Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Laboratory Procedures”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 775 records · Page 43Linked to original sources

Evaluation of five gentamicin assay procedures for clinical microbiology laboratories.

Five gentamicin assay procedures (a bioassay, an enzyme immunoassay, a latex agglutination inhibition test, a fluorescence immunoassay, and a radioimmunoassay) were evaluated to determine which was optimal for our laboratory. The evaluation was based on recovery and precision studies and results of analyses of patient samples, as well as technical assay performance factors. The latex agglutination inhibition test appears useful for laboratories performing only occasional assays for gentamicin; however, the fact that some rheumatoid factor-positive sera, as well as some other sera for unknown reasons, may give falsely low values is a potential drawback to this procedure. Because of its accuracy, precision, rapid turn-around time, and relative simplicity of performance, we selected the enzyme immunoassay procedure for routine use for gentamicin assays in our laboratory.

Biological Assay↗

Outreach health services for street youth.

A voluntary health agency operated a clinic at a drop-in center for street youth. Six hundred nine youths were seen, with an average age of 16 years, 9 months. There were 2,086 diagnoses made during 1,895 visits. Respiratory, dermatologic, and gynecologic problems represented 56% of all diagnoses. Pregnancy tests accounted for 38% of all procedures, 50% of all medications dispensed were either oral antibiotics or decongestants, and 17% of the visits resulted in referrals. This chart review revealed that street youth seen at a drop-in center sought care for common medical problems. Problems related to substance abuse and sexually transmitted diseases were seen much less frequently than anticipated. Elements critical to the success of this clinic included its on-site location, hours of operation when teenagers were using other services, close working relationships between clinic and center staffs, the capability to perform a few simple laboratory procedures, and an on-site pharmacy.

Adolescent↗

Fractional esterification rate of cholesterol and ratio of triglycerides to HDL-cholesterol are powerful predictors of positive findings on coronary angiography.

BACKGROUND: We examined the predictive value of various clinical and biochemical markers for angiographically defined coronary artery disease (aCAD). Specifically, we assessed the value of the ratio of plasma triglyceride (TGs) to HDL-cholesterol (HDL-C) and the fractional esterification rate of cholesterol in plasma depleted of apolipoprotein B (apoB)-containing lipoproteins (FER(HDL)), a functional marker of HDL and LDL particle size. METHODS: Patients (788 men and 320 women) undergoing coronary angiography were classified into groups with positive [aCAD(+)] and negative [aCAD(-)] findings. Patient age, body mass index, waist circumference, blood pressure (BP), medications, drinking, smoking, exercise habits, and plasma total cholesterol (TC), LDL-cholesterol (LDL-C), HDL-unesterified cholesterol, HDL-C, TGs, FER(HDL), apoB, log(TG/HDL-C), and TC/HDL-C were assessed. Lipids and apoproteins were measured by standard laboratory procedures; FER(HDL) was determined by a radioassay. RESULTS: Members of the aCAD(+) group were older and had a higher incidence of smoking and diabetes than those in the aCAD(-) group. The aCAD(+) group also had higher TG, apoB, FER(HDL), and log(TG/HDL-C) and lower HDL-C values. aCAD(+) women had greater waist circumference and higher plasma TC and TC/HDL-C. aCAD(+) men, but not women, had higher plasma LDL-C. In the multivariate logistic model, the significant predictors of the presence of aCAD(+) were FER(HDL), age, smoking, and diabetes. If only laboratory tests were included in the multivariate logistic model, FER(HDL) appeared as the sole predictor of aCAD(+). Log(TG/HDL-C) was an independent predictor when FER(HDL) was omitted from multivariate analysis. CONCLUSIONS: FER(HDL) was the best laboratory predictor of the presence of coronary atherosclerotic lesions.

Adolescent↗

Clinical utility of body fluid analyses: an overview.

OBJECTIVE: To assess new laboratory procedures for testing body cavity fluids from minor sites such as amniotic fluid, saliva, and synovial fluids, as well as major sites such as pleural, pericardial, peritoneal, and cerebrospinal fluids. DATA SOURCES: Recent professional literature. STUDY SELECTION: Not specified. DATA EXTRACTION: Survey of literature. DATA SYNTHESIS: Normal values for fluids in major body sites are given; causes of abnormalities include inflammation, infection, and neoplastic conditions. Clinical value of newer amniotic fluid tests for fetal lung material and other ancillary tests using synovial fluid, saliva, and cerebrospinal fluid in the diagnosis of metabolic disorders is assessed. CONCLUSION: Clinical laboratories will require a clear demonstration of that value before putting the tests into widespread use; data must show that tests are less expensive, more informative, and safer than the old ones.

Body Fluids↗

Outpatient cardiac catheterization and arteriography: Twenty-month experience at the Arizona Heart Institute.

Arteriographic examination of the coronary, cerebral, and peripheral circulatory systems is the ultimate diagnostic technique for the identification and quantification of atherosclerotic occlusive disease. In the past, hospitalization has been required for this invasive procedure. Recently, however, the concept of outpatient catheterization and arteriography has become a reality. To investigate the integrity, safety, and cost-effectiveness of our outpatient invasive procedures laboratory, we analyzed our experience with 254 cardiac catheterizations and 174 peripheral arteriograms performed during a 20-month period. There were no deaths or major complications. Minor complications (11%) included bleeding from the cutdown site, nausea, numbness, and allergic reactions. Two patients with arrhythmias required cardioversion. Nine patients (2%) were transferred to the hospital for observation or immediate surgery due to the nature of their atherosclerotic lesions. This study reveals (1) the technical quality, safety, indications, and contraindications for outpatient catheterization and arteriography; (2) the enthusiastic patient acceptance of outpatient invasive diagnostic studies; (3) the economic impact of these procedures on escalating health-care costs; and (4) the potential for outpatient catheterization and arteriography on a broad scale.

Journal Article↗

Towards the establishment and standardization of a veterinary antimicrobial resistance surveillance and monitoring programme in South Africa.

The objective of this study was to establish a repeatable, standardized laboratory procedure for monitoring the development of antimicrobial resistance in bacteria isolated from animals and food of animal origin in South Africa, with reagents prepared in-house. The emergence of resistance and the spread of resistant bacteria can be limited by implementing a veterinary antimicrobial drug policy, in which inter alia systematic monitoring and prudent use play essential roles. The bacteria included in this study represented three different categories, namely zoonotic bacteria (Salmonella), indicator bacteria (Escherichia coli, Enterococcus faecalis and Enterococcus faecium) and veterinary pathogens (Mannheimia haemolytica). Thirty isolates of each species were collected with the aim of standardizing the laboratory methodology for a future national veterinary surveillance and monitoring programme. Susceptibility to ten selected antimicrobial drugs was determined by means of minimum inhibitory concentrations (MICs) using the microdilution method. The method according to the National Committee for Clinical Laboratory Standards was used as the standard. Multi-well plates containing varying dilutions of antimicrobial drugs and prepared in-house for MIC determinations, yielded repeatable results. Storage of plates for 2 months at -70 degrees C did not influence results meaningfully. Within this limited sample of bacteria, MIC results did not indicate meaningful resistance against any of the ten selected antimicrobial drugs. The findings of the study will be used to establish a national veterinary antimicrobial resistance surveillance and monitoring programme in South Africa. To allow for international comparison of data, harmonisation of the surveillance and monitoring programme in accordance with global trends is encouraged. Ideally it should be combined with a programme monitoring the quantities of antimicrobial drugs used. The aim is to contribute to slowing down the emergence of resistance and the problems associated with this phenomenon by means of the rational use of antimicrobial drugs.

Animals↗

Microelectronics and computers in medicine.

Microelectronics and computers are in use in virtually every aspect of modern medicine. Computers are used widely in medical research, where an important need is for better microelectronic sensors for data acquisition. In medical practice, data collection from patients as well as subsequent storage, retrieval, and manipulation of data are enhanced by the computer. In medical decision-making computers improve accuracy, increase cost-efficiency, and advance understanding of the structure of medical knowledge and of the decision-making process itself. Powerful new noninvasive diagnostic instruments including x-ray tomographic scanners and ultrasonic imaging systems are based on computers. The efficiency and scope of clinical laboratory procedures and advanced analytical instruments are greatly increased by computerization, and careful application of computers has improved the interpretation of diagnostic tests, such as the electrocardiogram, and monitoring of critically ill patients. The powerful sensory, computational, memory, and display capabilities of microcomputer systems and their compact size offer new opportunities to relieve functional deficiencies associated with loss of limbs, paralysis, speech impediments, deafness, and blindness.

Clinical Laboratory Techniques↗

Remember to consider dermatophyte infection when dealing with recalcitrant dermatoses.

BACKGROUND: Superficial fungal infections of the skin are among the most common infections encountered in medicine. The diagnosis is easily confirmed with simple office-based procedures. In certain clinical situations, the diagnosis can be elusive. METHODS: We analyzed clinical data on five patients who came in referral for treatment of a recalcitrant dermatosis. RESULTS: All patients had their diagnosis confirmed by a positive potassium hydroxide preparation from skin scrapings or by a skin biopsy positive for fungal elements. All showed clinical improvement and ultimate resolution of their skin lesions with topical and/or systemic antifungal therapy. CONCLUSIONS: Diagnosis can be complicated by previous use of corticosteroid-containing topical and/or systemic agents, a clinical history closely resembling that of a photosensitive disorder, and a lack of clinical-histopathologic correlation. Laboratory procedures and skin biopsy of an ambiguous appearing lesion can be diagnostic, but an accurate diagnosis is dependent on communication between the clinician and the pathologist. We recommend that office-based procedures be done early in treatment so that subsequent efforts can be directed toward providing appropriate therapies.

Adolescent↗

Vitamin C metabolism and atopic allergy.

The procedure for carrying out the Leucocyte Ascorbic Acid Uptake Direct Antigen Challenge Test (LAADACT) is described. Leucocytes from normal individuals, when incubated in a buffered medium containing ascorbic acid, increase their ascorbic acid concentration by about 80%. When leucocytes from atopic individuals are incubated in a medium containing the antigen to which they are sensitive, as shown by positive skin tests, the leucocyte uptake of ascorbic acid is significantly reduced. Addition of antigen, to which atopic or normal individuals are not sensitive, to the incubation mixture does not reduce leucocyte ascorbic acid uptake. Measurement of ascorbic acid uptake into leucocytes is a relatively simple, routine, laboratory procedure. The LAADACT, therefore, provides a quick and accurate blood test for diagnosing sensitivity to specific antigens, and measuring relative antigenic sensitivities. The underlying mechanism of the LAADACT is discussed.

Antigen-Antibody Reactions↗

Effect of heat treatment of potentially infected blood samples on therapeutic drug monitoring of selected drugs.

OBJECTIVE: To investigate the effect of heart treatment on the outcome of drug analysis in whole blood and serum for eight drugs routinely assayed for therapeutic monitoring. DESIGN: All blood and serum samples (n = 373) received at the pharmacy laboratory for therapeutic monitoring of carbamazepine, digoxin, gentamicin, kanamycin, phenobarbital, phenytoin, theophylline, and valproic acid were heated at 60 degrees C for 30 minutes. Serum was subsequently assayed by fluorescence polarization immunoassay (TDx). SETTING: The study was conducted at the analytical laboratory of the pharmacy, using standard laboratory procedures. MAIN OUTCOME MEASURES: Analyses of heated samples were compared with analyses of untreated samples using a paired Wilcoxon signed-rank test. RESULTS: Serum concentrations of phenytoin from treated whole blood, and gentamicin in treated serum, were significantly lower than in untreated samples. These differences, however, were small, clinically irrelevant, and lie within assay variation intervals. Heat treatment did not influence the outcome of analyses for carbamazepine, digoxin, kanamycin, phenobarbital, theophylline, and valproic acid. CONCLUSIONS: Heat treatment of whole blood and serum samples of the investigated drugs does not influence the outcome of drug analysis, although drug instability cannot be fully excluded. Heat treatment can protect laboratory technicians from HIV infection without influencing therapeutic monitoring of these drugs.

Blood Physiological Phenomena↗

Influence of ceramic and cement thickness on the masking of various types of opaque posts.

STATEMENT OF PROBLEM: Dark-colored posts may negatively affect the esthetics of all-ceramic single unit crowns as the thin layers of luting cement may not be sufficiently opaque. PURPOSE: This in vitro study evaluated the influence of the color of 2 commercially available nonmetallic opaque posts (carbon fiber and zirconia) and an experimental esthetic post, and the shade and thickness of luting cements on the esthetics of all-ceramic restorations. MATERIAL AND METHODS: Sample disks at several thickness values were made in glass-ceramic (IPS-Empress), an experimental ceramic, a zirconia, a carbon fiber post material, a resin composite material (Z100) as reference, and a luting cement (Variolink II). A laboratory procedure, with 3 possible combinations of stapling the disks, was used. This was performed for 4 substrates, 3 cement colors at 2 thickness values, and 3 heights of ceramic disks. For each combination, the shift in color was measured with a spectrophotometer. Readings were performed for 3 conditions: (1) ability of ceramic to mask the aspect of the abutment in relation to its thickness (1.0, 1.5, or 2.0 mm); (2) effect of a change in cement color (W, Y, or B) on the final color of the ceramic; and (3) influence of cement film thickness (0.1 or 0.2 mm) on the final color of the ceramic. RESULTS: When ceramic thickness was 1 mm, all other variables were visually appreciable. For ceramic thickness of 1.5 mm, color differences decreased and most differences were appreciable only with laboratory instruments. For ceramic thickness of 2.0 mm, there were no detectable, clinically relevant differences. CONCLUSION: The final esthetic result of the all-ceramic IPS-Empress glass-ceramic restoration was not affected by the presence of different substrates with different colors when the thickness was more than 2.0 mm. When ceramic thickness decreases to 1.5 mm, it is advised to take the substrate aspects into consideration. If the ceramic thickness is less than 1.0 mm, the use of a full ceramic crown is contraindicated because color matching of the abutment is required to ensure an acceptable esthetic result. Differences in cement thickness (0.1 or 0.2 mm) may slightly affect the final result. As this parameter can be controlled by the operator only to a certain extent, it cannot be considered as a procedure to correct color. Availability of different cement shades allows only minor esthetic corrections, which might be instrumentally detectable but are clinically not relevant.

Aluminum Silicates↗

Use of the activated partial thromboplastin time for the diagnosis of congenital coagulation disorders: problems and possible solutions.

The activated partial thromboplastin time (APTT) is a commonly performed laboratory procedure which is used for multiple purposes including monitoring of heparin therapy, detection of coagulation factor deficiency, and detection of lupus anticoagulants. Among the hereditary coagulation deficiencies, factor VIII and factor IX are the most common. APTT reagents differ widely in both their sensitivity to factor VIII and factor IX deficiencies as well as their responsiveness. Sensitivity may be defined as the ability to identify a deficiency state while responsiveness is indicated by the degree of prolongation of the APTT result as compared to the upper limit of normal. Reagents may be both sensitive and responsive or alternatively sensitive and relatively nonresponsive. Consequently, it is extremely important for each laboratory to carefully identify the upper limit of the normal range. A variety of preanalytical variables will also effect the sensitivity of the APTT to factor deficiency states. These variables include specimen handling and the preparation of platelet poor plasma. The instrument effect is also of importance. Selection of the reagent tends to have the most impact on sensitivity and responsiveness while instrumentation affects the precision of a given APTT. The composition and concentration of phospholipid in APTT reagents does have an effect on reagent responsiveness and sensitivity. Sensitivity to factor deficiencies does not necessarily parallel sensitivity to lupus anticoagulants.

Blood Coagulation Disorders↗

Effect of rapid curing procedures on polymer implant materials.

This investigation of standard curing methods for PMMA implants has demonstrated that alternate means of using the air oven may produce good strength properties along with a considerable degree of porosity, when desired, in a relatively short period of time. Curing of polymers in a pressure pot offers few advantages owing to the length of time required to produce, at best, equivalent strength for the porous materials. The method also poses dangers inherent in the use of superheated salt solution or hot glycerin. The autoclave is widely used in dental offices for sterilizing and will fully and consistently cure polymers within 30 minutes. The best properties for the PMMA resin were achieved with this method (61 MPa or 9,130 p.s.i., tensile strength). The microwave oven has become relatively inexpensive in recent years, and it offers time savings of up to 90 per cent which would be beneficial in implant dentistry or in dental laboratory procedures in general. The exact condition for curing particular polymers must be carefully determined to adjust the time of irradiation in order not to under- or overcure the polymer object. Curing polymers which contain intrinsic foaming agents under pressure conditions slightly reduced the total pore volume. But, pore volume and pore diameter in the large-bead polymers are determined predominantly by packing conditions, not curing conditions. Biologic tolerance to materials cured by these methods in primates is presently being evaluated.

Chemical Phenomena↗

Dengue fever in US military personnel in Haiti.

OBJECTIVE: To describe clinical manifestations and public health implications of an outbreak of dengue fever (DF) during Operation Uphold Democracy, Haiti, 1994. DESIGN: Consecutive sample. SETTING: Military combat support hospital, Port-au-Prince, Haiti. PATIENTS: A total of 101 US military personnel with acute febrile illnesses. INTERVENTIONS: A disease surveillance team collected clinical and epidemiologic data from US military clinics throughout Haiti. Febrile patients admitted to the combat support hospital were evaluated with standardized clinical and laboratory procedures. The surveillance team followed patients daily. MAIN OUTCOME MEASURES: Arbovirus isolation and specific antibody determination and symptoms and physical findings. RESULTS: Febrile illnesses accounted for 103 (25%) of the 406 combat support hospital admissions during the first 6 weeks of deployment. All patients with febrile illness recovered. A total of 30 patients had DF; no patient had evidence of infection with malaria. Dengue virus serotypes 1, 2, and 4 were isolated from 22 patients, and 8 patients developed IgM antibody to dengue virus. Patients with DF could not be distinguished from other febrile patients on clinical grounds alone. No arboviruses other than dengue were identified. CONCLUSIONS: Active surveillance, with clinical and laboratory evaluation directed by an epidemiologic team, led to the timely recognition of an outbreak of febrile illness among US troops in Haiti. Viral isolation and serological studies were essential in confirming DF. During the surveillance period, DF accounted for at least 30% of the febrile illnesses among hospitalized US troops. Dengue fever is a significant threat to military personnel and civilian travelers in Haiti and has the potential for introduction to and transmission in the United States.

Adult↗

Measurement of total thyroxine concentration in serum from dogs and cats by use of various methods.

OBJECTIVE: To compare results obtained from assay of total thyroxine (T4) concentration in serum of dogs and cats by use of 4 methods. SAMPLE POPULATION: Serum samples obtained from 98 dogs and 100 cats and submitted by veterinarians to an endocrine testing laboratory. PROCEDURE: Total T4 concentration was determined in each sample by use of 4 assay methods. Assay methods included a radioimmunoassay (RIA) marketed for use in dogs, an RIA for use in humans, a chemiluminescent enzyme immunoassay for use in humans, and an in-house ELISA. RESULTS: Total T4 concentrations obtained by use of all methods were significantly correlated. Bias-plot comparison revealed similar good overall agreement. Total T4 concentrations determined by use of the RIA marketed for use in dogs were generally lower than concentrations measured by use of the other methods. Clinical comparisons were made by evaluation of the T4 results in the context of the reference range recommended by each laboratory. A difference was found for clinical comparisons on the basis of T4 assay method when used to identify dogs as possible hypothyroid suspects. This difference was related more to the reference range used than to the absolute T4 value. The number of hyperthyroid-suspect cats with T4 values greater than the reference range was the same for each of the 4 assay methods. CONCLUSIONS AND CLINICAL RELEVANCE: Total T4 concentrations determined in dogs and cats by use of 4 commonly used methods provided similar and consistent results.

Animals↗

[Usefulness of polymerase chain reaction (PCR) in the diagnosis of meningococcal meningitis].

BACKGROUND: The aim of this work was to evaluate the applicability of polymerase chain reaction (PCR) in the microbiological diagnostic of meningococcal meningitis as compared with the conventional methods (Gram stain and culture). METHODS: One hundred and fifteen cerebrospinalis fluid samples from 115 patients with suspicious symptoms of meningitis were studied. 47 of them belonged to patients suspicious for meningococcal disease; 28 to patients with bacterial meningitis of other infectious etiologies; 10 to patients with meningitis showing lymphocytic pleocytosis and 30 to patients with an unconfirmed meningitis. The cerebrospinalis fluid samples were processed for culture by standard procedures and by PCR according to the method described by Newcombe et al for peripheral blood samples. RESULTS: Thirty five out of 39 patients suspicious of meningococcal meningitis were microbiologically confirmed, being 22 culture and PCR positive, 3 microscopically and PCR positive, 1 only microscopically positive, and 9 positive only by PCR. By using PCR methodology, the number of confirmed diagnostics of meningococcal meningitis increased in a 23% as compared to those obtained by microscopic observation and culture. Sensitivity, specificity, predictive positive value and predictive negative value were 87.1, 98.7, 97.1 and 94.1 respectively for the PCR method. CONCLUSIONS: Our results indicate that PCR can be used on routine basis as a complementary technique to the standard laboratory procedures for diagnosis of meningococcal meningitis.

Humans↗

Idiopathic dilated cardiomyopathy: lack of association with hepatitis C virus infection.

OBJECTIVE: To determine whether there is an association between hepatitis C virus (HCV) infection and dilated cardiomyopathy in a well defined area of north western Greece; such an association has been reported elsewhere. DESIGN: Evaluation of consecutive patients with chronic HCV infection for the presence of clinical or subclinical manifestations of dilated cardiomyopathy by history, physical examination, and non-invasive laboratory procedures (ECG, chest x ray, and echocardiography) before the initiation of interferon alpha treatment; investigation for HCV infection markers in patients with dilated cardiomyopathy by enzyme and immunoblot assays (antibodies to HCV) and the reverse transcriptase polymerase chain reaction (HCV RNA). SETTING: A tertiary referral centre for patients with chronic hepatitis and dilated cardiomyopathy. PATIENTS: 102 patients with well defined chronic HCV infection and 55 patients with well established dilated cardiomyopathy were evaluated. MAIN OUTCOME MEASURES: The need for HCV testing in patients with dilated cardiomyopathy, or follow up for heart disease in patients with chronic HCV infection. RESULTS: None of the patients with chronic HCV infection had clinical or subclinical evidence of dilated cardiomyopathy from history and laboratory findings. None of the patients with dilated cardiomyopathy was positive for antibodies to HCV or viraemic on HCV RNA testing. CONCLUSIONS: The study neither confirms the findings of other investigators, nor indicates a pathogenic link between HCV and dilated cardiomyopathy. For this reason, at least in Greece, testing for HCV in patients with dilated cardiomyopathy or follow up for heart disease in HCV patients appears unnecessary. Genetic or other factors could be the reason for this discrepancy if previously reported associations between HCV and dilated cardiomyopathy or hypertrophic cardiomyopathy were not coincidental.

Adult↗

TWGDAM validation of AmpFlSTR PCR amplification kits for forensic DNA casework.

Laboratory procedures used in short tandem repeat (STR) analysis were subjected to various scenarios that assessed reliability and identified potential limitations. These validation studies were designed as recommended by the Technical Working Group on DNA Analysis Methods (TWGDAM) and the DNA Advisory Board (DAB) (17,18). Various DNA samples were amplified by the polymerase chain reaction (PCR) using AmpFlSTR PCR Amplification Kits (i.e., AmpFlSTR Green I, Profiler, Profiler Plus, and COfiler kits), detected with ABI Prism instrumentation, and analyzed using GeneScan and Genotyper software. Data acquired in these studies reinforced an existing body of knowledge and expertise regarding application and interpretation of STR typing in the forensic science community. Consistent STR genotypes were detected in various body tissues and fluids. Inter-laboratory comparisons produced concordant genotype results. Quantitative interpretational aids for DNA mixtures were characterized. Ability of the typing systems to type potentially compromised samples reliably was evaluated. Nonprobative case evidentiary DNA was successfully amplified, genotyped, and interpreted. Potential limitations or cautionary factors in the interpretation of minimal fluorescence intensity were demonstrated. Differential amplification between loci was observed when PCR was inhibited; preferential amplification typically was not. Single AmpFlSTR locus amplification did not offer consistent benefit over AmpFlSTR multiplexing, even in cases of DNA degradation or PCR inhibition. During rigorous evaluation, AmpFlSTR PCR Amplification Kits reproducibly yielded sensitive and locus-specific results, as required in routine forensic analyses.

DNA↗