In the literature to date, there are no studies that directly evaluate microscopic urine examination results obtained by a physician compared to those of a trained laboratory technician. Our purpose in undertaking this study was to determine whether there would be comparable results obtained by these two groups. The study took place in an Emergency Medicine Department with 45,000 visits annually. Each urine sample obtained on patients presenting to the Emergency Department was divided into two lots: one was sent to the laboratory and the other was analyzed by the emergency physician. A comparison of both dipstick and microscopic results by physician and laboratory staff was then made using sensitivity, specificity, and Kappa analysis. Statistical analysis of the data revealed close agreement between the emergency physician and laboratory technician with respect to the following components of urinalysis: red blood cell urinalysis and microscopy, leukocyte esterase, and nitrite testing. Microscopy for white cells and bacteria and testing for proteinuria were not in close agreement. Urinalysis by emergency physicians is comparable to laboratory technicians for a number of the testing components. However, in this limited pilot study, emergency physicians were not able to consistently perform urinalysis for the laboratory standard.

Adolescent↗

PubMedDate not supplied

Functions of ras oncogenes.

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Animals↗

PubMedDate not supplied

Sensitization of repeat plasmapheresis donors to ethylene oxide gas.

Repeat plasma donors were studied to determine whether there was a relationship between allergic-type reactions during plasmapheresis and IgE-dependent sensitization to ethylene oxide gas used for sterilization of disposable fluid administration sets. Serums from 32 donors with allergic-type reactions and 84 donors who had no reactions but were exposed to the same materials and served as controls were tested for IgE-antibodies to ethylene oxide. The results, expressed as an IgE ethylene oxide index, were greater than 2 in 78 percent of serums from donors with allergic reactions and 12 percent of serums from controls. This association was significant (p less than 0.0001). Reactivity of the antibodies was directed against an ethylene oxide-human serum albumin conjugate and not against human serum albumin carrier protein. IgG antibodies with ethylene oxide specificity also were present in the serums of repeat plasmapheresis donors. Each of seven rabbits immunized with an ethylene oxide-protein conjugate responded with a high serum level of antibody with ethylene oxide specificity. It was concluded that the residual ethylene oxide in fluid administration sets is immunogenic and may cause allergic reactions in plasma donors.

Animals↗

PubMedDate not supplied

The art of induction/augmentation of labor.

To manage safely and effectively oxytocin administration, nurses must be knowledgeable in theory and skilled in technique. Current theory is explored regarding initiation of labor and cervical ripening. The pharmacology of oxytocin, uterine response to endogenous and exogenous stimulation of oxytocin, and current methods being used to induce/augment labor are discussed. A protocol to provide safe, effective guidelines for managing induction/augmentation of labor is provided. The goal in oxytocin administration is to use the minimum dose necessary to facilitate and maintain an effective uterine response and avoid hyperstimulation and fetal distress.

Female↗

PubMedDate not supplied

The nipple stimulation contraction stress test.

The nipple stimulation contraction stress test is finding increasing favor as an alternative or adjunct to the nonstress test as an assessment of fetal well-being. The nipple stimulation contraction stress test has been found to be an effective, convenient alternative to the costly, time-consuming oxytocin challenge test. Current literature and protocols are reviewed to compare effectiveness, predictive value for perinatal outcomes, and current recommendations concerning the safe and effective use of the nipple stimulation contraction stress test for antepartum testing. A protocol provides clear guidelines for antepartum testing with the nipple stimulation contraction stress test.

Breast↗

PubMedDate not supplied

How green was my valley. Interview by David Crouch.

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Animal Husbandry↗

PubMedDate not supplied

Imaging factors influencing spine and cord measurements by CT: a phantom study.

Metrizamide computed tomography (CT) of the spine allows evaluation of the contents and measurement of the size of intracanalicular structures. The relative size (linear and area measurements) of spinal structures can be changed by varying imaging factors or the density of intrathecal contrast material. Two phantoms, one consisting of rods embedded in a plastic cylinder and the other of a vertebral body with a central rod simulating spinal cord, were evaluated with varying imaging factors (window width and window level) and different contrast concentrations within the surround. It was found that wide window widths allowed the most consistent measurements independent of window level, that a window level midway between the CT number of rod and surround would facilitate uniform measurements independent of window width, and that the use of high concentrations of contrast material (high CT number) in the surround, in combination with a wide window width, was most effective in establishing consistent measurements.

Humans↗