scholarly journals Impact of an Andean breakfast on biochemistry and immunochemistry laboratory tests: an evaluation on behalf COLABIOCLI WG-PRE-LATAM

2019 ◽  
Vol 29 (2) ◽  
pp. 302-314 ◽  
Author(s):  
Wilson Bajaña ◽  
Marise Danielle Campelo ◽  
Gabriel Lima-Oliveira ◽  
Beatriz Varela ◽  
Veronica Vega ◽  
...  
Keyword(s):  
Latin America ◽  
Laboratory Tests ◽  
Thyroid Stimulating Hormone ◽  
Laboratory Errors ◽  
Preanalytical Phase ◽  
Calcium Phosphorus ◽  
Andean Countries ◽  
Blood Specimens ◽  
Preanalytical Variability ◽  
Spurious Results

Introduction: In Andean countries, specifically in Ecuador, a food transition in the population has been observed because of economic growth. The Working Group for Preanalytical Phase in Latin America (WG-PRE-LATAM) of the Latin America Confederation of Clinical Biochemistry (COLABIOCLI) was established in 2017, and its main purpose is to study preanalytical variability and establish guidelines for preanalytical procedures in order to be implemented by clinical laboratories and healthcare professionals in Latin America. The aim of this study on behalf of COLABIOCLI WG-PRE-LATAM was to evaluate whether an Andean breakfast can interfere with routine biochemistry and immunochemistry laboratory tests. Materials and methods: We studied 20 healthy volunteers who consumed an Andean breakfast containing a standardized amount of carbohydrates, proteins and lipids. We collected blood specimens for laboratory tests before breakfast and 1, 2, and 4 hours thereafter. Significant differences between samples were assessed by the Wilcoxon ranked-pairs test. Results: The Andean breakfast statistically (P ≤ 0.05), modified the results of the following tests: triglycerides, insulin, cortisol, thyroid stimulating hormone, free thyroxine, total protein, albumin, urea, creatinine, lactate dehydrogenase, alkaline phosphatase, amylase, lipase, total bilirubin, direct bilirubin, iron, calcium, phosphorus, magnesium, and uric acid. Conclusions: Andean breakfast can influence the routine biochemistry and immunochemistry laboratory tests and might expose patient safety to some risks. Therefore, the COLABIOCLI WG-PRE-LATAM calls attention and highlights that the fasting time needs to be carefully considered when performing blood testing in order to prevent spurious results and thus, reduce laboratory errors.

scholarly journals Preanalytical Phase in Haematology

2008 ◽  
Vol 27 (3) ◽  
pp. 348-353 ◽  
Author(s):  
Giuseppe Banfi ◽  
L. Germagnoli
Keyword(s):  
Clinical Decision ◽  
Blood Parasites ◽  
Haematological Parameters ◽  
Pathological Conditions ◽  
Blood Drawing ◽  
Preanalytical Phase ◽  
Valid Data ◽  
Spurious Results ◽  
Instrumental Precision ◽  
Hematological Tests

Preanalytical Phase in Haematology The preanalytical phase is particularly important in haematology, where counts of particles and cells are performed in whole anticoagulated blood. The correct use and concentration of anticoagulant is mandatory to avoid spurious results, which can influence clinical decision. EDTA is the anticoagulant of choice, but it has some limits, especially for preserving stability and shape of platelets. Stability of haematological parameters is high, with the exception of leukocytes and reticulocytes. However, stability (and instrumental precision) should be evaluated together with biological variability and individuality index of various haematological parameters. Hematological tests are also influenced and interfered by high amounts of lipids and chylomicrons. The mixing procedure of the tubes after blood drawing and before analysis is also crucial for obtaining correct and valid data. There are some examples of interferences on automated haematological analysers which are used for diagnosing and screening pathological conditions. Cryoglobulins and erythrocytes parasites can induce spurious results of WBC, RBC and PLT, but the repeatability of these interferences could be used for alerting the pathologist and could reveal the presence of pathological proteins or blood parasites. New parameters have been proposed by modern haematological analysers, directly defined or calculated from traditional measures, but the clinical impact of these new parameters is often dependent on preanalytical variables.

The Thyroid Gland: Physiology and Pathophysiology

2000 ◽  
Vol 19 (8) ◽  
pp. 11-26 ◽  
Author(s):  
Denise Kirsten
Keyword(s):  
Thyroid Gland ◽  
Thyroid Hormones ◽  
Laboratory Tests ◽  
Clinical Manifestations ◽  
Thyroid Stimulating Hormone ◽  
The Body ◽  
Premature Delivery ◽  
Follicular Cells ◽  
Metabolic Hormones ◽  
Radiologic Findings

The thyroid gland contains many follicular cells that store the thyroid hormones within the thyroglobulin molecule until they are needed by the body. The thyroid hormones, often referred to as the major metabolic hormones, affect virtually every cell in the body. Synthesis and secretion of the thyroid hormones depend on the presence of iodine and tyrosine as well as maturation of the hypothalamic-pituitary-thyroid system. Interruption of this development, as occurs with premature delivery, results in inadequate production of thyroid-stimulating hormone and thyroxine, leading to a variety of physiologic conditions. Pathologic conditions occur in the presence of insufficient thyroid production or a defect in the thyroid gland. Laboratory tests are important in diagnosing conditions of the thyroid gland. A thorough history in combination with clinical manifestations and radiologic findings are also useful in diagnosing specific thyroid conditions. Nurses play an important role in identifying and managing thyroid disorders and in providing supportive care to infants and their families.

scholarly journals Errors in Laboratory Medicine

2002 ◽  
Vol 48 (5) ◽  
pp. 691-698 ◽  
Author(s):  
Pierangelo Bonini ◽  
Mario Plebani ◽  
Ferruccio Ceriotti ◽  
Francesca Rubboli
Keyword(s):  
Error Detection ◽  
Process Analysis ◽  
Laboratory Medicine ◽  
Laboratory Errors ◽  
Laboratory Error ◽  
Preanalytical Phase ◽  
Large Heterogeneity ◽  
Obsolete Technology ◽  
Definition Of ◽  
Study Designs

Abstract Background: The problem of medical errors has recently received a great deal of attention, which will probably increase. In this minireview, we focus on this issue in the fields of laboratory medicine and blood transfusion. Methods: We conducted several MEDLINE queries and searched the literature by hand. Searches were limited to the last 8 years to identify results that were not biased by obsolete technology. In addition, data on the frequency and type of preanalytical errors in our institution were collected. Results: Our search revealed large heterogeneity in study designs and quality on this topic as well as relatively few available data and the lack of a shared definition of “laboratory error” (also referred to as “blunder”, “mistake”, “problem”, or “defect”). Despite these limitations, there was considerable concordance on the distribution of errors throughout the laboratory working process: most occurred in the pre- or postanalytical phases, whereas a minority (13–32% according to the studies) occurred in the analytical portion. The reported frequency of errors was related to how they were identified: when a careful process analysis was performed, substantially more errors were discovered than when studies relied on complaints or report of near accidents. Conclusions: The large heterogeneity of literature on laboratory errors together with the prevalence of evidence that most errors occur in the preanalytical phase suggest the implementation of a more rigorous methodology for error detection and classification and the adoption of proper technologies for error reduction. Clinical audits should be used as a tool to detect errors caused by organizational problems outside the laboratory.

The effect of automated hemolysis index measurement on sample and test rejection rates

2019 ◽  
Vol 44 (5) ◽  
pp. 630-634
Author(s):  
Fazıla Atakan Erkal ◽  
Güzin Aykal ◽  
Hayriye Melek Yalçınkaya ◽  
Nihal Aksoy ◽  
Murat Özdemir
Keyword(s):  
Biochemical Analysis ◽  
Rejection Rate ◽  
Public Health Care ◽  
Sample Number ◽  
Laboratory Errors ◽  
Index Measurement ◽  
Preanalytical Phase ◽  
The Impact ◽  
Rejection Rates

Abstract Objective Vast majority of laboratory errors occurs in preanalytical phase and in vitro hemolysis is the most common among preanalytical errors. Automated serum index measurement is being used in routine biochemical analysis in Antalya Public Health Care Laboratory, since June 2014. Our aim in this study is to reveal the impact of serum index usage on rejected samples and rejected test rates due to hemolysis. Materials and methods Hemolysis, icterus and lipemia (HIL) spectral interference reagent and program have been used in our laboratory since June 2014. In the current study, the number of samples and tests that were rejected due to hemolysis in June–August 2014 were compared with those rejected in the same period of 2013. Results In 2014, the sample rejection rate was 2.53% and the rejected test rate was 0.48%. In 2013, the sample rejection rate was 0.56% and the rejected test rate was 0.55%. When compared two periods, statistically significant increase in rejected sample number due to hemolysis in 2014 is result of, visually undetectable hemolyzed samples previously can be identified by HIL method (p<0.05). Conclusion Usage of hemolysis index program in automated systems for detecting hemolysis was evaluated as a method which is standardized, semi-quantitative, with high reproducibility and allows test based rejection.

scholarly journals Pre-Analytical Workstations as a Tool for Reducing Laboratory Errors

2010 ◽  
Vol 29 (4) ◽  
pp. 315-324 ◽  
Author(s):  
Giorgio Rin
Keyword(s):  
Quality Improvement ◽  
Clinical Laboratory ◽  
Error Reduction ◽  
Laboratory Errors ◽  
Continuous Quality ◽  
Complex Process ◽  
Preanalytical Phase ◽  
Analytical Phase ◽  
Total Testing Process

Pre-Analytical Workstations as a Tool for Reducing Laboratory ErrorsReducing errors and improving quality are an integral part of Laboratory Medicine. Laboratory testing, a highly complex process commonly called the total testing process (TTP), is usually subdivided into three traditional (pre-, intra-, and post-) analytical phases. A series of papers published from 1989 drew the attention of laboratory professionals to the pre-analytical phase, which currently appears to be more vulnerable to errors than the other phases. Consequently, the preanalytical phase should be the main target for further quality improvement. Therefore, identifying the critical steps in the pre-analytical phase is a prerequisite for continuous quality improvement, further error reduction and thus for improving patient safety. Use of automated systems where feasible, and use of error reduction/improved quality as a factor when selecting instrumentation are the main tools we have to insure high quality and minimize errors in the pre-analytical phase. The reasons for automation of the pre-analytical phase have become so compelling that it is no longer simply a competitive advantage for laboratories, but rather a competitive necessity. These systems can impact on the clinical/laboratory interface and affect the efficiency, effectiveness and quality of care.

scholarly journals La representaci�_n de la literatura indigenista e ind�_gena en dos obras Colombianas: Jos̩ Tomb̩ de Diego Castrill�_n Arboleda y En Defensa de mi Raza de Manuel Quint�_n Lame

2019 ◽  
Author(s):  
◽  
Elkin Javier Perez Arroyo
Keyword(s):  
Latin America ◽  
20Th Century ◽  
Indigenous Communities ◽  
Theory Approach ◽  
Close Attention ◽  
Indigenous Literature ◽  
Literary Movement ◽  
Strongly Connected ◽  
Andean Countries ◽  
Do So

This dissertation is a study of the Indian's problem that is depicted in the Andean narrative of Indigenist, Indianist and Indigenous literature and how the literary movement of Indiginism created a wave of reivindicative narrative through Latin-America, especially in countries like: Peru, Bolivia and Ecuador. Through a theory approach, my study analyzes the most important indigenist narrative in Latin-America and how this theory could be applied to two Colombian writers that can be considered as indigenist and indigenous. To do so, I examine the work of a variety of indigenists and indigenous writes and theorists -- Diego Castrill�_n Arboleda Jose Tomb̩ (1942) y El Indio Quintin Lame (1973), Manuel Quintin Lame En Defensa de mi Raza (1987). Furthermore, this dissertation has taken into account the important contribution made by theorists in the field of indigenists studies such as: Antonio Cornejo Polar, Jos̩ Carlos Mari��tegui, Tom��s Escajadillo, among others. My research pays close attention to two important writings that will aid in understanding Indiginism as a literary movement in Colombia, Jose Tombe and En Defensa de mi Raza. By the beginning of the 20th century indigenist writers, through their novels, were advocating for the Indigenous communities throughout the Andean region. In Colombia, this advocation was not taking place in a similar way to the rest on the Andean countries with a strong indigenous influence. I have concluded these two writings are strongly connected to this literary movement. That conclusion is largely based upon an analysis of the characteristics in these works which led me to categorize Jose Tomb̩ as an indigenist novel and En Defensa de mi Raza as an indigenous written work. All the narratives that are part of this research project will provide valuable information about Indiginism as a literary movement in Colombia. Most importantly, it will add these two works to the existence of what is considered the indigenist and indigenous canon.

Coca divergence will widen across Latin America

2016 ◽  
Keyword(s):  
Latin America ◽  
United Nations ◽  
Cape Verde ◽  
Significant Shift ◽  
Content Type ◽  
Peace Negotiations ◽  
Andean Countries ◽  
The United Nations ◽  
Drugs And Crime

Subject 2015 coca trends. Significance Recent reports from the United Nations Office of Drugs and Crime (UNODC) point to a significant shift in patterns of coca production in the Andean countries. While acreages are down in Peru and Bolivia, there has been a sudden surge in Colombia, the world's largest producer. This suggests a last-minute attempt by producers to take advantage of peace negotiations which have led to a let-up in eradication. Impacts As production becomes more sophisticated, more cocaine will be produced from less coca. Africa will become increasingly important as a transhipment route, especially Nigeria and Cape Verde. Asia is emerging as a growing market for cocaine, and will shape future trafficking routes.

scholarly journals Quality analysis of the preanalytical phase of laboratory tests: Case of the civil hospital (TetouanMorocco)

2017 ◽  
Vol 8 (1) ◽  
pp. 1-7
Author(s):  
Wafa Chemao-Elfihri ◽  
M. Moussaoui ◽  
K. Firsiwi ◽  
B. Jbari ◽  
Morhit M. El
Keyword(s):  
Laboratory Tests ◽  
Quality Analysis ◽  
Civil Hospital ◽  
Preanalytical Phase

Evidence-Based Duplicate Order Alerts Promote Effective Test Utilization and Reduce Unnecessary Laboratory Testing

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S149-S149
Author(s):  
Jared Coberly ◽  
Emily Coberly ◽  
Katie Dettenwanger ◽  
Brandi Ross ◽  
Robert Pierce
Keyword(s):  
Clinical Judgment ◽  
Laboratory Testing ◽  
Laboratory Tests ◽  
Complete Blood Count ◽  
Medical Center ◽  
Academic Medical Center ◽  
Thyroid Stimulating Hormone ◽  
Blood Product Transfusion ◽  
Evidence Based ◽  
Hospital Acquired

Abstract Introduction Unnecessary and inappropriate laboratory testing contributes to increased health care costs, increases length of stay, and increases odds for blood product transfusion. The Choosing Wisely campaign recommends a judicious use of laboratory blood testing to combat iatrogenic anemia. Reducing the number of duplicate test orders may help address these issues. We evaluated duplicate order alert thresholds in our electronic health record for 10 common laboratory tests at an academic medical center. Methods In January 2019, alert intervals for 10 common inpatient laboratory tests (thyroid stimulating hormone, complete blood count, hemoglobin A1c, troponin, lactic acid, hemoglobin and hematocrit, urinalysis, vitamin D, urine beta HCG, and triglycerides) were adjusted to evidence-based, disease-specific thresholds. If a test was ordered within a timeframe shorter than this threshold, an alert interrupted the provider’s workflow. The provider was allowed to override the alert based on clinical judgment. This is a change from the previous settings, which alerted any test if ordered more frequently than 8 hours. Postintervention duplicate order alerts were compared to baseline rates and adjusted for number of inpatient discharges. Results In total, 914 orders were cancelled in 1 month as a result of tailored duplicate order alerts versus the baseline mean of 710 (95% CI, 633-786) and a predicted 552 (95% CI, 475-628) when adjusted for number of inpatient discharges, with the majority of cancelled orders being for CBC (530 accepted alerts). Overall, this reduction in unnecessary duplicate tests is equivalent to 3,092 mL of blood not collected from patients per month. Conclusion Tailoring duplicate order alert interval thresholds to evidence-based criteria helps reduce unnecessary testing, reduces costs, and may play an important role in reducing hospital-acquired anemia.

Sign in / Sign up

Export Citation Format

Share Document