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At least 19 recordsLinked to original sources
PubMed1980

A pitfall in hemoglobin electrophoresis. Artefactual minor unstable hemoglobin results from improper specimen handling.

Blood specimens are commonly mailed for the purpose of hemoglobin studies, such as identification of abnormal hemoglobins and measurement of hemoglobins A2 and F. In a period of a few months, the author examined eight specimens sent from a referring laboratory, in which cellulose acetate electrophoresis (p H 8.6) revealed a discrete minor band in a position approximately midway between the positions of hemoglobins A and S. For each specimen, tests for hemoglobin instability were positive. In one specimen, marked methemoglobinemia and sulfhemoglobinemia were also demonstrated. Further studies of fresh specimens obtained from the same subjects failed to demonstrate any hemoglobinopathy. The abnormal band in the original eight specimens was an artefact resulting from improper specimen handling--that is, unduly long transit times without refrigeration. The aftefactual band had electrophoretic mobility identical to that of methemoglobin derived from hemoglobin A.

Aged↗
PubMed1999

An overhead specimen handling system for variable workloads.

This unique overhead specimen handling system requires virtually no floor space and only a minimal amount of bench space. It uses state-of-the-art conveyors suspended near the ceiling to transport, log-in and sort blood specimens in standard specimen containers. Specimens placed into the system at bench-level bins are automatically singulated and loaded onto cleated conveyors and lifted to the main conveyor belt near the ceiling. The barcoded labels are then read as the containers are rotated under an optical scanner. The specimens are then diverted to the appropriate branch conveyor and lowered back to the bench level by cleated conveyors. The specimen handling system is rapid and accurate, requires no special containers, allows laboratorians to move unimpeded below it, and is inexpensive by automation standards. Studies show no adverse effect upon the specimens.

Automation↗
PubMed2004

The impact of involvement of biomedical scientists in specimen dissection and selection of blocks for histopathology: a study of time benefits and specimen handling quality in Ayrshire and Arran area laboratory.

AIMS: To assess possible time benefits of specimen dissection by biomedical scientists (BMSs) and the quality of specimen handling by BMSs, in a department where BMSs trim those specimens requiring simple descriptions, from which standard blocks are taken. METHODS: Specimen handling by BMSs and consultant pathologists was compared. Time taken for each specimen trimmed was recorded prospectively. To determine specimen handling quality, adherence to dissection standard operating procedures (SOPs) was assessed by recording retrospectively whether or not each action in the SOP had been performed. Information on subsequently required extra levels or blocks was recorded. RESULTS: Analysis of data from 672 specimens trimmed by consultants showed that any given action in the SOPs was performed on average on 60.2% of applicable/assessable specimens; for 660 similar specimens trimmed by BMSs, each action was performed on average on 80.1% of specimens. Of the specimens where data on extra blocks were recorded, extra blocks were required in 3% of those trimmed by pathologists and in 4% of those trimmed by BMSs. Extra levels were required in 12% of those trimmed by pathologists and in 16% of those trimmed by BMSs. BMS trimming saves 16 hours of consultant time each month. The difference between pathologists and BMSs in time for each specimen trimmed is negligible. CONCLUSIONS: The advantages of increased adherence to trimming SOPs and saving consultant time outweigh the relatively small number of extra blocks and levels required when BMSs trim. There is no reduction in quality of dissection.

Allied Health Personnel↗
PubMed1991

Is what you see what you get? Breast specimen handling re-visited.

Specimen radiography is already established as an essential adjunct to excisional biopsy of mammographically detected abnormalities. Two methods of specimen sectioning following the initial specimen radiograph are described. The techniques were devised to identify the lesion accurately in the specimen for subsequent pathological analysis. They have been tailored to suit the differing facilities at two Breast Screening Centres. The methods highlight the desirability of a cooperative multidisciplinary approach to the management of breast disease. They underline the importance of radiological localization of the lesion; not only for the surgeon, but also for the pathologist.

Biopsy↗
PubMed1997

Mammographically directed breast biopsies: a College of American Pathologists Q-Probes study of clinical physician expectations and of specimen handling and reporting characteristics in 434 institutions.

OBJECTIVES: To determine (1) the information that clinical physicians want in surgical pathology reports of biopsies performed for mammographic abnormalities, (2) how specimens are received and processed, and (3) what information is actually present in pathology reports. DESIGN: The standard data collection and questionnaire format of the College of American Pathologists' Q-Probes quality improvement program was used. Laboratories (1) surveyed clinical physicians working in selected specialties involved in the care of patients with breast disease concerning what information they wanted in a surgical pathology report, (2) documented laboratory specimen handling for 20 consecutive breast biopsy tissues obtained to investigate mammographic abnormalities, and (3) documented the information content of surgical pathology reports of these cases. PARTICIPANTS: Four hundred thirty-four participating laboratories surveyed 1469 clinical physicians and collected information on 7300 cases regarding specimen processing and report content. RESULTS: Clinical physicians were unanimous in the majority of items they desired for patient care. The information, however, differed depending on the diagnosis. In processing of tissues, 89% of specimens were received without fixative. In 83% of cases, radiographs were performed. Eighty-two percent of specimens were marked in some manner, but in only 45% of cases was a report of the radiographic abnormality given to the Pathology Department. The median number of blocks used to sample the lesion and the whole specimen was three and six blocks, respectively. The latter correlated with specimen size. Fifty-seven (13%) surgical pathology laboratories had radiography equipment. Radiographs of specimens and tissue blocks were made in 5% and 4% of cases, respectively. Correlation of a mammographic abnormality with a microscopic finding was documented in 62% of reports. In 92% of malignant cases the margin status was reported, and 77% of reports contained the lesion size. Eighty-three percent of reports with invasive carcinoma stated the tumor grade, and 76% stated the extent of intraductal carcinoma. The percentage of reports containing information items was significantly higher (P < .05) for institutions using checklists. SUMMARY: This multi-institutional Q-Probes study describes the current clinical expectations and laboratory practices associated with mammographically directed biopsies. Disparities between pathology reporting and clinician desires, as well as radiology and laboratory specimen handling practices, have been identified and may help focus future quality improvement efforts.

Biopsy↗
PubMed1987

Prevalence of antibody to human immunodeficiency virus and hepatitis B surface antigen in blood samples submitted to a hospital laboratory. Implications for handling specimens.

The prevalence of hepatitis B surface antigen (HBsAg) and antibody to human immunodeficiency virus (HIV) was determined in serum or plasma specimens of 506 patients submitted to the clinical chemistry laboratory of an urban teaching hospital, and the results were correlated with "biohazard" warning labels on the specimens. Hepatitis B surface antigen, HIV antibody, or either of these were present in 32 (6.3%), 15 (3.0%), and 44 specimens (8.7%), respectively. Ten (67%) of 15 specimens with HIV antibody and nine (28%) of 32 with HBsAg bore biohazard labels. Among 473 unlabeled specimens, HIV antibody was present in five (1.1%), HBsAg was present in 23 (4.9%), and 27 (5.7%) contained either or both of these markers. All clinical and laboratory personnel should be vaccinated against hepatitis B and should handle all blood specimens as if they were infected, regardless of biohazard labeling. By fostering complacency in handling unlabeled specimens, the use of biohazard labels may paradoxically increase the risk that health care workers will be exposed to HIV and hepatitis B virus.

Chemistry, Clinical↗
PubMed1987

Measurement of physician specimen-handling errors and its contribution to laboratory information system quality.

To reduce the frequency of errors associated with hematology specimens and requisitions arriving in the hematology laboratories of a large urban teaching hospital, an intervention was conducted to alter the behavior of the medical students, interns, residents, and board-qualified physicians who ordered the tests, completed the requisitions, and drew the specimens. This paper presents the method used for measuring specimen quality, certain results derived from the method, and corresponding considerations for changes in the design of the system by which specimens are collected and delivered to the laboratory. These changes should improve the quality of the entire laboratory information system.

Clinical Laboratory Information Systems↗
PubMed1997

Stability of HIV-1 RNA in blood during specimen handling and storage prior to amplification by NASBA-QT.

The influence of different storage temperatures and anticoagulation conditions on the HIV-1 RNA load as measured by NASBA-QT was examined. Blood specimens from 14 HIV-1 infected individuals were processed within 2 h after collection. The HIV-1 RNA load remained stable for at least 6 months when samples were frozen directly at -70 degrees C in lysis buffer. This lysis buffer fully inactivated the virus. When whole EDTA blood was stored, the HIV-1 RNA load was stable for 72 h at 25 degrees C, but it declined within 24 h at 4 degrees C. The HIV-1 RNA load in whole heparinized blood declined significantly after 24 h at both 4 and 25 degrees C. It was slightly lower (average of 0.18 log ml-1) than in whole EDTA blood. At 4 degrees C, the HIV-RNA load in serum and EDTA-plasma stored with lysis buffer did not decline up to 14 days. At + 30 degrees C, however, the load declined significantly after 2 days. Of clinical significance, the mean load in EDTA plasma was 0.5 log ml-1 higher than in serum. This difference was patient dependent (range 0.1-0.7 log ml-1). We thus recommend, for quantifying HIV-1 RNA by NASBA, to use preferably EDTA blood which is kept at room temperature until plasma separation. When using heparinized blood, the plasma should be stored frozen within 8 h.

Blood Preservation↗
PubMed1982

Sampling and specimen handling in the diagnosis of genital Chlamydia trachomatis infections.

In isolation of Chlamydia trachomatis, special consideration must be paid to the sampling technique, the type and quality of the sampling swab used, and the manner in which transport and storage of specimens are performed. The use of cotton-tipped swabs with aluminum shafts (E.N.T.) rather than calcium alginate-treated endourethral swabs (Calgiswabs), resulted in a higher frequency of isolation of C. trachomatis from clinical specimens. E.N.T. swabs were also preferable to cotton-tipped wooden swabs. In conformity with that finding, a higher chlamydial inclusion count was obtained in cultures of experimentally infected samples stored in contact with such swabs. The percentage of surviving C. trachomatis organisms after storage in transport medium (2-SP) for 2 days at room temperature, or 4 days at 4 degrees C, suggested that such sample storage should be acceptable in the routine diagnosis of genital chlamydial infections.

Chlamydia Infections↗