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L P Skendzel

Publications and source records attributed to L P Skendzel.

At least 19 recordsLinked to original sources
PubMed1986

The prevalence of hepatitis B in employees of small, rural hospitals--implications for vaccine administration.

The Centers for Disease Control Advisory Committee on Immunization Practices has based recommendations for hepatitis B vaccine for hospital employees on studies done in large urban hospitals. Data on the prevalence of hepatitis B in employees of small hospitals have been lacking. We measured hepatitis B surface and core antibody in 422 employees of six small, rural hospitals who were exposed to blood. The overall prevalence among those "high-risk" employees was 5.5%. The highest prevalence was found in General Nursing, Intensive Care Nursing, Recovery Room, IV Therapy, Laboratory, and Respiratory Therapy, although differences were seen between hospitals. Results of such testing for individual hospitals may have a major impact on the cost-effectiveness of vaccination programs for their employees.

Hepatitis B↗
PubMed1986

Latex agglutination test for rubella antibodies: report based on data from the College of American Pathologists surveys, 1983 to 1985.

In the College of American Pathologists (CAP) rubella survey program, 45% of laboratories rely on the latex agglutination (LA) card assay for detecting rubella immunoglobulin G (IgG) antibodies. By using CAP survey data over a 3-year period, we compared LA results with hemagglutination inhibition (HI) and enzyme immunoassay (EIA) results. EIA indices were used to classify results into three categories: nonimmune, EIA index of 0.300 or less; borderline, EIA index of 0.300 to 0.619; and immune, EIA index of 1.700 or greater. There was 91% or more agreement between LA, HI, and EIA for categories i and iii. In category ii, the response from LA users varied, depending on the level of antibody present in the survey samples; at an EIA index of 0.346, 81% reported nonimmune status, whereas at an EIA index of 0.619, 48% reported nonimmune status. Less than 10% indicated borderline status. In testing of samples in the same category, approximately 40%, using the HI method, reported titers of less than 1:8 (nonimmune status). Among EIA users, 97 to 99% regarded the specimens as nonimmune. On analysis of specimens in the borderline category, the LA test showed a pattern of sensitivity and specificity comparable to that reported with the HI technique, whereas the EIA method showed a greater degree of precision. The LA card assay provides a rapid screening test in which LA is read macroscopically, and the procedure differs considerably from the fully quantitative HI and EIA methods.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Viral↗
PubMed1985

Medically useful criteria for analytic performance of laboratory tests.

To establish medically useful guidelines for analytic precision of commonly used clinical laboratory procedures, the authors conducted a mail survey of physicians selected randomly from national lists of specialists. They were asked to review, briefly, outlined clinical problems and select the change in test results that would alter their diagnosis or treatment or prompt further assessment of the patient's condition. The responses were used to calculate goals for laboratory precision that are sufficient to meet the present requirements of the average physician. The medically useful limits were compared with existing performance of laboratories as reported in national proficiency surveys and regional quality control programs. Almost all the common laboratory procedures they studied are being assayed at a precision level adequate for the perceived needs. The authors suggest that, for the more common constituents, further progress in clinical laboratory testing will depend on factors other than the improvement of analytic precision.

Attitude of Health Personnel↗
PubMed1985

Evaluation of enzyme immunosorbent rubella assays.

Rubella enzyme-linked immunosorbent assays [( EIAs] Abbott Laboratories) were compared with hemagglutination inhibition methods in a national survey of clinical laboratories. Rubella EIAs demonstrated greater interlaboratory precision in screening for antibodies and better agreement among participants in quantification of antibody levels. From the viewpoint of interlaboratory surveys, EIA is well suited for routine use in clinical laboratories. The requirement for proper standardization of EIA was discussed.

Antibodies, Viral↗
PubMed1983

Evaluation of assays for the detection of antibodies to rubella. A report based on data from the College of American Pathologists Surveys of 1982.

Data from laboratories participating in the College of American Pathologists Surveys in 1982 provided information on the trends in testing for antibodies to rubella. Methods used by participants included: passive hemagglutination, 29%; latex agglutination card assay test, 25%; hemagglutination inhibition, 19%; enzyme immunosorbent assays, 13%; indirect fluorescent antibody assays, 11%; and radioimmunoassay, 3%. The results from these methods generally agreed well with the standard HI test, particularly for detection of immunity in negative and strongly positive samples. Laboratories should use caution, however, that the tests they use give satisfactory results with low titered sera. Compared to laboratories using the one to three-day-old chick cells with Heparin-MnCl2 for HI, laboratories using Human O Cells tended to get higher titers, and laboratories using Fixed Chick cell or Kaolin methods tended to get lower titers.

Animals↗
PubMed1981

Current status of rubella testing: a report based on data from the College of American Pathologists' surveys, 1978-1980.

Data from national survey programs were used to define selected attributes of popular rubella methods. Of those participating in the College of American Pathologists' survey, 47% used passive hemagglutination (PHA); 45% used hemagglutination-inhibition (HI), 7% used indirect immunofluorescence, and less than 1% used enzyme immunosorbent assays for rubella testing. Enzyme assays were not evaluated. The other methods had sensitivities and specificities exceeding 94% and 88%, respectively. The predictive value of a negative test was used to identify differences among the various methods. The HI tests using human O cells had a 90-95% prediction rate for a true-negative result. Indirect immunofluorescence, PHA, and HI using kaolin had the lowest predictive values (68-72%) values for other methods were intermediate. Levels of reactivity also differed. The HI methods using human O cells yielded higher titers than did the reference method (1- to 3-day-old chick/heparin MnCl2), while the titers for HI methods using kaolin tended to be lower.

Animals↗
PubMed1978

How physicians use laboratory tests.

The aim of our study was to measure the ways in which a physician perceives and reacts to a laboratory result. After reviewing a series of brief clinical problems, physicians were asked to indicate the change in test results that would alter the diagnosis or treatment. Although there were wide differences in attitudes, the pattern of responses from 125 internists offered estimates of what is a clinically important change. In selected clinical settings, the change in successive measurements chosen with the greatest frequency as indicators of a clinically important change in level were glucose, 35 mg/dl; BUN, 6 mg/dl; serum sodium, 4 to 6 mEq/liter; serum potassium, 4 to 6 mEq/liter; uric acid, 8 mg/dl; creatinine, 0.4 mg/dl; serum calcium, 4 to 5 mg/dl; triglycerides, 20 mg/dl; hemoglobin, 1 g/dl; and serum osmolality, 11 mOsm/kg. The responses were compared with estimates of laboratory precision drawn from a national quality control program. The quality of laboratory testing was rated as satisfactory for clinical use in four of five clinical settings. The study points out the need to correlate the activities in the clinical laboratory with the application of test results in the care of patients.

Attitude of Health Personnel↗
PubMed1978

Proposed classification of clinical laboratory methods.

A Task Force appointed by the College of American Pathologists studied the key elements that may affect a laboratory result, including the types of reagents, manufacturers of detection equipment, blanking procedures, calibrators, diluting and dispensing devices, and sample preparation. A field trial was conducted using cholesterol assay as the pilot study. Participants completed a lengthy questionnaire that requested information regarding the key elements used in the cholesterol assay. This report presents the preliminary findings of the field trial. Examples are shown to illustrate how obtaining additional information about how the laboratory test was performed led to identification of subtle differences in test results.

Cholesterol↗
PubMed1975

An international laboratory survey.

Lyopholized and liquid aliquots of human serum and blood were distributed in 1973 and 1974 to 50 international medical laboratories that took part in a pilot study sponsored by the College of American Pathologists (CAP) and the Commission on World Standards of the World Association of Societies of Pathology (COWS/WASP). The results were compared with data derived from more than 4,000 United States laboratories that received the same samples. Sodium, potassium, urea nitrogen, glucose, hemoglobin and hematocrit assays show a strikingg similarity in mean values when the World group (COWS/WASP) is compared with participants in the United States. The results suggest that laboratory testing in the international group follows the pattern seen in the United States. The study measures differences and similarities and the collected data serve as a springboard for discussion on international standards of laboratory testing.

Africa↗