Variability of total cholesterol concentrations in serum by repeated measurements in a large pediatric population--limitations of quality controls for laboratory analyses.

1981 ◽  
Vol 27 (12) ◽  
pp. 1988-1992 ◽  
Author(s):  
M C Sklov ◽  
S R Srinivasan ◽  
L S Webber ◽  
G S Berenson
Keyword(s):  
Disease Control ◽  
Total Cholesterol ◽  
Clinical Laboratory ◽  
Pediatric Population ◽  
Large Population ◽  
Repeated Measurements ◽  
Close Monitoring ◽  
Laboratory Methods ◽  
Laboratory Results ◽  
Centers For Disease Control

Abstract We evaluated the variability in total cholesterol concentrations in serum in a large population of children over a period of time, to help us discern the limitations in reliability of current clinical laboratory methods for its analysis. We analyzed sera from a population of approximately 4000 children over a four-year period, quality-control sera, pooled sera, and surveillance samples from the Centers for Disease Control over a seven-year period, with a Technicon AutoAnalyzer II. Two methods of correction were suggested to adjust deviations in yearly serum total cholesterol means: yearly screening data were corrected on the basis of monthly variability in pooled-serum determinations and on the basis of deviations from values suggested by the Centers for Disease Control. Both correction methods were insufficient. These changes occur very slowly, and unless there is close monitoring and frequent comparison with a known standard, changes in laboratory results still can occur.

TWENTY-TWO YEARS OF CANCER CLUSTER INVESTIGATIONS AT THE CENTERS FOR DISEASE CONTROL

1990 ◽  
Vol 132 (supp1) ◽  
pp. 43-47 ◽  
Author(s):  
GLYN G. CALDWELL
Keyword(s):  
New York ◽  
Disease Control ◽  
Local Health ◽  
Local Health Departments ◽  
Laboratory Methods ◽  
The Public ◽  
Foreign Countries ◽  
Cancer Cluster ◽  
Cancer Clusters ◽  
Centers For Disease Control

Abstract Beginning in 1961, the Centers for Disease Control investigated 108 cancer clusters and reported the findings in Epidemic Aid Reports. The clusters studied were of leukemia (38%), leukemia and lymphoma (30%), leukemia and other cancer combinations (13%), and all other cancer or combinations (19%). These clusters occurred in 29 states and five foreign countries, with the largest numbers from Connecticut (11), California (eight), Illinois (eight), New York (eight), Georgia (seven), Pennsylvania (six), and Iowa (five). All other states reported less than five. Eight different data collection methods were used, often in combinations, and four types of laboratory methods on four different specimen types. Although 14 different categories of associations were reported, no dear cause was found for any cluster. Nonetheless, concern about clusters by the public and media, and the need to investigate them, warrants the development of a uniform approach for use by local health departments.

scholarly journals Methicillin-Resistant Staphylococcus aureus Control in the 21st Century: Laboratory Involvement Affecting Disease Impact and Economic Benefit from Large Population Studies

2016 ◽  
Vol 54 (11) ◽  
pp. 2647-2654 ◽  
Author(s):  
Lance R. Peterson ◽  
Donna M. Schora
Keyword(s):  
Health Care ◽  
Staphylococcus Aureus ◽  
Disease Control ◽  
Clinical Laboratory ◽  
Large Population ◽  
Bloodstream Infections ◽  
Control Plan ◽  
Methicillin Resistant ◽  
Content Type ◽  
Program Cost

Methicillin-resistant Staphylococcus aureus (MRSA) infection is a global health care problem. Large studies (e.g., >25,000 patients) show that active surveillance testing (AST) followed by contact precautions for positive patients is an effective approach for MRSA disease control. With this approach, the clinical laboratory will be asked to select what AST method(s) to use and to provide data monitoring outcomes of the infection prevention interventions. This minireview summarizes evidence for MRSA disease control, reviews the involvement of the laboratory, and provides examples of how to undertake a program cost analysis. Health care organizations with total MRSA clinical infections of >0.3/1,000 patient days or bloodstream infections of >0.03/1,000 patient days should implement a MRSA control plan.

Improvement in Physician's Office Laboratory Practices, 1989–1994

2000 ◽  
Vol 124 (7) ◽  
pp. 1066-1073
Author(s):  
Tina M. St. John ◽  
Harvey B. Lipman ◽  
John M. Krolak ◽  
Thomas L. Hearn
Keyword(s):  
Quality Control ◽  
Disease Control ◽  
Quality Indicators ◽  
Clinical Laboratory ◽  
Site Testing ◽  
Laboratory Practice ◽  
Final Rule ◽  
Control And Prevention ◽  
Study Interval ◽  
Centers For Disease Control

Abstract Background.—In 1986 and 1989, the Centers for Disease Control and Prevention sponsored institutes on Critical Issues in Health Laboratory Practice. It was noted during the institutes that physician's office laboratories were a rapidly emerging site for clinical laboratory testing, yet no comprehensive data were available regarding the practice of clinical laboratory medicine in physician's office laboratories. As a mechanism to begin addressing this void, the Centers for Disease Control and Prevention added questions on clinical laboratory practice to the National Ambulatory Medical Care Survey, a national probability sample of ambulatory care provided by office-based physicians. Data were collected for survey years 1989, 1991, 1993, and 1994. Methods.—Each survey was conducted among a nationally representative, random sample of office-based physicians who provide ambulatory patient care. Sample physicians were enlisted using both mail and telephone contacts. Clinical laboratory data were obtained via telephone by trained field representatives. Weighted univariate and multivariate analyses were performed on responses from each of the 4 survey years. Analyses were repeated after combining survey responses from years 1989 and 1991 and 1993 and 1994 as representative of physician's office laboratory practices before and after implementation of the Clinical Laboratory Improvement Amendments of 1988 (CLIA ’88) final rule in 1992. Results.—Quality laboratory practice indicators showed significant increases during the study interval, with implementation of the CLIA ’88 final rule in 1992 playing a pivotal role. Relative to 1992, enrollment in proficiency testing programs increased from 32.4% to 52.7% (P < .001), use of daily quality control samples increased from 79.2% to 89.0% (P < .001), and use of daily quality control with written instructions for action following a questionable quality control result (quality control with action step documentation) increased from 62.6% to 77.2% (P < .001). The presence of a medical technologist or technician in the office laboratory was also significantly and independently associated with each of the quality indicators. Although the percentage of physician's offices performing on-site testing decreased from 56% to 45% during the survey interval, overall testing volume appeared unchanged. Conclusions.—The quality of clinical laboratory practice in physician's office laboratories improved during the study interval (1989–1994) as measured by the quality indicators used in the study. The association of this improvement with implementation of the CLIA ‘88 final rule and the presence of a trained laboratory professional in the testing site indicate the importance of minimum practice standards and professional expertise in ensuring use of quality laboratory practices. Overall test volume appeared to be stable despite a decreased proportion of physician's offices at which on-site testing was performed.

N-Acetylcysteine Interference with a Glucose Dehydrogenase Linked Glucose Meter

2021 ◽  
pp. 193229682199941
Author(s):  
Martha E. Lyon ◽  
Andrew W. Lyon
Keyword(s):  
Linear Regression ◽  
Clinical Laboratory ◽  
Comparative Method ◽  
Glucose Dehydrogenase ◽  
Gas Analyzer ◽  
Laboratory Methods ◽  
Laboratory Results ◽  
Glucose Meter ◽  
Roche Diagnostics ◽  
Blood Gas Analyzer

Background: Our objective was to determine the effect of therapeutic concentrations of N-acetylcysteine, following intravenous infusion, on the measurement of blood glucose using a Roche Diagnostics glucose dehydrogenase-linked glucose meter compared to hospital laboratory methods. Methods: N-acetylcysteine was added to aliquots of blood, with glucose promptly measured by the glucose meter, blood gas analyzer (glucose oxidase comparative method) and following centrifugation, plasma glucose measured with a hexokinase spectrophotometric comparative method. Glucose results were evaluated with linear regression and Bland Altman plots. Results: In the presence of NAC, at concentrations greater than 5 mg/dL (0.31 mmol/L), positively biased glucose meter results were compared to the clinical laboratory results. Multivariate linear regression revealed that NAC-mediated meter results are influenced by NAC and glucose concentrations. Conclusions: The addition of therapeutic concentrations of NAC to blood produces statistically significant positive biases when measured with the glucose dehydrogenase linked glucose meter device.

The New Immunization Debate

PEDIATRICS ◽  
1996 ◽  
Vol 98 (4) ◽  
pp. 795-795
Author(s):  
William F. Terry
Keyword(s):  
United States ◽  
Disease Control ◽  
High Titer ◽  
Pediatric Population ◽  
The United States ◽  
Wild Form ◽  
Institute Of Medicine ◽  
Polio Vaccine ◽  
Control And Prevention ◽  
Centers For Disease Control

Polio is a disease that has not occurred in the United States in its wild form in the last 17 years and which is likely to be eradicated worldwide in the next decade. Given these facts, it seems excessive to formulate a policy that attempts to achieve high-titer lifelong immunity in 100% of the pediatric population in this country. Dr Katz's excellent summary1 mentions that the Institute of Medicine and the Centers for Disease Control and Prevention considered five options involving either four doses of polio vaccine in various combinations or no immunization at all.

The Speech-Language Pathologists' Role in Mild Traumatic Brain Injury for Middle and High School–Age Children: Viewpoints on Guidelines From the Centers for Disease Control and Prevention

2019 ◽  
Vol 28 (3) ◽  
pp. 1363-1370 ◽  
Author(s):  
Jessica Brown ◽  
Katy O'Brien ◽  
Kelly Knollman-Porter ◽  
Tracey Wallace
Keyword(s):  
High School ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Disease Control ◽  
Mild Traumatic Brain Injury ◽  
School Age Children ◽  
School Age ◽  
Speech Language Pathologists ◽  
Control And Prevention ◽  
Centers For Disease Control

Purpose The Centers for Disease Control and Prevention (CDC) recently released guidelines for rehabilitation professionals regarding the care of children with mild traumatic brain injury (mTBI). Given that mTBI impacts millions of children each year and can be particularly detrimental to children in middle and high school age groups, access to universal recommendations for management of postinjury symptoms is ideal. Method This viewpoint article examines the CDC guidelines and applies these recommendations directly to speech-language pathology practices. In particular, education, assessment, treatment, team management, and ongoing monitoring are discussed. In addition, suggested timelines regarding implementation of services by speech-language pathologists (SLPs) are provided. Specific focus is placed on adolescents (i.e., middle and high school–age children). Results SLPs are critical members of the rehabilitation team working with children with mTBI and should be involved in education, symptom monitoring, and assessment early in the recovery process. SLPs can also provide unique insight into the cognitive and linguistic challenges of these students and can serve to bridge the gap among rehabilitation and school-based professionals, the adolescent with brain injury, and their parents. Conclusion The guidelines provided by the CDC, along with evidence from the field of speech pathology, can guide SLPs to advocate for involvement in the care of adolescents with mTBI. More research is needed to enhance the evidence base for direct assessment and treatment with this population; however, SLPs can use their extensive knowledge and experience working with individuals with traumatic brain injury as a starting point for post-mTBI care.

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