Clinical laboratory accreditation

This article reviews the requirements for competence and quality that are particular to clinical laboratories. There are several distinct ways in which clinical laboratories can seek recognition "as having reached the standard required to carry out a prescribed function". Accreditation process, with this respect, is an effective quality evaluation and management tool. It is a voluntary process and regarded as optimal and achievable. These accreditation schemes mainly concern with organizational processes and conditions under which laboratory services are planned, performed, monitored, recorded, and reported, as well as the considerations of safety and ethics in medical laboratory work. Quality Management and Improvement System, Management and Leadership, Resource Management, Planning, Development, and Provision of Laboratory Services, and Monitor, Analyse, and Improve are the major headings covered by the most of the accreditation bodies. By the end of inspection visits, a laboratory can fail, or be given full or conditional accreditation. In the case of conditional accreditation, recommendations for improvements are made and a time for demonstrating compliance is specified. Accredited laboratories receive an official accreditation report and award certificate. This award is valid for two or three years unless revoked by accrediting company

Joint Commission International Accreditation for Clinical Laboratories: Monitor, analyze and improve

PubMedID: 19863931[No abstract available

Comparison of serum cholesterol levels by three different methods

Purpose: Determination of serum cholesterol may be the initial step in the early diagnosis of coronary heart disease. Literally hundreds of cholesterol methods have been published, usually as modifications of chemical and enzymatic methods. The purpose of this study was to evaluate the agreement among the three most commonly used cholesterol methods. Methods: Serum cholesterol levels were measured in 20 serum specimens by three different methods from which two of them were enzymatic and the other was a chemical method. The results were compared by statistical methods such as regression analysis and correlation coefficent. Results: The meon concentrations of serum cholesterol levels obtained from Boehringer-Manheim CHOD-RAP. Biotrol Enzymatic and Chemical Zlatkis Zak methods have been found to be 179 ± 20 mg/dl, 190 ± 24 mg/dl, and 208 ± 26 mg/dl, respectively. Although statistically significant difference is found among the mean values obtained from the three different methods by repeated measures analysis of variance, a strong association was established by linear regression with the calculation of correlation coefficient. Conclusion: The reliability of the methods was confirmed by the strong correlation, however it should be stated that each method must be considered in its own reference intervals since the mean values were statistically different from each other

Evaluation of reference values for erythrocyte glutathione

PubMedID: 9027429The analytical, intra-individual and inter-individual variations as well as the best storage conditions were determined for erythrocyte glutathione, and the reference values were established. A total of 396 apparently healthy people, 206 male and 190 female, were randomly selected from villages and cities of the southern part of Turkey. The distribution was Gaussian and no significant difference was observed between the male and the female subjects. The mean (standard deviation) of the population investigated for glutathione was 6.9 (1.0) µmol/gHb. The analytical, intra-individual and inter-individual variations were assessed in 20 apparently healthy subjects and were found to be 4.63%, 13.67% and 11.16%, respectively. Whole blood stored at -70°C for up to 10 days was shown to be the best storage condition for erythrocyte glutathione determination. The results of the index of individuality showed that glutathione reference values could be used for diagnostic purposes

Effect of dietary conjugated linoleic acid (CLA) on carcass quality, serum lipid variables and histopathological changes of broiler chickens infected with aflatoxin B1

Three dietary inclusion rates of CLA (0, 2 and 4 g/kg feed) and aflatoxin B1 (0, 200 and 300 µg/kg feed) were tested in a 3 x 3 factorial experimental design on a total of 99 Ross-308 male broiler chickens from 1 to 42 days of age. The objective of this study was to determine the effect of dietary conjugated linoleic acid (CLA) on carcass characteristics, serum lipid variables and histopathological properties in broiler chickens receiving a diet containing aflatoxin B1 (AFB1). Carcass yield, abdominal fat weight and abdominal fat percentage were not significantly influenced by dietary CLA, AFB1 or CLA + AFB1. Altered serum lipid measurements induced by AFB1 treatments included increased serum cholesterol and triglyceride concentrations, and decreased serum concentration of high density lipoprotein (HDL). Serum HDL concentration was increased in birds supplemented with 2 and 4 g CLA/kg diet compared with the control group. However, CLA + AFB1 did not significantly affect these parameters compared to the groups that received AFB1 alone. Aflatoxin B 1 administration induced degenerative changes in the liver tissue, but dietary CLA supplementation offered protection to the livers against these changes. Aflatoxin B1 residues were not detected in any breast tissues collected from the broiler carcasses. Our results suggest that CLA provided protection against the negative effects of liver damage induced by AFB1 in broiler chickens. Furthermore, dietary CLA supplementation increased serum HDL levels. © South African Society for Animal Science

Physiological and biochemical responses in German Fawn kids subjected to cooling treatments under Mediterranean climate conditions [Serinletilen Alman Alaca oglaklarinin Akdeniz iklim koşullarindaki fizyolojik ve biyokimyasal tepkileri]

This study was conducted to determine the effects of different physical modifications (sprinkler and fan) related to heat stress during summer on relevant blood biochemical measures and physiological responses, such as rectal temperature (RT), respiration rate (RR), heart rate (HR), testis temperature (TT), and head temperature (HT), in kids. In total, 32 male German Fawn × Hair kids at 6 months of age were divided into 4 groups of 8. Treatments were as follows: group A: (no sprinkler, no fan) (control); group B: sprinkler only (at 1000-1100 and 1400-1500), no fan; group C: fan (1.5 m/h between 1000-1800), no sprinkler; group D: sprinkler (at 1000-1100 and 1400-1500) and fan (1.5 m/h between 1000-1800). Sprinkler + fan treatment decreased RR, RT, TT, and HT (P < 0.05), whereas sprinkler + fan, sprinkler only, and fan only increased HR. Sprinkler + fan treatment significantly decreased T3 and T4 secretion (P < 0.05). Time × fan × sprinkler interaction significantly affected HCT (P < 0.05), whereas F × S interaction affected CHO (P < 0.05). According to blood chemistry and physiological responses, fan treatment was more effective than sprinkler and may be recommended as a means to alleviate heat stress in goats under Mediterranean climate conditions; however, further research is needed to optimize sprinkler cooling. © TÜBİTAK

Effects of L-carnitine and niacin supplied by drinking water on fattening performance, carcass quality and plasma L-carnitine concentration of broiler chicks

PubMedID: 12866783The present study was initiated to determine whether dietary supplemental L-carnitine and niacin affect growth performance, carcass yield, abdominal fat and plasma L-carnitine concentration of broiler chicks. One-day-old broiler chicks (COB500) were used in the experiment. A two by two factorial arrangement was employed with two levels (0 and 50 mg/l) of supplemental L-carnitine and two levels (0 or 50 mg/l) of supplemental niacin in drinking water as main effects. Body weight gain was significantly improved by L-carnitine, or L-carnitine + niacin supplementation during the first 3 weeks. However, supplemental L-carnitine and niacin did not change body weight gain during the last 3 weeks of the experimental period. Supplemental L-carnitine significantly improved feed intake during the first 3 weeks. Supplemental L-carnitine or niacin did not influence carcass weight, carcass yield and abdominal fat weight. L-carnitine content in the plasma was significantly higher in the groups receiving supplemental L-carnitine and L-carnitine + niacin. It is concluded that dietary supplemental L-carnitine or L-carnitine + niacin could have positive effects on body weight gain and feed intake during the early stages of growing. However, supplemental L-carnitine or L-carnitine + niacin were not of benefit regarding the complete growth period.The authors would like to acknowledge the grant support provided by C¸ ukurova University of Research Fund. L-carnitine analysis in feed was determined by Lohmann Animal Health, Cuxhaven, Germany. Special thanks are due to Dr. S. Jacobs, Prof. Dr. H. Krog, Dr. Ö. Yücelt for their financial support

Analysis of peripheral blood T-cell subsets, natural killer cells and serum levels of cytokines in children with Down syndrome

PubMedID: 20477881The objective of this study was to evaluate the relationship between humoral and cell-mediated immune response parameters and impairment of immune functions in children with Down syndrome (DS). The patient group was consisted of cytogenetically documented 32 children with DS. Lymphocyte subsets and natural killer cells were counted by flow-cytometry system. Levels of interleukin (IL)-1ß, IL-2, IL-4, IL-6, IL-8, IL-10 and tumour necrosis factor-alpha (TNF-?) were detected by enzyme-linked immunosorbent assay method. Serum IgG, IgM, IgA levels were measured by turbidimetric methods. The percentage of CD8+ lymphocytes and CD56+ cells of patients with DS were significantly higher, whereas CD20+ lymphocytes were lower than that of controls (P 0.05). Levels of IL-4 and IL-10 were significantly increased, but IL-6 and TNF-a levels were decreased in children with DS (P 0.05, for all). Serum IgG, IgM and IgA levels were found to be similar between the groups (P > 0.05). It has been known that IL-4 and IL-10 are anti-inflammatory molecules which inhibit the synthesis of proinflammatory cytokines such as IL-6 and TNF-a. In this study, levels of IL-4 and IL-10 were significantly increased, but IL-6 and TNF-a levels were decreased in children with DS. These results may suggest that continuing anti-inflammatory state in DS and this process may explain the cause of recurrent infection of the disease. On the other hand, in contrast to the low percentage of CD20+ cells, high percentage of CD8+ and CD56+ cells were found. Our findings may demonstrate that the cell-mediated and humoral immune system parameters in children with DS were altered according to healthy children. © 2010 Blackwell Publishing Ltd

EFFECTS OF L-CARNITINE AND NIACIN SUPPLIED BY DRINKING WATER ON FATTENING PERFORMANCE, CARCASS QUALITY AND PLASMA L-CARNITINE CONCENTRATION OF BROILER CHICKS

The present study was initiated to determine whether dietary supplemental L-carnitine and niacin affect growth performance, carcass yield, abdominal fat and plasma L-carnitine concentration of broiler chicks. One-day-old broiler chicks (COB500) were used in the experiment. A two by two factorial arrangement was employed with two levels (0 and 50 mg/l) of supplemental L-carnitine and two levels (0 or 50 mg/l) of supplemental niacin in drinking water as main effects. Body weight gain was significantly improved by L-carnitine, or L-carnitine+niacin supplementation during the first 3 weeks. However, supplemental L-carnitine and niacin did not change body weight gain during the last 3 weeks of the experimental period. Supplemental L-carnitine significantly improved feed intake during the first 3 weeks. Supplemental L-carnitine or niacin did not influence carcass weight, carcass yield and abdominal fat weight. L-carnitine content in the plasma was significantly higher in the groups receiving supplemental L-carnitine and L-carnitine+niacin. It is concluded that dietary supplemental L-carnitine or L-carnitine+niacin could have positive effects on body weight gain and feed intake during the early stages of growing. However, supplemental L-carnitine or Lcarnitine+ niacin were not of benefit regarding the complete growth period

National external quality assessment follow-up: 2010-2017 Turkish experience

Objective: Medical laboratories encounter critical obstacles in External Quality Assessment (EQA) practices that are key to assessment of the analytical period. Present study aims to unveil the challenges in nationwide interlaboratory harmonization and suggest practical solutions. Materials and methods: EQA results of 1941 laboratories participating in 18 different EQA-programs between 2010 and 2017 were examined. Standard Deviation Index (SDI) of each program calculated using 801,028 sample data from 24 different clinical chemical tests were used to conduct a process assessment. Results: There is a significant discrepancy in unsatisfactory performance ratio among different EAQ-programs with an average of 3.4% (27,074 cases) between 2010 and 2017 and a decreasing trend (~40-50%) in 7-years. Programs with higher SDI display lower discrepancy rates. Reasons for unaccepted results appear to be data entry errors (8.27-22.2%), material dilution errors (5-11.4%), technical problems (3.76-7.9%); while random or unidentified causes account for a major of 44.9-59.5%. In 7-years, 15.7% reduction was observed in average SDI of all tests. Conclusion: With the launch of national EQA follow-up program, increased awareness of the analytical processes led to a decrease in unaccepted results and variances in the analytical period. Staff training is suggested as a significant measure. In addition, simultaneous assessment of SDI and allowable total error rates would reduce the variation between programs. © 2019 De Gruyter. All rights reserved