Clinical laboratory science : journal of the American Society for Medical Technology最新文献

Two myiasis cases are presented which illustrate aspects of this infestation, and the role of the medical laboratory scientist with regard to the importance of critical thinking, problem-solving, and interprofessional communication skills. The purpose is to heighten awareness of myiasis, and emphasize the role of the medical laboratory scientist as a member of the healthcare team in confirming diagnosis.

According to the American Heart Association, cardiovascular disease accounts for more than one third of all deaths in the United States. 1 The purpose of this retrospective case-control study was to determine which sample taken in a sequential draw was most important in diagnosing an acute myocardial infarction (AMI). One-hundred subjects were selected from a convenience sample. The "risk" of AMI diagnosis was modeled using binary multiple logistic regression. Overall, 78% (39 out of 50 cases) were diagnosed with an AMI at Tinitiai. Clearly, the initial cTnI assay is the most critical of the four sequential time points for the accurate assessment of the presence or absence of an AMI. Most importantly, sequential troponin testing increased the ability to diagnose AMI by 10-fold.

Clostridium difficile infection (CDI) results in clinical manifestations ranging from mild diarrhea to life-threatening pseudomembranous colitis. Infection is most often initiated by antimicrobial therapy which causes an imbalance in normal colonic microflora. The pathogenesis of C. difficile is predominantly controlled by the production of its two cytotoxins, A and B, which damage the intestinal mucosa. In recent years a nationwide increase in the rate of CDI has been noted as well as an increase in mortality, reduced initial response to antimicrobials, extended resolution time, and increased rates of recurrence. Traditional treatment includes administration of antimicrobials. Fecal microbiota transplant (FMT) is an alternative therapy for CDI that is effective and promising in multiple CDI relapse patients. This paper will provide an overview of CDI epidemiology, pathogenesis, diagnosis, and treatment, and explore the case of a 53-year-old woman suffering from her sixth episode of CDI.

Healthcare quality has yet to meet the aims of the Institute of Medicine (IOM) with respect to safety, effectiveness, patient-centeredness, efficiency, timeliness and equity. No professional curricula adequately prepare future healthcare practitioners-including medical laboratory science professionals-with all competencies necessary to deliver quality healthcare. Practicing evidence-based medicine, focusing on quality improvement, using information technology, delivering patient-centered care and working as part of interdisciplinary teams are identified by the IOM as the five core competencies that every healthcare practitioner needs to effectively provide healthcare. Medical laboratory science educators need to incorporate patient safety concepts into the curricula and include assignments to develop the IOM competencies in order to adequately prepare future practitioners to effectively practice medical laboratory science in the healthcare system of the 21st century.

Laboratory directors and administrators play vital roles in the recruitment and retention processes of their employees. A total of 71 laboratory directors from hospitals across 51 counties in Tennessee responded to questionnaires regarding recruitment and retention strategies. Respondents reported strategies for recruitment and retention, which were agreed to be effective by management. Overall, these major strategies were consistent regardless of geographic location and limited differences were noted with regard to urban-rural locations. The findings that varied significantly between urban and rural locations included: 1) rural employees needed additional supervision; 2) rural hospitals relied on local residents more so than urban hospitals; 3) rural laboratory administrators noted more limited access to resources; and the 4) lower effectiveness of recruitment agencies and family relocation programs for rural hospitals. This is significant given the disparities often associated with rural areas, and the potential to develop more successful recruitment and retention strategies for those areas. Active managers in clinical laboratory science programs in the hospital setting should note effective strategies for both, recruitment and retention of personnel, and note the potential impact of geography on such processes.

A prototype computer-based training tool to improve WBC identification skills was developed. Students were assigned to complete five simulated WBC differentials but were allowed ample free time to use the tool at will to complete additional cases and to use the software in two alternative learning modes. The assignment was made at the end of the traditional WBC differential training activities in the first semester of hematology in the clinical laboratory science curriculum. The tool recorded usage data during the one month that students had access. Student performance was compared to the consensus results from an expert panel of hematology instructors. Usage tracking data was extracted and reviewed. The performance data indicated that students varied in WBC identification skill on the assignment. The usage tracking data showed that students used the tool only slightly more than the assigned cases and did not use alternative learning modes. Data from the expert panel indicated that the experts varied greatly in the number of discrepancies from the consensus opinion. Item analysis indicated the cell types that were most problematic. The prototype experience prompted the creation of a revised subsequent version of the trainer that is now being evaluated in our CLS program. The new trainer is web-based offering personal computer and mobile device access.

The endocrine system comprises part of the body's communication system that links the brain to its organs and functions to control metabolism, growth development and reproduction. Control of this system is predominantly through a complex feedback system that works to maintain homeostasis. When there is disruption to an endocrine gland or to the feedback system, it can lead to endocrine disturbance. Due to the complexity of the endocrine system, diagnosis and interpretation of endocrine pathology can be challenging.