JOURNAL OF FOOD SAFETY, Issue 4 2009
DANIEL C. EDSON
ABSTRACT The objective of this study was to assess laboratories' ability to detect or rule out the presence of four common food pathogens: Escherichia coli O157:H7, Salmonella spp., Listeria monocytogenes and Campylobacter spp. To do this, qualitative proficiency test data provided by one proficiency test provider from 1999 to 2007 were examined. The annual and cumulative 9-year percentages of false-negative and false-positive responses were calculated. The cumulative 9-year false-negative rates were 7.8% for E. coli O157:H7, 5.9% for Salmonella spp., 7.2% for L. monocytogenes and 13.6% for Campylobacter spp. Atypical strains and low concentrations of bacteria were more likely to be missed, and the data showed no trend of improving performance over time. Percentages of false-positive results were below 5.0% for all four pathogens. PRACTICAL APPLICATIONS The results imply that food testing laboratories often fail to detect the presence of these four food pathogens in real food specimens. To improve pathogen detection, supervisors should ensure that testing personnel are adequately trained, that recommended procedures are followed correctly, that samples are properly prepared, that proper conditions (temperature, atmosphere and incubation time) are maintained for good bacterial growth and that recommended quality control procedures are followed. Supervisors should also always investigate reasons for unsatisfactory proficiency test results and take corrective action. Finally, more research is needed into testing practices and proficiency test performance in food testing laboratories. [source]

P-11 THE IMPACT OF INTRODUCING LIQUID BASED CYTOLOGY INTO A ROUTINE SCREENING LABORATORY

CYTOPATHOLOGY, Issue 2006
L. Gregory
With the exception of information from the liquid based cytology (LBC) pilot site there has been limited data to date on the impact of the introduction of SurePathÔ LBC in the NHSCSP. We will present data to show the impact on a medium sized laboratory (42 000 requests per annum) over the first phases of rollout. Data from before, during and post conversion, a period of 28 months, shows the following trends: (1) A significant fall in the inadequate rate (2) A slight decrease in the borderline / mild dyskaryosis rate (3) A small increase in the high-grade squamous dyskaryosis reporting rate (4) An increase in both the number and specificity of glandular lesions reported (5) A largely unchanged positive predictive value for high-grade abnormalities (6) A significant increase in laboratory productivity, unrelated to inadequate rate but through increased speed of screening. Although our experience is not directly comparable to the experience of the LBC pilot, our observations may well reflect that we were fortunate to be trained by staff from one of the LBC sites and thereby benefited directly from their experience. [source]

CASE STUDY: BUILDING BRIDGES OF HOPE , A "LIVING LABORATORY" FOR MISSION-MINDED CHURCHES

INTERNATIONAL REVIEW OF MISSION, Issue 364 2003
Simon Barrow
First page of article [source]

Java-powered virtual laboratories for earthquake engineering education

COMPUTER APPLICATIONS IN ENGINEERING EDUCATION, Issue 3 2005
Y. Gao
Abstract This paper presents a series of Java-Powered Virtual Laboratories (VLs), which have been developed to provide a means for on-line interactive experiments for undergraduate and graduate education. These VLs intend to provide a conceptual understanding of a wide range of topics related to earthquake engineering, including structural control using the tuned mass damper (TMD) and the hybrid mass damper (HMD), linear and nonlinear base isolation system, and nonlinear structural dynamic analysis of multi-story buildings. A total of five VLs are currently available on-line at: http://cee.uiuc.edu/sstl/java and have been incorporated as a reference implementation of educational modules in the NEESgrid software (http://www.neesgrid.org/). © 2005 Wiley Periodicals, Inc. Comput Appl Eng Educ 13: 200,212, 2005; Published online in Wiley InterScience (www.interscience.wiley.com); DOI 10.1002/cae.20050 [source]

A North American multilaboratory study of CD4 counts using flow cytometric panleukogating (PLG): A NIAID-DAIDS Immunology Quality Assessment Program Study,,§¶

CYTOMETRY, Issue S1 2008
Thomas N. Denny
Abstract Background The global HIV/AIDS pandemic and guidelines for initiating anti-retroviral therapy (ART) and opportunistic infection prophylaxis demand affordable, reliable, and accurate CD4 testing. A simple innovative approach applicable to existing technology that has been successfully applied in resource-challenged settings, PanLeukogated CD4 (PLG), could offer solutions for cost saving and improved precision. Methods Day-old whole blood from 99 HIV+ donors was simultaneously studied in five North-American laboratories to compare the performance of their predicate methods with the dual-platform PLG method. The predicate technology included varying 4-color CD45/CD3/CD4/CD8 protocols on different flow cytometers. Each laboratory also assayed eight replicate specimens of day-old blood from 10 to 14 local donors. Bias and precision of predicate and PLG methods was studied between- and within-participating laboratories. Results Significantly (P < 0.0001) improved between-laboratory precision/coefficient of variation (CV%) was noted using the PLG method (overall median 9.3% vs. predicate median CV 13.1%). Within-laboratory precision was also significantly (P < 0.0001) better overall using PLG (median 4.6% vs. predicate median CV 6.2%) and in 3 of the 5 laboratories. PLG counts tended to be 11% smaller than predicate methods (P < 0.0001) for shipped (median of predicate,PLG = 31) and local specimens (median of predicate,PLG = 23), both overall and in 4 of 5 laboratories (median decreases of 4, 16, 20, and 21% in shipped specimens); the other laboratory had a median increase of 5%. Conclusion Laboratories using predicate CD4 methods similar to those in this study could improve their between-laboratory and their within-laboratory precision, and reduce costs, by switching to the PLG method after adequate training, if a change (usually, a decrease) in CD4 counts is acceptable to their health systems. © 2008 Clinical Cytometry Society [source]

Quality control of CD4+ T-lymphocyte enumeration: Results from the last 9 years of the United Kingdom national external quality assessment scheme for immune monitoring (1993,2001)

CYTOMETRY, Issue 2 2002
Liam Whitby
Abstract The human immunodeficiency virus (HIV) global epidemic has necessitated the routine enumeration of T-lymphocyte subsets, which has created a need for external quality assurance (EQA). The United Kingdom National External Quality Assessment Scheme (UK NEQAS) for Immune Monitoring provides EQA for 296 laboratories in 40 countries. In 1993, UK NEQAS developed and incorporated into its program stabilized whole blood that enables the accurate monitoring of laboratory performance. Overall, the mean interlaboratory coefficient of variation (CV) for percentage CD4+ T-lymphocyte subset enumeration has fallen from 15% to less than 5%, as a direct result of the increased use of CD45/ side scatter (SSC) gating. Laboratories using alternative gating strategies (i.e., CD45/CD14 or forward scatter [FSC]/SSC) were about 7.4 times more likely to fail an EQA exercise. Furthermore, the adoption of single-platform technology resulted in a reduction of the overall mean interlaboratory CV for absolute CD4+ T lymphocytes from 56% (prior to the widespread use of single-platform technology) to 9.7%. Individual laboratory deficiencies were also identified using a performance monitoring system and, through re-education by collaboration with the coordinating center, satisfactorily resolved. In conclusion, during the last 9 years, the UK NEQAS for Immune Monitoring program has highlighted the significant technological advances made by laboratories worldwide that undertake lymphocyte subset enumeration. Cytometry (Clin. Cytometry) 50:102,110, 2002. © 2002 Wiley-Liss, Inc. [source]

The BSCC Code of Practice , exfoliative cytopathology (excluding gynaecological cytopathology)

CYTOPATHOLOGY, Issue 4 2009
A. Chandra
Exfoliative cytopathology (often referred to as non-gynaecological cytology) is an important part of the workload of all diagnostic pathology departments. It clearly has a role in the diagnosis of neoplastic disease but its role in establishing non-neoplastic diagnoses should also be recognised. Ancillary tests may be required to establish a definitive diagnosis. Clinical and scientific teamwork is essential to establish an effective cytology service and staffing levels should be sufficient to support preparation, prescreening, on-site adequacy assessment and reporting of samples as appropriate. Routine clinical audit and histology/cytology correlation should be in place as quality control of a cytology service. Cytology staff should be involved in multidisciplinary meetings and appropriate professional networks. Laboratories should have an effective quality management system conforming to the requirements of a recognised accreditation scheme such as Clinical Pathology Accreditation (UK) Ltd. Consultant pathologists should sign out the majority of exfoliative cytology cases. Where specimens are reported by experienced biomedical scientists (BMS), referred to as cytotechnologists outside the UK, this must only be when adequate training has been given and be defined in agreed written local protocols. An educational basis for formalising the role of the BMS in exfoliative cytopathology is provided by the Diploma of Expert Practice in Non-gynaecological Cytology offered by the Institute of Biomedical Science (IBMS). The reliability of cytological diagnoses is dependent on the quality of the specimen provided and the quality of the preparations produced. The laboratory should provide feedback and written guidance on specimen procurement. Specimen processing should be by appropriately trained, competent staff with appropriate quality control. Microscopic examination of preparations by BMS should be encouraged wherever possible. Specific guidance is provided on the clinical role, specimen procurement, preparation and suitable staining techniques for urine, sputum, semen, serous cavity effusion, cerebrospinal fluid, synovial fluid, cyst aspirates, endoscopic specimens, and skin and mucosal scrapes. [source]

CPA assessment , the regional assessors' experience

CYTOPATHOLOGY, Issue 2007
E. Welsh
Many individuals within Laboratory Medicine will be unaware that CPA conducts assessments to two different sets of CPA Standards. There are the Standards for the Medical Laboratory and the Standards for EQA Schemes in Laboratory Medicine. The style and format of both sets of standards is very similar with each being presented in eight sections A , H. The EQA standards are almost identical to the laboratory standards with the exception of the E.F and G standards which are specific to EQA schemes. There are approximately 40 EQA Schemes registered with CPA compared with almost 2 500 laboratories. These EQA schemes vary from very large national/international schemes with numerous analytes to small interpretive schemes run by one individual with a personal interest in that specific subject. The large schemes usually come under the UKNEQAS consortia banner and due to their size and configuration do not present undue problems in the assessment process. Smaller interpretive EQA schemes present a challenge both for the scheme and CPA in gaining accreditation. These schemes are usually within the discipline of Histopathology and are regarded as educational rather than proficiency testing schemes. Very frequently, the scheme is organized by a single individual with a collection of microscope slides, storage facilities for the slides and a computer. This presents the Scheme Organizer with great difficulty in complying with the Quality Management System requirements of the CPA Standards. There are a number of models which can be applied in order to satisfy the requirement of the Quality Management System, but ultimately it must be recognized that in some circumstances it is not possible to accredit these small schemes. The NHSCSP Gynae Cytology EQA Scheme is probably the largest EQA scheme within the UK, in respect of the number of participants and the number of staff supporting the scheme. Scheme Management decided that all nine regions of England would apply for accreditation under one CPA Reference Number. This process meant that the scheme would be assessed as a Managed Pathology Network. This is unique in terms of EQA schemes and presented a number of problems not previously encountered in EQA scheme accreditation. This decision meant that all nine regions must comply with a single Quality Management System and other CPA standards whilst allowing flexibility within the system for each region to facilitate the assessment process specific to their user's requirements. The process worked in a satisfactory manner and the overall outcome was not dissimilar to that of other large EQA schemes. The assessment to the current EQA Standards only commenced in April 2006 whilst the Standards for Medical Laboratories commenced in 2003, and it is perhaps not surprising to find that the principal non-conformities are related to the Quality Management System. This parallels the findings encountered in laboratory accreditation. There is an ongoing educational process for Scheme Management and the Facilitators in each region in how to comply fully with the standards and a commitment to quality improvement which ultimately is beneficial to the participant's of the scheme and to patient safety. [source]

Detecting Adverse Events in Dermatologic Surgery

DERMATOLOGIC SURGERY, Issue 1 2010
DANIEL PINNEY BS
BACKGROUND Despite increasing awareness of and public attention to patient safety, little is documented about how adverse events (AEs) can or should be monitored in dermatologic surgery. Data to address this shortcoming are needed, although well-defined methodologies have yet to be implemented. OBJECTIVE To summarize current strategies in detecting adverse outcomes of dermatologic surgical procedures. MATERIALS AND METHODS A Medline literature search was conducted using the terms "adverse event,""detection,""reporting,""monitoring," and "surgery." Articles selected addressed the efficacy of one or more AE reporting techniques in surgical patients. RESULTS Prospective and retrospective reporting methods were identified, with morbidity and mortality conference being the most commonly used method of AE reporting. Retrospective medical record review, the retrospective trigger tool approach, and an anonymous electronic reporting system were more sensitive approaches. The Surgical Quality Improvement Program, a program that has successfully translated AE data into lower postoperative morbidity and mortality, was analyzed. CONCLUSIONS Although generally considered safe, dermatologic surgery has no current standard for AE reporting. Standard definitions and high-quality data regarding AEs" currently limit this analysis. Pilot studies are needed to develop feasible measures, with the goal of increasing the sensitivity of AE detection and ultimately improving patient outcomes. The Center for Dermatology Research is supported by an unrestricted educational grant from Galderma Laboratories. [source]

Treatment of erythrodermic psoriasis in HCV+ patient with adalimumab

DERMATOLOGIC THERAPY, Issue 2009
Antonio Giovanni Richetta
ABSTRACT Erythrodermic psoriasis is a severe and disabling variant of psoriasis. The authors present the case of a 48-year-old man with psoriasis and hemophilia presented with a history of hepatitis C virus (HCV) infection treated with pegylated interferon alpha-2a and ribavirin therapy. At the end of antiviral therapy, skin manifestation progressively worsened, becoming erythrodermic, with lack of efficacy of steroid therapy. The authors decided to start biological therapy with induction dose of adalimumab (Humira, Abbott Laboratories, Abbott Park, Chicago, IL) 80 mg at Week 0 and 40 mg weekly. In our case, this resulted in a highly effective and safe treatment. [source]

Organisation of proficiency testing for plant health diagnostic tests: the experience of FAPAS®

EPPO BULLETIN, Issue 1 2010
A. Reynolds
Proficiency testing (PT) is an established quality assurance measure and is based on the comparison of laboratories' results in an inter-laboratory trial. It highlights problems in laboratory analysis and is an educational tool to help improve data quality. This article describes how PT is organised by FAPAS®. FAPAS® is an international PT provider (external quality assessments) for food chemistry, food microbiology, genetically modified material and water/environmental samples. Since 2007, FAPAS® have organized plant health proficiency tests in conjunction with the Plant Pest and Disease Identification Programme at the Food and Environment Research Agency (Fera). Up until 2009, FAPAS® has organised seven plant health proficiency tests that covered the identification of lyophilised bacteria, viruses in leaves and fungi in agar plugs. In 2009, FAPAS® organized over 10 plant health proficiency tests under the banner of ,PhytoPAS', including Potato spindle tuber viroid, Phytophthora ramorum, Thrips palmi, Erwinia amylovora, Clavibacter michiganensis subsp. sepedonicus, etc. DNA extracts, cyst nematodes (Globodera pallida) and slides/immunofluorescence (IF) slides have been added to the programme. The organization of the plant health proficiency tests follows a similar pattern. Suitable test materials are prepared and tested for quality before distribution to requesting participants. Laboratories usually have 1,2 months to analyze their samples and return their results. A report is then compiled for issue to laboratories and these contain all results in an anonymous form, so that laboratories can compare their results with those of other participants. If a laboratory's performance is unsatisfactory then it is up to them to investigate the situation. Thus, the primary purpose of PT is the detection of inaccuracy in a laboratory's results, so that they can investigate the problems and initiate corrective procedures. [source]

Servier: establishing research and education partnerships

FUTURE PRESCRIBER, Issue 3 2008
Article first published online: 19 JAN 200
This series of company profiles looks at some of the major players in the UK pharmaceutical industry, their current areas of expertise and forthcoming products and initiatives that will have an impact on therapeutics and prescribing in the near future. In this article we provide an overview of Servier Laboratories and its top products, as well as Servier's ongoing development of research and education partnerships. Copyright © 2008 John Wiley & Sons, Ltd. [source]

Laboratory identification of factor VIII inhibitors in the real world: the experience from Australasia

HAEMOPHILIA, Issue 4 2010
E. J. FAVALORO
Summary., The laboratory has a key role in the initial detection of factor inhibitors and an ongoing role in the measurement of inhibitor titres during the course of inhibitor eradication therapy. The most commonly seen factor inhibitors are those directed against factor VIII (FVIII), usually detected either using the original or Nijmegen-modified Bethesda assay. In view of previously demonstrated high variability in laboratory results for inhibitor assays, we have more extensively examined laboratory performance in the identification of FVIII inhibitors. Over the past 3 years, we conducted two questionnaire-based surveys and two wet-challenge surveys utilizing eight samples comprising no FVIII inhibitor (n = 1), or low-titre (n = 2), medium-titre (n = 3) or high-titre (n = 2) FVIII inhibitor. Four samples were tested by 42 laboratories in 2007, and four by 52 laboratories in 2009. High inter-laboratory variation was evident, with CVs around 50% not uncommon, and some 10% of all laboratories (or around 15% of laboratories using Bethesda method) failed to detect low-level inhibitors of around 1 BU mL,1. Laboratories using the Nijmegen method appeared to perform better than those using a standard Bethesda assay, with lower evident assay variation and no false negatives. There was a wide variety of laboratory practice, with no two laboratories using exactly the same process for testing and interpretation of factor inhibitor findings. In conclusion, our study indicates that there is still much need for standardization and improvement in factor inhibitor detection, and we hope that our findings provide a basis for future improvements in this area. [source]

Genotypic antiretroviral drug resistance testing at low viral loads in the UK

HIV MEDICINE, Issue 8 2008
PA Cane
Background Antiretroviral drug resistance testing is recommended in HIV-1 infected patients failing therapy in order to inform treatment selection. Although guidelines and test manufacturers recommend a viral load of at least 500,1000 HIV-1 RNA copies/mL for genotypic resistance testing to be performed, prompt management of virological failure could benefit from testing at lower viral load levels. Methods Laboratories undertaking genotypic resistance testing were asked to provide figures for the number of resistance tests undertaken at viral loads <2000 copies/mL, the success rates of such tests and the extent of resistance detected, all stratified for viral load levels. Results Of the replies received, most laboratories were attempting resistance testing at viral loads below the recommended guidelines, with variable success and outcomes. Conclusions This audit of current practice in the UK for undertaking genotypic resistance tests at viral loads <1000 copies/mL highlights the widespread use of such testing outside the British HIV Association guidelines. [source]

Frequently discordant results from therapeutic drug monitoring for digoxin: clinical confusion for the prescriber

INTERNAL MEDICINE JOURNAL, Issue 1 2010
N. M. Rogers
Abstract Background: Digoxin remains a commonly prescribed medication for the treatment of congestive cardiac failure or atrial tachyarrhythmias. Its utility is offset by its narrow therapeutic index requiring regular blood concentration monitoring. Recent evidence suggests that a lower therapeutic range (0.5,0.8 µg/L, or 0.6,1.0 nmol/L) is associated with reduced mortality in patients with congestive cardiac failure. Therapeutic drug monitoring for digoxin is carried out by immunoassays that are well established in routine clinical practice. Laboratories using different immunoassays may be involved in monitoring individual patients throughout the protracted course of therapy. These results should be concordant to ensure consistent dose individualization and optimum clinical management. We have investigated the discordance in digoxin measurements involving five different laboratories across the Adelaide metropolitan area. Methods: Aliquots from routine digoxin samples (n= 261) were analysed by accredited laboratories using commercially available immunoassays. Results: The results showed that 119 (46%) of 261 samples were so varied that a different clinical outcome was indicated when reviewed by the treating physician. The differences between the highest and lowest readings from any one sample were also substantial, with 45% of the measurements exceeding 0.3 µg/L. Conclusions: Our study shows the considerable variation in the routine monitoring of digoxin. This makes therapeutic drug monitoring difficult to interpret and complicates clinical management when treating physicians are endeavouring to avoid toxicity and optimize dosing. These results raise a significant concern for the quality of therapeutic drug monitoring of digoxin and have direct repercussions on patient care. [source]

EQAS for peripheral blood morphology in Spain: a 6-year experience

INTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 6 2008
G. GUTIÉRREZ
Summary The Spanish haematology external quality assessment scheme (EQAS), established in 1984, is run by the Spanish Haematology and Haemotherapy Association (AEHH) [Quality Assurance in Health Care 3 (1991) 75] and functions to evaluate the quality and reproducibility of the assessment of diagnostic samples by clinical laboratories. The Hospital Clinic of the University of Barcelona (HCB) serves as the EQAS Coordination Centre and follows the guidelines established by the International Committee for Standardization in Haematology [Annali dell'Istituto superiore di Sanità 31 (1995) 95; International Journal of Hematology 68 (1998) 45]. During the period 2001,2006, replicates of 25 different blood films were sent to 604 EQAS participants for cell morphology evaluation. Some patient details corresponding to the samples were disclosed, such us age, sex, haemoglobin value and white blood cell count. The participants were asked to select up to four significant morphology features using a coding list, provided by the Coordination Centre, which included significant morphological alterations that appear in haematopoietic cells. For each survey, individual results were assessed against the morphological reference results (MRR) established by the Cytology Group of the AEHH (,true' answers). This paper describes the organization of the 6-year-long study and the evaluation of laboratory performance for blood smear interpretation by the Spanish haematology EQAS. Different performance levels were detected relative to the laboratory category. Laboratories providing services to hospitalized patients showed higher performances compared with laboratories providing services to nonhospitalized patients. Pathological lymphoid cells were the most difficult to identify by the participants. To improve the results in EQAS peripheral blood morphology, the development of specific cytology educational trainings is discussed. [source]

Pain on injection from propofol may be avoided by changing its formulation

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 4 2010
J. A. ALDRETE
Background: After using propofol for a decade, pain on injection had been considered routine by patients and medical personnel. When given propofol from a different manufacturer, patients did not complain. Two preparations of propofol were compared. Methods: A comparative, double-blind, randomized study was conducted in 22 adult patients undergoing pain relief procedures; they received sedation by an intravenous injection of 1.7 mg/kg of propofol and then were treated with paravertebral injections. Pain on injection was assessed by verbal complaint, movement of the extremity, of the whole body and recollection of pain at induction, when discharged. Propofol from Baxter Laboratories, mixed with either 5 ml of 2% lidocaine or 5 ml of NaCl 0.9%, was compared with propofol Laboratorios Gray, which was similarly mixed. Injections were randomly administered four times, blindly, to each of 22 patients. Statistical analysis was conducted using the analysis of variance method. Results: A total of 352 propofol injections were given. Each of the four propofol solutions was administered 88 times; of patients receiving Baxter propofol+saline, 74 (84%) had pain; when mixed with 2% lidocaine 45 (50.2%) complained. After propofol Gray with NaCl 0.9% was given, two patients (2.2%) experienced pain. Propofol Gray with 2% lidocaine produced no pain. None of the latter group remembered having pain, whereas, those given propofol Baxter 54 (61.3%) and 26 (29.5%) remembered experiencing pain at injection. Pain on injection was prevented and statistically reduced (<0.01) with the propofol from Laboratorios Gray. Conclusions: By changing the formulation (size of molecules and their dispersion) of propofol, pain on injection was avoided. [source]

Possible automatic cell classification of bone marrow aspirate using the CELL-DYN 4000® automatic blood cell analyzer

JOURNAL OF CLINICAL LABORATORY ANALYSIS, Issue 2 2002
Ryousuke Yamamura
Abstract In clinical hematology, the demand for bone marrow aspiration testing is increasing. However, conventional automatic blood cell analyzers cannot completely analyze erythroblasts, and evaluation has mainly been performed by visual examination (the microscopic method). Using the CELL-DYN 4000® automatic blood cell analyzer (CD4000) (Abbott Laboratories, North Chicago, IL), specific recognition and classification of erythroblasts by DNA staining is possible. In the present study, using bone marrow blood collected from normal subjects and patients with hematological malignancy, we classified cells by the microscopic method and with the CD4000, and compared the results. Good correlations were found for total nucleated cell count (TNCC), neutrophils, lymphocytes, erythroblasts, and the myeloid series to erythroid series (M/E) ratio. It is possible to detect blasts that emerge in patients with hematological malignancy using the blast flag system installed on the CD4000. Since all of the items can be analyzed in about 80 sec with the CD4000, cells in bone marrow aspirates can be classified faster with this apparatus than by the microscopic method. Therefore, analysis of bone marrow aspirates with this apparatus appears to be very useful not only for laboratory testing but also for clinical screening. J. Clin. Lab. Anal. 16:86,90, 2002. © 2002 Wiley-Liss, Inc. [source]

Effect of elevated concentration of alkaline phosphatase on cardiac troponin I assays

JOURNAL OF CLINICAL LABORATORY ANALYSIS, Issue 4 2001
Amitava Dasgupta
Abstract Troponin I is the regulatory subunit of troponin complex associated with the actin thin filament within muscle cells. Cardiac troponin I (cTnI) is a good marker for diagnosis of myocardial damage. Several immunoassays are available for determination of cTnI in serum. The Stratus cTnI fluorometric enzyme immunoassay (Dade International) uses alkaline phosphatase (ALP) substrate. The microparticle enzyme immunoassay (MEIA) for cTnI (Abbott Laboratories) also uses ALP conjugate. On the other hand, the chemiluminescent assay (CLIA) for cTnI (Bayer Diagnostics) does not use ALP. ALP activity may frequently be elevated in serum of patients being evaluated for suspected myocardial infarction. Therefore, we studied the potential interference of ALP in cTnI assays. Serum pools were prepared from patients, and various concentrations of ALP solution were added to different aliquots. The cTnI concentrations were measured by the Stratus, MEIA, and CLIA assays. We observed no interference of ALP in the MEIA and CLIA assay for cTnI. On the other hand, we observed significant positive interference of ALP when cTnI concentrations were measured using the Stratus. J. Clin. Lab. Anal. 15:175,177, 2001. © 2001 Wiley-Liss, Inc. [source]

Negative interference of bilirubin and hemoglobin in the MEIA troponin I assay but not in the MEIA CK‐MB assay

JOURNAL OF CLINICAL LABORATORY ANALYSIS, Issue 2 2001
Amitava Dasgupta
Abstract Troponin I is a sensitive and specific marker for the diagnosis of myocardial infarction. Several commercially available immunoassays measure the concentration of troponin I in serum. The microparticle enzyme immunoassay (MEIA) for troponin I (Abbott Laboratories, Abbott Park, IL) is widely used in clinical laboratories, including our hospital laboratory. We studied the effect of bilirubin and hemolysis on the MEIA for troponin I and compared our assay with a newly available chemiluminescent assay (CLIA) for troponin I (Bayer Diagnostics, Tarrytown, NY). We also measured CK‐MB concentration using the MEIA CK‐MB assay. One serum pool was prepared by combining several specimens of one patient with elevated troponin I and with a diagnosis of myocardial infarction. Other serum pools were prepared by combining sera with similar troponin I values. All serum pools showed normal bilirubin concentrations and had no hemolysis. Then we supplemented aliquots of serum pools with various concentrations of bilirubin (5.0, 10.0, 15.0, and 20.0 mg/dL). After supplementation, troponin I concentrations were measured again using the MEIA and CLIA. We observed a statistically significant decrease in troponin I concentration in the presence of bilirubin with the MEIA. For example, in serum pool 1, the troponin I concentration was 16.3 (bilirubin: 0.8 mg/dL). In the presence of 5.0, 10.0, 15.0 and 20.0 mg/dL of added bilirubin, the cardiac troponin I concentrations were 13.9, 13.4, 13.3 and 13.0 ng/ml respectively. We observed similar negative interference of bilirubin in troponin I measurement by the MEIA in other pools. The troponin I value decreased slightly (not statistically significant) in one pool and did not change in two other pools in the presence of bilirubin when we measured troponin I concentration using the CLIA. Interestingly, bilirubin did not interfere with the MEIA CK‐MB assay. Moderate hemolysis did not have any effect on the troponin I assay using either the MEIA or CLIA. However, gross hemolysis (hemoglobin > 40 mg/dL) interfered with both assays for troponin I. J. Clin. Lab. Anal. 15:76–80, 2001. © 2001 Wiley‐Liss, Inc. [source]

Handmade Guns in Trabzon, Turkey

JOURNAL OF FORENSIC SCIENCES, Issue 4 2009
Riza Yilmaz M.D.
Abstract:, A wide variety of handmade firearms have been involved in criminal cases in the city of Trabzon, Turkey. Although they are often very similar to commercially manufactured firearms in terms of design, loading and locking mechanisms, and cocking and firing arrangements, these guns are constructed from cheap materials and are not safe for firing. Handmade firearms manufactured in the Black Sea region of Turkey, particularly in the city of Trabzon, are similar to pistols manufactured by Browning, Luger, Star, Smith and Wesson, Berretta, and MAB. A total of 201 handmade guns referred to the Criminal Police Laboratories for examination from 2003 to 2005 were evaluated with respect to type, number of barrels, size and caliber, rifling, design, mechanism, operability, legality, and similarity to commercial models. We found that most of these handmade guns resembled commercial models in several aspects. [source]

A high prevalence of hypovitaminosis D in Finnish medical in- and outpatients

JOURNAL OF INTERNAL MEDICINE, Issue 6 2001
R. Kauppinen-Mäkelin
Abstract.,Kauppinen-Mäkelin R, Tähtelä R, Löyttyniemi E, Kärkkäinen J, Välimäki MJ (Peijas Hospital, Vantaa; United Laboratories, Leiras Research, and Division of Endocrinology; Helsinki University Central Hospital, Helsinki, Finland). A high prevalence of hypovitaminosis D in Finnish medical in- and outpatients. J Intern Med 2001; 249: 559,563. Objective.,To study the prevalence of hypovitaminosis D [serum 25(OH)D , 37 nmol L,1)] in Finnish medical in- and outpatients in a cross-sectional study. Methods.,The subjects were 106 consecutive medical inpatients (57 females, 49 males with mean ages of 65 and 58 years) from the Peijas Hospital, Vantaa, Finland, and 99 ambulatory patients (48 females, 51 males with mean ages of 42 and 46 years) contacting a private outpatient centre in Helsinki, Finland. Serum 25(OH)D, vitamin D binding protein (DBP), free vitamin D index (FDI), intact PTH (iPTH), and albumin-corrected calcium were measured. Results.,Serum 25-hydroxyvitamin D [25(OH)D] was 37 nmol L,1 or less in 70% of female and in 61% of male inpatients and in 44% of female and in 37% of male outpatients. In the whole population, a statistically significant inverse association (P < 0.0001) was detected between iPTH and 25(OH)D levels; the iPTH concentration appeared to start increasing when 25(OH)D concentration was 50 nmol L,1 or less. The association remained the same (P < 0.0001) when FDI was used instead of 25(OH)D in the calculations. When the sexes were analysed separately, the statistically significant association was found only in females (P < 0.0001 for iPTH versus 25(OH)D; P < 0.0001 for iPTH versus FDI) but not in males. Conclusion.,Hypovitaminosis D is very common amongst Finnish in- and outpatients in both sexes, causing secondary hyperparathyroidism in females. More extensive studies are warranted to elucidate the vitamin D status of the Finnish population. [source]

Evaluation of four hematology and a chemistry portable benchtop analyzers using non-human primate blood

JOURNAL OF MEDICAL PRIMATOLOGY, Issue 6 2009
C.L. Snider
Abstract Background, Near patient testing (NPT) and point-of-care testing (POCT) using portable benchtop analyzers has become necessary in many areas of the medical community, including biocontainment. Methods, We evaluated the Beckman AcT diff, Abaxis Vetscan HMII (two instruments), Abbott Cell-Dyn 1800, and Abaxis Vetscan VS2 for within-run precision and correlation to central laboratory instruments using non-human primates blood. Results, Compared with the central laboratory instruments, the Beckman AcT diff correlated on 80%; the HMII instruments on 31% and 44%, the CD1800 on 31%, and the VS2 on 71% of assays. For assays with published manufacturers precision guidelines, the AcT diff met all nine, the HMII instruments met one and six of six, and the CD 1800 met one of six. Conclusions, Laboratories using NPT/POCT must test their individual instruments for precision and correlation, identify assays that are reliable, and exclude or develop supplemental procedures for assays that are not. [source]

Comparison of the performance of rapid HIV tests using samples collected for surveillance in Mozambique,

JOURNAL OF MEDICAL VIROLOGY, Issue 12 2009
Josefa Melo
Abstract Mozambique had low HIV prevalence until the mid-1990s, but recent data indicate increasing rates. There is little information on HIV-2. Therefore, HIV seroprevalence was assessed among pregnant women and field-ready HIV diagnostic strategies were evaluated. A total of 6,930 samples collected by three health centers from 2002 to 2005 were tested on site by nurses with two simple/rapid tests, Determine HIV-1/2 (Abbott Laboratories; screening) and Uni-Gold HIV (Trinity Biotech; confirmation), which is the national HIV testing strategy. The prevalence of HIV was 14.0% (2002), 17.8% (2003), 16.5% (2004), and 20.2% (2005). A subset of 888 samples collected 2003 was sent to the Central Microbiology Laboratory, Maputo for evaluation of tests and testing strategies. The assays included for comparison were Capillus HIV-1/HIV-2 (Trinity Biotech), DoubleCheckGold HIV-1&2 (Orgenics) and Enzygnost Anti-HIV-1/2 Plus (Behringwerke, reference ELISA). Confirmation of reactive samples was done by Uni-Gold HIV and ImmunoComb II HIV-1&2 BiSpot (for HIV type differentiation). The Capillus HIV-1/ HIV-2,+,ImmunoComb II HIV-1&2 BiSpot combination was the gold standard. The sensitivity of the rapid/simple screening assays (Determine HIV-1/2, DoubleCheckGold HIV-1&2) was 100% (N,=,160) and their (initial) specificities were 99.6% and 99.7%, respectively. Repeated testing and combinations of assays increased the specificity. Four suspected cases of recent seroconversion were found. Together with the increasing prevalence rates, this may indicate that Mozambique is a high-incidence area, although further studies are needed to confirm this. Testing strategies for on-site screening and confirmation based on the combination of Determine HIV-1/2, Uni-Gold HIV and DoubleCheckGold HIV-1&2 are well suited for local field use. J. Med. Virol. 81:1991,1998, 2009. © 2009 Wiley-Liss, Inc. [source]

HIV antigen,antibody combination enzyme immunoassay,the experience of a London Teaching Hospital

JOURNAL OF MEDICAL VIROLOGY, Issue S1 2007
Simon Goldenberg
Abstract The introduction of the fourth generation HIV antigen,antibody combination enzyme immunoassay (HIV Ag,Ab EIA) has led to a reduction in the diagnostic "window period" when HIV antibody is negative during primary infection. This facilitates earlier laboratory diagnosis during sero-conversion. An HIV Ag,Ab EIA (AxSYM, Abbott Laboratories, Kent, UK) was introduced to a London Teaching Hospital since 2004 as the primary screening test. Confirmation was performed using another HIV Ag,Ab EIA (Vironostika, BioMérieux, Hampshire, UK) and an HIV Ab only assay (Bispot, Orgenics, Yavne, Israel). Retrospective analysis identified a total of 20 sero-converting patients who would have been missed if the standard antibody-only HIV tests had been used as the primary screening test. This accounted for approximately 3% of the new diagnoses made by the laboratory. The median time from onset of illness to sero-conversion was 18 days. Two patients had multiple samples analyzed between initial presentation and eventual sero-conversion. One had a prolonged sero-conversion illness lasting for over 137 days; the other sero-converted within 17 days. A plotting of the signal to cut-off ratio with time of the two HIV Ag,Ab EIAs showed a V-shaped curve and both tests were below cut-off at some time-points during sero-conversion. These two cases highlighted the difficulties in diagnosing HIV infection during sero-conversion. On the basis of these results, it is recommended that a fourth generation HIV Ag,Ab EIA could be considered for use as the standard of care, particularly in any population with a high rate of HIV infection. J. Med. Virol. 79:S23,S26, 2007. © 2007 Wiley-Liss, Inc. [source]

TO DIVE OR NOT TO DIVE: SCUBA VERSUS ROV SAMPLING OF MACROALGAE AT 30M DEPTH

JOURNAL OF PHYCOLOGY, Issue 2001
Article first published online: 24 SEP 200
Spalding, H. L. Moss Landing Marine Laboratories, 8272 Moss Landing, Rd., Moss Landing, CA 95039 USA Remotely Operated Vehicles (ROVs) and enriched air Nitrox SCUBA diving have recently become available to researchers for studying the deep-water environment. Each use a different technique for collecting macroalgal abundance data: ROVs use collections and high-resolution digital video which can be quantified using an integrative laser and computer imagery program (high tech), while divers often count the densities of individuals and use a point contact method for sampling percent (%) cover in situ (low tech). While the types of data collected by both techniques are the same, the effects of the different sampling methods on data resolution are unknown. As part of a larger study on deep-water macroalgae in central California, I compared the abundance of common macroalgae (% cover of macroalgal groups and individuals/m2) collected by divers and the ROV Ventana at a depth of 30m at 3 locations in central California. Generally, there were no significant differences between diver and ROV data in the % cover of coralline Rhodophyta, non-coralline Rhodophyta, and Pleurophycus gardneri/m2. The use of a laser-calibrated computer imagery program and an ROV with user-controlled lighting greatly decreased lab analysis time, and a method for sampling macroalgal layers with the ROV was developed. Thus, ROVs with high-resolution digital video and supplemental macroalgal collections can be used to quantify deep-water algae as accurately as in situ divers, but without the limited dive time, depth limits, and physical demands of the latter. [source]

The discovery of polymer-clay hybrids

JOURNAL OF POLYMER SCIENCE (IN TWO SECTIONS), Issue 4 2004
Masaya Kawasumi
Abstract The first successful example of a polymer-clay hybrid was nylon-clay hybrid (NCH), which is a nano-meter-sized composite of nylon-6 and 1-nm-thick exfoliated aluminosilicate layers of the clay mineral. NCH was found and developed at Toyota Central Research and Development Laboratories over 17 years ago. The NCH containing a few weight percentages of clay exhibits superior properties such as high modulus, high strength, and good gas-barrier properties. The key for the discovery of NCH was the polymerization of a nylon monomer in the interlayer space of the clay. This highlight presents the development of NCH from its discovery to its commercialization. © 2004 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem 42: 819,824, 2004 [source]

Dentist Communication with the Dental Laboratory for Prosthodontic Treatment Using Implants

JOURNAL OF PROSTHODONTICS, Issue 3 2006
Zahra Afsharzand DMD
Purpose: A questionnaire was sent to U.S. dental laboratories to evaluate the level of communication between dentists and laboratory technicians and to determine trends in procedures and materials used in fixed and removable implant restorations. Methods and Materials: Dental laboratories were randomly chosen from the National Association of Dental Laboratories for each of the 50 states. The questionnaire was mailed to the laboratory directors for 199 dental laboratories. One hundred fourteen dental laboratories returned the survey, yielding a response rate of 57%. Of those laboratories, 37 indicated that they did not participate in the fabrication of fixed implant restorations, yielding a response rate of 39%. Forty-two dental laboratories indicated that they did not participate in the fabrication of implant-retained overdenture prostheses, yielding a response rate of 36%. Results: Results from this survey show inadequate communication by dentists in completing work authorization forms. Custom trays are used more frequently for implant-retained overdenture impressions and stock trays for impressions of fixed implant prostheses. Poly(vinyl siloxane) is the material most commonly used for both fixed and removable implant-supported prostheses. Two implants with stud attachments are used more widely than those with bar attachments for implant-retained overdentures. Conclusions: Most laboratories working on implant prosthodontic cases report inadequate communication between the laboratory and dentists related to materials and techniques used in fabrication of implant restorations. [source]

Communication Between the Dental Laboratory Technician and Dentist: Work Authorization for Fixed Partial Dentures

JOURNAL OF PROSTHODONTICS, Issue 2 2006
Zahra Afsharzand DMD
Purpose: A questionnaire was sent to laboratory technicians to determine the level of communication between dentists and dental laboratories in specific areas of the work authorization forms for the fabrication of fixed partial dentures. Materials and Methods: A select number of dental laboratories were randomly chosen from the National Association of Dental Laboratories (NADL) for each of the 50 states. The questionnaire was mailed to the laboratory directors for a total of 199 dental laboratories. The survey asked questions pertaining to the following areas of work authorization: legibility and thoroughness of prescriptions, patient information, choice of materials for the prosthesis, design of the prosthesis, and shade description. For each question, the number of responses received was tabulated and converted to a percentage. Results: Of the 199 laboratories surveyed, 114 (57%) responded to the questionnaire. Results from this survey suggest that there is lack of communication between dentists and dental laboratories through work authorization forms regarding choice of metal alloy, type of porcelain to be used, and choice of margin and pontic design for the prosthesis. Conclusions: Information obtained from the responding laboratories included effectiveness of work authorization forms. There were some similar trends indicated by the large percentage of dental laboratories agreeing on lack of communication by the dentists as reflected by the work authorization forms. [source]

Accuracy of a new ultrafast rapid urease test to diagnose Helicobacter pylori infection in 1000 consecutive dyspeptic patients

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2 2010
D. VAIRA
Summary Background, Rapid diagnostic tools for Helicobacter pylori are important in endoscopy. Aims, To assess the accuracy of a new 5 min rapid urease test (UFT300, ABS Srl, Cernusco sul Naviglio, Milan, Italy) and to compare it with the 1 h Pyloritek (Serim Laboratories, Elkhart, IN, USA) and the 24 h CLO test (Kimberly-Clark Ballard Medical Products, Roswell, GA, USA). Method, Consecutive dyspeptic patients referred to our unit for endoscopy were prospectively studied. All patients underwent a 13C-urea-breath test, histology and the UFT300 (ABS Srl; Cernusco sul Naviglio, Milan, Italy). In a sub-set of patients (n = 375), two additional RUTs were performed. Patients were deemed infected if both 13C-UBT and histology were positive. RUTs were read at 1, 5, and 60 min. Results, Of 1000 enrolled patients 45.3% were infected with H. pylori. The sensitivity of the UFT 300 was 90.3%, 94.5% and 96.2% at 1, 5 and 60 min respectively (specificity 100%). The Pyloritek and the UFT were comparable, but the CLO test was not reliable at 5 and 60 min. Conclusion, The UFT 300 test is comparable to the Pyloritek test, but the CLO test is significantly less sensitive at early time points. Reading test results at 1 min may increase false negative results, thereby decreasing sensitivity. Aliment Pharmacol Ther,31, 331,338 [source]