cramer, D.W; Cunningham, J.M.; Despierre, E.; Doherty, J.A.; Dork, T.; Durst, M.; Eccles, D.M.; Ekici, A.B.; Easton, D.; Fasching, P.A.; Fazio, A. de; Fenstermacher, D.A.; Flanagan, J.M.; Fridley, B.L.; Friedman, E.; Gao, B.; Sinilnikova, O.; Gentry-Maharaj, A.; Godwin, A.K.; Goode, E.L.; Goodman, M.T.; Gross, J.; Hansen, T.V.; Harnett, P.; Rookus, M.; Heikkinen, T.; Hein, R.; Hogdall, C.; Hogdall, E.; Iversen, E.S.; Jakubowska, A.; Johnatty, S.E.; Karlan, B.Y.; Kauff, N.D.; Kaye, S.B.; Chenevix-Trench, G.; Kelemen, L.E.; Kiemeney, L.A.L.M.; Kjaer, S.K.; Lambrechts, D.; Lapolla, J.P.; Lazaro, C.; Le, N.D.; Leminen, A.; Leunen, K.; Levine, D.A.; Lu, Y.; Lundvall, L.; MacGregor, S.; Marees, T.; Massuger, L.F.A.G.; McLaughlin, J.R.; Menon, U.; Montagna, M.; Moysich, K.B.; Narod, S.A.; Nathanson, K.L.; Nedergaard, L.; Ness, R.B.; Nevanlinna, H.; Nickels, S.; Osorio, A.; Paul, J.; Pearce, C.L.; Phelan, C.M.; Pike, M.C.; Radice, P.; Rossing, M.A.; Schildkraut, J.M.; Sellers, T.A.; Singer, C.F.; Song, H.; Stram, D.O.; Sutphen, R.; Lindblom, A.

    2011-01-01

    PURPOSE: An assay for the single-nucleotide polymorphism (SNP), rs61764370, has recently been commercially marketed as a clinical test to aid ovarian cancer risk evaluation in women with family histories of the disease. rs67164370 is in a 3'-UTR miRNA binding site of the KRAS oncogene and is a candi

  9. The role of KRAS rs61764370 in invasive epithelial ovarian cancer: implications for clinical testing

    DEFF Research Database (Denmark)

    Pharoah, Paul D P; Palmieri, Rachel T; Ramus, Susan J;

    2011-01-01

    PURPOSE: An assay for the single nucleotide polymorphism (SNP) rs61764370 has recently been commercially marketed as a clinical test to aid ovarian cancer risk evaluation in women with family histories of the disease. rs67164370 is in a 3'UTR miRNA binding site of the KRAS oncogene, and is a cand...

  10. Protease activity measurement in milk as a diagnostic test for clinical mastitis in dairy cows

    NARCIS (Netherlands)

    Koop, G.; Werven, van T.; Roffel, S.; Hogeveen, H.; Nazmi, K.; Bikker, F.J.

    2015-01-01

    Due to the increasing use of automated milking systems, automated detection of clinical mastitis is becoming more important. Various in- or on-line diagnostic tests are in use, but generally suffer from false mastitis alerts. In this study, we explored a new diagnostic approach based on measureme

  11. International Federation of Clinical Chemistry. Use of artificial intelligence in analytical systems for the clinical laboratory. IFCC Committee on Analytical Systems.

    Science.gov (United States)

    Place, J F; Truchaud, A; Ozawa, K; Pardue, H; Schnipelsky, P

    1994-12-16

    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 this 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 property and that there is a need for better documentation, evaluation and regulation of the systems already being used widely in clinical laboratories.

  12. TEST RORSCHACHA W DIAGNOSTYCE KLINICZNEJ I BADANIACH MIEDZYKULTUROWYCH [THE RORSCHACH TEST IN CLINICAL DIAGNOSIS AND CROSS-CULTURAL RESEARCH

    Directory of Open Access Journals (Sweden)

    Waszkiewicz, Ewa

    2012-06-01

    Full Text Available This article reviews the application of the Rorschach Inkblot Test in clinical practice. It concerns specificity of this test, its advantages, disadvantages and diagnostic value in assessment of mental disorders. Such an review seems to be important in face of controversies this tool has been evoking since its conceptualization in 1921 by Hermann Rorschach and current rising popularity of quantitative methods, which are often perceived as having more evidence-based psychometric foundations and demanding less clinical experience when it comes to analysis. The first part of this article is focused on methodological aspects of the Rorschach Test: specificity of its application, the most important variables and theoretical approaches. Also the arguments of Rorschach opponents and proponents will be discussed. The most important argument of its proponents is the variety of information about unconscious processes. The main argument of its opponents is the lack of validity, reliability and adequate norms for particular mental disorders. In the following paragraphs, the most crucial criteria for diagnosis of schizophrenia, affective and personality disorders will be described. This scope of disorders is reflected in typical traits found in the Rorschach scoring protocol. The second part of the article will be focused on the implementation of the method in cross-cultural and acculturation research. The results of some research imply that there are many of cross-cultural differences in norms and there was evidence found that the results, in case of individuals who go through the process of acculturation, especially biculturals, are strongly influenced by culture.

  13. 22项生化检测项目测量不确定度的评价%Evaluation of Measurement Uncertainty of 2 2 Clinical Chemistry Assays

    Institute of Scientific and Technical Information of China (English)

    包安裕; 李艳; 陈晨

    2014-01-01

    Objective To calculate the measurement uncertainty of clinical chemical analytes according to the internal quality control (IQC)and external quality assessment (EQA)data in clinical laboratory.Methods Collected the IQC data from January to June 2013 and EQA data between 2012~2014 of clinical chemistry in clinical laboratory.Calculated the measure-ment uncertainty and extended uncertainty according to the Nordtest criteria.Results It was effective to evaluate the uncer-tainty using IQC and EQA data.ALP ranked the highest extended uncertainty and Na+ ranked the lowest uncertainty.The range of uncertainty varies greatly,electrolyte 4.27~18.16,enzyme 8.12~24.88,small molecular 4.88~12.44,protein and lipids 4.78~13.1.Conclusion The evaluation of clinical chemistry uncertainty by IQC and EQA data is simple and practi-cal,which is beneficial for assurancing the measurement accuracy.%目的:根据临床实验室室内质量控制和室间质量评价的累积数据评价22项生化检测项目的测量不确定度。方法收集检验科2013年1~6月22项生化检测项目的室内质量控制数据和2012~2014年间常规化学室内质控和室间质评的数据,依据 Nordtest准则,分别计算与精密度和偏倚相关的不确定度分量,然后评估合成标准不确定度和扩展不确定度。结果利用室内质控与室间质评数据可以逐步计算出22项生化检测项目的不确定度范围为4.24~24.88,其中 ALP的扩展不确定度最大,达到24.88;Na+的扩展不确定度最小,仅为4.24。各类指标的扩展不确定度范围如下:电解质(4.27~18.16,Na+最低,Mg最高);酶类(8.12~24.88,GGT最低,ALP最高);小分子物质(4.88~12.44,GLU最低,Cr最高);蛋白与脂类(4.78~13.1,TC最低,TG最高)。结论使用累积的室内质控与室间质评数据评定生化定量检测项目的不确定度简便可行,可用于定期评估检验结果准确性。

  14. Water syphon test and gastrooesophageal reflux during childhood (correlation with the clinical findings and oesophageal manometry)

    International Nuclear Information System (INIS)

    The water syphon test is a simple and easily performed method for demonstrating gastro-oesophageal reflux with a high degree of reliability. It is carried out following a conventional barium swallow. Compared with clinical findings and oesophageal manometry, the water syphon test is very reliable for demonstrating gastro-oesophageal reflux during childhood. Prolonged irradiation in order to see spontaneous reflux becomes unnecessary. This results in a significant reduction in radiation dose. Barium swallow and the water syphon test are the most useful initial examinations in children with symptoms which suggest reflux. (orig.)

  15. Computerized Neuropsychological Assessment in Aging: Testing Efficacy and Clinical Ecology of Different Interfaces

    Directory of Open Access Journals (Sweden)

    Matteo Canini

    2014-01-01

    Full Text Available Digital technologies have opened new opportunities for psychological testing, allowing new computerized testing tools to be developed and/or paper and pencil testing tools to be translated to new computerized devices. The question that rises is whether these implementations may introduce some technology-specific effects to be considered in neuropsychological evaluations. Two core aspects have been investigated in this work: the efficacy of tests and the clinical ecology of their administration (the ability to measure real-world test performance, specifically (1 the testing efficacy of a computerized test when response to stimuli is measured using a touch-screen compared to a conventional mouse-control response device; (2 the testing efficacy of a computerized test with respect to different input modalities (visual versus verbal; and (3 the ecology of two computerized assessment modalities (touch-screen and mouse-control, including preference measurements of participants. Our results suggest that (1 touch-screen devices are suitable for administering experimental tasks requiring precise timings for detection, (2 intrinsic nature of neuropsychological tests should always be respected in terms of stimuli presentation when translated to new digitalized environment, and (3 touch-screen devices result in ecological instruments being proposed for the computerized administration of neuropsychological tests with a high level of preference from elderly people.

  16. Computerized neuropsychological assessment in aging: testing efficacy and clinical ecology of different interfaces.

    Science.gov (United States)

    Canini, Matteo; Battista, Petronilla; Della Rosa, Pasquale Anthony; Catricalà, Eleonora; Salvatore, Christian; Gilardi, Maria Carla; Castiglioni, Isabella

    2014-01-01

    Digital technologies have opened new opportunities for psychological testing, allowing new computerized testing tools to be developed and/or paper and pencil testing tools to be translated to new computerized devices. The question that rises is whether these implementations may introduce some technology-specific effects to be considered in neuropsychological evaluations. Two core aspects have been investigated in this work: the efficacy of tests and the clinical ecology of their administration (the ability to measure real-world test performance), specifically (1) the testing efficacy of a computerized test when response to stimuli is measured using a touch-screen compared to a conventional mouse-control response device; (2) the testing efficacy of a computerized test with respect to different input modalities (visual versus verbal); and (3) the ecology of two computerized assessment modalities (touch-screen and mouse-control), including preference measurements of participants. Our results suggest that (1) touch-screen devices are suitable for administering experimental tasks requiring precise timings for detection, (2) intrinsic nature of neuropsychological tests should always be respected in terms of stimuli presentation when translated to new digitalized environment, and (3) touch-screen devices result in ecological instruments being proposed for the computerized administration of neuropsychological tests with a high level of preference from elderly people. PMID:25147578

  17. Clinical tests for differentiating between patients with and without patellofemoral pain syndrome

    Directory of Open Access Journals (Sweden)

    Konstantinos Papadopoulos, MSc

    2014-06-01

    Full Text Available Patellofemoral pain syndrome (PFPS is a very common knee condition with various aetiologies. Because of the nebulous factors of the syndrome, physiotherapists often find it difficult to assess and treat these patients. The aim of this study was to identify the clinical assessment tool that can differentiate PFPS patients from patients with other lower limb conditions. Fifty-two patients from the National Health System (26 with PFPS and 26 with other lower limb conditions took part in this study. They underwent a series of strength, flexibility, and stress tests. Their pain levels were also recorded. The results showed that among the various clinical tests, only the hip flexion component of the Thomas test was able to differentiate between the two groups. In addition, the stress test showed that the PFPS group could not recover their gluteal muscle strength in the same way the group with the other lower limb conditions did. The Lower Extremity Functional Scale was found to be more able to differentiate between the two groups than the Anterior Knee Pain Scale. This study has shown that it is difficult to find specific clinical tests to diagnose PFPS. More research is needed in this important area.

  18. Test-retest reliability of the Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) scale.

    Science.gov (United States)

    Gustafsson, Margareta; Blomberg, Karin; Holmefur, Marie

    2015-07-01

    The Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) scale evaluates the student nurses' perception of the learning environment and supervision within the clinical placement. It has never been tested in a replication study. The aim of the present study was to evaluate the test-retest reliability of the CLES + T scale. The CLES + T scale was administered twice to a group of 42 student nurses, with a one-week interval. Test-retest reliability was determined by calculations of Intraclass Correlation Coefficients (ICCs) and weighted Kappa coefficients. Standard Error of Measurements (SEM) and Smallest Detectable Difference (SDD) determined the precision of individual scores. Bland-Altman plots were created for analyses of systematic differences between the test occasions. The results of the study showed that the stability over time was good to excellent (ICC 0.88-0.96) in the sub-dimensions "Supervisory relationship", "Pedagogical atmosphere on the ward" and "Role of the nurse teacher". Measurements of "Premises of nursing on the ward" and "Leadership style of the manager" had lower but still acceptable stability (ICC 0.70-0.75). No systematic differences occurred between the test occasions. This study supports the usefulness of the CLES + T scale as a reliable measure of the student nurses' perception of the learning environment within the clinical placement at a hospital. PMID:25814151

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

    Science.gov (United States)

    Ogawa, Shinji

    2014-12-01

    The number of commercial laboratories for clinical testing in Japan run privately has decreased to about 30 companies, and their business is getting tougher. Branch Lab. and FMS businesses have not expanded recently due to the new reimbursement system which adds an additional sample management fee, becoming effective in 2010. This presentation gives an outline of each role for hospital and commercial laboratories, and their pros & cons considering the current medical situation. Commercial laboratories have investigated how to utilize ICT systems for sharing test information between hospitals and our facilities. It would be very helpful to clarify issues for each hospital. We will develop and create new values for clinical laboratory testing services and forge mutually beneficial relationships with medical institutions. (Review). PMID:25823243

  20. [The clinical application of 13C-breath tests in pancreatic diseases].

    Science.gov (United States)

    Cherniavskiĭ, V V

    2014-11-01

    Maldigestion persists in most patients with chronic pancreatitis (GP). The objective lipase and amylase insufficiency diagnosis is needed to achieve an adequate clinical response to oral pancreatic enzyme substitution therapy. The novel data is presented in the article about the role of 13C-mixed triglyceride and 13C-corn starch breath tests as a tools for exocrine pancreatic insufficiency diagnosis, for evaluating fat and starch malabsorbtion in CP patients. 135 patients were included in the investigation. It has been shown, that 13C-breath tests could be useful tools in clinical practice for CP diagnosis. They are well correlate with fecal elastase-1 level, has high sensitivity and specificity for diagnosis of lipase and amylase deficiency. Tests make it possible to choose the initial pancreatic enzyme dosage and are beneficial during the treatment for pancreatic enzyme dose correction.

  1. Scapular dyskinesis in trapezius myalgia and intraexaminer reproducibility of clinical tests

    DEFF Research Database (Denmark)

    Juul-Kristensen, Birgit; Hilt, Kenneth; Enoch, Flemming;

    2011-01-01

    The aims were to test the intraexaminer reproducibility and report the presence of specific clinical variables of scapular dyskinesis in cases with trapezius myalgia and healthy controls, along with general health and work ability. A total of 38 cases and 23 controls were tested for scapular...... (ICC 0.42-0.74), test for muscular weakness having the lowest ICC (0.42). Cases showed significantly larger medial border misalignment, larger lower horizontal distance of the inferior scapular angle and larger passive shoulder internal rotation, by 110% (1.02 cm), 15% (1.38 cm), and 8% (5.......5°), respectively. Cases with the highest degree of scapular dyskinesis showed reduced work ability and general health. The present specific clinical variables on scapular dyskinesis showed satisfactory intraexaminer reproducibility. An increased standardization must be implemented to increase reproducibility...

  2. [Performance evaluation of VITEK 2 system in meropenem susceptibility testing of clinical Pseudomonas aeruginosa isolates].

    Science.gov (United States)

    Acuner, Ibrahim Cağatay; Bayramoğlu, Gülçin; Birinci, Asuman; Cekiç Cihan, Ciğdem; Bek, Yüksel; Durupınar, Belma

    2011-07-01

    Pseudomonas aeruginosa is an important opportunistic pathogen associated with various community-acquired or nosocomial infections. Multi-drug resistant P.aeruginosa strains increasingly cause epidemics and spread in various hospital wards and geographic regions. Carbapenems are among the most effective antimicrobials in the treatment of multi-drug resistant P.aeruginosa infections, and meropenem is the most successful among alternatives in initial therapy. Particularly in severe infections, inappropriate or inadequate initial antimicrobial therapy is independently associated with adverse clinical and economic outcomes. Availability of accurate and rapid susceptibility testing is a priority. Most of the automated microbiology systems can provide rapid results within 8 to 12 hours. In comparison to standard methods, problems in the antimicrobial susceptibility testing of particular microorganisms and antimicrobial agents have been reported for automated microbiology systems. Failures have been reported previously especially in the susceptibility testing of P.aeruginosa versus carbapenem. Most of these studies are designed according to the Food and Drug Administration (FDA, USA) performance analysis scheme (Class II Special Controls Guidance Document: Antimicrobial Susceptibility Test Systems) in a simplified form. However, there are many lacking issues in the design of most of these studies. Among these, insufficient sample size, use of inappropriate reference method, lack of reproducibility testing, and inadequate distribution of study isolates in interpretative categories are of notice. There are only few studies in the literature that evaluate the performance of automated systems in antimicrobial susceptibility testing of carbapenems in clinical P.aeruginosa isolates with a sufficient sample size (n ? 100). However, most of these studies still have one or more major deficiencies in the study design. Furthermore, none of these studies evaluate the performance of

  3. 'Aussie normals': an a priori study to develop clinical chemistry reference intervals in a healthy Australian population.

    Science.gov (United States)

    Koerbin, G; Cavanaugh, J A; Potter, J M; Abhayaratna, W P; West, N P; Glasgow, N; Hawkins, C; Armbruster, D; Oakman, C; Hickman, P E

    2015-02-01

    Development of reference intervals is difficult, time consuming, expensive and beyond the scope of most laboratories. The Aussie Normals study is a direct a priori study to determine reference intervals in healthy Australian adults. All volunteers completed a health and lifestyle questionnaire and exclusion was based on conditions such as pregnancy, diabetes, renal or cardiovascular disease. Up to 91 biochemical analyses were undertaken on a variety of analytical platforms using serum samples collected from 1856 volunteers. We report on our findings for 40 of these analytes and two calculated parameters performed on the Abbott ARCHITECTci8200/ci16200 analysers. Not all samples were analysed for all assays due to volume requirements or assay/instrument availability. Results with elevated interference indices and those deemed unsuitable after clinical evaluation were removed from the database. Reference intervals were partitioned based on the method of Harris and Boyd into three scenarios, combined gender, males and females and age and gender. We have performed a detailed reference interval study on a healthy Australian population considering the effects of sex, age and body mass. These reference intervals may be adapted to other manufacturer's analytical methods using method transference.

  4. Usefulness of the thyrotropin-releasing hormone test in pre-clinical acromegaly.

    Science.gov (United States)

    Kageyama, Kazunori; Moriyama, Takako; Sakihara, Satoru; Takayasu, Shinobu; Nigawara, Takeshi; Suda, Toshihiro

    2005-08-01

    Acromegaly is caused primarily by pituitary growth hormone (GH)-secreting tumors. It is usually recognized because of characteristic manifestations, and diagnosed clinically. However, there exists a mild stage of acromegaly, which poses a diagnostic problem due to the absence of typical clinical manifestations. Here we present four patients with pre-clinical acromegaly, who showed minimal acromegaloid features with elevated levels of insulin-like growth factor-I. Basal GH levels were within normal levels in 3 of 4 cases, while insulin-like growth factor-I levels were elevated above normal in all cases. Plasma GH levels were elevated in response to thyrotropin-releasing hormone (TRH) in all cases, indicating a diagnostic value of the TRH stimulation test. In contrast, an oral glucose tolerance test was not useful for the diagnosis, because of the low GH levels (less than 1 ng/ml) and/or secondary to diabetes mellitus. In response to a dopamine agonist, GH levels were increased in the two cases, whereas GH levels were decreased or remained unchanged in the other two cases. We therefore suggest that the TRH stimulation test would be helpful to examine the presence of pre-clinical acromegaly. Diagnosis of the early stages of acromegaly is important to prevent progression to overt acromegaly. PMID:15997199

  5. Current ADC Linker Chemistry

    OpenAIRE

    Jain, Nareshkumar; Smith, Sean W.; Ghone, Sanjeevani; Tomczuk, Bruce

    2015-01-01

    The list of ADCs in the clinic continues to grow, bolstered by the success of first two marketed ADCs: ADCETRIS® and Kadcyla®. Currently, there are 40 ADCs in various phases of clinical development. However, only 34 of these have published their structures. Of the 34 disclosed structures, 24 of them use a linkage to the thiol of cysteines on the monoclonal antibody. The remaining 10 candidates utilize chemistry to surface lysines of the antibody. Due to the inherent heterogeneity of conjugati...

  6. Study of result inter-accreditation for routine clinical chemistry items in Shanghai%上海市常规化学项目检验结果互认基础探讨

    Institute of Scientific and Technical Information of China (English)

    居漪; 唐立萍; 王美娟; 虞啸炫; 欧元祝; 李卿; 刘文彬; 吕元

    2012-01-01

    目的 分析2010至2011年上海市医院实验室常规化学项目飞行检查结果,为上海市医疗机构检验结果互认工作提供依据.方法 收集2010至2011年上海市二级甲等以上医院实验室参加由上海市临床检验中心组织的2次飞行检查常规化学项目结果,计算实验室的合格率,并分别比较20个常规化学项目的 全部参加实验室、三级医院、二级甲等医院和通过认可实验室检测结果间的离散度,用基于允许误差和生物学变异的分析变异质量标准评价每个项目的 达标情况.结果 上海二级甲等以上医院实验室间离散度分析,电解质[钾(K)、钠(Na)、氯(Cl)]3项和尿酸(UA)<3.0%,且Na≤1.6%;白蛋白(Alb)、钙(Ca)、肌酐(Cr)、总胆固醇(TC)、葡萄糖(Glu)、总蛋白(TP)均<5.0%;磷(P)、甘油三酯(TG)、尿素(Urea)和丙氨酸氨基转移酶(ALT)≤7.9%;天门冬氨酸氨基转移酶(AST)、γ-谷氨酰基转移酶(GGT)、乳酸脱氢酶(LDH)、肌酸激酶(CK)和总胆红素(TBil)离散度≤11.4%;高密度脂蛋白胆固醇(HDL-C)最大,术17.9%.认可实验室的Alb、ALT、AST、Ca、TC、TG、TP和CK检测质量相对优于其他组;全部医院、二级甲等医院、三级医院和认可实验室组间的均值基本无差异.ALT、CK和TG是20项常规化学检测中可达到较高质量标准的项目;其次为AST、K、TBil、UA和Urea;然后为Alb、Ca、Cr、Glu、P、TC和TP;Na、Cl、HDL-C、LDH和GGT为达到最低质量标准的项目.结论 通过开展实验室全面质量管理,建立检测项目参考体系,开展中国人群基础数据研究,加强质控管理,以此为基础,逐步达到检测结果的互认,为临床提供可靠的诊疗依据.%Objective To analyze the on-spot inspection results of routine clinical chemistry items in Shanghai clinical laboratories from 2010 to 2011 , and to provide the reierence for result inter-accreditation of clinical laboratory tests in Shanghai. Methods Shanghai

  7. The clinical application of UGT1A1 pharmacogenetic testing: Gene-environment interactions

    Directory of Open Access Journals (Sweden)

    Marques Sara

    2010-04-01

    Full Text Available Abstract Over the past decade, the number of pharmacogenetic tests has increased considerably, allowing for the development of our knowledge of their clinical application. The uridine diphosphate glucuronosyltransferase 1A1 gene (UGT1A1 assay is an example of a pharmacogenetic test. Numerous variants have been found in UGT1A1, the main conjugating enzyme of bilirubin and drugs such as the anticancer drug irinotecan. Recently, the US Food and Drug Administration (FDA recommended testing for the presence of UGT1A1*28, an allele correlated with decreased transcriptional activity, to predict patients at risk of irinotecan toxicity. The administration of other drugs -- such as inhibitors of the UGT1A1 enzyme -- can clinically mimic the *28 phenotype, whereas inducers of UGT1A1 can increase the glucuronidation rate of the enzyme. The *28 polymorphism is not present in all ethnicities at a similar frequency, which suggests that it is important to study different populations to determine the clinical relevance of testing for UGT1A1*28 and to identify other clinically relevant UGT1A1 variants. Environmental factors such as lifestyle can also affect UGT1A1 activity. This review is a critical analysis of studies on drugs that can be affected by the presence of UGT1A1*28, the distribution of this polymorphism around the globe, distinct variants that may be clinically significant in African and Asian populations and how lifestyle can affect treatment outcomes that depend on UGT1A1 activity.

  8. A chemical proteomics approach for the search of pharmacological targets of the antimalarial clinical candidate albitiazolium in Plasmodium falciparum using photocrosslinking and click chemistry.

    Science.gov (United States)

    Penarete-Vargas, Diana Marcela; Boisson, Anaïs; Urbach, Serge; Chantelauze, Hervé; Peyrottes, Suzanne; Fraisse, Laurent; Vial, Henri J

    2014-01-01

    Plasmodium falciparum is responsible for severe malaria which is one of the most prevalent and deadly infectious diseases in the world. The antimalarial therapeutic arsenal is hampered by the onset of resistance to all known pharmacological classes of compounds, so new drugs with novel mechanisms of action are critically needed. Albitiazolium is a clinical antimalarial candidate from a series of choline analogs designed to inhibit plasmodial phospholipid metabolism. Here we developed an original chemical proteomic approach to identify parasite proteins targeted by albitiazolium during their native interaction in living parasites. We designed a bifunctional albitiazolium-derived compound (photoactivable and clickable) to covalently crosslink drug-interacting parasite proteins in situ followed by their isolation via click chemistry reactions. Mass spectrometry analysis of drug-interacting proteins and subsequent clustering on gene ontology terms revealed parasite proteins involved in lipid metabolic activities and, interestingly, also in lipid binding, transport, and vesicular transport functions. In accordance with this, the albitiazolium-derivative was localized in the endoplasmic reticulum and trans-Golgi network of P. falciparum. Importantly, during competitive assays with albitiazolium, the binding of choline/ethanolamine phosphotransferase (the enzyme involved in the last step of phosphatidylcholine synthesis) was substantially displaced, thus confirming the efficiency of this strategy for searching albitiazolium targets. PMID:25470252

  9. Evaluation of clinical chemistry analytes from a single mouse using diluted plasma: effective way to reduce the number of animals in toxicity studies.

    Science.gov (United States)

    Goyal, Vinod Kumar; Pandey, Santosh Kumar; Kakade, Somesh; Nirogi, Ramakrishna

    2016-10-01

    Clinical chemistry is an essential analytical tool in many areas of research, drug assessment and development, and in the evaluation of general health. A certain amount of blood is required to evaluate all blood analytes. Experiments where mice are used, it is difficult to measure all analytes due to the small amount of blood that can be obtained from a single animal. To overcome this problem, separate cohorts of animals are used in toxicity studies for hematology and biochemistry analysis. This requires the use of extra animals and additional resources. Hence interpretation of results derived from using these different animals can be unreliable. This study was undertaken to explore the possibility of using diluted plasma for measuring various biochemistry analytes. Plasma from mice was diluted to 3, 5 and 10-fold with Water for Injection, and various biochemistry analytes were analyzed using an automated analyzer. Results of diluted and undiluted plasma from the same mouse were compared. Most of the analytes from the diluted plasma were found to be well within the ranges of the undiluted plasma except for sodium, potassium and chloride. Diluting plasma to analyze some analytes also freed up undiluted plasma for analyzing electrolytes. In conclusion, in order to obtain reliable and interpretable data from a single mouse it is worthwhile considering diluting the plasma, which should reduce the number of animals used in an experiment.

  10. A chemical proteomics approach for the search of pharmacological targets of the antimalarial clinical candidate albitiazolium in Plasmodium falciparum using photocrosslinking and click chemistry.

    Science.gov (United States)

    Penarete-Vargas, Diana Marcela; Boisson, Anaïs; Urbach, Serge; Chantelauze, Hervé; Peyrottes, Suzanne; Fraisse, Laurent; Vial, Henri J

    2014-01-01

    Plasmodium falciparum is responsible for severe malaria which is one of the most prevalent and deadly infectious diseases in the world. The antimalarial therapeutic arsenal is hampered by the onset of resistance to all known pharmacological classes of compounds, so new drugs with novel mechanisms of action are critically needed. Albitiazolium is a clinical antimalarial candidate from a series of choline analogs designed to inhibit plasmodial phospholipid metabolism. Here we developed an original chemical proteomic approach to identify parasite proteins targeted by albitiazolium during their native interaction in living parasites. We designed a bifunctional albitiazolium-derived compound (photoactivable and clickable) to covalently crosslink drug-interacting parasite proteins in situ followed by their isolation via click chemistry reactions. Mass spectrometry analysis of drug-interacting proteins and subsequent clustering on gene ontology terms revealed parasite proteins involved in lipid metabolic activities and, interestingly, also in lipid binding, transport, and vesicular transport functions. In accordance with this, the albitiazolium-derivative was localized in the endoplasmic reticulum and trans-Golgi network of P. falciparum. Importantly, during competitive assays with albitiazolium, the binding of choline/ethanolamine phosphotransferase (the enzyme involved in the last step of phosphatidylcholine synthesis) was substantially displaced, thus confirming the efficiency of this strategy for searching albitiazolium targets.

  11. A chemical proteomics approach for the search of pharmacological targets of the antimalarial clinical candidate albitiazolium in Plasmodium falciparum using photocrosslinking and click chemistry.

    Directory of Open Access Journals (Sweden)

    Diana Marcela Penarete-Vargas

    Full Text Available Plasmodium falciparum is responsible for severe malaria which is one of the most prevalent and deadly infectious diseases in the world. The antimalarial therapeutic arsenal is hampered by the onset of resistance to all known pharmacological classes of compounds, so new drugs with novel mechanisms of action are critically needed. Albitiazolium is a clinical antimalarial candidate from a series of choline analogs designed to inhibit plasmodial phospholipid metabolism. Here we developed an original chemical proteomic approach to identify parasite proteins targeted by albitiazolium during their native interaction in living parasites. We designed a bifunctional albitiazolium-derived compound (photoactivable and clickable to covalently crosslink drug-interacting parasite proteins in situ followed by their isolation via click chemistry reactions. Mass spectrometry analysis of drug-interacting proteins and subsequent clustering on gene ontology terms revealed parasite proteins involved in lipid metabolic activities and, interestingly, also in lipid binding, transport, and vesicular transport functions. In accordance with this, the albitiazolium-derivative was localized in the endoplasmic reticulum and trans-Golgi network of P. falciparum. Importantly, during competitive assays with albitiazolium, the binding of choline/ethanolamine phosphotransferase (the enzyme involved in the last step of phosphatidylcholine synthesis was substantially displaced, thus confirming the efficiency of this strategy for searching albitiazolium targets.

  12. American Society of Clinical Oncology policy statement update: genetic testing for cancer susceptibility.

    Science.gov (United States)

    2003-06-15

    As the leading organization representing cancer specialists involved in patient care and clinical research, the American Society of Clinical Oncology (ASCO) reaffirms its commitment to integrating cancer risk assessment and management, including molecular analysis of cancer predisposition genes, into the practice of oncology and preventive medicine. The primary goal of this effort is to foster expanded access to, and continued advances in, medical care provided to patients and families affected by hereditary cancer syndromes. The 1996 ASCO Statement on Genetic Testing for Cancer Susceptibility set forth specific recommendations relating to clinical practice, research needs, educational opportunities, requirement for informed consent, indications for genetic testing, regulation of laboratories, and protection from discrimination, as well as access to and reimbursement for cancer genetics services. In updating this Statement, ASCO endorses the following principles: Indications for Genetic Testing: ASCO recommends that genetic testing be offered when 1) the individual has personal or family history features suggestive of a genetic cancer susceptibility condition, 2) the test can be adequately interpreted, and 3) the results will aid in diagnosis or influence the medical or surgical management of the patient or family members at hereditary risk of cancer. ASCO recommends that genetic testing only be done in the setting of pre- and post-test counseling, which should include discussion of possible risks and benefits of cancer early detection and prevention modalities. Special Issues in Testing Children for Cancer Susceptibility: ASCO recommends that the decision to offer testing to potentially affected children should take into account the availability of evidence-based risk-reduction strategies and the probability of developing a malignancy during childhood. Where risk-reduction strategies are available or cancer predominantly develops in childhood, ASCO believes that

  13. Laboratory tests in the detection of extended spectrum beta-lactamase production: National Committee for Clinical Laboratory Standards (NCCLS screening test, the E-test, the double disk confirmatory test, and cefoxitin susceptibility testing

    Directory of Open Access Journals (Sweden)

    Pedro A. d'Azevedo

    2004-10-01

    Full Text Available Extended spectrum beta-lactamase (ESBL production by Klebsiella sp. and E. coli is an emerging problem. In this study, 107 clinical isolates (53 E. coli, 47 K. pneumoniae and 7 K. oxytoca screened as ESBL producers by the NCCLS disk diffusion procedure were submitted to a double disk confirmatory test (DDT and to the E-test double strip for confirmation of ESBL production by demonstration of clavulanic acid inhibition effect (CAIE. Only 72/107 (67% of the isolates were confirmed as ESBL producers by DDT, with diverse results among species. By the E-test, 58/107 (54% isolates were confirmed as ESBL producers, and 18/107 (17% were not determinable. Susceptibility to cefoxitin was found in 57/68 (83% of strains that did not show CAIE. ESBL detection remains a controversial issue and clinical laboratories are in need of a simple and effective way to recognize strains with this kind of resistance.

  14. The next controversy in genetic testing: clinical data as trade secrets?

    Science.gov (United States)

    Cook-Deegan, Robert; Conley, John M; Evans, James P; Vorhaus, Daniel

    2013-06-01

    Sole-source business models for genetic testing can create private databases containing information vital to interpreting the clinical significance of human genetic variations. But incomplete access to those databases threatens to impede the clinical interpretation of genomic medicine. National health systems and insurers, regulators, researchers, providers and patients all have a strong interest in ensuring broad access to information about the clinical significance of variants discovered through genetic testing. They can create incentives for sharing data and interpretive algorithms in several ways, including: promoting voluntary sharing; requiring laboratories to share as a condition of payment for or regulatory approval of laboratory services; establishing - and compelling participation in - resources that capture the information needed to interpret the data independent of company policies; and paying for sharing and interpretation in addition to paying for the test itself. US policies have failed to address the data-sharing issue. The entry of new and established firms into the European genetic testing market presents an opportunity to correct this failure. PMID:23150081

  15. Idiopathic normal pressure hydrocephalus: diagnostic and predictive value of clinical testing, lumbar drainage, and CSF dynamics.

    Science.gov (United States)

    Mahr, Cynthia V; Dengl, Markus; Nestler, Ulf; Reiss-Zimmermann, Martin; Eichner, Gerrit; Preuß, Matthias; Meixensberger, Jürgen

    2016-09-01

    OBJECTIVE The aim of the study was to analyze the diagnostic and predictive values of clinical tests, CSF dynamics, and intracranial pulsatility tests, compared with external lumbar drainage (ELD), for shunt response in patients with idiopathic normal pressure hydrocephalus (iNPH). METHODS Sixty-eight consecutive patients with suspected iNPH were prospectively evaluated. Preoperative assessment included clinical tests, overnight intracranial pressure (ICP) monitoring, lumbar infusion test (LIFT), and ELD for 24-72 hours. Simple and multiple linear regression analyses were conducted to identify predictive parameters concerning the outcome after shunt therapy. RESULTS Positive response to ELD correctly predicted improvement after CSF diversion in 87.9% of the patients. A Mini-Mental State Examination (MMSE) value below 21 was associated with nonresponse after shunt insertion (specificity 93%, sensitivity 67%). Resistance to outflow of CSF (ROut) > 12 mm Hg/ml/min was false negative in 21% of patients. Intracranial pulsatility parameters yielded different results in various parameters (correlation coefficient between pulse amplitude and ICP, slow wave amplitude, and mean ICP) but did not correlate to outcome. In multiple linear regression analysis, a calculation of presurgical MMSE versus the value after ELD, ROut, and ICP amplitude quotient during LIFT was significantly associated with outcome (p = 0.04). CONCLUSIONS Despite a multitude of invasive tests, presurgical clinical testing and response to ELD yielded the best prediction for improvement of symptoms following surgery. The complication rate of invasive testing was 5.4%. Multiple and simple linear regression analyses indicated that outcome can only be predicted by a combination of parameters, in accordance with a multifactorial pathogenesis of iNPH. PMID:26824377

  16. Evaluation of dengue NS1 antigen rapid tests and ELISA kits using clinical samples.

    Directory of Open Access Journals (Sweden)

    Subhamoy Pal

    Full Text Available Early diagnosis of dengue virus (DENV infection can improve clinical outcomes by ensuring close follow-up, initiating appropriate supportive therapies and raising awareness to the potential of hemorrhage or shock. Non-structural glycoprotein-1 (NS1 has proven to be a useful biomarker for early diagnosis of dengue. A number of rapid diagnostic tests (RDTs and enzyme-linked immunosorbent assays (ELISAs targeting NS1 antigen (Ag are now commercially available. Here we evaluated these tests using a well-characterized panel of clinical samples to determine their effectiveness for early diagnosis.Retrospective samples from South America were used to evaluate the following tests: (i "Dengue NS1 Ag STRIP" and (ii "Platelia Dengue NS1 Ag ELISA" (Bio-Rad, France, (iii "Dengue NS1 Detect Rapid Test (1st Generation" and (iv "DENV Detect NS1 ELISA" (InBios International, United States, (v "Panbio Dengue Early Rapid (1st generation" (vi "Panbio Dengue Early ELISA (2nd generation" and (vii "SD Bioline Dengue NS1 Ag Rapid Test" (Alere, United States. Overall, the sensitivity of the RDTs ranged from 71.9%-79.1% while the sensitivity of the ELISAs varied between 85.6-95.9%, using virus isolation as the reference method. Most tests had lower sensitivity for DENV-4 relative to the other three serotypes, were less sensitive in detecting secondary infections, and appeared to be most sensitive on Day 3-4 post symptom onset. The specificity of all evaluated tests ranged from 95%-100%.ELISAs had greater overall sensitivity than RDTs. In conjunction with other parameters, the performance data can help determine which dengue diagnostics should be used during the first few days of illness, when the patients are most likely to present to a clinic seeking care.

  17. Improving Decision Making about Genetic Testing in the Clinic: An Overview of Effective Knowledge Translation Interventions

    Science.gov (United States)

    Légaré, France; Robitaille, Hubert; Gane, Claire; Hébert, Jessica; Labrecque, Michel; Rousseau, François

    2016-01-01

    Background Knowledge translation (KT) interventions are attempts to change behavior in keeping with scientific evidence. While genetic tests are increasingly available to healthcare consumers in the clinic, evidence about their benefits is unclear and decisions about genetic testing are thus difficult for all parties. Objective We sought to identify KT interventions that involved decisions about genetic testing in the clinical context and to assess their effectiveness for improving decision making in terms of behavior change, increased knowledge and wellbeing. Methods We searched for trials assessing KT interventions in the context of genetic testing up to March 2014 in all systematic reviews (n = 153) published by two Cochrane review groups: Effective Practice and Organisation of Care (EPOC) and Consumers and Communication. Results We retrieved 2473 unique trials of which we retained only 28 (1%). Two EPOC reviews yielded two trials of KT interventions: audit and feedback (n = 1) and educational outreach (n = 1). Both targeted health professionals and the KT intervention they assessed was found to be effective. Four Consumers and Communication reviews yielded 26 trials: decision aids (n = 15), communication of DNA-based disease risk estimates (n = 7), personalized risk communication (n = 3) and mobile phone messaging (n = 1). Among these, 25 trials targeted only health consumers or patients and the KT interventions were found to be effective in four trials, partly effective in seven, and ineffective in four. Lastly, only one trial targeted both physicians and patients and was found to be effective. Conclusions More research on the effectiveness of KT interventions regarding genetic testing in the clinical context may contribute to patients making informed value-based decisions and drawing the maximum benefit from clinical applications of genetic and genomic innovations. PMID:26938633

  18. Analysis of clinical features, serologic and cerebrospinal fluid tests in patients with neurosyphilis at different stages

    Directory of Open Access Journals (Sweden)

    Bao-jie WANG

    2016-08-01

    Full Text Available Objective To summarize the clinical features, serologic, cerebrospinal fluid (CSF tests in patients with neurosyphilis at different stages.  Methods A retrospective analysis was made on the clinical features, imaging, serologic and CSF tests, treatment and prognosis of 12 cases diagnosed as neurosyphilis. In those cases, 5 cases were early-stage neurosyphilis, including 4 syphilitic meningitis (meningomyelitis and one meningovascular syphilis; 7 cases were late-stage neurosyphilis, all of whom were general paresis.  Results The serum Treponema pallidum antibody (TP-Ab and rapid plasma regain (RPR tests were positive in all 12 cases. The CSF TP-Ab tests of 12 cases were all positive and CSF RPR tests were positive in 9 cases. In 5 cases of early-stage neurosyphilis, one case had elevated intracranial pressure (ICP, 3 cases presented with elevated white blood cell (WBC, 4 cases had elevated protein concentration. In 7 cases of late-stage neurosyphilis, one case had elevated ICP, 7 cases presented with elevated WBC and protein concentration. CSF cytology showed lymphocyte reaction, mainly small lymphocytes. All cases were treated with different doses of intravenous penicillin or ceftriaxone sodium by intramuscular injection, among whom 8 cases presented improved neuropsychiatric symptoms, while 4 cases had no significant improvement.  Conclusions Neurosyphilis is easy to be misdiagnosed because of various styles of onset and nontypical clinical manifestations. A definite diagnosis depends on clinical manifestations and serologic and CSF examinations. Early diagnosis and standard treatment is essential for improving prognosis and reducing complications. DOI: 10.3969/j.issn.1672-6731.2016.07.005

  19. Method comparison of the Ortho Vitros Fusion 5,1 chemistry analyzer and the Roche COBAS Integra 400 for urine drug screen testing in the emergency department.

    Science.gov (United States)

    Johnson-Davis, Kamisha L; Thompson, Catherine D; Clark, Chantry J; McMillin, Gwen A; Lehman, Christopher M

    2012-06-01

    Exposure to drugs and toxins is a major cause for the rising number of emergency department visits each year. Immunoassays are commonly used in the emergency department to provide rapid turnaround time for acute care. The purpose of this study was to compare two automated immunoassay chemistry analyzers to determine which platform produced the fewest number of false positive/negative results. Residual patient urine samples were were collected for each of the following drugs/drug classes: cocaine (n = 40), opiates (n = 45), and amphetamines (n = 54) and confirmed either positive or negative by mass spectrometry. Split sample analyses of these specimens were performed on both the Roche COBAS INTEGRA 400 plus and Ortho Vitros 5,1 FS instruments. The results from the two chemistry analyzers were compared to confirmed results. Both immunoassays were prone to false positive results for cocaine and false negative results for opiates and amphetamines. The Vitros Fusion analyzer generated fewer false positive and false negative results for opiate and amphetamine testing than the Roche Integra, but the platforms performed comparably for cocaine.

  20. Summarising and validating test accuracy results across multiple studies for use in clinical practice.

    Science.gov (United States)

    Riley, Richard D; Ahmed, Ikhlaaq; Debray, Thomas P A; Willis, Brian H; Noordzij, J Pieter; Higgins, Julian P T; Deeks, Jonathan J

    2015-06-15

    Following a meta-analysis of test accuracy studies, the translation of summary results into clinical practice is potentially problematic. The sensitivity, specificity and positive (PPV) and negative (NPV) predictive values of a test may differ substantially from the average meta-analysis findings, because of heterogeneity. Clinicians thus need more guidance: given the meta-analysis, is a test likely to be useful in new populations, and if so, how should test results inform the probability of existing disease (for a diagnostic test) or future adverse outcome (for a prognostic test)? We propose ways to address this. Firstly, following a meta-analysis, we suggest deriving prediction intervals and probability statements about the potential accuracy of a test in a new population. Secondly, we suggest strategies on how clinicians should derive post-test probabilities (PPV and NPV) in a new population based on existing meta-analysis results and propose a cross-validation approach for examining and comparing their calibration performance. Application is made to two clinical examples. In the first example, the joint probability that both sensitivity and specificity will be >80% in a new population is just 0.19, because of a low sensitivity. However, the summary PPV of 0.97 is high and calibrates well in new populations, with a probability of 0.78 that the true PPV will be at least 0.95. In the second example, post-test probabilities calibrate better when tailored to the prevalence in the new population, with cross-validation revealing a probability of 0.97 that the observed NPV will be within 10% of the predicted NPV.

  1. Testing grain surface chemistry a survey of deuterated formaldehyde and methanol in low-mass Class 0 protostars

    CERN Document Server

    Parise, B; Caux, E; Ceccarelli, C; Le Floc'h, B; Maret, S; Tielens, A G G M

    2006-01-01

    Context : Despite the low cosmic abundance of deuterium (D/H ~ 1e-5), large degrees of deuterium fractionation in molecules are observed in star forming regions with enhancements that can reach 13 orders of magnitude, which current models have difficulties to account for. Aims : Multi-isotopologue observations are a very powerful constraint for chemical models. The aim of our observations is to understand the processes forming the observed large abundances of methanol and formaldehyde in low-mass protostellar envelopes (gas-phase processes ? chemistry on the grain surfaces ?) and better constrain the chemical models. Methods : Using the IRAM 30m single-dish telescope, we observed deuterated formaldehyde (HDCO and D2CO) and methanol (CH2DOH, CH3OD, and CHD2OH) towards a sample of seven low-mass class 0 protostars. Using population diagrams, we then derive the fractionation ratios of these species (abundance ratio between the deuterated molecule and its main isotopologue) and compare them to the predictions of ...

  2. Evaluation of Methacholine Challenge Test Results in Chronic Cough Patients Referring to Clinic of Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Derakhshan Deilami Gholamreza

    2009-10-01

    Full Text Available Chronic cough is a common problem in patients visiting physicians and its prevalence in different populations range from 3 to 40%. Postnasal drip, asthma and gastroesophageal reflux are the known cause of chronic cough. Although diagnosis of asthma is usually made by clinical signs and spirometeric results, methacholine challenge test is a good diagnostic test in patients who show normal physical examination and spirometeric results. In this study, the results of methacholine challenge test in chronic cough patients are investigated. This is a cross sectional study performed on patients suffering from chronic cough (over 8 weeks, who went to Pulmonary Disease Clinic of Imam Khomeini Hospital in 2006. Postnasal drip, gastroesophageal reflux was evaluated and ruled out in all patients. Then they were tested by methacholine inhalation using low to high doses of methacholine. The results of test was defined as 20% fall in FEV1 and its relationship with age, sex, history of allergic disease, family history of asthma and smoking status was investigated. 81 patients (36 female and 45 male entered this study who had mean age of 32.5 ± 13.06 years. 81.5% of patients had never smoked or closed contact with smokers, 6.2% were passive smokers, 8.6% were smokers and 3.7% had quit smoking. 37% had suffered from chronic cough less than 6 months, 11% for 6-11 months and 52% for more than 12 months. In 26% of patients, family history of asthma was present and 34.5% had a history of one type of allergy. In 29.5% the results of methacholine challenge test was positive, among them 45.8% showed an intense response and 54.2% a moderate response. The test results and its intensity had no statistically significant relationship with age, sex, smoking status, the duration of cough and family history of asthma, but the relationship between methacholine challenge test and the history of allergic disease was significant. Methacholine challenge test can be used as a

  3. Rapid antimicrobial susceptibility testing of clinical isolates by digital time-lapse microscopy

    DEFF Research Database (Denmark)

    Fredborg, M; Rosenvinge, F S; Spillum, E;

    2015-01-01

    (168 antimicrobial agent-organism combinations) demonstrated 3.6 % minor, no major and 1.2 % very major errors of the oCelloScope system compared to conventional susceptibility testing, as well as a rapid and correct phenotypic detection of strains with methicillin-resistant Staphylococcus aureus (MRSA......Rapid antimicrobial susceptibility testing (AST) is essential for early and appropriate therapy. Methods with short detection time enabling same-day treatment optimisation are highly favourable. In this study, we evaluated the potential of a digital time-lapse microscope system, the o......CelloScope system, to perform rapid AST. The oCelloScope system demonstrated a very high accuracy (96 % overall agreement) when determining the resistance profiles of four reference strains, nine clinical isolates, including multi-drug-resistant isolates, and three positive blood cultures. AST of clinical isolates...

  4. Tests of pancreatic exocrine function - clinical significance in pancreatic and non-pancreatic disorders.

    Science.gov (United States)

    Keller, Jutta; Aghdassi, Ali Alexander; Lerch, Markus M; Mayerle, Julia V; Layer, Peter

    2009-01-01

    The pancreas functions as the main factory for digestive enzymes and therefore enables food utilisation. Pancreatic exocrine insufficiency, partial or complete loss of digestive enzyme synthesis, occurs primarily in disorders directly affecting pancreatic tissue integrity. However, other disorders of the gastrointestinal tract, such as coeliac disease, inflammatory bowel disease, Zollinger-Ellison syndrome or gastric resection can either mimic or cause pancreatic exocrine insufficiency. The overt clinical symptoms of pancreatic exocrine insufficiency are steatorrhoea and maldigestion, which frequently become apparent in advanced stages. Several direct and indirect function tests are available for assessment of pancreatic function but until today diagnosis of excretory insufficiency is difficult as in mild impairment clinically available function tests show limitations of diagnostic accuracy. This review focuses on diagnosis of pancreatic exocrine insufficiency in pancreatic and non-pancreatic disorders. PMID:19505669

  5. Culinary Spice Plants in Dietary Supplement Products and Tested in Clinical Trials.

    Science.gov (United States)

    Saldanha, Leila G; Dwyer, Johanna T; Betz, Joseph M

    2016-03-01

    Dried plant parts used as culinary spices (CSs) in food are permitted as dietary ingredients in dietary supplements (DSs) within certain constraints in the United States. We reviewed the amounts, forms, and nutritional support (structure/function) claims of DSs that contain CS plants listed in the Dietary Supplement Label Database (DSLD) and compared this label information with trial doses and health endpoints for CS plants that were the subject of clinical trials listed in clinicaltrials.gov. According to the DSLD, the CS plants occurring most frequently in DSs were cayenne, cinnamon, garlic, ginger, pepper, rosemary, and turmeric. Identifying the botanical species, categorizing the forms used, and determining the amounts from the information provided on DS labels was challenging. CS plants were typically added as a component of a blend, as the powered biomass, dried extracts, and isolated phytochemicals. The amounts added were declared on about 55% of the labels, rendering it difficult to determine the amount of the CS plant used in many DSs. Clinicaltrials.gov provided little information about the composition of test articles in the intervention studies. When plant names were listed on DS labels and in clinical trials, generally the common name and not the Latin binomial name was given. In order to arrive at exposure estimates and enable researchers to reproduce clinical trials, the Latin binomial name, form, and amount of the CS plant used in DSs and tested in clinical trials must be specified. PMID:26980817

  6. Methodological study of the diffusion of interacting cations through clays. Application: experimental tests and simulation of coupled chemistry-diffusion transport of alkaline ions through a synthetical bentonite

    International Nuclear Information System (INIS)

    The subject of this work deals with the project of underground disposal of radioactive wastes in deep geological formations. It concerns the study of the migration of radionuclides through clays. In these materials, the main transport mechanism is assumed to be diffusion under natural conditions. Therefore, some diffusion experiments are conducted. With interacting solutes which present a strong affinity for the material, the duration of these tests will be too long, for the range of concentrations of interest. An alternative is to determine on one hand the geochemical retention properties using batch tests and crushed rock samples and, on the other hand, to deduce the transport parameters from diffusion tests realised with a non-interacting tracer, tritiated water. These data are then used to simulate the migration of the reactive elements with a numerical code which can deal with coupled chemistry-diffusion equations. The validity of this approach is tested by comparing the numerical simulations with the results of diffusion experiments of cations through a clay. The subject is investigated in the case of the diffusion of cesium, lithium and sodium through a compacted sodium bentonite. The diffusion tests are realised with the through-diffusion method. The comparison between the experimental results and the simulations shows that the latter tends to under estimate the propagation of the considered species. The differences could be attributed to surface diffusion and to a decrease of the accessibility to the sites of fixation of the bentonite, from the conditions of clay suspensions in batch tests to the situation of compacted samples. The influence of the experimental apparatus used during the diffusion tests on the results of the measurement has also been tested. It showed that these apparatus have to be taken into consideration when the experimental data are interpreted. A specific model has been therefore developed with the numerical code CASTEM 2000. (author)

  7. A multi-centre phase IIa clinical study of predictive testing for preeclampsia

    DEFF Research Database (Denmark)

    Navaratnam, Kate; Alfirevic, Zarko; Baker, Philip N;

    2013-01-01

    5% of first time pregnancies are complicated by pre-eclampsia, the leading cause of maternal death in Europe. No clinically useful screening test exists; consequentially clinicians are unable to offer targeted surveillance or preventative strategies. IMPROvED Consortium members have pioneered...... a personalised medicine approach to identifying blood-borne biomarkers through recent technological advancements, involving mapping of the blood metabolome and proteome. The key objective is to develop a sensitive, specific, high-throughput and economically viable early pregnancy screening test for pre-eclampsia....

  8. Chlamydia trachomatis Laboratory Strains versus Recent Clinical Isolates: Implications for Routine Microbicide Testing

    OpenAIRE

    Skinner, M. C.; Stamm, W. E.; Lampe, M. L.

    2009-01-01

    A topical microbicide that women can use to prevent sexually transmitted diseases (STDs) is essential, and many microbicide candidates are being tested for activity against human immunodeficiency virus and other STDs, including Chlamydia trachomatis. Screening assays for assessing the activity of microbicides against C. trachomatis are typically done with laboratory-adapted strains, but it is possible that recent clinical isolates may have different susceptibilities to microbicides, as has be...

  9. Laboratory and clinical tests of a prototype pressure sensor for clincial assessment of prosthetic socket fit.

    Science.gov (United States)

    Polliack, A A; Craig, D D; Sieh, R C; Landsberger, S; Mcneal, D R

    2002-04-01

    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.

  10. Public health clinic-based hepatitis C testing and linkage to care in Baltimore.

    Science.gov (United States)

    Falade-Nwulia, O; Mehta, S H; Lasola, J; Latkin, C; Niculescu, A; O'Connor, C; Chaulk, P; Ghanem, K; Page, K R; Sulkowski, M S; Thomas, D L

    2016-05-01

    Testing and linkage to care are important determinants of hepatitis C virus (HCV) treatment effectiveness. Public health clinics serve populations at high risk of HCV. We investigated their potential to serve as sites for HCV testing, initiation of and linkage to HCV care. Cross-sectional study of patients accessing sexually transmitted infection (STI) care at the Baltimore City Health Department (BCHD) STI clinics, from June 2013 through April 2014 was conducted. Logistic regression was used to assess factors associated with HCV infection and specialist linkage to care. Between 24 June 2013 and 15 April 2014, 2681 patients were screened for HCV infection. Overall, 189 (7%) were anti-HCV positive, of whom 185 (98%) received follow-up HCV RNA testing, with 155 (84%) testing RNA positive. Of 155 RNA-positive individuals, 138 (89%) returned to the STI clinic for HCV RNA results and initial HCV care including counselling regarding transmission and harm reduction in alcohol, and 132 (85%) were referred to a specialist for HCV care. With provision of patient navigation services, 81 (52%) attended an offsite HCV specialist appointment. Alcohol use and lack of insurance coverage were associated with lower rates of specialist linkage (OR 0.4 [95% CI 0.1-0.9] and OR 0.4 [95% CI 0.1-0.9], respectively). We identified a high prevalence of HCV infection in BCHD STI clinics. With availability of patient navigation services, a large proportion of HCV-infected patients linked to off-site specialist care. PMID:26840570

  11. Coracoid pain test: a new clinical sign of shoulder adhesive capsulitis

    OpenAIRE

    S. Carbone; Gumina, S.; Vestri, A. R.; Postacchini, R.

    2009-01-01

    Patients with adhesive capsulitis were clinically evaluated to establish whether pain elicited by pressure on the coracoid area may be considered a pathognomonic sign of this condition. The study group included 85 patients with primary adhesive capsulitis, 465 with rotator cuff tear, 48 with calcifying tendonitis, 16 with glenohumeral arthritis, 66 with acromioclavicular arthropathy and 150 asymptomatic subjects. The test was considered positive when pain on the coracoid region was more sever...

  12. Quantum chemistry

    CERN Document Server

    Lowe, John P

    1993-01-01

    Praised for its appealing writing style and clear pedagogy, Lowe's Quantum Chemistry is now available in its Second Edition as a text for senior undergraduate- and graduate-level chemistry students. The book assumes little mathematical or physical sophistication and emphasizes an understanding of the techniques and results of quantum chemistry, thus enabling students to comprehend much of the current chemical literature in which quantum chemical methods or concepts are used as tools. The book begins with a six-chapter introduction of standard one-dimensional systems, the hydrogen atom,

  13. Perception of HIV testing among attendees at an STD clinic in India.

    Science.gov (United States)

    Subramanian, T; Gupte, M D; Mathai, A K; Boopathi, K; Dorairaj, V S

    2008-01-01

    This study reports perception of STD clinic attendees of Government General hospital, Chennai, India towards free HIV testing. All STD clinic attendees who were eligible for the study (511), from January to April 2001 formed the study subjects. In all, 362 (71%) subjects responded to the question on perception of risk in getting HIV/AIDS. Among them 36% perceived that they were at risk of getting infected with HIV. There was a significant difference (P=0.01) between the genders, as more males perceived risk of getting HIV than females and, with the increase in number of sexual partners in a lifetime there was an increasing trend (pwilling for HIV testing. A significant difference between the genders (pwilling to accept free HIV testing than males. When adjusting the effect of co-variates such as gender, age, marital status and perception of risk in getting HIV, persons having two or more sexual partners in their life time were four times more willing to be HIV tested than persons with one sexual partner (OR=4; p=0.001). The findings in this study will help optimize HIV testing in at risk patient populations in India. PMID:18278612

  14. Diagnostic tests for influenza and other respiratory viruses: determining performance specifications based on clinical setting.

    Science.gov (United States)

    Takahashi, Hiroshi; Otsuka, Yoshihito; Patterson, Bruce K

    2010-06-01

    The lack of sensitivity of rapid immunoassays in detecting the novel 2009 H1N1 influenza virus infection has led to recommendations on influenza diagnostic testing for clinicians treating patients as well as advising clinicians on testing decisions. Studies have also shown that rapid immunoassays for seasonal influenza virus show considerable variability in performance characteristics, based on age of patient, prevalence of disease, course of infection, and the quality of the kit used. While public health authorities are currently focused on influenza virus diagnostics, a lack of sensitivity of rapid immunoassays for other viral respiratory pathogens has been widely reported, such as the very limited value of rapid immunoassays for the detection of respiratory syncytial virus in adults. In light of the lack of sensitivity of diagnostic tests for suspected 2009 H1N1 influenza virus infection, as well as their variable performance characteristics for seasonal influenza virus, a number of recommendations have been made by public health authorities advising clinicians on the need for clinical judgment as an important part of testing and treatment decisions as well as reliance on local epidemiologic and surveillance data. With the availability of new molecular methodologies that are user-friendly and allow the front-line physician as well as hospital infection control programs to significantly improve respiratory viral diagnostics, there is a need to carefully determine the most optimal diagnostic testing methodology based on the clinical setting. This review will describe the historical, current, and changing dynamics of respiratory virus infection diagnostics.

  15. Changes in permeability and fluid chemistry of the Topopah Spring Member of the Paintbrush tuff (Nevada Test Site) when held in a temperature gradient: summary of results

    International Nuclear Information System (INIS)

    The permeability and groundwater chemistry results for the Topopah Spring Member are reported and compared with the results from the previous work on Bullfrog. Permeability measurements made on samples of the Topopah Spring Member of the Paintbrush Tuff at room-temperature and in a temperature gradient show that the initially high (3-65 μda) permeabilities are little affected by heating to at least 1500C. These permeability relationships are favvorable for the disposal of nuclear waste in this stuff in an unsaturated zone at the Nevada Test Site. The fluids discharged from the samples of tuff during the experiments are dilute, nearly neutral solutions that differ only slightly from the starting groundwater composition. 8 references, 10 figures, 5 tables

  16. Materials Chemistry

    CERN Document Server

    Fahlman, Bradley D

    2011-01-01

    The 2nd edition of Materials Chemistry builds on the strengths that were recognized by a 2008 Textbook Excellence Award from the Text and Academic Authors Association (TAA). Materials Chemistry addresses inorganic-, organic-, and nano-based materials from a structure vs. property treatment, providing a suitable breadth and depth coverage of the rapidly evolving materials field. The 2nd edition continues to offer innovative coverage and practical perspective throughout. After briefly defining materials chemistry and its history, seven chapters discuss solid-state chemistry, metals, semiconducting materials, organic "soft" materials, nanomaterials, and materials characterization. All chapters have been thoroughly updated and expanded with, for example, new sections on ‘soft lithographic’ patterning, ‘click chemistry’ polymerization, nanotoxicity, graphene, as well as many biomaterials applications. The polymer and ‘soft’ materials chapter represents the largest expansion for the 2nd edition. Each ch...

  17. Introductory Chemistry

    OpenAIRE

    Baron, Mark; Gonzalez-Rodriguez, Jose; Stevens, Gary; Gray, Nathan; Atherton, Thomas; Winn, Joss

    2010-01-01

    Teaching and Learning resources for the 1st Year Introductory Chemistry course (Forensic Science). 30 credits. These are Open Educational Resources (OER), made available for re-use under a Creative Commons license.

  18. 21 CFR 862.1185 - Compound S (11-deoxycortisol) test system.

    Science.gov (United States)

    2010-04-01

    ... SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry... resulting in clinical symptoms of masculinization and hypertension. (b) Classification. Class I...

  19. Analytical chemistry

    International Nuclear Information System (INIS)

    This book is comprised of nineteen chapters, which describes introduction of analytical chemistry, experimental error and statistics, chemistry equilibrium and solubility, gravimetric analysis with mechanism of precipitation, range and calculation of the result, volume analysis on general principle, sedimentation method on types and titration curve, acid base balance, acid base titration curve, complex and firing reaction, introduction of chemical electro analysis, acid-base titration curve, electrode and potentiometry, electrolysis and conductometry, voltammetry and polarographic spectrophotometry, atomic spectrometry, solvent extraction, chromatograph and experiments.

  20. Green Chemistry

    Energy Technology Data Exchange (ETDEWEB)

    Collison, Melanie

    2011-05-15

    Green chemistry is the science of chemistry used in a way that will not use or create hazardous substances. Dr. Rui Resendes is working in this field at GreenCentre Canada, an offshoot of PARTEQ Innovations in Kingston, Ontario. GreenCentre's preliminary findings suggest their licensed product {sup S}witchable Solutions{sup ,} featuring 3 classes of solvents and a surfactant, may be useful in bitumen oil sands extraction.

  1. Cluster Chemistry

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    @@ Cansisting of eight scientists from the State Key Laboratory of Physical Chemistry of Solid Surfaces and Xiamen University, this creative research group is devoted to the research of cluster chemistry and creation of nanomaterials.After three-year hard work, the group scored a series of encouraging progresses in synthesis of clusters with special structures, including novel fullerenes, fullerene-like metal cluster compounds as well as other related nanomaterials, and their properties study.

  2. Clinical neuropathology practice guide 06-2012: MGMT testing in elderly glioblastoma patients – yes, but how?

    OpenAIRE

    Berghoff, Anna S.; Preusser, Matthias

    2012-01-01

    Abstract. In 2005, a seminal paper showed that glioblastoma patients aged 18 to 70, whose tumors have a methylated MGMT promoter have a better prognosis than patients with tumors carrying an unmethylated MGMT promoter. As a consequence of this and several confirmatory studies, routine MGMT testing in the clinical setting was promoted. However, only few centers have indeed implemented routine clinical MGMT testing, mostly due the lack of clear clinical consequence and because of considerable t...

  3. Optimisation and assessment of three modern touch screen tablet computers for clinical vision testing.

    Directory of Open Access Journals (Sweden)

    Humza J Tahir

    Full Text Available Technological advances have led to the development of powerful yet portable tablet computers whose touch-screen resolutions now permit the presentation of targets small enough to test the limits of normal visual acuity. Such devices have become ubiquitous in daily life and are moving into the clinical space. However, in order to produce clinically valid tests, it is important to identify the limits imposed by the screen characteristics, such as resolution, brightness uniformity, contrast linearity and the effect of viewing angle. Previously we have conducted such tests on the iPad 3. Here we extend our investigations to 2 other devices and outline a protocol for calibrating such screens, using standardised methods to measure the gamma function, warm up time, screen uniformity and the effects of viewing angle and screen reflections. We demonstrate that all three devices manifest typical gamma functions for voltage and luminance with warm up times of approximately 15 minutes. However, there were differences in homogeneity and reflectance among the displays. We suggest practical means to optimise quality of display for vision testing including screen calibration.

  4. Clinically available RNA profiling tests of prostate tumors: utility and comparison

    Directory of Open Access Journals (Sweden)

    Rong Na

    2016-01-01

    Full Text Available In the postscreening era, physicians are in need of methods to discriminate aggressive from nonaggressive prostate cancer (PCa to reduce overdiagnosis and overtreatment. However, studies have shown that prognoses (e.g., progression and mortality differ even among individuals with similar clinical and pathological characteristics. Existing risk classifiers (TMN grading system, Gleason score, etc. are not accurately enough to represent the biological features of PCa. Using new genomic technologies, novel biomarkers and classifiers have been developed and shown to add value to clinical or pathological risk factors for predicting aggressive disease. Among them, RNA testing (gene expression analysis is useful because it can not only reflect genetic variations but also reflect epigenetic regulations. Commercially available RNA profiling tests (Oncotype Dx, Prolaris, and Decipher have demonstrated strong abilities to discriminate PCa with poor prognosis from less aggressive diseases. For instance, these RNA profiling tests can predict disease progression in active surveillance patients or early recurrence after radical treatments. These tests may offer more dependable methods for PCa prognosis prediction to make more accurate and personal medical decisions.

  5. Optimisation and assessment of three modern touch screen tablet computers for clinical vision testing.

    Science.gov (United States)

    Tahir, Humza J; Murray, Ian J; Parry, Neil R A; Aslam, Tariq M

    2014-01-01

    Technological advances have led to the development of powerful yet portable tablet computers whose touch-screen resolutions now permit the presentation of targets small enough to test the limits of normal visual acuity. Such devices have become ubiquitous in daily life and are moving into the clinical space. However, in order to produce clinically valid tests, it is important to identify the limits imposed by the screen characteristics, such as resolution, brightness uniformity, contrast linearity and the effect of viewing angle. Previously we have conducted such tests on the iPad 3. Here we extend our investigations to 2 other devices and outline a protocol for calibrating such screens, using standardised methods to measure the gamma function, warm up time, screen uniformity and the effects of viewing angle and screen reflections. We demonstrate that all three devices manifest typical gamma functions for voltage and luminance with warm up times of approximately 15 minutes. However, there were differences in homogeneity and reflectance among the displays. We suggest practical means to optimise quality of display for vision testing including screen calibration.

  6. Clinically available RNA profiling tests of prostate tumors: utility and comparison

    Science.gov (United States)

    Na, Rong; Wu, Yishuo; Ding, Qiang; Xu, Jianfeng

    2016-01-01

    In the postscreening era, physicians are in need of methods to discriminate aggressive from nonaggressive prostate cancer (PCa) to reduce overdiagnosis and overtreatment. However, studies have shown that prognoses (e.g., progression and mortality) differ even among individuals with similar clinical and pathological characteristics. Existing risk classifiers (TMN grading system, Gleason score, etc.) are not accurately enough to represent the biological features of PCa. Using new genomic technologies, novel biomarkers and classifiers have been developed and shown to add value to clinical or pathological risk factors for predicting aggressive disease. Among them, RNA testing (gene expression analysis) is useful because it can not only reflect genetic variations but also reflect epigenetic regulations. Commercially available RNA profiling tests (Oncotype Dx, Prolaris, and Decipher) have demonstrated strong abilities to discriminate PCa with poor prognosis from less aggressive diseases. For instance, these RNA profiling tests can predict disease progression in active surveillance patients or early recurrence after radical treatments. These tests may offer more dependable methods for PCa prognosis prediction to make more accurate and personal medical decisions. PMID:26975490

  7. Nutritional value, performance, carcass quality, visceral organ size, and blood clinical chemistry of broiler chicks fed 30% tannin-free fava bean diets.

    Science.gov (United States)

    Usayran, N N; Sha'ar, H; Barbour, G W; Yau, S K; Maalouf, F; Farran, M T

    2014-08-01

    Two experiments were conducted to evaluate the chemical and nutritional values of 5 tannin-free fava bean (FB) cultivars (FB9, FB10, FB13, FB17, and FB24) on growth, visceral organ size, and blood clinical chemistry of broiler chicks fed a corn-soybean meal 48 (SBM48) diet containing 30% tannin-free FB. In the first experiment, 49 Hy-line roosters, 55 wk of age, were individually precision-fed 30 g of each FB cultivar and soybean meal 44 (SBM44). Protein, methionine, and lysine contents of the FB seeds (0.005% tannin) were 27.7, 0.23, and 1.98% of DM, respectively. The AMEn of all FB cultivars was 2,839 kcal/kg and higher (P control) or 30% of FB9, FB10, FB13, FB17, or FB24 seeds were each fed to Ross 308 1-wk-old male broiler chicks for 14 d. The determined FB nutrient values were used in formulating FB-containing diets. Birds fed FB-containing diets had better (P control. When compared with the control birds, relative weights of abdominal fat pad and liver were reduced (P < 0.05) by 30% inclusion of all dietary FB varieties, except for FB17 and FB13, respectively. Broiler chicks fed the FB13 diet had plasma thrombocyte and white blood cell (WBC) differential counts higher (P < 0.05) than those fed the FB10 diet and WBC count higher (P < 0.05) than the birds fed the FB17 diet. In conclusion, tannin-free FB was lower in protein, methionine, and lysine, but higher in AMEn, compared with SBM44. Moreover, FB seeds, especially FB10, can be included in a broiler chick diet with no adverse effects on performance, but FB13 increased WBC count.

  8. Progress report on the influence of test temperature and grain boundary chemistry on the fracture behavior of ITER copper alloys

    Energy Technology Data Exchange (ETDEWEB)

    Li, M.; Stubbins, J.F. [Univ. of Illinois, Urbana, IL (United States). Dept. of Nuclear Engineering; Edwards, D.J. [Pacific Northwest National Lab., Richland, WA (United States)

    1998-09-01

    This collaborative study was initiated to determine mechanical properties at elevated temperatures of various copper alloys by University of Illinois and Pacific Northwestern National Lab (PNNL) with support of OMG Americas, Inc. and Brush Wellman, Inc. This report includes current experimental results on notch tensile tests and pre-cracked bend bar tests on these materials at room temperature, 200 and 300 C. The elevated temperature tests were performed in vacuum and indicate that a decrease in fracture resistance with increasing temperature, as seen in previous investigations. While the causes for the decreases in fracture resistance are still not clear, the current results indicate that environmental effects are likely less important in the process than formerly assumed.

  9. COMPARATIVE EFFICIENCY OF SOME INDIRECT DIAGNOSTIC TESTS FOR THE DETECTION OF SUB-CLINICAL MASTITIS IN COWS AND BUFFALOES

    OpenAIRE

    M. IQBAL, M. AMJED1, M. A. KHAN, M. S. QURESHI1 AND U. SADIQUE1

    2006-01-01

    The present study was undertaken to compare five laboratory diagnostic tests for sub-clinical mastitis in cattle and buffaloes and to compute cost, time taken by each test and its ranking for availability, adoptability, interpretability and sensitivity. There were 352 cases with each test type viz. California Mastitis Test (CMT), White Side Test (WST), White Side + Dye (WSTD), Surf Test and Surf + Dye, and 880 cases with each species type (cattle and buffaloes). Result scores (1760 ) for sub...

  10. Targeted testing with diethylthiourea often reveals clinically relevant allergic contact dermatitis caused by neoprene rubber

    DEFF Research Database (Denmark)

    Dall, Anne B-H; Andersen, Klaus Ejner; Mortz, Charlotte G

    2012-01-01

    Background. Diethylthiourea is widely used in the rubber industry, particularly in neoprene rubber, and may cause allergic contact dermatitis. However, as thiourea allergens are not part of the European baseline series, the diagnosis of allergic contact dermatitis caused by thiourea compounds...... depends on clinical suspicion and aimed testing. Objectives. The aims of this study were to evaluate the occurrence of sensitization to diethylthiourea during a 19-year period by using data from the Allergen Bank database at the Department of Dermatology and Allergy Centre, Odense University Hospital, and...... Bank. The records for patients with positive reactions were evaluated retrospectively. Results. One hundred and fifty-one patients were tested by 27 different dermatologists in private practice, and positive reactions were found in 16% (24/151) of the patients; 88 patients were tested at the...

  11. Validation of the Danish Addenbrooke's Cognitive Examination as a screening test in a memory clinic

    DEFF Research Database (Denmark)

    Stokholm, Jette; Vogel, Asmus; Johannsen, Peter;

    2009-01-01

    BACKGROUND: Addenbrooke's Cognitive Examination (ACE) is a cognitive screening test developed to detect dementia. It has been validated in several countries. Validation studies have predominantly included patients with various degrees of dementia and healthy controls. OBJECTIVE: The aim...... of this study was to evaluate the Danish version of ACE as a screening test for early dementia in an outpatient memory clinic. Further, we wanted to investigate the ability of the ACE to discriminate patients with early Alzheimer's disease (AD) from patients with depression. METHOD: 78 patients with mild AD......-off points for optimal trade-off between sensitivity and specificity for ACE were 85/86 (sensitivity 0.99, specificity 0.94). When these cut-off points were applied to the group of depressive patients, the specificity dropped to 0.64, indicating a great overlap in individual test scores for demented...

  12. Validity of Commonly Used Clinical Tests to Diagnose and Screen for Spinal Pain in Adolescents

    DEFF Research Database (Denmark)

    Aartun, Ellen; Hartvigsen, Jan; Hestbaek, Lise

    2016-01-01

    OBJECTIVE: The overall aim of this study was to determine the ability of 2 selected clinical tests to detect or predict neck pain, mid back pain, and low back pain in a school-based cohort of Danish 11- to 15-year-olds. METHODS: A school-based 2-year prospective cohort study was conducted. Data...... were collected at the age of 11 to 13 (n = 1224) and 2 years later (n = 963). Spinal pain (neck pain, mid back pain, and low back pain) was assessed by an electronic survey completed during school time, and reference standard was defined as both lifetime prevalence and frequent pain as a proxy...... of severity. The tests included assessments of scoliosis, hypermobility, global mobility, intersegmental mobility, end range pain, and isometric endurance of back extensors. Sensitivity, specificity, negative and positive predictive values, and odds ratios were calculated for each test individually, and area...

  13. A Rapid In-Clinic Test Detects Acute Leptospirosis in Dogs with High Sensitivity and Specificity

    Directory of Open Access Journals (Sweden)

    Angeli Kodjo

    2016-01-01

    Full Text Available A rapid IgM-detection immunochromatographic test (WITNESS® Lepto, Zoetis has recently become available to identify acute canine leptospirosis at the point of care. Diagnostic sensitivity and specificity of the test were evaluated by comparison with the microscopic agglutination assay (MAT, using a positive cut-off titer of ≥800. Banked serum samples from dogs exhibiting clinical signs and suspected leptospirosis were selected to form three groups based on MAT titer: (1 positive (n=50; (2 borderline (n=35; and (3 negative (n=50. Using an analysis to weight group sizes to reflect French prevalence, the sensitivity and specificity were 98% and 93.5% (88.2% unweighted, respectively. This test rapidly identifies cases of acute canine leptospirosis with high levels of sensitivity and specificity with no interference from previous vaccination.

  14. A Rapid In-Clinic Test Detects Acute Leptospirosis in Dogs with High Sensitivity and Specificity.

    Science.gov (United States)

    Kodjo, Angeli; Calleja, Christophe; Loenser, Michael; Lin, Dan; Lizer, Joshua

    2016-01-01

    A rapid IgM-detection immunochromatographic test (WITNESS® Lepto, Zoetis) has recently become available to identify acute canine leptospirosis at the point of care. Diagnostic sensitivity and specificity of the test were evaluated by comparison with the microscopic agglutination assay (MAT), using a positive cut-off titer of ≥800. Banked serum samples from dogs exhibiting clinical signs and suspected leptospirosis were selected to form three groups based on MAT titer: (1) positive (n = 50); (2) borderline (n = 35); and (3) negative (n = 50). Using an analysis to weight group sizes to reflect French prevalence, the sensitivity and specificity were 98% and 93.5% (88.2% unweighted), respectively. This test rapidly identifies cases of acute canine leptospirosis with high levels of sensitivity and specificity with no interference from previous vaccination. PMID:27110562

  15. Impact of clinical awareness and diagnostic tests on the underdiagnosis of Clostridium difficile infection.

    Science.gov (United States)

    Alcalá, L; Reigadas, E; Marín, M; Martín, A; Catalán, P; Bouza, E

    2015-08-01

    A multicenter study of Clostridium difficile infection (CDI) performed during 2008 in Spain revealed that two of every three episodes went undiagnosed or were misdiagnosed owing to nonsensitive diagnostic tests or lack of clinical suspicion and request. Since then, efforts have been made to improve the diagnostic tests used by laboratories and to increase the awareness of this disease among both clinicians and microbiologists. Our objective was to evaluate the impact of these efforts by assessing the current magnitude of underdiagnosis of CDI in Spain using two point-prevalence studies performed on one day each in January and July of 2013. A total of 111 Spanish laboratories selected all unformed stool specimens received for microbiological diagnosis on these days, and toxigenic culture was performed at a central reference laboratory. Toxigenic isolates were characterized both pheno- and genotypically. The reference laboratory detected 103 episodes of CDI in patients aged 2 years or more. Half (50.5 %) of the episodes were not diagnosed in the participating laboratories, owing to insensitive diagnostic tests (15.5 %) or the lack of clinical suspicion and request (35.0 %). The main ribotypes were 014, 078/126, 001/072, and 106. Ribotype 027 caused 2.9 % of all cases. Despite all the interventions undertaken, CDI remains a highly neglected disease because of the lack of sensitive diagnostic tests in some institutions and, especially, the absence of clinical suspicion, mainly in patients with community-associated CDI. Toxigenic C. difficile should be routinely sought in unformed stools sent for microbiological diagnosis, regardless of their origin.

  16. A low-order coupled chemistry meteorology model for testing online and offline data assimilation schemes: L95-GRS (v1.0)

    Science.gov (United States)

    Haussaire, J.-M.; Bocquet, M.

    2016-01-01

    Bocquet and Sakov (2013) introduced a low-order model based on the coupling of the chaotic Lorenz-95 (L95) model, which simulates winds along a mid-latitude circle, with the transport of a tracer species advected by this zonal wind field. This model, named L95-T, can serve as a playground for testing data assimilation schemes with an online model. Here, the tracer part of the model is extended to a reduced photochemistry module. This coupled chemistry meteorology model (CCMM), the L95-GRS (generic reaction set) model, mimics continental and transcontinental transport and the photochemistry of ozone, volatile organic compounds and nitrogen oxides. Its numerical implementation is described. The model is shown to reproduce the major physical and chemical processes being considered. L95-T and L95-GRS are specifically designed and useful for testing advanced data assimilation schemes, such as the iterative ensemble Kalman smoother (IEnKS), which combines the best of ensemble and variational methods. These models provide useful insights prior to the implementation of data assimilation methods into larger models. We illustrate their use with data assimilation schemes on preliminary yet instructive numerical experiments. In particular, online and offline data assimilation strategies can be conveniently tested and discussed with this low-order CCMM. The impact of observed chemical species concentrations on the wind field estimate can be quantitatively assessed. The impacts of the wind chaotic dynamics and of the chemical species non-chaotic but highly nonlinear dynamics on the data assimilation strategies are illustrated.

  17. Revitalizing chemistry laboratory instruction

    Science.gov (United States)

    McBride, Phil Blake

    This dissertation involves research in three major domains of chemical education as partial fulfillment of the requirements for the Ph.D. program in chemistry at Miami University with a major emphasis on chemical education, and concurrent study in organic chemistry. Unit I, Development and Assessment of a Column Chromatography Laboratory Activity, addresses the domain of Instructional Materials Development and Testing. This unit outlines the process of developing a publishable laboratory activity, testing and revising that activity, and subsequently sharing that activity with the chemical education community. A laboratory activity focusing on the separation of methylene blue and sodium fluorescein was developed to demonstrate the effects of both the stationary and mobile phase in conducting a separation. Unit II, Bringing Industry to the Laboratory, addresses the domain of Curriculum Development and Testing. This unit outlines the development of the Chemistry of Copper Mining module, which is intended for use in high school or undergraduate college chemistry. The module uses the learning cycle approach to present the chemistry of the industrial processes of mining copper to the students. The module includes thirteen investigations (three of which are web-based and ten which are laboratory experiments) and an accompanying interactive CD-ROM, which provides an explanation of the chemistry used in copper mining with a virtual tour of an operational copper mine. Unit III, An Alternative Method of Teaching Chemistry. Integrating Lecture and the Laboratory, is a project that addresses the domain of Research in Student Learning. Fundamental Chemistry was taught at Eastern Arizona College as an integrated lecture/laboratory course that met in two-hour blocks on Monday, Wednesday, and Friday. The students taking this integrated course were compared with students taking the traditional 1-hour lectures held on Monday, Wednesday, and Friday, with accompanying 3-hour lab on

  18. Genetic Testing as a New Standard for Clinical Diagnosis of Color Vision Deficiencies

    Science.gov (United States)

    Davidoff, Candice; Neitz, Maureen; Neitz, Jay

    2016-01-01

    Purpose The genetics underlying inherited color vision deficiencies is well understood: causative mutations change the copy number or sequence of the long (L), middle (M), or short (S) wavelength sensitive cone opsin genes. This study evaluated the potential of opsin gene analyses for use in clinical diagnosis of color vision defects. Methods We tested 1872 human subjects using direct sequencing of opsin genes and a novel genetic assay that characterizes single nucleotide polymorphisms (SNPs) using the MassArray system. Of the subjects, 1074 also were given standard psychophysical color vision tests for a direct comparison with current clinical methods. Results Protan and deutan deficiencies were classified correctly in all subjects identified by MassArray as having red–green defects. Estimates of defect severity based on SNPs that control photopigment spectral tuning correlated with estimates derived from Nagel anomaloscopy. Conclusions The MassArray assay provides genetic information that can be useful in the diagnosis of inherited color vision deficiency including presence versus absence, type, and severity, and it provides information to patients about the underlying pathobiology of their disease. Translational Relevance The MassArray assay provides a method that directly analyzes the molecular substrates of color vision that could be used in combination with, or as an alternative to current clinical diagnosis of color defects.

  19. The clinical utility of HPV DNA testing in cervical cancer screening strategies.

    Science.gov (United States)

    Bhatla, Neerja; Moda, Nidhi

    2009-09-01

    Cervical cancer continues to be the commonest cause of death among women in developing countries, largely due to the failure to the inability to sustain effective cytology-based screening programs. While this burden may come down following implementation of the human papillomavirus (HPV) vaccine, screening will still be required. HPV DNA testing is a promising new technology for cervical cancer prevention and is the most reproducible of all cervical cancer screening tests. Presently, the two assays most widely used for the detection of genital types are the polymerase chain reaction (PCR) and Hybrid Capture 2 assays (hc2). Rapid, affordable tests are expected to be available soon. HPV DNA testing can be used in a variety of clinical scenarios that include primary screening in women older than 30 yr; as an adjunctive test to cytology; in the triage of women with an equivocal cytologic report, e.g., ASC-US; or for follow-up post-treatment for cervical intraepithelial neoplasia (CIN). HPV DNA testing can also be performed on self-collected samples, which allows screening in remote areas and also in women who refuse gynecologic examination. PMID:19901435

  20. The clinical utility of HPV DNA testing in cervical cancer screening strategies.

    Science.gov (United States)

    Bhatla, Neerja; Moda, Nidhi

    2009-09-01

    Cervical cancer continues to be the commonest cause of death among women in developing countries, largely due to the failure to the inability to sustain effective cytology-based screening programs. While this burden may come down following implementation of the human papillomavirus (HPV) vaccine, screening will still be required. HPV DNA testing is a promising new technology for cervical cancer prevention and is the most reproducible of all cervical cancer screening tests. Presently, the two assays most widely used for the detection of genital types are the polymerase chain reaction (PCR) and Hybrid Capture 2 assays (hc2). Rapid, affordable tests are expected to be available soon. HPV DNA testing can be used in a variety of clinical scenarios that include primary screening in women older than 30 yr; as an adjunctive test to cytology; in the triage of women with an equivocal cytologic report, e.g., ASC-US; or for follow-up post-treatment for cervical intraepithelial neoplasia (CIN). HPV DNA testing can also be performed on self-collected samples, which allows screening in remote areas and also in women who refuse gynecologic examination.

  1. Feasibility of HIV Universal Voluntary Counseling and Testing in a Thai General Practice Clinic.

    Science.gov (United States)

    Khawcharoenporn, Thana; Apisarnthanarak, Anucha; Chunloy, Krongtip; Smith, Kimberly

    2016-05-01

    An HIV transmission prevention program incorporating universal voluntary counseling and testing (UVCT) was conducted in a general practice (GP) clinic of a Thai hospital. Of the 494 participating patients, 356 (72%) accepted HIV-UVCT. Independent factors associated with HIV-UVCT acceptance included participating in the program after office hours (4-8 pm; P marriage (P = .01), and having primary school education or less (P = .02). The main reasons for declining HIV-UVCT were time constraint (38%) and perceiving self as no risk (35%). Among the 356 patients undergoing HIV-UVCT, having moderate to high HIV risk (P homosexual men. The findings suggest feasibility of HIV-UVCT in our GP clinic and factors to be considered for improving the program. PMID:24759448

  2. Evaluation of oxidative stress and whole blood viscosity for clinical laboratory testing of smoking toxicity

    Directory of Open Access Journals (Sweden)

    Ezekiel U. Nwose

    2016-06-01

    Full Text Available Background: There are no clearly established clinical biochemical markers for cigarette smoking despite the knowledge that cigarette smoking is a risk factor for various diseases, especially cardiovascular complications of respiratory pathologies. However, there are reports of significant increases in blood viscosity and oxidative stress among smokers. The main objective of the study was to ascertain the association of toxicity from cigarette smoking on whole blood viscosity in our data. Methods: This study analysed the archived clinical data of 20 cigarette smokers and 20 apparently healthy individuals. Results: The data show that on average, oxidative stress levels are relatively the same between groups, while whole blood viscosity is statistically significantly lower in non-smokers compared to smokers. Conclusions: This report suggests that oxidative stress induced whole blood hyper-viscosity could be a valid biomarker for laboratory testing of smoking toxicity among cigarette smokers. [Int J Res Med Sci 2016; 4(6.000: 2332-2336

  3. Evaluation of Clinical Decision Rules for Bone Mineral Density Testing among White Women

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    Michael E. Anders

    2013-01-01

    Full Text Available Background. Osteoporosis is a devastating, insidious disease that causes skeletal fragility. Half of women will suffer osteoporotic fractures during their lifetimes. Many fractures occur needlessly, because of inattentiveness to assessment, diagnosis, prevention, and treatment of osteoporosis. Study Purpose. Study Purpose. To evaluate the discriminatory performance of clinical decision rules to determine the need to undergo bone mineral density testing. Methods. A nationally representative sample from the Third National Health and Nutrition Examination Survey consisted of 14,060 subjects who completed surveys, physical examinations, laboratory tests, and bone mineral density exams. Multivariable linear regression tested the correlation of covariates that composed the clinical decision rules with bone mineral density. Results. Increased age and decreased weight were variables in the final regression models for each gender and race/ethnicity. Among the indices, the Osteoporosis Self-Assessment Tool, which is composed of age and weight, performed best for White women. Study Implications. These results have implications for the prevention, assessment, diagnosis, and treatment of osteoporosis. The Osteoporosis Self-Assessment Tool performed best and is inexpensive and the least time consuming to implement.

  4. Clinically significant anaerobic bacteria isolated from patients in a South African academic hospital: antimicrobial susceptibility testing.

    Science.gov (United States)

    Naidoo, S; Perovic, O; Richards, G A; Duse, A G

    2011-09-27

    BACKGROUND. Increasing resistance to some antimicrobial agents among anaerobic bacteria has made susceptibility patterns less predictable. METHOD. This was a prospective study of the susceptibility data of anaerobic organisms isolated from clinical specimens from patients with suspected anaerobic infections from June 2005 until February 2007. Specimens were submitted to the microbiology laboratory at Charlotte Maxeke Johannesburg Academic Hospital, where microscopy, culture and susceptibility testing were performed the using E test® strip minimum inhibitory concentration method. Results were interpreted with reference to Clinical and Laboratory Standards Institute guidelines for amoxicillin-clavulanate, clindamycin, metronidazole, penicillin, ertapenem, cefoxitin, ceftriaxone, chloramphenicol and piperacillin-tazobactam. RESULTS. One hundred and eighty anaerobic isolates were submitted from 165 patients. The most active antimicrobial agents were chloramphenicol (100% susceptible), ertapenem (97.2%), piperacillin-tazobactam (99.4%) and amoxicillin-clavulanic acid (96.7%). Less active were metronidazole (89.4%), cefoxitin (85%), clindamycin (81.7%), ceftriaxone (68.3%) and penicillin (33.3%). CONCLUSION. Susceptibility testing should be performed periodically to identify emerging trends in resistance and to modify empirical treatment of anaerobic infections.

  5. Radiation Chemistry

    Science.gov (United States)

    Wojnárovits, L.

    Ionizing radiation causes chemical changes in the molecules of the interacting medium. The initial molecules change to new molecules, resulting in changes of the physical, chemical, and eventually biological properties of the material. For instance, water decomposes to its elements H2 and O2. In polymers, degradation and crosslinking take place. In biopolymers, e.g., DNS strand breaks and other alterations occur. Such changes are to be avoided in some cases (radiation protection), however, in other cases they are used for technological purposes (radiation processing). This chapter introduces radiation chemistry by discussing the sources of ionizing radiation (radionuclide sources, machine sources), absorption of radiation energy, techniques used in radiation chemistry research, and methods of absorbed energy (absorbed dose) measurements. Radiation chemistry of different classes of inorganic (water and aqueous solutions, inorganic solids, ionic liquids (ILs)) and organic substances (hydrocarbons, halogenated compounds, polymers, and biomolecules) is discussed in concise form together with theoretical and experimental backgrounds. An essential part of the chapter is the introduction of radiation processing technologies in the fields of polymer chemistry, food processing, and sterilization. The application of radiation chemistry to nuclear technology and to protection of environment (flue gas treatment, wastewater treatment) is also discussed.

  6. Clinical Validation of 4-Dimensional Computed Tomography Ventilation With Pulmonary Function Test Data

    International Nuclear Information System (INIS)

    Purpose: A new form of functional imaging has been proposed in the form of 4-dimensional computed tomography (4DCT) ventilation. Because 4DCTs are acquired as part of routine care for lung cancer patients, calculating ventilation maps from 4DCTs provides spatial lung function information without added dosimetric or monetary cost to the patient. Before 4DCT-ventilation is implemented it needs to be clinically validated. Pulmonary function tests (PFTs) provide a clinically established way of evaluating lung function. The purpose of our work was to perform a clinical validation by comparing 4DCT-ventilation metrics with PFT data. Methods and Materials: Ninety-eight lung cancer patients with pretreatment 4DCT and PFT data were included in the study. Pulmonary function test metrics used to diagnose obstructive lung disease were recorded: forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity. Four-dimensional CT data sets and spatial registration were used to compute 4DCT-ventilation images using a density change–based and a Jacobian-based model. The ventilation maps were reduced to single metrics intended to reflect the degree of ventilation obstruction. Specifically, we computed the coefficient of variation (SD/mean), ventilation V20 (volume of lung ≤20% ventilation), and correlated the ventilation metrics with PFT data. Regression analysis was used to determine whether 4DCT ventilation data could predict for normal versus abnormal lung function using PFT thresholds. Results: Correlation coefficients comparing 4DCT-ventilation with PFT data ranged from 0.63 to 0.72, with the best agreement between FEV1 and coefficient of variation. Four-dimensional CT ventilation metrics were able to significantly delineate between clinically normal versus abnormal PFT results. Conclusions: Validation of 4DCT ventilation with clinically relevant metrics is essential. We demonstrate good global agreement between PFTs and 4DCT-ventilation, indicating that 4DCT

  7. Clinical Validation of 4-Dimensional Computed Tomography Ventilation With Pulmonary Function Test Data

    Energy Technology Data Exchange (ETDEWEB)

    Brennan, Douglas [University of Colorado School of Medicine, Aurora, Colorado (United States); Schubert, Leah; Diot, Quentin [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States); Castillo, Richard [Department of Radiation Oncology, The University of Texas Medical Branch, Galveston, Texas (United States); Castillo, Edward; Guerrero, Thomas [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, Michigan (United States); Martel, Mary K. [Department of Radiation Physics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Linderman, Derek; Gaspar, Laurie E.; Miften, Moyed; Kavanagh, Brian D. [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States); Vinogradskiy, Yevgeniy, E-mail: yevgeniy.vinogradskiy@ucdenver.edu [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States)

    2015-06-01

    Purpose: A new form of functional imaging has been proposed in the form of 4-dimensional computed tomography (4DCT) ventilation. Because 4DCTs are acquired as part of routine care for lung cancer patients, calculating ventilation maps from 4DCTs provides spatial lung function information without added dosimetric or monetary cost to the patient. Before 4DCT-ventilation is implemented it needs to be clinically validated. Pulmonary function tests (PFTs) provide a clinically established way of evaluating lung function. The purpose of our work was to perform a clinical validation by comparing 4DCT-ventilation metrics with PFT data. Methods and Materials: Ninety-eight lung cancer patients with pretreatment 4DCT and PFT data were included in the study. Pulmonary function test metrics used to diagnose obstructive lung disease were recorded: forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity. Four-dimensional CT data sets and spatial registration were used to compute 4DCT-ventilation images using a density change–based and a Jacobian-based model. The ventilation maps were reduced to single metrics intended to reflect the degree of ventilation obstruction. Specifically, we computed the coefficient of variation (SD/mean), ventilation V20 (volume of lung ≤20% ventilation), and correlated the ventilation metrics with PFT data. Regression analysis was used to determine whether 4DCT ventilation data could predict for normal versus abnormal lung function using PFT thresholds. Results: Correlation coefficients comparing 4DCT-ventilation with PFT data ranged from 0.63 to 0.72, with the best agreement between FEV1 and coefficient of variation. Four-dimensional CT ventilation metrics were able to significantly delineate between clinically normal versus abnormal PFT results. Conclusions: Validation of 4DCT ventilation with clinically relevant metrics is essential. We demonstrate good global agreement between PFTs and 4DCT-ventilation, indicating that 4DCT

  8. Drug susceptibility testing of clinical isolates of streptococci and enterococci by the Phoenix automated microbiology system

    Directory of Open Access Journals (Sweden)

    Sokeng Gertrude

    2007-05-01

    Full Text Available Abstract Background Drug resistance is an emerging problem among streptococcal and enterococcal species. Automated diagnostic systems for species identification and antimicrobial susceptibility testing (AST have become recently available. We evaluated drug susceptibility of clinical isolates of streptococci and enterococci using the recent Phoenix system (BD, Sparks, MD. Diagnostic tools included the new SMIC/ID-2 panel for streptococci, and the PMIC/ID-14 for enterococci. Two-hundred and fifty isolates have been investigated: β-hemolytic streptococci (n = 65, Streptococcus pneumoniae (n = 50, viridans group streptococci (n = 32, Enterococcus faecium (n = 40, Enterococcus faecalis (n = 43, other catalase-negative cocci (n = 20. When needed, species ID was determined using molecular methods. Test bacterial strains were chosen among those carrying clinically-relevant resistance determinants (penicillin, macrolides, fluoroquinolones, glycopeptides. AST results of the Phoenix system were compared to minimal inhibitory concentration (MIC values measured by the Etest method (AB Biodisk, Solna, Sweden. Results Streptococci: essential agreement (EA and categorical agreement (CA were 91.9% and 98.8%, respectively. Major (ME and minor errors (mE accounted for 0.1% and 1.1% of isolates, respectively. No very major errors (VME were produced. Enterococci: EA was 97%, CA 96%. Small numbers of VME (0.9%, ME (1.4% and mE (2.8% were obtained. Overall, EA and CA rates for most drugs were above 90% for both genera. A few VME were found: a teicoplanin and high-level streptomycin for E. faecalis, b high-level gentamicin for E. faecium. The mean time to results (± SD was 11.8 ± 0.9 h, with minor differences between streptococci and enterococci. Conclusion The Phoenix system emerged as an effective tool for quantitative AST. Panels based on dilution tests provided rapid and accurate MIC values with regard to clinically-relevant streptococcal and enterococcal

  9. Impact of HFE genetic testing on clinical presentation of hereditary hemochromatosis: new epidemiological data

    Directory of Open Access Journals (Sweden)

    Ka Chandran

    2005-06-01

    Full Text Available Abstract Background Hereditary hemochromatosis (HH is a common inherited disorder of iron metabolism in Northern European populations. The discovery of a candidate gene in 1996 (HFE, and of its main mutation (C282Y, has radically altered the way to diagnose this disease. The aim of this study was to assess the impact of the HFE gene discovery on the clinical presentation and epidemiology of HH. Methods We studied our cohort of 415 patients homozygous for the C282Y allele and included in a phlebotomy program in a blood centre in western Brittany, France. Results In this cohort, 56.9% of the patients were male and 21.9% began their phlebotomy program before the implementation of the genetic test. A significant decrease in the sex ratio was noticed following implementation of this DNA test, from 3.79 to 1.03 (p -5, meaning that the proportion of diagnosed females relatives to males greatly increased. The profile of HH patients at diagnosis changed after the DNA test became available. Serum ferritin and iron values were lower and there was a reduced frequency of clinical signs displayed at diagnosis, particularly skin pigmentation (20.1 vs. 40.4%, OR = 0.37, p Conclusion This study highlights the importance of the HFE gene discovery, which has simplified the diagnosis of HH and modified its clinical presentation and epidemiology. This study precisely measures these changes. Enhanced diagnosis of HFE-related HH at an early stage and implementation of phlebotomy treatment are anticipated to maintain normal life expectancy for these patients.

  10. Impact of the clinical context on the 14-3-3 test for the diagnosis of sporadic CJD

    Directory of Open Access Journals (Sweden)

    Sierra-Moros Maríajosé

    2006-07-01

    Full Text Available Abstract Background The 14-3-3 test appears to be a valuable aid for the clinical diagnosis of sporadic Creutzfeldt-Jakob disease (sCJD in selected populations. However, its usefulness in routine practice has been challenged. In this study, the influence of the clinical context on the performance of the 14-3-3 test for the diagnosis of sCJD is investigated through the analysis of a large prospective clinical series. Methods Six hundred seventy-two Spanish patients with clinically suspected sCJD were analyzed. Clinical classification at sample reception according to the World Health Organization's (WHO criteria (excluding the 14-3-3 test result was used to explore the influence of the clinical context on the pre-test probabilities, and positive (PPV and negative (NPV predictive values of the 14-3-3 test. Results Predictive values of the test varied greatly according to the initial clinical classification: PPV of 98.8%, 96.5% and 45.0%, and NPV of 26.1%, 66.6% and 100% for probable sCJDi (n = 115, possible sCJDi (n = 73 and non-sCJDi (n = 484 cases, respectively. According to multivariate and Bayesian analyses, these values represent an improvement of diagnostic certainty compared to clinical data alone. Conclusion In three different contexts of sCJD suspicion, the 14-3-3 assay provides useful information complementary to clinical and electroencephalographic (EEG data. The test is most useful supporting a clinical impression, whilst it may show deceptive when it is not in agreement with clinical data.

  11. Handgrip strength test as a complementary tool in monitoring asthma in daily clinical practice in children.

    Directory of Open Access Journals (Sweden)

    Pedro Ángel Latorre-Román

    2014-12-01

    Full Text Available The aim of this study was to demonstrate that handgrip strength test can discriminate the presence/absence of asthma and between intermittent and moderate persistent asthma in children. 140 children (70 healthy and 70 with asthma completed the Pediatric Asthma Quality of Life Questionnaire (PAQLQ and performed the handgrip strength test. Forty-eight hours later, subjects performed spirometry. The results showed Handgrip strength was significantly lower (p<0.001 in children with asthma compared with healthy ones. There were also significant differences (p= 0.024 according to the severity of the disease; children with moderate persistent asthma performed worse than children with intermittent asthma. Binary logistic regression analysis and ROC curve analysis revealed that the result in handgrip strength test was a predictive factor for asthma (cut-off at 16.84 kg and for severity of pathology (cut-off at 15.06 kg. Handgrip strength was reduced in children with asthma. Handgrip strength was positively associated with lung capacity and quality of life. The fact that the handgrip strength test was able to discriminate between presence/absence of asthma and between intermittent and moderate persistent asthma in children suggested that this test could be used as a complementary tool in the monitoring of asthma in daily clinical practice.

  12. Clinical usefulness of the clock drawing test applying rasch analysis in predicting of cognitive impairment.

    Science.gov (United States)

    Yoo, Doo Han; Lee, Jae Shin

    2016-07-01

    [Purpose] This study examined the clinical usefulness of the clock drawing test applying Rasch analysis for predicting the level of cognitive impairment. [Subjects and Methods] A total of 187 stroke patients with cognitive impairment were enrolled in this study. The 187 patients were evaluated by the clock drawing test developed through Rasch analysis along with the mini-mental state examination of cognitive evaluation tool. An analysis of the variance was performed to examine the significance of the mini-mental state examination and the clock drawing test according to the general characteristics of the subjects. Receiver operating characteristic analysis was performed to determine the cutoff point for cognitive impairment and to calculate the sensitivity and specificity values. [Results] The results of comparison of the clock drawing test with the mini-mental state showed significant differences in according to gender, age, education, and affected side. A total CDT of 10.5, which was selected as the cutoff point to identify cognitive impairement, showed a sensitivity, specificity, Youden index, positive predictive, and negative predicive values of 86.4%, 91.5%, 0.8, 95%, and 88.2%. [Conclusion] The clock drawing test is believed to be useful in assessments and interventions based on its excellent ability to identify cognitive disorders.

  13. EVALUATION OF VITEK 2 SYSTEM FOR CLINICAL IDENTIFICATION OF CANDIDA SPECIES AND THEIR ANTIFUNGAL SUSCEPTIBILITY TEST

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    Mohan

    2016-06-01

    Full Text Available BJECTIVES 1. To evaluate the Vitek 2 system for clinical identification of Candida species and their antifungal susceptibility test; 2. To study the incidence of various types of Candida species in this part of Tamilnadu. METHODS Samples collected from different wards were subjected for culture, isolation and identification of Candida Species and Antifungal Susceptibility testing by Vitek System. Vitek 2 test was carried out in Apollo Specialty Hospital Lab Services, Madurai. The cost per test is Rs. 200 (Subsidized rate. The expenses for the lab tests (Vitek were borne by the author himself. RESULTS 124 samples were collected from urine, sputum, blood, pus and wounds. Candida albicans formed 43% of the samples. Among the 57% of Non-Candida albicans, Candida tropicalis formed 42%, Candida krusei formed 6%, Candida guilliermondii formed 4%, Candida inconspicua, Candida parapsilosis, Candida glabrata, Candida rugosa and Candida lusitaniae formed 1% each. Candida albicans and C. tropicalis showed high sensitivity to Voriconazole, Flucytosine, Amphotericin B and Fluconazole. CONCLUSION Candida tropicalis was identified as the most common Candida non-albicans species. Candida albicans and C. tropicalis showed high sensitivity to Voriconazole, Flucytosine, Amphotericin B and Fluconazole. This study was helpful to treat Candida albicans and Non-Candida albicans species patients accurately and earlier by Vitek method.

  14. The Effect of Provocative Tests on Electrodiognosis of Clinical Carpal Tunnel Syndrome

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    MR Emad

    2006-04-01

    Full Text Available ABSTRACT: Introduction & Objective: Nerve conduction study is the most sensitive test for diagnosis of carpal tunnel syndrome (CTS. This test is normal in some patients with mild CTS. Median nerve conduction study evaluation after a provocative test (e.g. wrist flexion may be helpful for diagnosis of mild CTS. This study aimed to determine the effect of wrist flexion on median nerve conduction in patients suspected to CTS and in healthy subjects. Materials & Methods: In this case-controlled study, 20 patients (20 hands with clinical signs of CTS and normal routine electrodiagnosis test results and 20 healthy subjects were investigated. Measured parameters included: median nerve distal sensory latency (DSL, nerve conduction velocity (NCV, compound nerve action potential (CNAP, distal motor latency (DML and compound muscle action potential amplitude (CMAP AMP. The above noted parameters were measured before and after 5 minutes of full wrist flexion. Data were collected by filling out a questionnaire and were analyzed using Paired T-test. Results: Distal Sensory Latency increment and NCV decrement after 5 minutes wrist flexion in the patients group were statistically significant (p<0.05. The same parameters did not show a significant incremental or decremental change in the control group. Conclusion: Median nerve DSL and NCV measurement after 5 minutes wrist flexion may be helpful in determining more sensitive parameters in the electrodiagnosis of CTS.

  15. Intraocular pressure dynamics with prostaglandin analogs: a clinical application of water-drinking test

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    Özyol P

    2016-07-01

    Full Text Available Pelin Özyol,1 Erhan Özyol,1 Ercan Baldemir2 1Ophthalmology Department, 2Biostatistics Department, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey Aim: To evaluate the clinical applicability of the water-drinking test in treatment-naive primary open-angle glaucoma patients. Methods: Twenty newly diagnosed primary open-angle glaucoma patients and 20 healthy controls were enrolled in this prospective study. The water-drinking test was performed at baseline and 6 weeks and 3 months after prostaglandin analog treatment. Peak and fluctuation of intraocular pressure (IOP measurements obtained with the water-drinking test during follow-up were analyzed. Analysis of variance for repeated measures and paired and unpaired t-tests were used for statistical analysis. Results: The mean baseline IOP values in patients with primary open-angle glaucoma were 25.1±4.6 mmHg before prostaglandin analog treatment, 19.8±3.7 mmHg at week 6, and 17.9±2.2 mmHg at month 3 after treatment. The difference in mean baseline IOP of the water-drinking tests was statistically significant (P<0.001. At 6 weeks of prostaglandin analog treatment, two patients had high peak and fluctuation of IOP measurements despite a reduction in baseline IOP. After modifying treatment, patients had lower peak and fluctuation of IOP values at month 3 of the study. Conclusion: Peak and fluctuation of IOP in response to the water-drinking test were lower with prostaglandin analogs compared with before medication. The water-drinking test can represent an additional benefit in the management of glaucoma patients, especially by detecting higher peak and fluctuation of IOP values despite a reduced mean IOP. Therefore, it could be helpful as a supplementary method in monitoring IOP in the clinical practice. Keywords: glaucoma, intraocular pressure, water-drinking test, prostaglandin analog, intra­ocular pressure fluctuation

  16. The value of the UK Clinical Aptitude Test in predicting pre-clinical performance: a prospective cohort study at Nottingham Medical School

    OpenAIRE

    James David; Yates Janet

    2010-01-01

    Abstract Background The UK Clinical Aptitude Test (UKCAT) was introduced in 2006 as an additional tool for the selection of medical students. It tests mental ability in four distinct domains (Quantitative Reasoning, Verbal Reasoning, Abstract Reasoning, and Decision Analysis), and the results are available to students and admissions panels in advance of the selection process. As yet the predictive validity of the test against course performance is largely unknown. The study objective was to d...

  17. Quantum chemistry

    CERN Document Server

    Lowe, John P

    2006-01-01

    Lowe's new edition assumes little mathematical or physical sophistication and emphasizes an understanding of the techniques and results of quantum chemistry. It can serve as a primary text in quantum chemistry courses, and enables students and researchers to comprehend the current literature. This third edition has been thoroughly updated and includes numerous new exercises to facilitate self-study and solutions to selected exercises.* Assumes little initial mathematical or physical sophistication, developing insights and abilities in the context of actual problems* Provides thorough treatment

  18. Testing of evaluation bias for progression free survival endpoint in oncology clinical trials.

    Science.gov (United States)

    Sun, Yan; Wu, Wenting; Sargent, Daniel

    2016-09-30

    Progression-free survival is an increasingly popular end point in oncology clinical trials. A complete blinded independent central review (BICR) is often required by regulators in an attempt to reduce the bias in progression-free survival (PFS) assessment. In this paper, we propose a new methodology that uses a sample-based BICR as an audit tool to decide whether a complete BICR is needed. More specifically, we propose a new index, the differential risk, to measure the reading discordance pattern, and develop a corresponding hypothesis testing procedure to decide whether the bias in local evaluation is acceptable. Simulation results demonstrate that our new index is sensitive to the change of discordance pattern; type I error is well controlled in the hypothesis testing procedure, and the calculated sample size provides the desired power. Copyright © 2016 John Wiley & Sons, Ltd. PMID:27089832

  19. Prostate Cancer Specificity of PCA3 Gene Testing: Examples from Clinical Practice

    Science.gov (United States)

    Marks, Leonard S; Bostwick, David G

    2008-01-01

    A specific marker for early prostate cancer would fill an important void. In initial evaluations of the prostate cancer antigen 3 (PCA3) gene vis-à-vis serum prostate-specific antigen (PSA) levels, the gene offers great promise. At the cellular level, PCA3 specificity for cancer is nearly perfect because of the gross overexpression of the gene by cancer cells. As a clinical test for early prostate cancer, heightened specificity is also seen in urine containing prostate cells from men with the disease. PCA3 gene testing holds valuable potential in PSA quandary situations: (1) men with elevated PSA levels but no cancer on initial biopsy; (2) men found to have cancer despite normal levels of PSA; (3) men with PSA elevations associated with varying degrees of prostatitis; and (4) men undergoing active surveillance for presumed microfocal disease. PMID:18836536

  20. Internet-facilitated, voluntary counseling and testing (VCT clinic-based HIV testing among men who have sex with men in China.

    Directory of Open Access Journals (Sweden)

    Huachun Zou

    Full Text Available OBJECTIVE: To explore the feasibility of using Internet outreach to encourage men who have sex with men (MSM to get tested for HIV at voluntary counseling and testing (VCT clinics in Beijing and Urumqi, China. METHODS: From June to August 2007, two volunteers contacted MSM using instant messaging, online chat rooms, mobile phone, and e-mail (active recruitment. Banners with study information were put at the front pages of three major Chinese gay websites (passive recruitment. Those contacted were offered a modest financial incentive to seek HIV testing at existing VCT clinics. Those who subsequently sought HIV testing services at VCT clinics and provided informed consent completed a questionnaire and a blood draw to test for HIV and syphilis. RESULTS: A total of 3,332 MSM were contacted and 429 attended VCT clinics. One out of every 4 men that were recruited through instant messaging actually went for HIV testing, while the recruitment yields for online gay chat rooms, mobile phone contact, and email were 1∶6, 1∶10, and 1∶140, respectively. The majority of participants (80%, 317/399 reported being motivated to seek HIV testing out of concern for their health, and only 3% (11/399 reported being motivated by the financial incentive. Active recruitment tend to recruit MSM who are younger (X(2 = 11.400, P = 0.001, never tested for HIV (X(2 = 4.281, P = 0.039, tested less often (X(2 = 5.638, P = 0.018. CONCLUSION: Internet outreach is a promising way to encourage MSM to seek HIV testing at existing VCT clinics. Active recruitment can target MSM who are younger, never tested for HIV and tested less often.

  1. An evaluation of the interference of alamin with chemistry and co-oximetry tests on nine commonly used instruments

    DEFF Research Database (Denmark)

    Carlsson, Christian J; Hansen, Heidi E; Hilsted, Linda Maria;

    2011-01-01

    . Some affected tests are important in the treatment of cyanide poisoning. The interference is not solely due to wavelength, but also to chemical interaction. Without delaying the administration of OHCob, blood should, preferably, be drawn in advance, or, at least, the laboratory should be informed about......The administration of hydroxocobalamin (OHCob), alone or with sodium thiosulfate, is a standard therapy for cyanide poisoning. OHCob is a red chromophore, and its interference with co-oximetric and colorimetric laboratory measurements has been evaluated in a few conflicting reports...... 10%. Interference was generally limited to photometric assays, whereas immunological and ion-selective electrode measurements were unaffected. OHCob present in the blood after treatment for cyanide poisoning interfered with many laboratory assays in an unpredictable way, making some results invalid...

  2. Clinical testing of propofol geriatic dose for sedation designed via in silico trial.

    Science.gov (United States)

    Gallardo-Hernandez, Ana Gabriela; Hernandez-Perez, Ana Luisa; Ordoñez-Espinosa, German; Sanchez-Lopez, Antonio; Revilla-Monsalve, Cristina; Islas-Andrade, Sergio

    2016-08-01

    The geriatric population shows significant physiological changes due to aging and the multiple co-morbidities that they often present. Conventionally the propofol sedation dose for patients older than 65 years is 80% of the adult dose. We performed an in silico trial for elderly population and the results showed that the necessary simulated dose of propofol was lower than the conventional dose; therefore, a clinical trial was implemented to test three different propofol doses, two of them lower than the conventional dose, during a pacemaker implantation. The clinical trial showed that there was no clinical difference between the effects of the doses. A BIS monitor was used to measure the level of sedation, which proved to be adequate and well maintained by all patients. All the patients maintained an acceptable level of sedation, measured by a BIS monitor. Since propofol has some dose-dependent secondary effects, the use of lower doses, especially the ones designed for this age group, helps to avoid them. PMID:27282224

  3. The modification of the thrombin generation test for the clinical assessment of dabigatran etexilate efficiency.

    Science.gov (United States)

    Gribkova, Irina V; Lipets, Elena N; Rekhtina, Irina G; Bernakevich, Alex I; Ayusheev, Dorzho B; Ovsepyan, Ruzanna A; Ataullakhanov, Fazoil I; Sinauridze, Elena I

    2016-01-01

    A new oral anticoagulant, dabigatran etexilate (DE, a prodrug of direct thrombin inhibitor (DTI) dabigatran), has been used clinically to prevent thrombosis. The assessment of dabigatran efficiency is necessary in some clinical cases, such as renal insufficiency, risk of bleeding, and drug interactions. However, a specific thrombin generation test (TGT) that is one of the most informative and sensitive to anticoagulant therapy (calibrated automated thrombinography (САТ)) shows a paradoxical increase of test parameters, such as endogenous thrombin potential (ETP) and peak thrombin, in patients receiving DE. The paradoxical behaviour of ETP and peak thrombin in these patients in the presence of DTIs is mostly caused by a decrease in the activity of thrombin in the α2-macroglobulin-thrombin complex that is used as a calibrator in CAT. For a correct estimation of the TGT parameters in patient's plasma containing DTIs we proposed to use our previously described alternative calibration method that is based on the measurement of the fluorescence signal of a well-known concentration of the reaction product (7-amino-4-methylcoumarin). In this study, the validity of such approach was demonstrated in an ex vivo study in patients with knee replacement and two special patients with multiple myeloma, who received DE for thrombosis prophylaxis. PMID:27377013

  4. The modification of the thrombin generation test for the clinical assessment of dabigatran etexilate efficiency

    Science.gov (United States)

    Gribkova, Irina V.; Lipets, Elena N.; Rekhtina, Irina G.; Bernakevich, Alex I.; Ayusheev, Dorzho B.; Ovsepyan, Ruzanna A.; Ataullakhanov, Fazoil I.; Sinauridze, Elena I.

    2016-01-01

    A new oral anticoagulant, dabigatran etexilate (DE, a prodrug of direct thrombin inhibitor (DTI) dabigatran), has been used clinically to prevent thrombosis. The assessment of dabigatran efficiency is necessary in some clinical cases, such as renal insufficiency, risk of bleeding, and drug interactions. However, a specific thrombin generation test (TGT) that is one of the most informative and sensitive to anticoagulant therapy (calibrated automated thrombinography (САТ)) shows a paradoxical increase of test parameters, such as endogenous thrombin potential (ETP) and peak thrombin, in patients receiving DE. The paradoxical behaviour of ETP and peak thrombin in these patients in the presence of DTIs is mostly caused by a decrease in the activity of thrombin in the α2-macroglobulin-thrombin complex that is used as a calibrator in CAT. For a correct estimation of the TGT parameters in patient’s plasma containing DTIs we proposed to use our previously described alternative calibration method that is based on the measurement of the fluorescence signal of a well-known concentration of the reaction product (7-amino-4-methylcoumarin). In this study, the validity of such approach was demonstrated in an ex vivo study in patients with knee replacement and two special patients with multiple myeloma, who received DE for thrombosis prophylaxis. PMID:27377013

  5. A Laboratory Test Expert System for Clinical Diagnosis Support in Primary Health Care

    Directory of Open Access Journals (Sweden)

    Rodrigo Fernandez-Millan

    2015-08-01

    Full Text Available Clinical Decision Support Systems have the potential to reduce lack of communication and errors in diagnostic steps in primary health care. Literature reports have showed great advances in clinical decision support systems in the recent years, which have proven its usefulness in improving the quality of care. However, most of these systems are focused on specific areas of diseases. In this way, we propose a rule-based expert system, which supports clinicians in primary health care, providing a list of possible diseases regarding patient’s laboratory tests results in order to assist previous diagnosis. Our system also allows storing and retrieving patient’s data and the history of patient’s analyses, establishing a basis for coordination between the various health care levels. A validation step and speed performance tests were made to check the quality of the system. We conclude that our system could improve clinician accuracy and speed, resulting in more efficiency and better quality of service. Finally, we propose some recommendations for further research.

  6. American Society of Clinical Oncology Policy Statement Update: Genetic and Genomic Testing for Cancer Susceptibility.

    Science.gov (United States)

    Robson, Mark E; Bradbury, Angela R; Arun, Banu; Domchek, Susan M; Ford, James M; Hampel, Heather L; Lipkin, Stephen M; Syngal, Sapna; Wollins, Dana S; Lindor, Noralane M

    2015-11-01

    The American Society of Clinical Oncology (ASCO) has long affirmed that the recognition and management of individuals with an inherited susceptibility to cancer are core elements of oncology care. ASCO released its first statement on genetic testing in 1996 and updated that statement in 2003 and 2010 in response to developments in the field. In 2014, the Cancer Prevention and Ethics Committees of ASCO commissioned another update to reflect the impact of advances in this area on oncology practice. In particular, there was an interest in addressing the opportunities and challenges arising from the application of massively parallel sequencing-also known as next-generation sequencing-to cancer susceptibility testing. This technology introduces a new level of complexity into the practice of cancer risk assessment and management, requiring renewed effort on the part of ASCO to ensure that those providing care to patients with cancer receive the necessary education to use this new technology in the most effective, beneficial manner. The purpose of this statement is to explore the challenges of new and emerging technologies in cancer genetics and provide recommendations to ensure their optimal deployment in oncology practice. Specifically, the statement makes recommendations in the following areas: germline implications of somatic mutation profiling, multigene panel testing for cancer susceptibility, quality assurance in genetic testing, education of oncology professionals, and access to cancer genetic services.

  7. Clinical efficiency of the Auditory Verbal Learning Test for patients with internal carotid artery stenosis

    International Nuclear Information System (INIS)

    Most patients who have an internal carotid artery (ICA) stenosis with cerebral lesion have some cognitive dysfunction. To clarify the clinical efficiency of the Auditory Verbal Learning Test (AVLT) and to assess the relationship between AVLT and cerebral damage, we examined AVLT in patients with ICA stenosis. 44 patients (35 males and 9 females) with ICA stenosis aged 56 to 83 (69.6±6.5) years old were evaluated. The educational periods were from 9 to 16 (12.3±2.8) years. Their activities of daily living (ADL) were independent. We assessed cognitive function with neuropsychological tests including AVLT, Mini-mental State Examination (MMSE), Raven's coloured progressive matrices (RCPM) and Frontal Assessment Battery (FAB), etc. We assessed cerebral damage (periventricular high intensity; PVH and white matter hyperintensity; WMH) with MRI. Then, we investigated the relationship between AVLT and other neuropsychological tests, and the relationship between AVLT and carotid/cerebral lesion. There was no association with lesion side of ICA stenosis and the scores of AVLT. In patients with ICA stenosis and cerebral damage (PVH and/or WMH), there was a significant relationship between the severity of cerebral damage and the scores in AVLT. AVLT had a significant relationship to other neuropsychological tests. AVLT might be a good cognitive assessment for patients who have cerebral damage due to ICA stenosis. (author)

  8. Approaches to informed consent for hypothesis-testing and hypothesis-generating clinical genomics research

    Directory of Open Access Journals (Sweden)

    Facio Flavia M

    2012-10-01

    Full Text Available Abstract Background Massively-parallel sequencing (MPS technologies create challenges for informed consent of research participants given the enormous scale of the data and the wide range of potential results. Discussion We propose that the consent process in these studies be based on whether they use MPS to test a hypothesis or to generate hypotheses. To demonstrate the differences in these approaches to informed consent, we describe the consent processes for two MPS studies. The purpose of our hypothesis-testing study is to elucidate the etiology of rare phenotypes using MPS. The purpose of our hypothesis-generating study is to test the feasibility of using MPS to generate clinical hypotheses, and to approach the return of results as an experimental manipulation. Issues to consider in both designs include: volume and nature of the potential results, primary versus secondary results, return of individual results, duty to warn, length of interaction, target population, and privacy and confidentiality. Summary The categorization of MPS studies as hypothesis-testing versus hypothesis-generating can help to clarify the issue of so-called incidental or secondary results for the consent process, and aid the communication of the research goals to study participants.

  9. Comprehensive genetic testing in the clinical evaluation of 1119 patients with hearing loss.

    Science.gov (United States)

    Sloan-Heggen, Christina M; Bierer, Amanda O; Shearer, A Eliot; Kolbe, Diana L; Nishimura, Carla J; Frees, Kathy L; Ephraim, Sean S; Shibata, Seiji B; Booth, Kevin T; Campbell, Colleen A; Ranum, Paul T; Weaver, Amy E; Black-Ziegelbein, E Ann; Wang, Donghong; Azaiez, Hela; Smith, Richard J H

    2016-04-01

    Hearing loss is the most common sensory deficit in humans, affecting 1 in 500 newborns. Due to its genetic heterogeneity, comprehensive diagnostic testing has not previously been completed in a large multiethnic cohort. To determine the aggregate contribution inheritance makes to non-syndromic hearing loss, we performed comprehensive clinical genetic testing with targeted genomic enrichment and massively parallel sequencing on 1119 sequentially accrued patients. No patient was excluded based on phenotype, inheritance or previous testing. Testing resulted in identification of the underlying genetic cause for hearing loss in 440 patients (39%). Pathogenic variants were found in 49 genes and included missense variants (49%), large copy number changes (18%), small insertions and deletions (18%), nonsense variants (8%), splice-site alterations (6%), and promoter variants (<1%). The diagnostic rate varied considerably based on phenotype and was highest for patients with a positive family history of hearing loss or when the loss was congenital and symmetric. The spectrum of implicated genes showed wide ethnic variability. These findings support the more efficient utilization of medical resources through the development of evidence-based algorithms for the diagnosis of hearing loss. PMID:26969326

  10. Clinical value of MRI and acute madopar responsiveness test in diagnosing progressive supranuclear palsy

    Directory of Open Access Journals (Sweden)

    LI Xiao-hong

    2013-07-01

    Full Text Available Objective To investigate the MRI abnormalities and acute madopar responsiveness test in diagnosing progressive supranuclear palsy (PSP and Parkinson's disease (PD. Methods Seventeen patients with PSP and 17 gender and age matched patients with PD were studied with cranial MRI examinations and results of acute madopar responsiveness test, and the clinical manifestations of PSP were summarized. Results The atrophy of the midbrain tegmentum and hummingbird sign was demonstrated in all of the PSP patients in our study, but was not observed in the PD patients. The areas of the midbrain on mid-sagittal MRI in PSP patients [(77.35 ± 15.30 mm2] were significantly smaller than that in those with PD [(142.35 ± 31.49 mm2]. The average ratio of the area of the midbrain to the area of pons in the patients with PSP [(14.31 ± 2.47%] was significantly smaller than that in those with PD [(24.08 ± 4.73%; P = 0.000, for all]. According to the result of acute madopar responsiveness test, the maximum Unified Parkinson's Disease Rating Scale (UPDRS Ⅲ improvement rate of 2 patients with PSP and 16 patients with PD was more than 30% (χ2 = 23.142, P = 0.000. Conclusion The assessment of the mid-sagittal MRI and acute madopar responsiveness test may be a useful method to differentiate PSP from PD.

  11. Chromosomal microarray analysis as a first-tier clinical diagnostic test: Estonian experience.

    Science.gov (United States)

    Zilina, Olga; Teek, Rita; Tammur, Pille; Kuuse, Kati; Yakoreva, Maria; Vaidla, Eve; Mölter-Väär, Triin; Reimand, Tiia; Kurg, Ants; Ounap, Katrin

    2014-03-01

    Chromosomal microarray analysis (CMA) is now established as the first-tier cytogenetic diagnostic test for fast and accurate detection of chromosomal abnormalities in patients with developmental delay/intellectual disability (DD/ID), multiple congenital anomalies (MCA), and autism spectrum disorders (ASD). We present our experience with using CMA for postnatal and prenatal diagnosis in Estonian patients during 2009-2012. Since 2011, CMA is on the official service list of the Estonian Health Insurance Fund and is performed as the first-tier cytogenetic test for patients with DD/ID, MCA or ASD. A total of 1191 patients were analyzed, including postnatal (1072 [90%] patients and 59 [5%] family members) and prenatal referrals (60 [5%] fetuses). Abnormal results were reported in 298 (25%) patients, with a total of 351 findings (1-3 per individual): 147 (42%) deletions, 106 (30%) duplications, 89 (25%) long contiguous stretches of homozygosity (LCSH) events (>5 Mb), and nine (3%) aneuploidies. Of all findings, 143 (41%) were defined as pathogenic or likely pathogenic; for another 143 findings (41%), most of which were LCSH, the clinical significance remained unknown, while 61 (18%) reported findings can now be reclassified as benign or likely benign. Clinically relevant findings were detected in 126 (11%) patients. However, the proportion of variants of unknown clinical significance was quite high (41% of all findings). It seems that our ability to detect chromosomal abnormalities has far outpaced our ability to understand their role in disease. Thus, the interpretation of CMA findings remains a rather difficult task requiring a close collaboration between clinicians and cytogeneticists.

  12. Vestibular migraine in children and adolescents: clinical findings and laboratory tests

    Directory of Open Access Journals (Sweden)

    Thyra eLanghagen

    2015-01-01

    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.

  13. Clinical validation of 4DCT-ventilation with pulmonary function test data

    Science.gov (United States)

    Brennen, Douglas; Schubert, Leah; Diot, Quentin; Castillo, Richard; Castillo, Edward; Guerrero, Thomas; Martel, Mary K.; Linderman, Derek; Gaspar, Laurie E.; Miften, Moyed; Kavanagh, Brian D.; Vinogradskiy, Yevgeniy

    2015-01-01

    Purpose A new form of functional imaging has been proposed in the form of 4DCT-ventilation. Because 4DCTs are acquired as part of routine care for lung cancer patients, calculating ventilation maps from 4DCTs provides spatial lung function information without added dosimetric or monetary cost to the patient. Before 4DCT-ventilation is implemented it needs to be clinically validated. Pulmonary function tests (PFTs) provide a clinically established way of evaluating lung function. The purpose of our work was to perform a clinical validation by comparing 4DCT-ventilation metrics with PFT data. Methods and Materials Ninety-eight lung cancer patients with pre-treatment 4DCT and PFT data were included in the study. PFT metrics used to diagnose obstructive lung disease were recorded: forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity (FEV1/FVC). 4DCT data sets and spatial registration were used to compute 4DCT-ventilation images using a density-change based and a Jacobian-based model. The ventilation maps were reduced to single metrics intended to reflect the degree of ventilation obstruction. Specifically, we computed the coefficient of variation (CoV) (standard deviation/mean), ventilation V20 (volume of lung ≤20% ventilation), and correlated the ventilation metrics with PFT data. Regression analysis was used to determine whether 4DCT-ventilation data could predict for normal versus abnormal lung function using PFT thresholds. Results Correlation coefficients comparing 4DCT-ventilation to PFT data ranged from 0.63–0.72 with the best agreement between FEV1 and CoV. 4DCT-ventilation metrics were able to significantly delineate between clinically normal versus abnormal PFT results. Conclusions Validation of 4DCT-ventilation with clinically relevant metrics is essential. We demonstrate good global agreement between PFTs and 4DCT-ventilation, indicating that 4DCT ventilation provides a reliable assessment of lung function. 4DCT-ventilation enables

  14. Combined array CGH plus SNP genome analyses in a single assay for optimized clinical testing.

    Science.gov (United States)

    Wiszniewska, Joanna; Bi, Weimin; Shaw, Chad; Stankiewicz, Pawel; Kang, Sung-Hae L; Pursley, Amber N; Lalani, Seema; Hixson, Patricia; Gambin, Tomasz; Tsai, Chun-hui; Bock, Hans-Georg; Descartes, Maria; Probst, Frank J; Scaglia, Fernando; Beaudet, Arthur L; Lupski, James R; Eng, Christine; Cheung, Sau Wai; Bacino, Carlos; Patel, Ankita

    2014-01-01

    In clinical diagnostics, both array comparative genomic hybridization (array CGH) and single nucleotide polymorphism (SNP) genotyping have proven to be powerful genomic technologies utilized for the evaluation of developmental delay, multiple congenital anomalies, and neuropsychiatric disorders. Differences in the ability to resolve genomic changes between these arrays may constitute an implementation challenge for clinicians: which platform (SNP vs array CGH) might best detect the underlying genetic cause for the disease in the patient? While only SNP arrays enable the detection of copy number neutral regions of absence of heterozygosity (AOH), they have limited ability to detect single-exon copy number variants (CNVs) due to the distribution of SNPs across the genome. To provide comprehensive clinical testing for both CNVs and copy-neutral AOH, we enhanced our custom-designed high-resolution oligonucleotide array that has exon-targeted coverage of 1860 genes with 60,000 SNP probes, referred to as Chromosomal Microarray Analysis - Comprehensive (CMA-COMP). Of the 3240 cases evaluated by this array, clinically significant CNVs were detected in 445 cases including 21 cases with exonic events. In addition, 162 cases (5.0%) showed at least one AOH region >10 Mb. We demonstrate that even though this array has a lower density of SNP probes than other commercially available SNP arrays, it reliably detected AOH events >10 Mb as well as exonic CNVs beyond the detection limitations of SNP genotyping. Thus, combining SNP probes and exon-targeted array CGH into one platform provides clinically useful genetic screening in an efficient manner.

  15. Reliability of clinical tests to evaluate nerve function and mechanosensitivity of the upper limb peripheral nervous system

    Directory of Open Access Journals (Sweden)

    Bachmann Lucas M

    2009-01-01

    Full Text Available Abstract Background Clinical tests to assess peripheral nerve disorders can be classified into two categories: tests for afferent/efferent nerve function such as nerve conduction (bedside neurological examination and tests for increased mechanosensitivity (e.g. upper limb neurodynamic tests (ULNTs and nerve palpation. Reliability reports of nerve palpation and the interpretation of neurodynamic tests are scarce. This study therefore investigated the intertester reliability of nerve palpation and ULNTs. ULNTs were interpreted based on symptom reproduction and structural differentiation. To put the reliability of these tests in perspective, a comparison with the reliability of clinical tests for nerve function was made. Methods Two experienced clinicians examined 31 patients with unilateral arm and/or neck pain. The examination included clinical tests for nerve function (sensory testing, reflexes and manual muscle testing (MMT and mechanosensitivity (ULNTs and palpation of the median, radial and ulnar nerve. Kappa statistics were calculated to evaluate intertester reliability. A meta-analysis determined an overall kappa for the domains with multiple kappa values (MMT, ULNT, palpation. We then compared the difference in reliability between the tests of mechanosensitivity and nerve function using a one-sample t-test. Results We observed moderate to substantial reliability for the tests for afferent/efferent nerve function (sensory testing: kappa = 0.53; MMT: kappa = 0.68; no kappa was calculated for reflexes due to a lack of variation. Tests to investigate mechanosensitivity demonstrated moderate reliability (ULNT: kappa = 0.45; palpation: kappa = 0.59. When compared statistically, there was no difference in reliability for tests for nerve function and mechanosensitivity (p = 0.06. Conclusion This study demonstrates that clinical tests which evaluate increased nerve mechanosensitivity and afferent/efferent nerve function have comparable moderate to

  16. Clinical Validation of the Cervista HPV HR Test According to the International Guidelines for Human Papillomavirus Test Requirements for Cervical Cancer Screening

    NARCIS (Netherlands)

    Boers, Aniek; Wang, Rong; Slagter-Menkema, Lorian; van Hemel, Bettien M.; Ghyssaert, Hilde; van der Zee, Ate G. J.; Schuurs-Wisman, G. Bea A.; Schuuring, Ed

    2014-01-01

    This study demonstrates that both the clinical sensitivity and specificity of the Cervista HPV HR test for high-risk human papillomavirus (HPV) detection are not inferior to those of the Hybrid Capture 2 (HC2) test. The intra- and interlaboratory reproducibilities of Cervista were 92.0% (kappa, 0.83

  17. Complete definite positive spasm on acetylcholine spasm provocation tests: comparison of clinical positive spasm.

    Science.gov (United States)

    Sueda, Shozo; Miyoshi, Toru; Sasaki, Yasuhiro; Ohshima, Kousei; Sakaue, Tomoki; Habara, Hirokazu; Kohno, Hiroaki

    2016-02-01

    In the clinical grounds, patients with ≥90 % luminal narrowing during acetylcholine (ACh) testing had variable response. We investigated ischemic findings and chest symptoms in patients with ≥90 % luminal narrowing when performing ACh tests, retrospectively. We performed 763 ACh tests over 13 years (2001-2013). We analyzed chest symptoms and positive ischemic ECG changes during ACh tests. More than 90 % luminal narrowing was found in 441 patients (57.8 %) including 355 patients in the right coronary artery (RCA) and 363 patients in the left coronary artery (LCA). Chest symptom was observed in 386 patients (87.5 %) including 293 patients in the RCA and 304 patients in the LCA. ST elevation was found in 161 patients including 110 in the RCA and 85 patients in the LCA, while ST depression was recognized in 146 patients including 119 patients in the RCA and 117 patients in the LCA. Three quarter of patients with ≥90 % luminal narrowing had significant ischemic ECG changes, whereas two-third of patients with ≥90 % luminal narrowing complained usual chest pain accompanied with significant ischemic ECG changes. Unusual chest symptom was complained in 7.3 % patients with ≥90 % luminal narrowing. Neither chest symptom nor ECG changes were found in 30 patients (6.8 %) with ≥90 % luminal narrowing. A third of these patients had ischemic findings on non-invasive tests before catheterization and six patients had subtotal or total occlusion. We should realize some limitation to define positive coronary spasm based on the ischemic ECG change and chest symptom during ACh tests. PMID:25366988

  18. Organic chemistry

    International Nuclear Information System (INIS)

    The activities of the mycotoxin research group are discussed. This includes the isolation and structure determination of mycotoxins, plant products, the biosyntheris of mycotoxins, the synthesis and characteristics of steroids, the synthesis and mechanistic aspects of heterocyclic chemistry and the functionality of steroids over long distances. Nmr spectra and mass spectroscopy are some of the techniques used

  19. Reinventing Chemistry

    OpenAIRE

    Whitesides, George McClelland

    2015-01-01

    Chemistry is in a period of change, from an era focused on molecules and reactions, to one in which manipulations of systems of molecules and reactions will be essential parts of controlling larger systems. This Essay traces paths from the past to possible futures.

  20. Forensic Luminol Blood Test for Preventing Cross-contamination in Dentistry: An Evaluation of a Dental School Clinic

    OpenAIRE

    Marcelo Carlos Bortoluzzi; Peterson Cadore; Andrea Gallon; Soraia Almeida Watanabe Imanishi

    2014-01-01

    Background: More than 200 different diseases may be transmitted from exposure to blood in the dental setting. The aim of this study is to identify possible faults in the cross-contamination chain control in a dental school clinic searching for traces of blood in the clinical contact surfaces (CCS) through forensic luminol blood test. Methods: Traces of invisible blood where randomly searched in CCS of one dental school clinic. Results: Forty eight surfaces areas in the CCS were tes...

  1. Will sacubitril-valsartan diminish the clinical utility of B-type natriuretic peptide testing in acute cardiac care?

    DEFF Research Database (Denmark)

    Mair, Johannes; Lindahl, Bertil; Giannitsis, Evangelos;

    2016-01-01

    Since the approval of sacubitril-valsartan for the treatment of chronic heart failure with reduced ejection fraction, a commonly raised suspicion is that a wider clinical use of this new drug may diminish the clinical utility of B-type natriuretic peptide testing as sacubitril may interfere with ...

  2. 75 FR 30041 - Medicare Program; Public Meeting in Calendar Year 2010 for New Clinical Laboratory Tests Payment...

    Science.gov (United States)

    2010-05-28

    ...This notice announces a public meeting to receive comments and recommendations (including accompanying data on which recommendations are based) from the public on the appropriate basis for establishing payment amounts for a specified list of new Clinical Procedural Terminology (CPT) codes for clinical laboratory tests in calendar year (CY) 2011. The meeting provides a forum for interested......

  3. From Usability Testing to Clinical Simulations: Bringing Context into the Design and Evaluation of Usable and Safe Health Information Technologies

    DEFF Research Database (Denmark)

    Kushniruk, Andre; Nøhr, Christian; Jensen, Sanne;

    2013-01-01

    of clinical context into stronger focus. This involves testing of systems with representative users doing representative tasks, in representative settings/environments. Results: Application of methods where realistic clinical scenarios are used to drive the study of users interacting with systems under...

  4. Ethanolic carbon-11 chemistry: The introduction of green radiochemistry

    International Nuclear Information System (INIS)

    The principles of green chemistry have been applied to a radiochemistry setting. Eleven carbon-11 labeled radiopharmaceuticals have been prepared using ethanol as the only organic solvent throughout the entire manufacturing process. The removal of all other organic solvents from the process simplifies production and quality control (QC) testing, moving our PET Center towards the first example of a green radiochemistry laboratory. All radiopharmaceutical doses prepared are suitable for clinical use. - Highlights: • We report application of the principles of green chemistry to a radiochemistry setting. • Radiopharmaceuticals are prepared using ethanol as the only organic solvent. • Green radiochemistry simplifies production and QC in busy clinical production laboratories. • Residual solvent analysis can be relegated to a quarterly or annual QC test

  5. Restoration of non-carious cervical lesions with ceramic inlays: A possible model for clinical testing of adhesive cements

    OpenAIRE

    Michal Staninec; Tsuji, Grant H.

    2012-01-01

    Introduction: There are many luting cements coming to market which claim to be adhesive, but there is no clinical protocol currently for testing these claims. There is a standardized protocol for testing direct restorations bonded to dentin and it is used extensively. Case Report: We describe a clinical procedure for restoring a non-carious cervical lesion (NCCL) with a ceramic inlay using Computer-Aided Design and Computer-Aided Manufacturing (CAD-CAM) technology and an adhesive resin cement...

  6. Impact of a Routine, Opt-Out HIV Testing Program on HIV Testing and Case Detection in North Carolina Sexually-Transmitted Disease Clinics

    Science.gov (United States)

    Klein, Pamela W.; Messer, Lynne C.; Myers, Evan R.; Weber, David J.; Leone, Peter A.; Miller, William C.

    2016-01-01

    The impact of routine, opt-out HIV testing programs in clinical settings is inconclusive. The objective of this study was to estimate the impact of an expanded, routine HIV testing program in North Carolina sexually transmitted disease (STD) clinics on HIV testing and case detection. Adults aged 18–64 who received an HIV test in a North Carolina STD clinic July 1, 2005 through June 30, 2011 were included in this analysis, dichotomized at the date of implementation on November 1, 2007. HIV testing and case detection counts and rates were analyzed using interrupted time series analysis, and Poisson and multilevel logistic regression. Pre-intervention, 426 new HIV-infected cases were identified from 128,029 tests (0.33%), whereas 816 new HIV-infected cases were found from 274,745 tests post-intervention (0.30%). Pre-intervention, HIV testing increased by 55 tests per month (95% confidence interval [CI]: 41, 72), but only 34 tests per month (95% CI: 26, 42) post-intervention. Increases in HIV testing rates were most pronounced in females and non-Hispanic whites. A slight pre-intervention decline in case detection was mitigated by the intervention (mean difference [MD]=0.01; 95% CI: −0.02, 0.05). Increases in case detection rates were observed among females and non-Hispanic blacks. The impact of a routine HIV screening in North Carolina STD clinics was marginal, with the greatest benefit among persons not traditionally targeted for HIV testing. The use of a pre-intervention comparison period identified important temporal trends that otherwise would have been ignored. PMID:24825338

  7. Trend of glycated hemoglobin testing in diabetic patients: to assess compliance with clinical practice guidelines

    International Nuclear Information System (INIS)

    Objective: To determine appropriate use of glycated hemoglobin (HbA1c) testing in accordance with current recommended guidelines. Study Design: Descriptive study. Place and Duration of Study: Chemical Pathology Department Shifa International Hospital, Islamabad from Oct 2011 to Oct 2012. Material and Methods: We randomly selected 170 known diabetic patients' data from our Laboratory Information System (LIS) who were retrospective analyzed for HbA1c to check for intervals and test frequency for each patient in one year. Patients with follow-up for at least one year at Shifa International Hospital, Islamabad and having their routine investigations in our chemical pathology laboratory were included. The concentrations of HbA1c for all the specimens were measured immunoturbidimetrically using a microparticle agglutination inhibition method. Four guidelines namely World Health Organization (WHO), American Diabetic Association (ADA), Canadian Diabetic Association (CDA) and National Institute for Health and Clinical Excellence (NICE) about HbA1c testing were utilized for data interpretation. All tests ordered within a 2 months period or more than 6 months following the previous order were labeled as inappropriate. Results: Only 35.8% of the patients were being properly monitored as per guidelines. Out of 64% patients who were inappropriately monitored, 12.9% had repeat orders within 2 months while 51.1% of patients were being monitored at longer interval against recommended guidelines. Conclusions: Glycated hemoglobin is a useful tool to objectively assess the prior glycemic control of patients with type 1 and type 2 diabetes. The study highlights that in large proportion of diabetic patients, HbA1c is not utilized properly as a tool to assess the risk of diabetic complications but in a small proportion is also tested unnecessarily which adds to avoidable health expenditure. (author)

  8. Correlation of accelerometry with clinical balance tests in older fallers and non-fallers.

    LENUS (Irish Health Repository)

    O'Sullivan, Maura

    2012-02-01

    BACKGROUND: falls are a common cause of injury and decreased functional independence in the older adult. Diagnosis and treatment of fallers require tools that accurately assess physiological parameters associated with balance. Validated clinical tools include the Berg Balance Scale (BBS) and the Timed Up and Go test (TUG); however, the BBS tends to be subjective in nature, while the TUG quantifies an individuals functional impairment but requires further subjective evaluation for balance assessment. Other quantitative alternatives to date require expensive, sophisticated equipment. Measurement of the acceleration of centre of mass, with relatively inexpensive, lightweight, body-mounted accelerometers is a potential solution to this problem. OBJECTIVES: to determine (i) if accelerometry correlates with standard clinical tests (BBS and TUG), (ii) to characterise accelerometer responses to increasingly difficult challenges to balance and (iii) to characterise acceleration patterns between fallers and non-fallers. Study design and setting: torso accelerations were measured at the level of L3 using a tri-axial accelerometer under four conditions; standing unsupported with eyes open (EO), eyes closed (EC) and on a mat with eyes open (MAT EO) and closed (MAT EC). Older patients (n = 21, 8 males, 13 females) with a mean age of 78 (SD +\\/- 7.6) years who attended a day hospital were recruited for this study. Patients were identified as fallers or non-fallers based on a comprehensive falls history. MEASUREMENTS: Spearman\\'s rank correlation analysis examined the relationship between acceleration root mean square (RMS) data and the BBS while Pearson\\'s correlation was used with TUG scores. Differences in accelerometer RMS between fallers and non-fallers and between test conditions were examined using t-test and non-parametric alternatives where appropriate. RESULTS: there was a stepwise increase in accelerometer RMS with increasing task complexity, and the accelerometer

  9. The use of rapid dengue diagnostic tests in a routine clinical setting in a dengue-endemic area of Colombia

    OpenAIRE

    Lyda Osorio; Marcela Uribe; Gloria Ines Ardila; Yaneth Orejuela; Margarita Velasco; Anilza Bonelo; Beatriz Parra

    2015-01-01

    There is insufficient evidence of the usefulness of dengue diagnostic tests under routine conditions. We sought to analyse how physicians are using dengue diagnostics to inform research and development. Subjects attending 14 health institutions in an endemic area of Colombia with either a clinical diagnosis of dengue or for whom a dengue test was ordered were included in the study. Patterns of test-use are described herein. Factors associated with the ordering of dengue diagnostic tests were ...

  10. Laboratory demonstration of a prozone-like effect in HRP2-detecting malaria rapid diagnostic tests: implications for clinical management

    OpenAIRE

    McCarthy James S; Cheng Qin; Belizario Vicente; Alcantara Sheila; Baker Joanne; Luchavez Jennifer; Bell David

    2011-01-01

    Abstract Background Malaria rapid diagnostic tests (RDTs) are now widely used for prompt on-site diagnosis in remote endemic areas where reliable microscopy is absent. Aberrant results, whereby negative test results occur at high parasite densities, have been variously reported for over a decade and have led to questions regarding the reliability of the tests in clinical use. Methods In the first trial, serial dilutions of recombinant HRP2 antigen were tested on an HRP2-detectiing RDT. In a s...

  11. Clinical Neuropathology practice news 1-2014: Pyrosequencing meets clinical and analytical performance criteria for routine testing of MGMT promoter methylation status in glioblastoma

    Science.gov (United States)

    Preusser, Matthias; Berghoff, Anna S.; Manzl, Claudia; Filipits, Martin; Weinhäusel, Andreas; Pulverer, Walter; Dieckmann, Karin; Widhalm, Georg; Wöhrer, Adelheid; Knosp, Engelbert; Marosi, Christine; Hainfellner, Johannes A.

    2014-01-01

    Testing of the MGMT promoter methylation status in glioblastoma is relevant for clinical decision making and research applications. Two recent and independent phase III therapy trials confirmed a prognostic and predictive value of the MGMT promoter methylation status in elderly glioblastoma patients. Several methods for MGMT promoter methylation testing have been proposed, but seem to be of limited test reliability. Therefore, and also due to feasibility reasons, translation of MGMT methylation testing into routine use has been protracted so far. Pyrosequencing after prior DNA bisulfite modification has emerged as a reliable, accurate, fast and easy-to-use method for MGMT promoter methylation testing in tumor tissues (including formalin-fixed and paraffin-embedded samples). We performed an intra- and inter-laboratory ring trial which demonstrates a high analytical performance of this technique. Thus, pyrosequencing-based assessment of MGMT promoter methylation status in glioblastoma meets the criteria of high analytical test performance and can be recommended for clinical application, provided that strict quality control is performed. Our article summarizes clinical indications, practical instructions and open issues for MGMT promoter methylation testing in glioblastoma using pyrosequencing. PMID:24359605

  12. SUSCEPTIBILITY TEST FOR FUNGI: CLINICAL AND LABORATORIAL CORRELATIONS IN MEDICAL MYCOLOGY

    Directory of Open Access Journals (Sweden)

    Ana ALASTRUEY-IZQUIERDO

    2015-09-01

    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.

  13. Initial clinical testing of a multi-spectral imaging system built on a smartphone platform

    Science.gov (United States)

    Mink, Jonah W.; Wexler, Shraga; Bolton, Frank J.; Hummel, Charles; Kahn, Bruce S.; Levitz, David

    2016-03-01

    Multi-spectral imaging systems are often expensive and bulky. An innovative multi-spectral imaging system was fitted onto a mobile colposcope, an imaging system built around a smartphone in order to image the uterine cervix from outside the body. The multi-spectral mobile colposcope (MSMC) acquires images at different wavelengths. This paper presents the clinical testing of MSMC imaging (technical validation of the MSMC system is described elsewhere 1 ). Patients who were referred to colposcopy following abnormal screening test (Pap or HPV DNA test) according to the standard of care were enrolled. Multi-spectral image sets of the cervix were acquired, consisting of images from the various wavelengths. Image acquisition took 1-2 sec. Areas suspected for dysplasia under white light imaging were biopsied, according to the standard of care. Biopsied sites were recorded on a clockface map of the cervix. Following the procedure, MSMC data was processed from the sites of biopsied sites. To date, the initial histopathological results are still outstanding. Qualitatively, structures in the cervical images were sharper at lower wavelengths than higher wavelengths. Patients tolerated imaging well. The result suggests MSMC holds promise for cervical imaging.

  14. How relevant is heterogeneous chemistry on Mars? Strong tests via global mapping of water and ozone (sampled via O2 dayglow)

    Science.gov (United States)

    Villanueva, Geronimo Luis; Mumma, Michael J.; Novak, Robert E.

    2015-11-01

    Ozone and water are powerful tracers of photochemical processes on Mars. Considering that water is a condensable with a multifaceted hydrological cycle and ozone is continuously being produced / destroyed on short-time scales, their maps can test the validity of current 3D photochemical and dynamical models. Comparisons of modern GCM models (e.g., Lefèvre et al. 2004) with certain datasets (e.g., Clancy et al. 2012; Bertaux et al. 2012) point to significant disagreement, which in some cases have been related to heterogeneous (gas-dust) chemistry beyond the classical gas-gas homogeneous reactions.We address these concerns by acquiring full 2D maps of water and ozone (via O2 dayglow) on Mars, employing high spectral infrared spectrometers at ground-based telescopes (CRIRES/VLT and CSHELL/NASA-IRTF). By performing a rotational analysis on the O2 lines, we derive molecular temperature maps that we use to derive the vertical level of the emission (e.g., Novak et al. 2002). Our maps sample the full observable disk of Mars on March/25/2008 (Ls=50°, northern winter) and on Jan/29/2014 (Ls=83°, northern spring). The maps reveal a strong dependence of the O2 emission and water burden on local orography, while the temperature maps are in strong disagreement with current models. Could this be the signature of heterogeneous chemistry? We will present the global maps and will discuss possible scenarios to explain the observations.This work was partially funded by grants from NASA's Planetary Astronomy Program (344-32-51-96), NASA’s Mars Fundamental Research Program (203959.02.02.20.29), NASA’s Astrobiology Program (344-53-51), and the NSF-RUI Program (AST-805540). We thank the administration and staff of the European Southern Observatory/VLT and NASA-IRTF for awarding observing time and coordinating our observations.Bertaux, J.-L., Gondet, B., Lefèvre, F., et al. 2012. J. Geophys. Res. Pl. 117. pp. 1-9.Clancy, R.T., Sandor, B.J., Wolff, M.J., et al. 2012. J. Geophys. Res

  15. Ethanolic Carbon-11 Chemistry: the Introduction of Green Radiochemistry

    Science.gov (United States)

    Shao, Xia; Fawaz, Maria V.; Jang, Keunsam; Scott, Peter J. H.

    2014-01-01

    The principles of green chemistry have been applied to a radiochemistry setting. Eleven carbon-11 labeled radiopharmaceuticals have been prepared using ethanol as the only organic solvent throughout the entire manufacturing process. The removal of all other organic solvents from the process simplifies production and quality control (QC) testing, moving our PET Center towards the first example of a green radiochemistry laboratory. All radiopharmaceutical doses prepared are suitable for clinical use. PMID:24631743

  16. Ethanolic carbon-11 chemistry: the introduction of green radiochemistry.

    Science.gov (United States)

    Shao, Xia; Fawaz, Maria V; Jang, Keunsam; Scott, Peter J H

    2014-07-01

    The principles of green chemistry have been applied to a radiochemistry setting. Eleven carbon-11 labeled radiopharmaceuticals have been prepared using ethanol as the only organic solvent throughout the entire manufacturing process. The removal of all other organic solvents from the process simplifies production and quality control (QC) testing, moving our PET Center towards the first example of a green radiochemistry laboratory. All radiopharmaceutical doses prepared are suitable for clinical use.

  17. Unexplained exertional dyspnea caused by low ventricular filling pressures: results from clinical invasive cardiopulmonary exercise testing.

    Science.gov (United States)

    Oldham, William M; Lewis, Gregory D; Opotowsky, Alexander R; Waxman, Aaron B; Systrom, David M

    2016-03-01

    To determine whether low ventricular filling pressures are a clinically relevant etiology of unexplained dyspnea on exertion, a database of 619 consecutive, clinically indicated invasive cardiopulmonary exercise tests (iCPETs) was reviewed to identify patients with low maximum aerobic capacity (V̇o2max) due to inadequate peak cardiac output (Qtmax) with normal biventricular ejection fractions and without pulmonary hypertension (impaired: n = 49, V̇o2max = 53% predicted [interquartile range (IQR): 47%-64%], Qtmax = 72% predicted [62%-76%]). These were compared to patients with a normal exercise response (normal: n = 28, V̇o2max = 86% predicted [84%-97%], Qtmax = 108% predicted [97%-115%]). Before exercise, all patients received up to 2 L of intravenous normal saline to target an upright pulmonary capillary wedge pressure (PCWP) of ≥5 mmHg. Despite this treatment, biventricular filling pressures at peak exercise were lower in the impaired group than in the normal group (right atrial pressure [RAP]: 6 [IQR: 5-8] vs. 9 [7-10] mmHg, P = 0.004; PCWP: 12 [10-16] vs. 17 [14-19] mmHg, P volume (SV) augmentation with exercise (+13 ± 10 [standard deviation (SD)] vs. +18 ± 10 mL/m(2), P = 0.014). A review of hemodynamic data from 23 patients with low RAP on an initial iCPET who underwent a second iCPET after saline infusion (2.0 ± 0.5 L) demonstrated that 16 of 23 patients responded with increases in Qtmax ([+24% predicted [IQR: 14%-34%]), V̇o2max (+10% predicted [7%-12%]), and maximum SV (+26% ± 17% [SD]). These data suggest that inadequate ventricular filling related to low venous pressure is a clinically relevant cause of exercise intolerance. PMID:27162614

  18. Unexplained exertional dyspnea caused by low ventricular filling pressures: results from clinical invasive cardiopulmonary exercise testing

    Science.gov (United States)

    Lewis, Gregory D.; Opotowsky, Alexander R.; Waxman, Aaron B.; Systrom, David M.

    2016-01-01

    Abstract To determine whether low ventricular filling pressures are a clinically relevant etiology of unexplained dyspnea on exertion, a database of 619 consecutive, clinically indicated invasive cardiopulmonary exercise tests (iCPETs) was reviewed to identify patients with low maximum aerobic capacity (V̇o2max) due to inadequate peak cardiac output (Qtmax) with normal biventricular ejection fractions and without pulmonary hypertension (impaired: n = 49, V̇o2max = 53% predicted [interquartile range (IQR): 47%–64%], Qtmax = 72% predicted [62%–76%]). These were compared to patients with a normal exercise response (normal: n = 28, V̇o2max = 86% predicted [84%–97%], Qtmax = 108% predicted [97%–115%]). Before exercise, all patients received up to 2 L of intravenous normal saline to target an upright pulmonary capillary wedge pressure (PCWP) of ≥5 mmHg. Despite this treatment, biventricular filling pressures at peak exercise were lower in the impaired group than in the normal group (right atrial pressure [RAP]: 6 [IQR: 5–8] vs. 9 [7–10] mmHg, P = 0.004; PCWP: 12 [10–16] vs. 17 [14–19] mmHg, P < 0.001), associated with decreased stroke volume (SV) augmentation with exercise (+13 ± 10 [standard deviation (SD)] vs. +18 ± 10 mL/m2, P = 0.014). A review of hemodynamic data from 23 patients with low RAP on an initial iCPET who underwent a second iCPET after saline infusion (2.0 ± 0.5 L) demonstrated that 16 of 23 patients responded with increases in Qtmax ([+24% predicted [IQR: 14%–34%]), V̇o2max (+10% predicted [7%–12%]), and maximum SV (+26% ± 17% [SD]). These data suggest that inadequate ventricular filling related to low venous pressure is a clinically relevant cause of exercise intolerance. PMID:27162614

  19. Non-invasive prenatal testing for fetal chromosome abnormalities: review of clinical and ethical issues

    Directory of Open Access Journals (Sweden)

    Gekas J

    2016-02-01

    Full Text Available Jean Gekas,1,2 Sylvie Langlois,3 Vardit Ravitsky,4 François Audibert,5 David Gradus van den Berg,6 Hazar Haidar,4 François Rousseau2,7 1Prenatal Diagnosis Unit, Department of Medical Genetics and Pediatrics, Faculty of Medicine, Université Laval, Québec City, QC, Canada; 2Department of Medical Biology, CHU de Québec, Québec City, QC, Canada; 3Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada; 4Bioethics Program, Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, QC, Canada; 5Department of Obstetrics and Gynecology, Hospital Sainte-Justine, Montreal, QC, Canada; 6Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Québec City, QC, Canada; 7Department of Molecular Biology, Medical Biochemistry and Pathology, Faculty of Medicine, Université Laval, Québec City, QC, Canada Abstract: Genomics-based non-invasive prenatal screening using cell-free DNA (cfDNA screening was proposed to reduce the number of invasive procedures in current prenatal diagnosis for fetal aneuploidies. We review here the clinical and ethical issues of cfDNA screening. To date, it is not clear how cfDNA screening is going to impact the performances of clinical prenatal diagnosis and how it could be incorporated in real life. The direct marketing to users may have facilitated the early introduction of cfDNA screening into clinical practice despite limited evidence-based independent research data supporting this rapid shift. There is a need to address the most important ethical, legal, and social issues before its implementation in a mass setting. Its introduction might worsen current tendencies to neglect the reproductive autonomy of pregnant women. Keywords: prenatal diagnosis, Down syndrome, non-invasive prenatal testing, cell-free fetal DNA, informed consent, reproductive autonomy

  20. Successful Integration of Hepatitis C Virus Point-of-Care Tests into the Denver Metro Health Clinic

    Directory of Open Access Journals (Sweden)

    A. Jewett

    2013-01-01

    Full Text Available Background. The Centers for Disease Control and Prevention (CDC recommends testing and linkage to care for persons most likely infected with hepatitis C virus (HCV, including persons with human immunodeficiency virus. We explored facilitators and barriers to integrating HCV point-of-care (POC testing into standard operations at an urban STD clinic. Methods. The OraQuick HCV rapid antibody test was integrated at the Denver Metro Health Clinic (DMHC. All clients with at least one risk factor were offered the POC test. Research staff conducted interviews with clients (three HCV positive and nine HCV negative. Focus groups were conducted with triage staff, providers, and linkage-to-care counselors. Results. Clients were pleased with the ease of use and rapid return of results from the HCV POC test. Integrating the test into this setting required more time but was not overly burdensome. While counseling messages were clear to staff, clients retained little knowledge of hepatitis C infection or factors related to risk. Barriers to integrating the HCV POC test into clinic operations were loss to follow-up and access to care. Conclusion. DMHC successfully integrated HCV POC testing and piloted a HCV linkage-to-care program. Providing testing opportunities at STD clinics could increase identification of persons with HCV infection.