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PubMed2004

Animal laboratories for procedural education of emergency medicine residents.

Many Emergency Medicine residencies incorporate animal laboratories into their training for procedural education because clinical opportunities to practice some emergency technical procedures are limited. To determine the proportion of Emergency Medicine residency programs utilizing animal laboratories, their characteristics, and the major impediments to providing animal laboratories, a cross-sectional descriptive survey of Emergency Medicine residency directors was conducted. Surveys were returned by 109/123 (89%) program directors. Ninety-four (87%) programs provide live animal laboratories for procedural training, an increase from previous studies. Although only 28% of directors knew the cost of the laboratories, this was the most commonly listed impediment (66%) to providing them. In conclusion, the use of animal laboratories for procedural training in Emergency Medicine residencies has increased in recent years. Cost is reported to be the most significant impediment to providing animal laboratories. The majority of program directors do not know the actual expense of providing animal laboratories.

Animals↗
PubMedDate not supplied

Hypersensitivity reactions to drugs: correlation between clinical probability score and laboratory diagnostic procedures.

The in vitro diagnosis of allergic drug reactions have not made significant progress in recent years. Specific stimulation of lymphocytes from allergic patients represents an approach to demonstrating sensitization to the implicated drug. So far, skin tests and RAST can only be applied to a limited number of situations. The purpose of this study was to standardize the clinical criteria in order to establish a clinical probability score for each drug. Independently, the various laboratory procedures mentioned were compared with the established clinical probability score for each drug. The results showed that, for the few common drugs studied, the correlation between the clinical probability score and the results of the in vitro lymphocyte transformation test was significant. A significant correlation between the clinical probability score and the skin tests was only shown for penicillin and its derivatives.

Drug Hypersensitivity↗
PubMed1978

Financial incentives to perform medical procedures and laboratory tests: illustrative models of office practice.

Financial return is one of several factors that may affect a physician's decision to order services for a patient. The extent of financial incentives to perform in-office medical procedures and laboratory tests is illustrated by four hypothetical models of general internal medicine office practice. The model practices consist of fixed ratios of history and physical examinations to return visits, with numbers and types of medical procedures and laboratory tests increasing stepwise through the four models. The procedures and tests included are an electrocardiogram, urinalysis, complete blood count, sigmoidoscopy, tuberculin skin test, two-view chest x-ray, cardiovascular treadmill stress test, and an automated 12-channel blood chemistry test. Charges and office expenses are estimated at 1977 Northern California levels. Net incomes derived for the four models are as follows: $31,000, $55,000; $60,000; and $90,000. The demonstrated financial incentives, which apply not only to internal medicine, but to all fields of medical care, are in conflict with policies that would emphasize personal rather than technical services. National health insurance proposals should include a continuing review of medical services valuation.

California↗
PubMed1982

Reaction time performance as a function of cigarette smoking procedure.

Laboratory studies examining the effects of cigarette smoking on behaviour have routinely employed a variety of standardized smoking procedures. This study examined whether reaction time performance after smoking varied as a function of the cigarette smoking procedure employed. Twelve regular smokers were tested on a reaction time task after smoking on three different occasions. In each session, they smoked by one of the three following procedures: (1) ad libitum smoking of their own cigarette; (2) ad libitum smoking of a standard cigarette; (3) smoking a standard cigarette with a prescribed puff pattern. The results show that reaction time performance was significantly faster after smoking under the latter two conditions relative to the subjects' performance after ad libitum smoking of their own cigarette. These findings illustrate that experimental requirements which are commonly imposed upon subjects may affect the results obtained.

Adult↗
PubMed1979

Determining clinical significance in repeated laboratory measurements. The "Clinical Delta Range".

A study of healthy subjects was conducted at the University of Florida wherein 52 routine clinical laboratory procedures were measured durng normal operation of the clinical laboratories. The goal of the study ws to quantify nonsignificant personal variation for a number of laboratory procedures referred to as a "Clinical Delta Range," which results from taking several samples per day, several days during the week. Results of the statistical test of hypotheses are given together with summary statistics for the 52 different laboratory procedures. A discussion of the model and testing methods are provided. Further, examples are given to illustrate the methodology and certain limitations associated with the concept of a Clinical Delta Range.

Adult↗
PubMed1995

The effects of laboratory handling procedures on naloxone-precipitated withdrawal behavior in morphine-dependent rats.

Previous studies of opiate dependence in our laboratory have shown that opiate-naive (control) animals can display behaviors normally ascribed to withdrawal following naloxone challenge. The possibility arises that in these control rats, the stress of the induction of dependence, pharmacological challenge, and behavioral testing may result in the release of endogenous opioids such that on naloxone administration withdrawal behaviors are elicited. In the present study, we have utilized two differing experimental protocols for the induction of morphine dependence in rats that would represent the extremes of normal laboratory handling procedures and have then assessed withdrawal behaviors following naloxone challenge. In control animals, the results show that the stressors alone are insufficient to allow for the precipitation of naloxone-induced withdrawal. However, withdrawal behavior was generally greater in the opiate-dependent animals in the "high" rather than the "low" stress group, suggesting a summation of opiate effects. Similarly, a residual effect was noted in the control opiate-naive animals; naloxone rather than saline (control) challenged rats displayed a slightly higher incidence of withdrawal behavior. These results stress the importance of maintaining constant laboratory protocols, minimizing stressful procedures, and performing appropriate controls in assessing opiate dependence and withdrawal.

Animals↗
PubMed1997

The dental student as technician: an 18-year follow-up of clinical laboratory programs.

In 1977, a survey of American and Canadian dental schools was conducted by Weintraub to determine the delegation of laboratory procedures in preclinical and clinical complete and removable partial denture programs. This was performed in light of challenges raised to the value of requiring dental students, rather than laboratory technicians, to perform the various laboratory procedures involved in the fabrication of complete and removable partial dentures. Since 1977, the rate of edentulism has declined in the United States, and fewer edentulous patients have sought regular dental care. In addition, approximately 20% fewer curriculum hours have been spent in dental schools in removable prosthodontic instruction; a declining number of graduating dental students have felt comfortable with their level of knowledge of removable prosthodontics, especially complete dentures, and have performed fewer removable prosthodontic procedures in practice because of a perceived lack of treatment cost-effectiveness. The present study, an 18-year follow-up to the 1977 survey, was designed to determine if such trends toward a de-emphasis on removable prosthodontic treatment have affected the mechanisms of instruction in and the extent to which dental schools instruct students about removable-prosthodontics laboratory procedures. The 1995 survey was mailed to 53 American dental schools. Forty-six schools returned the completed survey, for a response rate of 87%. Results showed that the relative amount of material presented to students in clinical removable prosthodontics programs increased, primarily through the enhancement of laboratory technician support, both in-house and commercial, of student clinical removable prosthodontic laboratory procedures. The increase was greater than in preclinical removable prosthodontic programs, which were described in a companion article. The conflict between these outcomes and the call by the dental community, as well as that of the 1995 Institute of Medicine Study, for a reduced emphasis on teaching students about the technical details involved in removable prosthesis fabrication is recognized and explored.

Canada↗
PubMed1997

The dental student as technician: an 18-year follow-up of preclinical laboratory programs.

In 1977, a survey of American and Canadian dental schools was conducted by Weintraub to determine the delegation of laboratory procedures in preclinical and clinical complete and removable partial denture programs. This was performed in light of challenges raised to the value of requiring dental students, rather than laboratory technicians, to perform the various laboratory procedures involved in the fabrication of complete and removable partial dentures. Since 1977, the rate of edentulism has declined in the United States, and fewer edentulous patients have sought regular dental care. In addition, approximately 20% fewer curriculum hours have been spent in dental schools in removable prosthodontic instruction; a declining number of graduating dental students have felt comfortable with their level of knowledge of removable prosthodontics, especially complete dentures, and have performed fewer removable prosthodontic procedures in practice because of a perceived lack of treatment cost-effectiveness. The present study, an 18-year follow-up to the 1977 survey, was designed to determine if such trends toward a deemphasis on removable prosthodontic treatment have affected the mechanisms of instruction in and the extent to which dental schools instruct students about removable prosthodontics laboratory procedures. The 1995 survey was mailed to 53 American dental schools. Forty-six schools returned the completed survey, for a response rate of 87%. Results showed that the proportion of schools with removable prosthodontic preclinical programs, especially those in removable partial dentures, increased, as did the relative amount of material presented to students in these programs. This was accomplished primarily through the enhancement of laboratory technician support, both in-house and commercial, of student preclinical removable prosthodontic laboratory procedures. The conflict between these outcomes and the call by the dental community, as well as that of the 1995 Institute of Medicine Study, for a reduced emphasis on teaching students about the technical details involved in removable prosthesis fabrication is recognized and explored.

Curriculum↗
PubMed1995

Time course and inhibitors of Hae III digestion in the forensic laboratory.

Forensic restriction fragment length polymorphism (RFLP) profiling has become standardized in the United States and Canada to the extent that all federal, state and local forensic laboratories employ the restriction enzyme Hae III. Forensic DNA samples are sometimes resistant to digestion with Hae III. This problem is typically ascribed to sample characteristics and is dealt with through prolonged incubation with Hae III, repeated incubations and/or re-extraction. We determined and extensively tested the maximum useful duration of Hae III incubation for several types of samples. We also examined the effect of common DNA extraction reagents and laboratory procedures on subsequent restrictability of DNA. No benefit whatsoever was found to continuing digestion reactions past 1 hour. Certain laboratory reagents were found to inhibit Hae III activity at extremely low concentrations whereas others were found to have little effect on the success of the restriction digestion. Significantly, no contaminating reagent or other laboratory procedure was found to cause loss of Hae III specificity, whether enzyme activity was compromised or not. The results of this study allow the streamlining of the RFLP procedure and provide a basis for understanding how laboratory procedures may adversely affect Hae III activity and DNA digestion.

Bacteriophage phi X 174↗
PubMed1996

Experiences with extended-duration medical laboratory support in deployable medical systems.

Medical laboratory services in an echelon-II Deployable Medical Systems environment were examined after a 6-month deployment in Guatemala-Fuertes Caminos 94 (N). The limitations in preparing and executing laboratory operations by U.S. Army Reserve units using Minimal Essential Equipment for Training components were identified. Corrective actions for planning future operations requiring laboratory support were addressed. Despite significant limitations, 353 laboratory procedures were conducted to standard. Additionally, laboratory procedures supporting blood-transfusion activities was successfully undertaken. Employment of laboratory services in remote environments for extended durations requires special attention and complete planning to ensure that all elements of care are in place to support medical operations.

Blood Banks↗
PubMed2005

[Current status of team communication considered from a questionnaire survey on the laboratory prescription card].

Team communication between dentists and dental technicians offers high-quality medical treatment for patients. When dentists and dental technicians understand dental treatments and laboratory procedures and talk to each other from an equal standpoint, good team communication between them can be established. However, undergraduate dental students do not sufficiently understand the content and processes of laboratory procedures because the subjects and hours in laboratory procedures have been reduced at present. Education on team communication between dentists and dental technicians is not sufficiently included in the training content of postgraduate training practice. It seems that at present, it is difficult for good team communication to be established between new graduate dentists and dental technicians. In view of this, the current status of the team communication between dentists and dental technicians in the present clinic was investigated, because a guideline for constructing team communications between dentists and dental technicians is given in the dental education before and after graduation. That is to say, the current status of the team communication of dentists and dental technicians was investigated by considering a questionnaire survey on the laboratory prescription card, which is the most important information means for connecting dentists with dental technicians in the dental clinic. The results were as follows: The entry items were insufficient on the laboratory prescription cards. Therefore, it is necessary to prepare such laboratory prescription cards that required items are entirely indicated as well as to enter them fully by dentists.

Communication↗
PubMed1984

What's new in laboratory testing procedures for psychiatrists?

The potential uses of the laboratory in psychiatric diagnosis and treatment expanded greatly over the decade of the 70s. This paper focuses on some of the newer areas of neurobiological research that may become clinically available to psychiatrists during the decade of the 80s. Research on state markers such as platelet serotonin and MAO levels, CSF metabolites, endorphins, MHPG, TRH and DST is discussed, followed by information on possible trait markers such as HLA gene typing, red blood cell membranes, and beta adrenergic receptor assays. Through these areas of study it is hoped that there will come more accurate psychiatric diagnosis and improved response to treatment.

Clinical Laboratory Techniques↗
PubMed1995

A laboratory exposure procedure for screening pulp and paper mill effluents for the potential of causing increased mixed function oxidase activity in fish.

To better understand the relationships between pulp manufacturing processes and mixed function oxidase (MFO) enzyme induction in fish, a practical and standardized exposure procedure is required. This study was undertaken to develop a laboratory-based exposure procedure to quantify the relative MFO induction potencies of different types of pulp and paper mill effluents. One major consideration in developing the procedure was to ensure that the protocol was practical so that tests could be performed in a short time, with small volumes of effluents and using simple experimental conditions. A series of concentration-response and time-course experiments were conducted to find the minimum time and effluent concentration which could distinguish the ability of different effluents to cause significant MFO induction in rainbow trout in the laboratory. Experiments were also conducted to determine the effects of biotic and abiotic factors such as loading density, fish size and feeding regime. This study showed that the exposure of rainbow trout in the laboratory to 10% concentration of secondary-treated effluent for 96 h caused significant increases in hepatic MFO activity. The magnitude of MFO induction was comparable to other field and laboratory observations. While fish size, loading density and feeding regime were found to affect the test results, consistent responses within a laboratory using this protocol are possible, provided that these factors are standardized. Therefore, the short-term exposure approach described in this paper could be a relevant tool for assessing the ability of different types of pulp and paper mill effluents to cause MFO induction in fish.

Journal Article↗
PubMed1988

Comparison of Reflotron and laboratory cholesterol measurements.

Fifty-three patients from a general practice and 33 subjects who were in a community-screening promotion underwent total cholesterol level measurements both with a portable Reflotron system and by a standardized laboratory procedure. The intraclass correlation coefficient between the paired measurements was equal to 0.956; this suggests that the results of the Reflotron system agreed very closely with those of the laboratory procedure. In spite of this agreement, the Reflotron instrument, on average, gave lower results than did the laboratory procedure (mean difference, -0.164 mmol/L; 95% confidence interval, -0.094 to -0.234 mmol/L). This difference is small and, in comparison with other sources of variation in cholesterol measurement, is unlikely to be important in day-to-day clinical practice. However, the difference between the two methods appeared to be related to the cholesterol level (larger differences at lower cholesterol levels). In large studies, where small differences in cholesterol levels are important, this difference should be considered against the obvious convenience of rapid portable cholesterol measurements.

Adult↗
PubMed2001

The dental student as a technician: preclinical and clinical laboratory programs in fixed prosthodontics.

PURPOSE: A 2-part survey of United States dental schools was conducted. The first part of the survey was published in 1998 and determined the curricular structure, techniques taught, and materials used in predoctoral fixed prosthodontics courses. The purpose of the second part of the survey was to ascertain the delegation of laboratory procedures in preclinical and clinical fixed prosthodontic programs. MATERIALS AND METHODS: The survey was mailed to the course directors of predoctoral fixed prosthodontic programs at 53 US dental schools. Of these, 42 schools returned the completed survey, resulting in a response rate of 79%. RESULTS: Results from this survey show that certain laboratory procedures in preclinical and clinical fixed prosthodontics are completed by dental laboratories (either in-house or commercially available laboratories). CONCLUSIONS: For the preclinical programs of fixed prosthodontics, there is more student involvement in the completion of laboratory procedures in the dental schools surveyed. In clinical fixed prosthodontic programs, there is a high emphasis on patient care and less on laboratory techniques that can be delegated to laboratory technicians.

Crowns↗
PubMed1998

[Laboratorial tests in pulmonary diseases]

OBJECTIVE: The authors present a review about the diagnosis of pulmonary diseases, with special emphasis on laboratorial procedures. METHODS: The most important articles about laboratorial procedures were selected through Medline search. RESULTS: To diagnose pulmonary diseases we need to evaluate clinical history, laboratorial tests, several radiografic techniques, bronchoscopy, thoracentesis and lung biopsy among others. We present the main laboratorial tests which include the clinical tests and pulmonary function evaluation to diagnose these diseases. CONCLUSION: The laboratorial tests are part of pulmonary tests diagnosis. The obtained results should be associated with clinical history and the other diagnostic methods.

Journal Article↗