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At least 199 records · Page 11Linked to original sources
PubMed1995

Investigative approach to frog gastrocnemius laboratory: potential impact on animal use in teaching laboratories.

With growing concern over the use of animal experimentation in the teaching of physiology, many biology departments are reassessing the use of animal experiments in the teaching lab. However, it may be just as important to assess how animal experimentation is used in the undergraduate teaching laboratory rather than simply assessing if animal experimentation should be used at all. In our study, sophomore-level life science students enrolled in a core organismal biology course undertook a laboratory exercise designed to elucidate properties of muscles and neuromuscular communication following two protocols: 1) a standard demonstrational model wherein students were told to undertake the exercise as a means to understand physiological processes that they had been exposed to previously in lecture or 2) an investigative model wherein the use of the gastrocnemius preparation was a logical next step in an ongoing investigation, the content of which was driven by student-generated hypotheses. We have observed a significant decrease in a number of the negative comments concerning the use of animals in experimentation (25.6 vs. 3.6%) since the implementation of the investigative approach to the laboratory, suggesting that curricular approaches to the use of animals in the teaching laboratory may have an impact on student attitudes concerning animal experimentation.

Animal Welfare↗
PubMedDate not supplied

[The "Instituto de Salud Carlos III" and the public health in Spain. Origin of laboratory medicine and of the central laboratories and research in public health].

The "Instituto de Salud Carlos III" is the Central Public Health Laboratory in Spain with an important component of scientific research in health related areas, such as cancer, cardiovascular diseases, infectious diseases and environmental health. The article describes the development of the Public Health Institutes. arising from the introduction and development of scientific and laboratory based medicine and the introduction of vaccination and sanitation with the control of water and food. At about the same time, the discoveries in microbiology and immunology were produced, being the research activities incardinated with the practical advances in the control of products. To cope with the practical needs, Institutions were created with the responsibility of providing smallpox vaccine but incorporating very soon production of sera and other vaccines and water and sanitation control and foods control. At the same time. colonization of countries specially in Africa, South East Asia and explorations in Central America confront the Europeans with new diseases and the need of laboratories where to study them. These circumstances gave rise to the birth of the Central Public Health Laboratories and the National institutes of Health at the beginning of the XX century in many countries. In Spain, the Spanish Civil War was a breaking point in the development of such an institution that finally was reinvented with the creation of the Instituto de Salud Carlos III, in 1986, incorporating research and epidemiological surveillance and control of diseases and also the responsibilities of the Food and Drug Control, lately separated from it.

Academies and Institutes↗
PubMed1993

Discrepancy in HbA1c measurements performed at different local laboratories and at a selected central reference laboratory.

As participants in a general practice intervention study, 66 patients had their HbA1c measured both at a local and at a selected central reference laboratory. A discrepancy in the results was observed, as 97% of the results measured locally were lower than the centrally determined results. Bias (as calculated from mean value of measured HbA1c) between local laboratories and the central laboratory was measured to -1.47% HbA1c. A bias of this magnitude gave "problems" both to the general practitioners, patients and laboratories. To reduce the "problems" a bias of 0.5% HbA1c is estimated to be acceptable. But, to avoid these "problems" totally, a bias of 0.25% HbA1c is estimated to be the highest allowed bias. For HbA1c, a control system for both control of method standardisation and for specificity is described.

Evaluation Studies as Topic↗
PubMed2003

Improvement in Japanese clinical laboratory measurements of total cholesterol and HDL-cholesterol by the US Cholesterol Reference Method Laboratory Network.

BACKGROUND: Accurate and precise measurements of total cholesterol (TC) and HDL-cholesterol (HDL-C) are necessary for effective diagnosis and treatment of lipid disorders. We studied the impact of TC certification and HDL-C evaluation in Japanese clinical laboratories to standardize their measurements. METHODS: We selected 78 laboratories participated at least twice for TC and 46 laboratories participated twice for HDL-C in the standardization protocols developed by the Cholesterol Reference Method Laboratory Network (CRMLN). We compared the initial and subsequent results using the performance guidelines established by US National Cholesterol Education Program (NCEP). RESULTS: For TC, mean percentage bias of all participants was -0.93% and -0.49% for the initial and second rounds, respectively. Mean within-sample CV was 0.72% and 0.69% for the initial and second rounds, respectively. For HDL-C, mean percentage bias of all participants was -1.86% and -0.06% for the initial and second events, respectively. Mean among-run CV was 1.56% and 1.58% for the initial and second events, respectively. CONCLUSIONS: TC accuracy in the second round than the initial round tended to improvement although statistically not significant, however in the five years follow-up, mean absolute percentage bias was reduced over time. HDL-C accuracy was statistically improved in the second event than the initial event. The precision for both TC and HDL-C did not change. This study shows CRMLN protocols contribute effectively to improvement of TC and HDL-C performance.

Certification↗
PubMed1996

A strategy to promote the rational use of laboratory tests. IFCC Education and Management Division Committee on Rational Laboratory Use. International Federation of Clinical Chemistry.

The following guidelines suggest ways in which clinical chemists can promote rational laboratory use by critically evaluating the tests they offer. This may be done by documenting the clinical uses and limitations of tests in the same way that clearly written method descriptions outline analytical procedures in a particular laboratory. This information can then be disseminated on result report forms, during discussion, or through investigational protocols or clinical guidelines. For the information to be of value, it should be the result of clinical and laboratory input reflecting the local practice and facilities. The material should be clearly written, easily accessible to the users, and updated whenever there is a change in methodology or clinical practice. Much can be achieved by applying common sense to common knowledge, and laboratories of all sizes can prepare their own material. In addition, national scientific societies and other professional organizations can assist local endeavors by providing educational material on test evaluation, selection, and use.

Clinical Laboratory Information Systems↗
PubMedDate not supplied

Laboratory administration--visions into the future. Success in the future will require financially skilled laboratory leaders.

The health-care industry will continue to undergo dramatic changes aimed at reducing cost and improving quality. A high cost department like the clinical laboratory will be a prime candidate for restructuring, reengineering, or outsourcing. The new realities require the laboratory manager to have a working knowledge of financial issues facing both the laboratory and the entire organization. These skills coupled with formal education in medical technology will place the laboratory manager in a leadership position.

Financial Management↗
PubMed2006

[Status of the clinical laboratory in the mandatory postgraduate medical training system. (1) Report from a laboratory technologist].

According to a new system for postgraduate clinical training, 33 medical trainees have been accepted for the past two years at Osaka General Medical Center. Before practicing clinical medicine in each division by a super-rotated table, orientation is scheduled for 5 days to master the basic systems indispensable to the hospital. In this orientation, training in laboratory medicine is performed for 7 hours (3.5 hours for 2 days). Trainees are divided into 4 groups and learn emergency tests of chemistry, hematology and urinalysis, blood transfusion, physiology and microbiology for 60 min each. Laboratory technologists instruct the trainees to gain the basic skills. The main contents are blood gas measuring in chemistry, sample preparation in hematology and urinalysis, taking each other's ECG, ordering blood products for transfusion, serologic study of infectious diseases, and Gram stain in microbiology. Although it is difficult to find time for routine analysis and instructing trainees in the clinical laboratory, it is a suitable opportunity for revision, also for laboratory technologists, and for communication to discuss clinical matters.

Curriculum↗
PubMed2006

The laboratory animal boards study group: A multifaceted tool for preparation for the American College for Laboratory Medicine board examination.

Preparation for the specialty board examination for the American College of Laboratory Animal Medicine (ACLAM) is an intensive process that is facilitated by geographic regions where many people studying for the exam are located in close proximity. However, many people work at institutions that are distant from these 'study centers'. Approximately 10 y ago, the Laboratory Animal Boards Study Group (LABSG) online journal club was established to provide a forum for journal review for examination preparation. Over the years, the mission of this group has expanded to include practice examinations and practicals, questions from common resources, and summaries and questions from common laboratory animal science journals. These study aids are beneficial for those preparing for the ACLAM certification examination. They are also beneficial for those preparing for the technician and manager certification examinations offered by the American Association for Laboratory Animal Science (AALAS). This article is intended to be an introduction to the variety of study aids available through the LABSG online journal review club and the LABSG web page (www.labsg.org). It also provides details on the demographics of participants and an exploration of how this resource enhances examination preparation.

Academies and Institutes↗
PubMed1991

The ins and outs of laboratory information systems. Combining the hospital and reference laboratory.

Regulatory and reimbursement pressure on laboratory and hospital organizations have led to diversified or hybrid combinations of hospital inpatient, outpatient, and reference laboratory operations. Laboratory information system (LIS) requirements to integrate these operations become more complex than for either operation alone, because inpatient and reference operations have different and sometime conflicting priorities. Careful attention to LIS requirements is necessary to implement hybrid laboratory operations systems successfully.

Appointments and Schedules↗
PubMed1977

The impact of laboratory improvement programs on laboratory performance: the CLIA 67 experience.

The experience acquired by the Center for Diseases Control during the past 7 years in the administration of the Clinical Laboratories Improvement Act of 1967 suggests that the key indicators of reliability have been identified and that sensitive measurement of those indicators is now possible and practical. The costs of assuring high quality are inconsequential compared to the costs to the patient and taxpaying public of inaccurate test results. This objective system for evaluating clinical laboratories has been applied to licensed interstate laboratories and has been shown to be effective. This proven system has been offered to the Bureau of Health Insurance of the Social Security Administration for application to Medicare laboratories.

Communicable Disease Control↗
PubMed1996

Toward optimal laboratory use. Problems in laboratory testing in primary care.

OBJECTIVE: To examine the frequency and characteristics of problems in laboratory testing in primary care physicians's offices and their impact on health care. DESIGN: Prospective descriptive study in which participating office-based primary care clinicians reported each occurrence of any laboratory incident during a 6-month study. Each identified problem was reported on a structured data collection instrument with an open-ended description of the problem. SETTING: Primary care physicians' offices in North America. PARTICIPANTS: One hundred twenty-four primary care clinicians in 49 practices of the Ambulatory Sentinel Practice Network (ASPN). MAIN RESULTS: A total of 180 problems were reported, yielding a crude rate of 1.1 problems per 1000 patient visits. Problems involving test ordering and specimen handling were the most common (56%), while those attributable to the test analysis itself accounted for 13% of the total. In the judgment of the practice staff, 27% of the reported problems had an impact on patient care. Of the 24 cases for which the specific impact was known and reported, half of the impacts were minor and about half were significant, as judged by whether or not the diagnosis and/or treatment of the patient was measurably affected. CONCLUSIONS: Clinically apparent problems with laboratory testing in primary care were found at a rate of 1.1 problems per 1000 patient visits. Of the laboratory problems that occurred in this study, 27% were judged by the physician to have an effect on patient care.

Clinical Laboratory Techniques↗
PubMed1996

[Quality improvement project 'laboratory diagnosis by family physicians' leads to considerable decrease in number of laboratory tests].

OBJECTIVE: Quality improvement of laboratory diagnostics by general practitioners (GPs) through introduction of a simplified, problem-oriented application form, supported by information and feedback. DESIGN: Prospective descriptive study. SETTING: Laboratory of Clinical Chemistry and Haematology of St. Maartens Gasthuis, Venlo, the Netherlands and the GPs in the region. METHODS: The effects of the intervention were measured by counting the analyses requested by all GPs in the region in 1992, 1993 and 1994. Furthermore requests by every GP for fifteen selected analyses in the first 6 months of 1992, 1993 and 1994 were counted and reported together with the anonymous data of all colleagues. RESULTS: After the intervention a 23% reduction of the total number of analyses request by GPs was noticed. Blood sampling increased by 8% and the mean number of laboratory test requests per patient decreased from 5.9 to 4.2. The largest request reductions were noticed for analyses not listed on the application form. Measurements in the first 6 months of 1992, 1993 and 1994 showed continuation of the trend and a fadeaway of 'redundant' analyses. CONCLUSION: The introduction of a simplified problem-oriented application form for GPs supported by feedback caused a marked decrease of the number of (redundant) laboratory requests.

Clinical Laboratory Techniques↗
PubMed1993

Guidelines for personnel radiation monitoring in the cardiac catheterization laboratory. Laboratory Performance Standards Committee of the Society for Cardiac Angiography and Interventions.

The Laboratory Performance Standards Committee of the Society for Cardiac Angiography and Interventions has devised guidelines to inform catheterization laboratory personnel about appropriate radiation monitoring and protection. A personal monitoring dosimeter must be placed over any radiation protective garments on the collar near the thyroid. A second dosimeter, worn at the waist level under any radiation protective garments, is mandatory for any declared pregnant workers exposed to radiation. This dosimeter is recommended, but not required, for all personnel in the catheterization laboratory. The limit for whole body radiation exposure is stated in terms of the effective dose equivalent (EDE). Different formulas are used for calculating the EDE, depending on the number of dosimeters worn simultaneously by the individual. Finger dosimeters should be worn by personnel whose hands are likely to be directly exposed to the x-ray beam. Initial and periodic training in radiation protection is a part of good laboratory practice.

Cardiac Catheterization↗
PubMedDate not supplied

Community as laboratory: reflections from Rochester, New York, in celebration of the dedication of the Robert J. Haggerty child health services research laboratories.

The dedication of the Robert J. Haggerty Child Health Services Research Laboratories at the University of Rochester (New York) Medical Center in October 2004 provided an opportunity to reflect on the current state of child health services research. Dr Haggerty had a grand vision for using the community in which children live as a laboratory for studying the varied medical, psychosocial, and behavioral morbidities that affect them. He believed that the diverse problems faced by children were best studied by a multidisciplinary team, including both academic and community pediatricians, epidemiologists, sociologists, policy makers, and community leaders. Research done in the community involving front-line providers allows investigation into the most challenging and relevant problems faced by children. To this end, Dr Haggerty made collaboration and cooperation between the community and the academic medical center a priority during his tenure at Rochester. His vision of community as laboratory continues through the child health services research emanating from the Haggerty Laboratories. Nevertheless, many barriers remain that need to be overcome for the sake of improving the lives of children in the United States and throughout the world.

Child↗
PubMed2001

Analysis of laboratory data in acne patients treated with isotretinoin: is there really a need to perform routine laboratory tests?

INTRODUCTION: Isotretinoin has been used to treat acne since 1982. Its current indications in the package insert are limited and many physicians still feel uncomfortable prescribing it because of its side effects. Serum levels of liver enzymes and lipids are carried out as a routine in most clinics both before and during treatment. AIMS: Our objective was to evaluate the effect of isotretinoin on serum lipids, liver function and other laboratory parameters in order to assess the necessity to perform routine laboratory tests. METHODS: Computerized medical files of 1292 patients in private practice that received isotretinoin for acne were analyzed. RESULTS: 907 patients completed a treatment course of 5 to 9 months. Serum levels of liver enzymes were not elevated to a degree necessitating discontinuation of treatment. Only 1.5% of the patients had serum triglyceride levels above 400 mg%. No laboratory abnormalities were a cause for discontinuation of treatment. During a 6-year follow up only 3.5% of patients received a second course of therapy with isotretinoin. CONCLUSIONS: Aside from its teratogenic effect, isotretinoin is a safe and excellent drug for acne therapy. It should be prescribed for any inflammatory acne and in our opinion there is no need for a routine laboratory follow-up in young, healthy patients aside from a pregnancy test in females. At present, isotretinoin should be considered as the drug of choice for moderate to severe acne.

Acne Vulgaris↗
PubMedDate not supplied

The laboratory diagnosis of tuberculosis in a period of resurgence: challenge for the laboratory.

OBJECTIVE: To review the current and contemporary approaches to the laboratory diagnosis of Mycobacterium tuberculosis and related mycobacteria. DATA SOURCES: Current literature. STUDY SELECTION: Determined by the author. DATA EXTRACTION: Determined by the author. DATA SYNTHESIS: The definitive diagnosis of mycobacterial disease depends upon the laboratory for the isolation and identification of the infecting microorganism. Laboratory studies encompass microscopic examination for the presence of AFB; isolation and recovery of the organism by cultural methods; phenotypic biochemical or other contemporary means to identify the recovered organism; and anti-tuberculosis susceptibility testing. Because of the extended growth period of this group of organisms, it is imperative that the lab use the most rapid means to provide information to the clinician for isolation of the patient if needed and for the initiation of prompt rational therapy as determined by susceptibility testing. More than 25 species in the Mycobacterium genus are capable of causing human disease. In the United States, the five most frequently encountered species are M. tuberculosis, M. avium, M. kansasii, M. fortuitum and M. chelonei. CONCLUSION: Tuberculosis is a reemerging disease with significant health problem implications in the US and worldwide. Diagnosis and appropriate treatment are dependent on the prompt response of the laboratory.

Bacteriological Techniques↗
PubMed2003

[Education in laboratory medicine for undergraduates--laboratory medicine in core curriculum].

A model core curriculum for medical education was proposed in March 2001. This guideline is meant to serve as the essential basis of material to be mastered at present and as a reference for curricula to be constructed by individual medical schools. Laboratory medicine plays an important role in this guideline, not only as an essential component of diagnosis and laboratory testing in various diseases but also in consultation. In the Department of Clinical Pathology, Showa University School of Medicine, we revised the curriculum of lectures and clinical training in laboratory medicine according to the guideline. This revision is expected to improve education and result in better doctors. We also will modify the method for education from lectures to a tutorial system, in which laboratory medicine should play an important role in devising tasks for tutorials.

Curriculum↗
PubMed2003

[Out-of-laboratory control screening of growth mediums used by sanitary service laboratories for isolation of pathogenic enteric bacteria from fecal specimens].

The aim of the study was to test the selective-differential plating mediums used for isolation of Salmonella and Shigella for routine stool specimens examination for epidemiological and sanitary purpose. Three plates of any such medium used in the laboratories in 37 Sanitary Service Stations in Poland were obtained. The specimens of Mac Conkey Lactose Bile Salt Agar and SS Agar were obtained from all laboratories, Hektoen Enteric medium from 8 and EosinMethylene Blue Agar from only one laboratory. The desiccated substrates of these mediums originated from 11 manufactures. The mediums were inoculated by "drops" method. The five control strains of selected taxons were chosen from National Institute of Hygiene strains collection. The quality of growth was evaluated by comparison with the growth on two control mediums: the general outlook of bacterial colonies, size and number of cfu/ml was taken under consideration. It was found that the results were satisfying for Hektoen medium, Levine and all but two Mac Conkey's medium specimens. The results of growth on SS medium were much worse: only on 10 specimens out of 39 checked supported properly the growth of all the five control strains. On 18 specimens the growth appeared after 48 hours of incubation and the size of colonies was too small to be isolated. On 11 there was no growth on 1, 2 or 3 control strains. The need of systematic extra-laboratory control of plating mediums used for examination stool specimen was shown.

Bacteriological Techniques↗