The American journal of medical technology最新文献

Capnocytophaga species are normal mouth flora but can be opportunistic pathogens causing juvenile peridontitis and bacteremia in the compromised host. Indole-negative fusiforms isolated anaerobically or in the presence of increased CO2 can presumptively be identified as Capnocytophaga species.

The availability of new immunoassay and chromatographic methods has led to the revolution in therapeutic drug monitoring. The immunochemical and chromatographic methods both meet the analytical requirements of sensitivity, precision, and accuracy needed for most TDM applications. The technique chosen for any laboratory will depend upon numerous factors such as the availability of personnel and equipment, the time required to perform the assay, the speed with which the clinician needs the results, and the cost and medical benefit to the patient. It is reasonable to assume that the rapid development of new equipment and methodologies will continue to keep therapeutic drug monitoring one of the most interesting and fastest growing areas in clinical medicine.

The use of type and screen (T&S) has reduced our overall crossmatch:transfusion (C:T) ratio from 2.5:1 prior to T&S to 1.9:1. Review of our progress, however, demonstrated only a partial reduction of C:T for elective cholecystectomy from 103:1 to 18:1, with only 39% T&S utilization. In addition, units crossmatched in excess of the surgical schedule for 174 high-risk patients had a C:T ratio of 18.6:1. Routine questioning of all excess orders proved unacceptable to blood bank staff and surgeons. An inflexible schedule was also deemed unacceptable. We therefore began monthly written summary reports to each surgical division listing each case in which extra crossmatching was reported and whether the units requested were transfused. These reports enabled the surgical directors to help monitor crossmatch utilization. In addition, we have reduced our C:T ratio of extra units for 405 high-risk patients to 4.0:1. T&S utilization for elective cholecystectomy has increased to 64%, and C:T has fallen to 9:1. These results demonstrate that establishing T&S can reduce the C:T ratio and patient costs; but continued attention is required to maximize the benefits of this procedure.

A total of 350 clinical isolates of gram-positive, catalase-positive cocci were collected from patients at three hospitals over a five-month period. Each isolate was biochemically identified using coagulase production, mannitol and dextrose fermentation, and resistance to a 5-micrograms disc of novobiocin on sheep blood agar, Mueller-Hinton agar, and P agar. After 18-24 hours of incubation at 35 degrees C, zone sizes were read in millimeters, and the results were compared to the reference method of Kloos and Schleifer on P agar. The zone sizes obtained using Mueller-Hinton agar most closely resembled the reference method, while the zone sizes on sheep blood agar had markedly smaller values.

Renal epithelial fragments, an infrequently reported entity, were observed by cytologists in urine sediment from a patient who underwent nephrostomy for the relief of a ureteral obstruction. This case report describes the occurrence and various cytomorphologic features of exfoliated renal fragments. Urine specimens obtained following the insertion of a nephrostomy tube can provide the cytologist a unique opportunity to study and distinguish renal epithelial fragments from those of urothelial origin.