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PubMed2002

Evaluation of the Sysmex UF-100 automated urinalysis analyzer and comparative study with JCCLS reference method.

Microscopic urine sediment analysis has been accepted as the mainstay test for examining urine cells and particles. Although it provides essential information for clinicians about disease states in the patients, it is a high-volume and laborious procedure. Therefore, an automated analyzer was developed recently and has just been introduced to Thailand. In this study, the authors evaluated the analytical performance of this new automated urine analyze. Also a comparative study was performed between the UF-100 test results and those of JCCLS reference method. In evaluation of the Sysmex UF-100 automated urinalysis analyzer, both precision and linearity studies were performed. Between-run CVs for RBCs (mean = 182.46/microl), WBCs (mean = 193.37/microl), ECs (mean = 70.05/microl) and casts (mean = 12.21/microl) were 7.74 per cent, 5.52 per cent, 21.32 per cent and 7.69 per cent, respectively. Concerning the within-run CVs for the RBC analysis, the CV ranged from 16.28 per cent for low numbers of RBCs (35.67/microl) to 2.93 per cent at RBC concentrations (712.13/microl). Concerning within-run precision for the WBC analysis, the CV ranged from 22.31 per cent for low numbers of WBCs (WBCs 12.53/microl) to 2.07 per cent at a WBC count of 211.01/microl. Within-run precision ranged from 11.36 per cent at 24.99 ECs/microl to 6.18 per cent at 53.08 ECs/microl. Within-run precision for casts varied from 35 per cent for samples with 1.33 casts/microl to 12.38 per cent for samples with 4927.35 casts/microl. From the comparative study, good agreements (p < 0.05) were obtained between UF-100 and JCCLS reference method for RBCs counts (p = 0.000, r = 0.974) and WBCs counts (p = 0.000, r = 0.913). However, fair agreement (p > 0.05) was obtained between UF-100 and JCCLS reference method for ECs counts (p = 0.017, r = 0.212) and casts counts (p = 0.624, r = 0.044). In conclusion, the UF-100 analyzer is a new useful analyzer although it cannot be a substitute for microscopic sediment examination.

Automation↗
PubMed2003

ENFSI proficiency test program on identification of GSR by SEM/EDX.

Within the framework of the ENFSI Expert Working Group "Firearms," a proficiency test on the detection and identification of GSR by SEM/EDX was organized and performed. The test material was designed by the Bundeskriminalamt and manufactured to order by an external company for SEM accessories. The participating laboratories were requested to determine the total number of PbSbBa-containing particles on the test samples following their own laboratory specific methods of automated GSR particle search and detection by SEM/EDX. Two similar samples with synthetic GSR particles were dispatched to all participants in order to gain additional information on systematic errors within the obtained results (split-level study), whereas one sample was supplied only with PbSbBa particles, and the second one was additionally contaminated with some environmental particles. This report summarizes the results of the study as well as a statistical evaluation and comparison with previous studies.

Journal Article↗
PubMed2003

Validation of data collection for the HEDIS performance measure on chlamydia screening in an MCO.

OBJECTIVE: To determine the validity of calculating the chlamydia Health Plan Employer Data and Information Set (HEDIS) measure using administrative data available in a mixed-model managed care organization (MCO). STUDY DESIGN: Retrospective cohort study. METHODS: A review of International Classification of Diseases, Ninth Revision (ICD-9), Current Procedural Termin-ology (CPT), Healthcare Common Procedure Coding System (HCPCS), and National Drug Code codes and electronic laboratory files in 1998 and a medical chart review to validate sexual activity and chlamydia testing codes specified by the National Committee for Quality Assurance (NCQA) in 1999 for the chlamydia HEDIS 2000 measure. RESULTS: Fewer than 25% of female enrollees with laboratory evidence of a chlamydia test had a CPT code for chlamydia testing as specified by the NCQA. Non-pathogen-specific test codes instead of NCQA-specified codes were used in 1998 to code chlamydia tests. By incorporating electronic laboratory data into the automated claims-generating process, all chlamydia tests performed at staff-model clinics were coded. Use of pharmacy dispensing data to identify contraceptive prescriptions increased the proportion of enrollees classified as sexually active by 4% to 5% vs documentation of sexual activity using ICD-9, CPT, and HCPCS codes only. CONCLUSIONS: The MCO quality assurance specialists examining chlamydia testing rates under HEDIS may want to evaluate chlamydia testing coding practices in their MCOs to determine whether simple changes in coding practices may present a more accurate picture of actual testing practices. The proportion of female enrollees classified as sexually active using different data available in the staff and network models varied only slightly.

Adolescent↗
PubMed2004

[Thrombophilic syndrome associated to phenotypic resistance to activated protein C in postmenopausal women].

AIM: Hormone replacement therapy (HRT) may reduce the risk of cardiovascular events in healthy postmenopausal women. However recent studies suggest a 2-4 fold increased risk of idiopathic venous thromboembolism (VTE) among users of HRT. Our aim was to evaluate the overall effect of HRT on hemostatic variables probably related to increased VTE risk reported in epidemiological studies. METHODS: Therefore, 100 healthy postmenopausal women aged 45-60 years divided into 50 HRT non-users and 50 HRT users were examined. The authors assayed on the automated coagulometer ACL7000 (Instrumentation Laboratory, Milan) the procoagulant proteins: factor VIII (VIII:C) and factor VII (VII:C); the natural anticoagulant proteins: antithrombin (ATIII), protein C (PC), protein S (PS) and the resistance to anticoagulant action of activated protein C (APC-Resistance). The free tissue factor pathway inhibitor (TFPI) was measured with an ELISA method (Diagnostica Stagò; France, Roche). The in vivo coagulation and fibrinolysis activation was evaluated by the assays of prothrombin fragment 1+2 (F1+2) and plasmin- antiplasmin complexes (PAP) using ELISA techniques. RESULTS: Increased levels of FVIII:C and FVII:C were observed in HRT users and HRT non-users women compared to controls (FVIII:C= 126+/-58%, 120+/-59% vs 85+/-15% p=0.0001; FVII: C 113+/-23%, 103+/-19% vs 90+/-16% p=0.0001). The activation peptides were significantly different compared to those found in control subjects; higher values were observed in HRT users compared to HRT non-users (F1+2=1.11+/-0.44 nM, 077+/-0.31 nM vs 0.45+/-0.35 p=0.00001; P-AP= 606+/-406 ng/ml, 514+/-205 ng/ml vs 235+/-59 p=0.0001). The ATIII and the PC were similar among the 3 different groups of subjects, but reduced levels of PS were observed in HRT users (PS 93+/-23%, 105+/-22% vs 109+/-12 p=0.0001). The mean normalized APC sensitivity ratio (APC-SR) was lower in the two populations of women as compared with that of controls (nAPC-SR 1.02+/-0.7, 1.02+/-0.8 vs 1.1+/-25 p=0.02). The values of free TFPI were reduced in HRT users compared to HRT non-users (9.1+/-1.9 ng/ml, 10.1+/-2.3 ng/ml vs 4.6+/-1.5 ng/ml p<0.0001). CONCLUSION: HRT appears to be associated to a shift in the procoagulant-anticoagulant balance towards a procoagulant state. The changes in hemostatic system could explain the increased risk of VTE in healthy postmenopausal women during HRT, nevertheless this risk could be higher in women known to have a congenital or acquired thrombophilic state.

Activated Protein C Resistance↗
PubMed2004

Design and implementation of relational databases relevant to the diverse needs of a tuberculosis case contact study in the Gambia.

The data requirements of a large multidisciplinary tuberculosis case contact study are complex. We describe an ACCESS-based relational database system that meets our rigorous requirements for data entry and validation, while being user-friendly, flexible, exportable, and easy to install on a network or stand alone system. This includes the development of a double data entry package for epidemiology and laboratory data, semi-automated entry of ELISPOT data directly from the plate reader, and a suite of new programmes for the manipulation and integration of flow cytometry data. The double entered epidemiology and immunology databases are combined into a separate database, providing a near-real-time analysis of immuno-epidemiological data, allowing important trends to be identified early and major decisions about the study to be made and acted on. This dynamic data management model is portable and can easily be applied to other studies.

Automation↗