doi: 10.1093/labmed/20.4.221pmid: N/A
Article PDF first page preview Close This content is only available as a PDF. © American Society of Clinical Pathologists
doi: 10.1093/labmed/20.4.225pmid: N/A
Article PDF first page preview Close This content is only available as a PDF. © American Society of Clinical Pathologists
doi: 10.1093/labmed/20.4.231pmid: N/A
Article PDF first page preview Close This content is only available as a PDF. © American Society of Clinical Pathologists
Wetli, Charles, V.;Mittleman, Roger, E.
doi: 10.1093/labmed/20.4.233pmid: N/A
Article PDF first page preview Close This content is only available as a PDF. © American Society of Clinical Pathologists
Westgard, James, O.;Barry, Patricia, L.
doi: 10.1093/labmed/20.4.241pmid: N/A
Abstract The improvement of quality is becoming increasingly important for health care laboratories in today's competitive marketplace. Quality improvement requires new management practices that go beyond present quality assurance practices. Quality improvement is accomplished by solving problems that currently limit laboratory performance. Problem solving is promoted through participative mechanisms such as management project teams, voluntary quality teams, and suggestion programs. Implementation requires a careful plan for supporting the development and growth of these problem-solving mechanisms. New skills, tools, and techniques are required to assure the success of problem-solving teams. Additional training must be provided to enhance and expand laboratorians’ problem-solving skills. Continuous quality improvement provides a management strategy for satisfying customers with improved quality, satisfying laboratorians with improved quality of work life, and satisfying management with improved productivity and reduced costs. This content is only available as a PDF. © American Society of Clinical Pathologists
doi: 10.1093/labmed/20.4.248pmid: N/A
Article PDF first page preview Close This content is only available as a PDF. © American Society of Clinical Pathologists
Burns, Terry, R.;Irani, Mehraboon, S.
doi: 10.1093/labmed/20.4.251pmid: N/A
Abstract Screening blood donors for elevated levels of alanine aminotransferase (ALT) is required to help reduce the incidence of transfusion-transmitted non-A, non-B hepatitis. A study of the cost-effectiveness and usability of the Reflotron (Boehringer-Mannheim Diagnostics, Indianapolis, Ind), an on-site instrument for measuring ALT, is reported. On four blood drives, 118 donors were tested, with a rejection rate of 4.2%. The Reflotron was found to be cost-saving in terms of the College of American Pathologists workload units at a rejection rate of 0.85% or greater. Advantages regarding utility include portability, easy oper ability, and savings on donor time. The disadvantages (single-specimen analysis and lack of sample identification) are relatively minor and can be overcome. We conclude that the Reflotron is a convenient and cost-effective instrument for use in donor screening. This content is only available as a PDF. © American Society of Clinical Pathologists
Houlihan, Peter, M.;Geier, Nancy, A.;Lofsness, Karen, G.
doi: 10.1093/labmed/20.4.254pmid: N/A
Abstract After the transfusion of packed red cells, two pediatric patients showed unexpectedly decreased mean corpuscular volumes (MCVs), increased red cell distribution widths (RDWs), and visible alterations in their red cell histogram patterns. Further investigation of the donor units involved showed that both children had received red cells that were extremely microcytic (MCVs of 58.4 and 63.9 fL, respectively). Subsequent laboratory studies of blood from these two donors showed that both were iron deficient and that one of the donors also had the hemoglobin electrophoresis pattern characteristic of β-thalassemia trait. This content is only available as a PDF. © American Society of Clinical Pathologists
Ross, Dennis, W.;Dent, Georgette, A.;Simmons,, Elizabeth;Prokopetz,, Sandra
doi: 10.1093/labmed/20.4.258pmid: N/A
Abstract Recombinant DNA technology is a rapidly developing tool with growing applications for the clinical diagnostic laboratory. We report our three-year experience in establishing and running a Molecular Diagnostics service within our Department of Hospital Laboratories. A small number of specific tests related to cancer diagnosis were originally chosen. These tests use primarily the Southern blot technique. The technology was not difficult to transfer from the research to the clinical lab setting. However, it was necessary to develop additional protocols for quality control and positive sample identification. Education of technologists performing the tests and physicians using the service is a large component of the service's activities that has produced gratifying results. Clinical diagnostic testing using recombinant DNA technology is now feasible, even though the technology itself is rapidly evolving. This content is only available as a PDF. © American Society of Clinical Pathologists
Saxena,, Sunita;Shulman, Ira, A.;Shaw, S., T.
doi: 10.1093/labmed/20.4.264pmid: N/A
Abstract The serum levels of many analytes have been shown to vary with the gender and racial background of the tested subjects. However, it is unclear whether serum alanine aminotransferase (ALT) levels exhibit similar heterogeneity. To investigate the effect of gender and racial / ethnic background on serum ALT activity, we compared the serum ALT levels of 1,069 healthy hospital employees; 349 whites, 433 blacks, and 287 Hispanics. Hispanics, both men and women, had significantly higher ALT levels than their white (P <.001) and black (P <.01) counterparts. Blacks had levels intermediate between those of whites and Hispanics. The difference in serum ALT activity between blacks and whites was significant only among men. Men in all three groups had higher (P <.001) ALT levels than women. We conclude that there are significant racial and sex differences in ALT levels among healthy hospital employees and that these differences should be taken into consideration when interpreting serum ALT results. This content is only available as a PDF. © American Society of Clinical Pathologists
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