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PubMedDate not supplied

The activities of the Narcotics Laboratory Section of the Division of Narcotic Drugs in supporting national laboratories. United Nations Secretariat.

Since the establishment of the Narcotics Laboratory Section of the Division of Narcotic Drugs of the United Nations Secretariat in 1954, in accordance with resolution 834 (IX) of the United Nations General Assembly, the activities of the Narcotics Laboratory Section have developed according to the recommendations of the Commission on Narcotic Drugs. The Narcotics Laboratory Section carried out research on opium, cannabis, khat and codeine. The current programme of the Laboratory Section includes the following activities: Providing training in drug identification techniques to scientists, primarily from developing countries, and developing training standards; Strengthening national narcotics laboratories in developing countries, including the procurement of basic laboratory equipment; Developing standard testing methods applicable in developing countries; Providing reference samples for analytical and research purposes; Providing scientific and technical information on drugs of abuse; Collaborating with national narcotics laboratories.

Developing Countries↗
PubMed1995

Is New Zealand's recent increase in campylobacteriosis due to changes in laboratory procedures? A survey of 69 medical laboratories.

AIMS: To evaluate the contribution of changing procedures in microbiology laboratories over the previous 5 years to the increase in campylobacteriosis notifications. To assess whether regional differences in notification rates are due to variations in laboratory procedures. METHODS: A questionnaire was sent to 69 New Zealand medical laboratories, requesting data on their identification procedures for enteric pathogens, including campylobacter. RESULTS: Changes over the last 5 years in laboratory techniques were insufficient to account for a marked increase in campylobacter isolations. On the basis of data provided by 12 laboratories, the number of specimens that grew campylobacter increased by 49% between 1992 and 1993. Differences in laboratory methods do not explain regional differences in campylobacter notification rates. CONCLUSION: Changes in laboratory methodologies over the last 5 years do not appear to account for the recent national increase in campylobacteriosis notifications.

Campylobacter↗
PubMed1998

Guidelines of the Office International des Epizooties for laboratory quality evaluation, for international reference standards for antibody assays and for laboratory proficiency testing.

Three guidelines, adopted by the International Committee of the Office International des Epizooties (OIE), have been combined for publication in a single document. The Guidelines for evaluating laboratory quality (adopted in 1995) form part of the OIE Guidelines for evaluating Veterinary Services. General requirements for equipment, staffing and management of laboratories are outlined. The guidelines for international reference standards for antibody assays (adopted in 1998) provide general rules governing the preparation of immune sera by OIE Reference Laboratories. A data sheet should accompany each preparation dispatched from the laboratory, and details are given of the information to be contained in the data sheet. The guidelines are to be used in conjunction with the OIE Manual of standards for diagnostic tests and vaccines. Guidelines on the proficiency of laboratory testing (adopted in 1996) describe how the operation of a laboratory can be assessed by inter-laboratory testing, and by voluntary participation in an accreditation (quality assurance) audit, operated by an independent authority. Criteria for assessing serological testing are provided.

Accreditation↗
PubMed1988

Laboratory-acquired infections and injuries in clinical laboratories: a 1986 survey.

A mail survey of all 54 US State and Territorial Public Health Laboratories and the 165 Hospital Clinical Laboratories in Minnesota was carried out, soliciting information on laboratory-acquired infections and injuries for calendar year 1986. The aggregate infection incidence rates were 3.5/1,000 full-time equivalent (FTE) workers for hospital laboratories and 1.43/1,000 for public health laboratories. Injury rates were 21.2/100 FTE workers for hospital laboratories and 7.21/100 for public health labs.

Accidents, Occupational↗
PubMed2003

[Roles of the laboratory information division and laboratory technicians in changing medical circumstances].

It is often voiced recently that the medical administration and medical environment are changing drastically. Hospital management in the future must face the challenges of improving efficiency and quality of medical care. Thus, promotion of team care is indispensable, and the clinical path and Nutrition support Team (NST) are rapidly spreading. We consider that the hospital laboratory must also implement and develop a Laboratory Information Division for more comprehensive exchange of information with clinical departments, and move beyond the laboratory by participating in team care. We have planned and organized the Kinki Laboratory Forum from 2000 as an opportunity for information exchange among laboratory technicians who aspire to establish the Laboratory Information Division and recognize the necessity of new actions for participation in team care. Its contents are presented.

Clinical Laboratory Information Systems↗
PubMed1999

Laboratory data in healthy volunteers: reference values, reference changes, screening and laboratory adverse event limits in Phase I clinical trials.

OBJECTIVE: Laboratory data are key evaluation procedures for Phase I clinical pharmacology for two reasons. Firstly, laboratory data are used within the screening process to exclude subjects with asymptomatic diseases, which could result in increased danger to themselves or confuse interpretation of the study results. Secondly, during study implementation, safety evaluation and in particular maximum tolerated dose determination have to be done by a case-by-case analysis, sometimes using laboratory adverse events (LAEs). Thus, relevant limits are needed to discriminate between a usual common variation and a significant abnormality, which is considered to be a LAE. This report presents laboratory data distribution, reference values and reference changes and, based on previously published new methods, suggests inclusion limits at screening and laboratory adverse event limits for analysis during study implementation. SUBJECTS AND METHODS: Nine hundred and twenty-seven young healthy male volunteers were recruited in one centre (Association de Recherche Thérapeutique). A standard screening process was carried out. Protocols were approved by the local ethics committee. Blood sampling was performed in the same conditions. Reference values (at screening and at baseline) were determined by a non-parametric procedure selecting 2.5% and 97.5% of the distribution of data. Reference changes were also defined as the 2.5-97.5% interval of distribution of the variations between the end of treatment and baseline. Inclusion limit and LAE limit methods of determination used had been specified in previous articles. RESULTS: Detailed results of laboratory data distribution, reference values at screening and at baseline, reference changes, inclusion limits and LAE limits are presented in tables with number of subjects, mean, median, standard deviation, minimal and maximal values and the 2.5-97.5% interval for each laboratory parameter. CONCLUSION: The key aims of this paper are to provide clinical pharmacologists with data, reference values or changes obtained in the real conditions of Phase I study implementation, and to propose relevant limits, either for screening as inclusion limits, or during studies as LAE limits. Thus, these data, reference values and specific limits improve the capacity to screen healthy volunteers and to analyse LAEs during Phase I studies.

Adult↗
PubMed1997

Cytopathology laboratory improvement programs of the College of American Pathologists: Laboratory Accreditation Program (CAP LAP) and Performance Improvement Program in Cervicovaginal Cytology (CAP PAP).

Major programs of the College of American Pathologists (CAP) are directed toward improvement of laboratory practices through peer review, interlaboratory comparison, education, and development of practice standards and guidelines. Two programs provided to cytopathology laboratories, the Laboratory Accreditation Program and the Interlaboratory Comparison Program in Cervicovaginal Cytology, are dedicated to these laboratory improvement principles. In 1996, each of these programs served over 2100 laboratories that provide cytopathology services. This paper reviews the peer development, structure, and administration of the Laboratory Accreditation Program and the Interlaboratory Comparison Program in Cervicovaginal Cytology, focusing on recent and ongoing initiatives to enhance their contribution to continued improvement of gynecologic cytopathology laboratory practices.

Accreditation↗
PubMed1996

A new clinical laboratory information system architecture from the OpenLabs project offering advanced services for laboratory staff and users.

The OpenLabs project aims to improve the efficiency and effectiveness of clinical laboratory services by integrating decision support systems with laboratory information systems and equipment. Standards for electronic data interchange between laboratories and other medical systems using the EUCLIDES/OpenLabs coding scheme and an open architecture for clinical laboratory information systems have been specified. This article gives an account of the proposed architecture and outlines new software applications being developed using the architecture which provide advanced services for ordering and reporting of laboratory tests, advanced instrument workstation and laboratory management services, including an OpenLabs Service Manager application which co-ordinates the available services.

Chemistry, Clinical↗
PubMed2002

Automated production of an on-line laboratory reference manual from a laboratory information system.

Laboratories provide information beyond test results, including information related to patient preparation, specimen collection and handling, test methodology, test availability, and interpretation of results. Most laboratories publish reference manuals to distribute this information to clients, while relying on the laboratory information system to provide this information to laboratory staff. Maintaining duplicate sources of information is expensive and error-prone, and printed materials become rapidly outdated. We developed a process to automate the production of a web-based reference manual directly from the laboratory information system, using a combination of MUMPS programs and HTML templates. We now focus our resources to assure that the laboratory information system database is accurate and complete, and then with minimal additional effort or expense produce an up-to-date on-line reference manual. We are therefore able to provide better sources of information in a sustainable manner.

Clinical Laboratory Information Systems↗
PubMed1995

A clinician's workstation for improving laboratory use. Integrated display of laboratory results.

Physicians are often forced to make decisions about the use of laboratory resources without adequate access to earlier results and related supporting information. Less than optimal use of the laboratory may result. The authors developed and deployed a clinical workstation meant to provide ready access to laboratory information that is presented in a format well-matched to the patient monitoring task. The workstation was one element of a multifaceted effort to improve blood component use in adult and pediatric bone marrow transplantation units. It was the sole intervention focused on improving laboratory testing. In the 2 years since the introduction of the workstation, median charges of bone marrow transplantation cases for laboratory test fell by 32%. This reduction in charges has been maintained for 2 years. Better informed physicians appear to use laboratory resources more sparingly.

Clinical Laboratory Information Systems↗
PubMed2003

National academy of clinical biochemistry laboratory medicine practice guidelines: recommendations for the use of laboratory tests to support poisoned patients who present to the emergency department.

BACKGROUND: Exposure to drugs and toxins is a major cause for patients' visits to the emergency department (ED). METHODS: Recommendations for the use of clinical laboratory tests were prepared by an expert panel of analytical toxicologists and ED physicians specializing in clinical toxicology. These recommendations were posted on the world wide web and presented in open forum at several clinical chemistry and clinical toxicology meetings. RESULTS: A menu of important stat serum and urine toxicology tests was prepared for clinical laboratories who provide clinical toxicology services. For drugs-of-abuse intoxication, most ED physicians do not rely on results of urine drug testing for emergent management decisions. This is in part because immunoassays, although rapid, have limitations in sensitivity and specificity and chromatographic assays, which are more definitive, are more labor-intensive. Ethyl alcohol is widely tested in the ED, and breath testing is a convenient procedure. Determinations made within the ED, however, require oversight by the clinical laboratory. Testing for toxic alcohols is needed, but rapid commercial assays are not available. The laboratory must provide stat assays for acetaminophen, salicylates, co-oximetry, cholinesterase, iron, and some therapeutic drugs, such as lithium and digoxin. Exposure to other heavy metals requires laboratory support for specimen collection but not for emergent testing. CONCLUSIONS: Improvements are needed for immunoassays, particularly for amphetamines, benzodiazepines, opioids, and tricyclic antidepressants. Assays for new drugs of abuse must also be developed to meet changing abuse patterns. As no clinical laboratory can provide services to meet all needs, the National Academy of Clinical Biochemistry Committee recommends establishment of regional centers for specialized toxicology testing.

Antidepressive Agents, Tricyclic↗
PubMed2000

Experiences with external quality assessment (EQA) in molecular diagnostics in clinical laboratories in Germany. Working Group of the German Societies for Clinical Chemistry (DGKC) and Laboratory Medicine (DGLM).

The German Societies for Clinical Chemistry (DGKC) and Laboratory Medicine (DGLM) have established an official working group on molecular diagnostics in the field of laboratory medicine. The group's objectives are to support the establishment of molecular biology methods for the use in diagnostics in German clinical laboratories. Towards this end, we have defined specific aims, which are 1) the implementation and extension of external quality assessment (EQA) schemes and methodological exercises offered to clinical diagnostic laboratories, 2) the establishment of a proficiency network and data base within the societies, 3) the implementation of an educational program in molecular diagnostic procedures for clinical chemists and laboratory physicians through the organisation of symposia and workshops and 4) the cooperation with other DGKC/DGLM working groups on shared aspects of laboratory analysis, e.g. preanalytics. The focus of this presentation is to introduce some of these goals in more detail with particular emphasis on the first two program aspects and to discuss experiences with these activities.

Clinical Laboratory Techniques↗
PubMed2003

Learning curve of a new hospital laboratory. The monitoring of computer-generated turnaround time of laboratory tests in an emergency department.

Learning curves have been described for different health technologies, mainly new surgical or diagnostic procedures, but learning curves for a new hospital's laboratory procedures have not been systematically studied. To monitor the timeliness (turnaround time) of stat tests from the Emergency Department as a marker of laboratory quality and to address the issue of a learning curve for procedures performed in a new hospital laboratory, we employed a computerized system for collecting data of turnaround time (from order entry to result verification) on stat tests from the Emergency Department of a newly opened (July 24, 2000) 471-bed general hospital. The data collection operates without user intervention. We evaluated the turnaround times of stat complete blood count and biochemistry tests from August 2000 to December 2001. Results show that it took 6 to 12 months before the turnaround times reached a plateau, we believe that this is the learning curve of a new hospital laboratory. Computer-generated turnaround times for Emergency Department stat tests appear to be a useful tool for monitoring the quality of laboratory tests and can demonstrate the learning curve of a new hospital laboratory.

Clinical Laboratory Information Systems↗
PubMed1990

Horizontal and vertical integration in hospital laboratories and the laboratory information system.

An understanding of horizontal and vertical integration and their quasi-integration variants is important for pathologists to formulate a competitive strategy for hospital clinical laboratories. These basic organizational concepts, in turn, are based on the need to establish control over critical laboratory inputs and outputs. The pathologist seeks greater control of mission-critical system inputs and outputs to increase the quality and efficiency of the laboratory operations. The LIS produces horizontal integration of the various hospital laboratories by integrating them vertically. Forward vertical quasi-integration of the laboratories is mediated primarily by the LIS through front-end valued-added features such as reporting of results and creating a long-term on-line test result archive. These features increase the value of the information product of pathology for clinicians and increase the cost of switching to another system. The LIS can also serve as a means for customizing the information product of the laboratories to appeal to new market segments such as hospital administrators.

Clinical Laboratory Information Systems↗
PubMed1995

[Idea and practice with the systematization of clinical laboratory in the Central Laboratory, Osaka University Hospital].

On 1 September 1993, we left our old hospital and moved to our brand new establishment, and at that time we adopted the order-entry and reporting system. In this paper we report on our new laboratory computer system that has been developed to manage a lot of information and to analyze rapidly many test tubes (4000 samples per day) and to elevate the service for our patients. We developed the automated clinical laboratory system and this new system was named as the Clinical Laboratory Supervised System (CLASSY). We used the NEC system 3500 Model 10, NEC N5200 Model 03 sx and NEC PC9821 Ae as a laboratory host computer, an interface unit and a terminal for routine work, respectively. CLASSY covers the automated analysis not only for clinical chemistry, but also for hematology, urinalysis and microbiology. As the ordering and reporting system is applied to the hospital information system, order information for clinical test is transferred to our laboratory host computer when the bar-code label is printed out from the automatic bar-code labeller. Then it is transferred from the laboratory host computer to some subsystems or automatically to an analyzer through the interface units or modems.

Clinical Laboratory Information Systems↗
PubMed1996

Impact of cost cutting on laboratories: new business strategies for laboratories.

Cost reduction is the primary force driving healthcare reform. To survive and thrive in these tumultuous times, laboratories must adapt and implement new business strategies. Business paradigm shifts create opportunities for organizations with a plan; a wait-and-see attitude forecasts failure. Drawing upon an 11-year experience with the "ARUP business model," this work will highlight business strategies that have contributed to the success of this university-based reference laboratory. In the future, successful laboratories will implement new business strategies to become more effective members of the emerging integrated healthcare delivery teams. Within the laboratory, traditional organizational disciplinary boundaries, i.e., chemistry, microbiology, and hematology, are melding together to increase efficiency. Laboratorians must become influential members of institutional healthcare delivery teams formed to control utilization. Laboratory services are being adjusted to optimize patient care. Incremental pricing is only one of the strategies to be implemented to expand outpatient business to those in the region. Expanded computer capabilities, client services, specimen handling, marketing, and sales are also required. On a regional basis, service laboratories are increasingly joining forces to increase efficiency while at the same time improving the quality of patient care.

Chemistry, Clinical↗
PubMed1998

[Actual situation and problems in the information office of clinical laboratories; questionnaire surveys of central laboratories of university hospitals].

The laboratory tests supplied by clinical laboratory comprise an increasing volume in most hospitals. Consultation and effective utilization of laboratory data are important aspects of evidence-based medicine. Effective utilization of laboratory data will also contribute to the efficiency of hospital practice. Questionnaire surveys were conducted to investigate the actual situation in the information office of clinical laboratories in national, public and private facilities of 80 medical universities in Japan. Few facilities demonstrated efficient functioning, although information offices had been opened in six national, one public, and four private universities. The office staff received many questions on specimen handling and analytical methods. In the future, the office will be expected to be actively involved in mutual communications with clinical physicians and an information system such as computerized web is anticipated. Furthermore, a full-time laboratory physician and technicians are expected to provide support as experts in patient diagnosis.

Clinical Laboratory Information Systems↗
PubMed1999

Length of time to laboratory diagnosis of Mycobacterium tuberculosis infection: comparison of in-house methods with reference laboratory results.

OBJECTIVES: To audit the time taken to obtain laboratory confirmation of infection with Mycobacterium tuberculosis using in-house methods of polymerase chain reaction (PCR) and culture and referral to a reference laboratory. METHODS: Retrospective collection of data from laboratory records covering a period of 1 year. RESULTS: Median time to microbiological diagnosis of a new infection using the in-house services in addition to the reference laboratory was 22.0 days. Using reference laboratory results alone, median time to diagnosis would have been 61.5 days. CONCLUSIONS: Development of on-site laboratory facilities to identify Mycobacterium tuberculosis can reduce the time to its identification by almost two-thirds.

Clinical Laboratory Techniques↗