Autoverification of test results in the core clinical laboratory

2019 ◽  
Vol 73 ◽  
pp. 11-25
Author(s):  
Edward W. Randell ◽  
Sedef Yenice ◽  
Aye Aye Khine Wamono ◽  
Matthias Orth
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Sujata Gupta ◽  
Anupam Mital

Abstract This study presents the behaviour of model footing resting over unreinforced and reinforced sand bed under different loading conditions carried out experimentally. The parameters investigated in this study includes the number of reinforced layers (N = 0, 1, 2, 3, 4), embedment ratio (Df /B = 0, 0.5, 1.0), eccentric and inclined ratio (e/L, e/B = 0, 0.05, 0.10, 0.15) and (a = 0°, 7°, 14°). The test sand was reinforced with bi-axial geogrid (Bx20/20). The test results show that the ultimate bearing capacities decrease with axial eccentricity and inclination of applied loads. The test results also show that the depth of model footing increase zero to B (B = width of model footing), an increase of ultimate bearing capacity (UBC) approximated at 93%. Similarly, the multi-layered geogrid reinforced sand (N = 0 to 4) increases the UBC by about 75%. The bearing capacity ratio (BCR) of the model footing increases with an increasing load eccentricity to the core boundary of footing; if the load eccentricities increase continuity, the BCR decreases. The tilt of the model footing is increased by increasing the eccentricity and decreases with increasing the number of reinforcing layers.


2021 ◽  
Vol 8 ◽  
Author(s):  
Catherine Bornemann ◽  
Katharina Woyk ◽  
Caroline Bouter

Subacute thyroiditis is an inflammatory thyroid disorder associated with viral infections. Rare cases of subacute thyroiditis have also been described following vaccination. Recently, a few cases of subacute thyroiditis following SARS-CoV-2 vaccination have also been reported. Here, we present two cases of cytological proven subacute thyroiditis after receiving the first dose of a SARS-CoV-2 vaccination. We describe clinical, laboratory, imaging and cytological findings in two cases of subacute thyroiditis that presented in our department 2 weeks after SARS-CoV-2 vaccination with Spikevax (Moderna Biotech, Spain) and Vaxzevria (AstraZeneca; Sweden). Both cases did not have a previous history of thyroid disorders and presented with anterior and lateral neck pain. Clinical test results as well as cytological findings were consistent with subacute thyroiditis. Subacute thyroiditis may develop following a SARS-CoV-2 vaccination and should be considered as a possible side effect in cases that present with thyroid pain.


Author(s):  
Екатерина Владимировна Силина ◽  
Е.Н. Кабаева ◽  
В.А. Ступин ◽  
А.А. Тяжельников ◽  
Т.Г. Синельникова ◽  
...  

Актуальность работы обусловлена поиском путей улучшения результатов лечения больных инсультом. Цель исследования: выявить критерии прогноза риска развития венозных тромбозов, а также ключевые звенья патогенеза тромбоэмболических осложнений у пациентов с острым инсультом. Материалы и методы: в проспективное исследование включено 145 больных с инсультом (104 с ишемическим (ИИ) и 41 с геморрагическим (ГИ)), госпитализированных в отделение нейрореанимации в период 3,5-24 часа от начала заболевания и имеющих на момент включения в исследование различную степень депрессии сознания (тяжелая степень инсульта). Пациентам проводилась терапия в соответствии со стандартами оказания медицинской помощи, согласно которым всем пациентам назначали антикоагулянтную терапию (АКТ). Выполняемый в динамике стандартный клинико-диагностический и лабораторный мониторинг был дополнен тестом «Тромбодинамика». Результаты: у 95% пациентов с инсультом зарегистрированы различные факторы риска венозных тромбоэмболических осложнений (ВТЭО). Тромбоэмболия легочной артерии (ТЭЛА) развилась в 24% случаев, преимущественно на 2-3 неделе, в среднем через 6 дней после отмены АКТ. Описана динамика и признаки дисбаланса в системе гемостаза у больных инсультом, нараставшие после отмены АКТ. Показано, что стандартные методы исследования системы гемостаза по сравнению с прямым методом менее информативны для выявления ВТЭО и оценки эффективности АКТ. Вероятность развития ВТЭО прямо пропорциональна скорости смены состояния гиперкоагуляции состоянием гипокоагуляции. При этом состояние фоновой гиперкоагуляции не коррелирует с развитием ВТЭО. Корреляционный анализ изменений в системе гемостаза с динамикой клинико-лабораторных маркеров у больных с тяжелым инсультом выявил закономерные изменения показателей коагуляционного гемостаза в условиях реализации разных схем стандартной АКТ. Эти схемы были сопоставимы по содержанию при развитии как ВТЭО и ТЭЛА, так и геморрагических осложнений. Вывод: К больным инсультом необходим персонализированный подход при динамическом мониторировании гемостаза и назначении антикоагулянтной терапии. This work was warranted by the need to improve results in the treatment of stroke. The aim of this study was to identify criteria for predicting the risk of venous thrombosis and to elucidate the pathogenesis of thromboembolic complications in patients with acute stroke. Materials and methods. This prospective study included 145 patients (104 patients with ischemic stroke and 41 patients (28.3%) with hemorrhagic stroke). All patients were hospitalized to the neuroresuscitation unit within 3.5 to 24 hours of the disease onset at different stages of consciousness impairment. The patients received anticoagulant therapy (ACT) according to current healthcare standards. Standard clinical diagnostic and laboratory monitoring was supplemented with a Thrombodynamics test. Results. Risk factors for venous thromboembolic events (VTE) were observed in 95% of patients. Pulmonary embolism developed in 24% of cases mostly during weeks 2-3, generally at 6 days of ACT withdrawal. Hemostatic changes and disbalance progressed after the ACT withdrawal. Standard methods of studying hemostasis were shown to be less informative in detecting VTE and evaluating ACT efficacy than the thermodynamics method. The probability of VTE was directly proportional to the velocity of hypercoagulation transformation into hypocoagulation. In this process, the background hypocoagulation was not correlated with the development of VTE. Analysis of correlations of hemostasis changes with changes in clinical-laboratory markers identified relationships of changes in coagulation hemostasis with different standard ACT programs. VTE, pulmonary embolism, and hemorrhagic complications developed in association with administration of comparable ACT programs to patients with severe stroke.


2006 ◽  
Vol 130 (4) ◽  
pp. 521-528 ◽  
Author(s):  
Amitava Dasgupta ◽  
David W. Bernard

AbstractContext.—Complementary and alternative medicine (herbal medicines) can affect laboratory test results by several mechanisms.Objective.—In this review, published reports on effects of herbal remedies on abnormal laboratory test results are summarized and commented on.Data Sources.—All published reports between 1980 and 2005 with the key words herbal remedies or alternative medicine and clinical laboratory test, clinical chemistry test, or drug-herb interaction were searched through Medline. The authors' own publications were also included. Important results were then synthesized.Data Synthesis.—Falsely elevated or falsely lowered digoxin levels may be encountered in a patient taking digoxin and the Chinese medicine Chan Su or Dan Shen, owing to direct interference of a component of Chinese medicine with the antibody used in an immunoassay. St John's wort, a popular herbal antidepressant, increases clearance of many drugs, and abnormally low cyclosporine, digoxin, theophylline, or protease inhibitor concentrations may be observed in a patient taking any of these drugs in combination with St John's wort. Abnormal laboratory results may also be encountered owing to altered pathophysiology. Kava-kava, chaparral, and germander cause liver toxicity, and elevated alanine aminotransferase, aspartate aminotransferase, and bilirubin concentrations may be observed in a healthy individual taking such herbal products. An herbal product may be contaminated with a Western drug, and an unexpected drug level (such as phenytoin in a patient who never took phenytoin but took a Chinese herb) may confuse the laboratory staff and the clinician.Conclusions.—Use of alternative medicines may significantly alter laboratory results, and communication among pathologists, clinical laboratory scientists, and physicians providing care to the patient is important in interpreting these results.


SPE Journal ◽  
2021 ◽  
pp. 1-21
Author(s):  
M. R. Fassihi ◽  
E. Turek ◽  
M. Matt Honarpour ◽  
D. Peck ◽  
R. Fyfe

Summary As part of studying miscible gas injection (GI) in a major field within the Green Canyon protraction area in the Gulf of Mexico (GOM), asphaltene-formation risk was identified as a key factor affecting a potential GI project. The industry has not conducted many experiments to quantify the effect of asphaltenes on reservoir and well performance under GI conditions. In this paper we discuss a novel laboratory test for evaluating the asphaltene effect on permeability. The goals of the study were to define the asphaltene-precipitation envelope using blends of reservoir fluid and injection gas, and measure permeability reduction caused by asphaltene precipitation in a core under GI. To properly analyze the effect of GI, a suite of fluid-characterization studies was conducted, including restored-oil samples, compositional analysis, constant composition expansion (CCE), and differential vaporization. Miscibility conditions were defined through slimtube-displacement tests. Gas solubility was determined through swelling tests complemented by asphaltene-onset-pressure (AOP) testing. The unique procedure was developed to estimate the effect of asphaltene deposition on core permeability. The 1-ft-long core was saturated with the live-oil and GI mixture at a pressure greater than the AOP, and then pressure was depleted to a pressure slightly greater than the bubblepoint. Several cycles of charging and depletion were conducted to mimic continuous flow of oil along the path of injected gas and thereby to observe the accumulation of asphaltene on the rock surface. The test results indicated that during this cyclic asphaltene-deposition process, the core permeability to the live mixture decreased in the first few cycles but appeared to stabilize after Cycle 5. The deposited asphaltenes were analyzed further through environmental scanning electron microscopy (ESEM), and their deposition was confirmed by mass balance before and after the tests. Finally, a relationship was established between permeability reduction and asphaltene precipitation. The results from the asphaltene-deposition experiment show that for the sample, fluids, and conditions used, permeability is impaired as asphaltene flocculates and begins to coat the grain surfaces. This impairment reaches a plateau at approximately 40% of the initial permeability. Distribution of asphaltene along the core was measured at the end by segmenting the core and conducting solvent extraction on each segment. Our recommendation is numerical modeling of these test results and using this model to forecast the magnitude of the permeability impairment in a reservoir setting during miscible GI.


2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S656-S656
Author(s):  
James Karichu ◽  
Mindy Cheng ◽  
Pedro Rodriguez ◽  
Nicole Robinson ◽  
Chakkarin Burudpakdee ◽  
...  

Abstract Background Current HIV diagnostic laboratory testing guidelines from the US Centers for Disease Control and Prevention (CDC) recommend a sequence of tests for detection, differentiation, and confirmation of HIV-1 and HIV-2 diagnosis. There is a gap in knowledge about real-world implementation of the testing algorithm. The aim of this study was to characterize the population that underwent HIV antibody differentiation and confirmatory testing and to describe subsequent testing patterns from a large US clinical laboratory database. Methods Patients who received one or more HIV-1/2 antibody differentiation test (BioRad Geenius™ HIV 1/2 Supplemental Assay [Geenius]) in the Quest Diagnostics laboratory database between January 1, 2017 and December 31, 2017 were selected into the study; earliest test date was index date. Geenius tests, HIV-1 qualitative RNA (Aptima HIV-1 RNA Qualitative Assay [Aptima]), and HIV-2 DNA/RNA confirmatory tests subsequent to index date were captured. Study measures included pt demographic characteristics, testing frequency and sequencing, and test results. For patients with >1 Geenius test in 2017, concordance between index and subsequent test results was assessed. Results There were 26,319 unique patients identified who received ≥1 HIV antibody differentiation result from the Geenius assay. Mean age was 40.7 ± 14.3 years, 66.4% were male, and 42.5% were from southern states. Among the study population, there were 28,954 Geenius, 7,234 Aptima, and 298 HIV-2 DNA/RNA confirmatory tests. 26.4% of Geenius test results were discordant with the initial positive fourth-generation HIV screening results and required subsequent confirmatory testing. In terms of sequencing, the CDC-recommended HIV diagnostic algorithm was followed 74% of the time after screening. 8.5% of patients had >1 Geenius test in 2017; 11.2% of the retests returned different results compared with the first test. Conclusion The CDC recommended algorithm for HIV diagnosis is complex for laboratories to implement and currently available assays do not support testing efficiency. To mitigate observed inefficiencies and reduce the laboratory burden of HIV testing, a more accurate and reliable approach for HIV differentiation and confirmatory testing is needed. Disclosures All authors: No reported disclosures.


Author(s):  
Petr Jarolim

AbstractWe discuss the sensitivity terminology of cardiac troponin assays and its dependence on the selection of the reference population. In addition, the need for reasonable censoring of clinical laboratory test results is contrasted with potential loss of valuable clinical information.


1985 ◽  
Vol 25 (04) ◽  
pp. 482-490 ◽  
Author(s):  
Robert Ray McDaniel ◽  
Asoke Kumar Deysarkar ◽  
Michael Joseph Callanan ◽  
Charles A. Kohlhaas

Abstract A test apparatus is designed to carry out dynamic and static fluid-loss tests of fracturing fluids. This test apparatus simulates the pressure difference, temperature, rate of shear, duration of shear, and fluid-flow pattern expected under fracture conditions. For a typical crosslinked fracturing fluid, experimental results indicate that fluid loss values can be a function of temperature, pressure differential, rate of shear, and degree of non-Newtonian behavior of the fracturing fluid. A mathematical development demonstrates that the fracturing-fluid coefficient and filter-cake coefficient can be obtained only if the individual pressure drops can be measured during a typical fluid-loss test. Introduction In a hydraulic fracturing treatment, the development of fracture length and width is strongly dependent on a number of key fluid and formation parameters. One of the most important of these parameters is the rate at which the fracturing fluid leaks, off into the created fracture faces. This parameter, identified as fluid loss, also influences the time required for the fracture to heal after the stimulation treatment has been terminated. This in turn will influence the final distribution of proppant in the fracture and will dictate when the well can be reopened and the cleanup process started. Historically, tests to measure fluid loss have been carried out primarily under what is characterized as static conditions. In such tests, the fracturing fluid is forced through filter paper or through a thin core wafer under a pressure gradient, and the flow rate at the effluent side is determined. Of course, the use of filter paper cannot account for reservoir formation permeability and porosity; therefore, the fluid-loss characteristics derived from such tests should be viewed as only gross approximations. The static core-wafer test on the other hand, reflects to some extent the interaction of the formation and fracturing-fluid properties. However, one important fluid property is altogether ignored in such static core-wafer tests. This is the effect of shear rate in the fracture on the rheology (viscosity) of fracturing fluid and subsequent effects of viscosity on the fluid loss through the formation rock. In the past, several attempts were made to overcome the drawbacks of static core-wafer tests by adopting dynamic fluid-loss tests. Although these dynamic tests were a definite improvement over the static versions, each had drawbacks or limitations that could influence test results. In some of the studies, the shearing area was annular rather than planar as encountered in the fracture. In other cases, the fluid being tested did not experience a representative shear rate for a sufficiently long period of time. An additional problem arose because most studies were performed at moderate differential pressures and temperatures. The final drawback in several of the studies was that the fluid flow and leakoff patterns did not realistically simulate those occurring in the field. In the first part of this paper, we emphasize the design of a dynamic fluid-loss test apparatus that possesses none of these drawbacks. In the second part of the paper, test results with this apparatus are presented for three different fluid systems. These systems areglycerol, a non-wall-building Newtonian fluid,a polymer gel solution that is slightly wall-building and non-Newtonian, anda crosslinked fracturing system that is highly non-Newtonian in nature and possesses the ability to build a wall (filter cake) on the fracture face (see Table 1). The fluids were subjected to both static and dynamic test procedures. In the third part of the paper, results of experiments carried out with crosslinked fracturing fluid for different core lengths, pressure differences, temperatures, and shear rates are compared and the significance of the difference of fluid loss is emphasized. Experimental Equipment and Procedure The major components of the experimental apparatus shown in Fig. 1 are a fluid-loss cell, circulation pump, heat exchanger, system pressurization accumulators, and a fluid-loss recording device. The construction material throughout most of the system is 316 stainless steel. The fluid loss is measured through a cylindrical core sample, 1.5 in. [3.81 cm] in diameter, mounted in the fluid-loss cell. Heat-shrink tubing is fitted around the circumference of the core and a confining pressure is maintained to prevent channeling. Fracturing fluid is circulated through a rectangular channel across one end of the core. SPEJ P. 482^


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