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PubMed1977

Urinalysis by modular learning.

A self-instructional approach to the entry-level presentation of urinalysis in a written modular format was used by a class of medical laboratory technician students. The course consisted of 13 modules based upon behavioral objectives. The modules used no audio or visual media but required "hands-on" performance of laboratory procedures. The achievements of a test sample of 12 students were compared with those of a previous class in which the same material was presented in lectures. Evaluation by written tests given to both classes showed no statistical difference. The self-instructed students performed adequately in their practical laboratory work, but the overall learning time was increased by 50 percent when self-pacing was used. A measurement questionnaire revealed that the students preferred instructor-led courses to self-instructional units for a variety of reasons which lead to some further considerations.

Attitude↗
PubMed1965

HOMEOSTATIC PROBLEMS IN GENERAL SURGERY.

For electrolyte problems that arise during surgical procedures, the surgeon must be versed in the physiologic function of the organs that play vital roles in homeostasis. Pulmonary and renal evaluation before operation can give forewarning of potential dangers. Hyperaldosteronism, a disease entity influencing electrolytic changes and causing other pathophysiological effects, should be understood by the surgeon. Not only should he understand the causes of dehydration, hyperhydration, metabolic and respiratory acidosis and metabolic and respiratory alkalosis, he should also be able to recognize their deleterious effects clinically, know how to make use of adequate laboratory procedures to substantiate a diagnosis and determine the effect of treatment. The effect of water deficit and water excess, and of deficits and excesses of such ions as sodium, potassium, calcium, carbon dioxide and bicarbonate on the renal, cardiac, pulmonary and neuromuscular systems must be considered.Tetany before or after operation challenges a surgeon's diagnostic acuity. Relying on laboratory tests only, without correlating the results with history and clinical features, may lead to errors in the administration of electrolytic fluids.

Acidosis, Respiratory↗
PubMed2006

Chapter 23: International Standard reagents for harmonization of HPV serology and DNA assays--an update.

International reference materials such as International Standard reagents facilitate quality assurance of essential biopharmaceutical products and related in vitro diagnostic tests. Standardization of antibody and DNA measurements and harmonization of laboratory procedures are key to the success of cancer prevention strategies through screening methods as well as for development and implementation of vaccination against the human papillomavirus (HPV). The WHO supported the preparation and initial analysis of a panel of candidate serological and DNA reference reagents aimed at facilitating inter-laboratory comparisons and detection of HPV worldwide. Two international collaborative studies assessed the performance of various HPV antibody and HPV-DNA detection assays and examined the feasibility of generating HPV antibody and DNA standard reagents. These studies showed that improvement in performance and comparability of assays is urgently needed and that the use of the same International Standard reference reagent could significantly improve performance and comparability. It is hoped that the establishment of International Units and International Standards for HPV antibody and DNA analysis will be pursued with high priority.

Humans↗
PubMed2001

Analysis of costs and cost-effectiveness in multinational trials.

OBJECTIVES: the number of economic evaluations alongside multinational trials is increasing. Pooling of health effects of patients from different countries may be possible, but simply pooling costs does not give valid results and may not address national health policy issues properly. How should costs be handled in multinational economic evaluations? METHODS: a range of factors is discussed, that determine the (un)comparability of medical consumption and costs between countries; patient characteristics, epidemiology, patterns of medical practice, absolute and relative prices of medical services and cost estimation procedures. RESULTS: as an empirical example we investigated a clinical trial on breast cancer therapy in three European countries, focusing on the relationship between differences in medical practice and hospital medical consumption and costs. Correcting for differences in patient mix a multivariate analysis showed that differences in the number of laboratory procedures, day care treatments and outpatient visits between countries appear to be related to differences in medical practice. We calculated the costs of medical consumption as if all patients were treated in one country, correcting for these differences in medical practice. CONCLUSIONS: although the extent of the correction in this particular example was not very substantial, this approach seems a sensible way of analysis in order to investigate cost differences between countries in multinational trials. This provisional approach should be further developed and compared with alternative methods of correcting medical consumption and costs.

Breast Neoplasms↗
PubMed2006

Naturally occurring hypertension in New World nonhuman primates: Potential role of the perifornical hypothalamus.

Hypertension is a prominent underlying factor in the genesis of cardiovascular-related morbidity and mortality. A major impediment to the investigation into the causes of the disease is the paucity of naturally occurring animal models of the disease. There is evidence that some species of New World primates spontaneously become hypertensive. We used chronically implanted pressure transducers to assess normally occurring blood pressure and heart rate levels at rest and during routine laboratory procedures in a group of one of these New World primates (Aotus sp.). Resting mean arterial pressure ranged from 72 to 130 mmHg. Three animals were judged to have resting mean arterial pressure levels in the hypertensive range (> or =110 mmHg). In all of the animals, pressor responses to routine laboratory events were exaggerated (average highest mean pressure during 1 min from any session was 97-196 mmHg). Subsequently, the region of the perifornical/lateral hypothalamus known to produce elevated blood pressure and heart rate responses to electrical stimulation was removed, and the blood pressure responses to the laboratory routines were significantly decreased and, in some cases, eliminated. Control lesions in nearby tissue had no effect on these responses. This region may play a critical role in initiating or exacerbating cardiovascular responses that contribute to the development of essential hypertension.

Animals↗
PubMed1998

1997 Judson C. Hickey Scientific Writing Awards. Lip prosthesis retained with resin-bonded retentive elements as an option for the restoration of labial defects: a clinical report.

Surgical resection of the lips is a relatively uncommon procedure, and it usually presents surgical and prosthodontic rehabilitation challenges. The goals of prosthetic treatment include regaining favorable speech and restoration of esthetics. This clinical report described a method for fabricating a lip prosthesis that uses resin-bonded retentive elements bonded to the patient's teeth for retention. Clinical and laboratory procedures of the prosthetic treatment were described, and the advantages and disadvantages were reviewed.

Acrylic Resins↗
PubMedDate not supplied

The hidden illness of endoscopy patients: mental health disorders, Part I.

Because nearly half of all adults experience some mental health disorders in their lifetime, many endoscopy patients must have psychiatric problems along with their gastrointestinal (GI) illnesses. In addition, all patients undergoing an endoscopic procedure experiences some degree of apprehension and worry; anxiety itself is a major factor in most mental illnesses. Endoscopy nurses are very good at establishing rapport quickly with patients and learning about the patient's health history from all the available sources of information. These nurses spend much of their time teaching, listening, reassuring, and caring for people undergoing GI procedure, and these same skills are an important part of the care in mental health disorders. A series of case studies of GI patients in a busy endoscopy department document and summarize the mental health disorder each experienced and the pertinent care given by the GI nurse during an endoscopy or gastric laboratory procedure. Although it is inappropriate for endoscopy nurses to attempt to diagnose major psychiatric disease or provide psychiatric interventions for these patients, their nursing care and reassurance enable the patients to successfully complete their GI procedures.

Adult↗
PubMed1997

The use of a Hemocue blood glucose analyser in a neonatal unit.

Near patient testing for glucose is now a widely accepted procedure in hospital wards and clinics. However, in a neonatal ward where the detection of hypoglycaemia rather than hyperglycaemia is of paramount importance, it is more difficult to find a suitable glucose monitoring instrument. We compared two Hemocue blood glucose analysers (Hemocue Ltd) in our special care baby unit (SCBU) with the laboratory procedures and found that the Hemocue may overestimate the glucose by as much as 2.5 mmol/L. In addition, Hemocue analysers are costly to run. We feel these analysers may be more useful in a general ward rather than in a SCBU.

Blood Glucose↗
PubMed2002

Biventricular pacing for congestive heart failure: early experience in surgical epicardial versus coronary sinus lead placement.

OBJECTIVE: Biventricular pacing (BVP) has recently been introduced for the treatment of refractory congestive heart failure. Coronary sinus lead placement for left ventricular pacing is technically difficult, has a risk of lead dislodgement, and has long procedure times. Surgical epicardial lead placement has the potential advantage of the visual selection of an optimal pacing site, does not need exposure to ionic radiation, and allows lead multiplicity, but it does require a thoracotomy and general anesthesia. We report our early experience of BVP with both modalities. METHODS: BVP was performed in 12 patients with New York Heart Association (NYHA) class IV congestive heart failure (10 men, 2 women). Mean patient age was 68.7 years (range, 41-83 years). Surgical epicardial leads were placed through a 2- to 3-inch incision via a left fourth or fifth intercostal thoracotomy in 4 patients with single lung ventilation under general anesthesia. The other 8 patients underwent transvenous coronary sinus lead placement under conscious sedation. RESULTS: Postoperative NYHA class status improved from class IV to class II in 8 patients and to class III in 3 patients. In 5 of the 8 patients who had undergone follow-up echocardiography with mitral regurgitation, the severity of the mitral regurgitation improved. The mean left ventricular ejection fractions before and after BVP were 18.3% +/- 8.3% and 20.5% +/- 8.0%, respectively (P =.16). Mean fluoroscopy and total procedure times for transvenous lead placement were 77 +/- 19 minutes and 266 +/- 117 minutes, respectively. The mean surgery time for epicardial lead placement was 122 +/- 13 minutes. There were no differences between the 2 methods in pacing threshold or in lead dislodgement. There were no complications related to the surgery or the laboratory procedure. CONCLUSION: In patients with NYHA class IV congestive heart failure, epicardial lead placement through a minithoracotomy for BVP was performed safely with benefits equivalent to those of coronary sinus lead placement and with a shorter procedure time.

Adult↗
PubMed1989

DNA probe technology in parentage testing.

Paternity tests involve laboratory procedures on blood samples obtained from the alleged father, mother, and child to determine if the alleged father is the true father. Conclusions are based on the principle that the child inherits half of the characteristics (markers) in his/her blood from each true parent. DNA probe analysis has emerged from the research laboratory and is currently being utilized by laboratories engaged in parentage testing to improve their efficiency in discriminating between fathers and nonfathers. This new technique provides a very powerful tool.

Journal Article↗
PubMed2000

Molecular and phenotypic identification of the yeast pathogen Candida dubliniensis.

Candida dubliniensis is an emerging yeast pathogen generally misclassified as Candida albicans by standard diagnostic procedures. This study examined the efficiency of molecular identification, based on a discriminative PCR test, in a prospective study on the prevalence of C. dubliniensis among 103 oropharyngeal isolates from HIV-infected individuals or transplant recipients, and 30 vaginal isolates. All of the isolates had been classified as C. albicans by standard laboratory procedures. The PCR was evaluated in a blinded fashion against classification achieved by sequencing rDNA. Sequencing results corresponded 100% to the results of the discriminative PCR, indicating the validity of this rapid test. Twenty-one C. dubliniensis isolates were identified, all of them from HIV-infected individuals (prevalence 30%). The internal transcribed spacer regions of the C. dubliniensis isolates were sequenced. Phenotypic features of C. dubliniensis, namely abundant chlamydospore formation, atypical color on CHROMagar, growth defect at 45 degrees C, and colony morphology on Staib agar, were evaluated in a blinded fashion with respect to their discriminative potential, facilitating the design of further epidemiological studies. Carbohydrate assimilation patterns were determined for C. dubliniensis with a novel automated system showing that, in contrast to previous reports, C. dubliniensis is able to utilize D-xylose and trehalose. In evaluating these tests we present a rational approach to identification of the new species and characterization of C. dubliniensis isolates.

AIDS-Related Opportunistic Infections↗
PubMed1987

Needle puncture of cystic renal masses: a survey of the Society of Uroradiology.

A survey of 114 members of the Society of Uroradiology provided data on the results of needle punctures of cystic renal masses in approximately 16,000 cases. The 73 respondents reported that cyst puncture is currently performed only for specific indications, that opacification is only occasionally performed after puncture, and that cytology is the laboratory procedure of choice for aspirated fluid. While all respondents accepted sonographic confirmation of cysts seen on nephrotomography, only 92% accepted sonography alone as diagnostic, compared to 100% for CT alone. Aspiration of clear fluid (usually an indicator of benignity) with positive or negative cytology, occurred in 19 cystic renal malignancies. Thus, gross and laboratory characteristics of aspirated fluid are not conclusive in diagnosing cystic lesions. CT should be the final arbiter in suspicious lesions.

Biopsy, Needle↗
PubMed1976

[The development of colposcopy (author's transl)].

In 1925, in this Journal, Hans Hinselmannn gave the reslults of his experience with the method of colposcopy he devised for the early recognition of cancer of the uterine cervix. In 50 years it has proved to be an indispensable procedure in experienced hands, by which the prestages and early stages of the most frequent genital cancer in women, carcinoma of the cervix, can be detected while still of microscopic dimensions (microcarcinoma). Papanicolaou's vaginal cytology used in combination with colposcopy increases diagnostic accuracy to more than 95%. Cytology, as a preliminary orienting laboratory procedure, and colposcopy as a clinical investigation method togethe - if the two individual methods are used in their proper places - offer optimal diagnostic prospects. The opportunities of mastering colposcopy and its use in the cancer prophylaxis program are pointed out.

Adult↗
PubMed1997

Eye protection in dental laboratories.

Many dental laboratory procedures increase the chances of serious eye injury. This would include traumatic injuries due to projectiles or through exposure to harsh chemicals or heat and infections from contact with patient body fluids. To help assure a safer working environment, awareness of the need for eye protection must be established and maintained by all laboratory personnel. The purpose of this article are: 1) to list the applicable federal regulations concerning eye safety in dental laboratory workplaces; 2) to describe the various types of appropriate eyewear; and 3) to identify which protective devices best prevent exposure to specific types of hazards. The goal of this article is to help dental laboratories with their employee safety programs, especially concerning the selection of protective eyewear. Such programs must include engineering controls and work practice controls plus appropriate personal protective equipment. Laboratories today must comply with safety mandates in the most effective and efficient manner.

Equipment Design↗
PubMed2004

A procedure for fitting a fixed partial denture to an existing removable partial denture.

An indirect technique for fitting a new cast gold crown or fixed partial denture (FPD) to an existing removable partial denture (RPD) is presented. This method uses an acrylic resin coping made on a definitive cast fit directly to the patient's RPD intraorally, with the new FPD subsequently completed on the cast. The patient does not have to relinquish the RPD for laboratory procedures, although an appointment is required to fit the coping intraorally where contact is made with the RPD.

Crowns↗
PubMed1986

In vitro fertilization 1986. New procedures and new questions.

The number of infertile couples undergoing treatment by means of in vitro fertilization and embryo replacement is still increasing at a logarithmic rate from the first successful delivery in July 1978. At the present time, several hundred centers around the world are treating patients and had produced in excess of 2,200 live births by fall of 1985. Recent advances including better treatment regimens to increase the number of recoverable oocytes, refinements of laboratory procedures, less invasive oocyte recovery procedures, and the development of embryo freezing should lead to wider availability, lower cost, and most importantly, higher success rates of successful pregnancy establishment. Along with these advantages, the increased number of oocytes and embryo freezing have raised certain questions concerning the rights and obligations of doctors, parents, and even embryos.

Australia↗
PubMed1997

Sectional prosthesis for total maxillectomy patients: a clinical report.

Total maxillectomy is a relatively uncommon surgical procedure and usually results in a surgical and prosthetic reconstructive challenge. The goals of prosthetic treatment include separation of oral and nasal cavities, which allows for adequate speech and deglutition, along with restoration of esthetics. Treatment of a patient with total maxillectomy due to verrucous carcinoma was presented in this clinical report. Clinical and laboratory procedures of the prosthetic treatment were described. The sectional prosthesis retained by magnets eliminated long-term use of a nasogastric tube, rehabilitated the patient's speech, and restored proper midfacial esthetic contour.

Aged↗