The document discusses various types of interferences that can occur in clinical chemistry analysis, including hemolysis, lipemia, and icterus. Hemolysis occurs when red blood cells rupture, releasing intracellular components into plasma and affecting test results. Lipemia is the presence of fatty substances in blood from high triglyceride levels, interfering with light transmission. Icterus is yellowing from increased bilirubin, which absorbs light and acts as a chemical interferant. These interferences can lead to incorrect test results and diagnoses if not properly identified and accounted for.
Water is the most common reagent used in the laboratory, and while water quality can often be overlooked, the grade of water being used in an application is critical. Minute traces of salts or biological contaminants can result in unfortunate consequences when culturing cells or performing analytical measurements of biological macromolecules.
Water is the most common reagent used in the laboratory, and while water quality can often be overlooked, the grade of water being used in an application is critical. Minute traces of salts or biological contaminants can result in unfortunate consequences when culturing cells or performing analytical measurements of biological macromolecules.
In the continuous quality journey, Controlling laboratory Errors is an integral part & focusing on analytical, post-analytical process is the first step. Developing a reporting culture followed by thorough analysis and implementation of appropriate corrective, preventive actions is required.
Internal quality control (IQC) in coagulation labAnkit Raiyani
In the haematology laboratory it is essential to ensure that the right test is carried out on the right specimen and that the correct results are delivered to the appropriate recipient without delay.
Quality control (QC) is defined as measures that must be included during each assay run to verify that the test is working properly.
Internal quality control (IQC) is monitoring the haematology test procedures to ensure continual evaluation of the reliability of the daily work of the laboratory with validation of tests before reports are released
Urinalysis for detection of abnormal constituentsrohini sane
An illustrative presentation on Urinalysis for detection of abnormal constituents for medical ,dental , pharmacology and biotechnology students to facilitate easy-learning.
Urinary Stone analysis
A kidney stone is a hard mass developed from crystals that separate from the urine and build up on the inner surfaces of the kidney.
In the continuous quality journey, Controlling laboratory Errors is an integral part & focusing on analytical, post-analytical process is the first step. Developing a reporting culture followed by thorough analysis and implementation of appropriate corrective, preventive actions is required.
Internal quality control (IQC) in coagulation labAnkit Raiyani
In the haematology laboratory it is essential to ensure that the right test is carried out on the right specimen and that the correct results are delivered to the appropriate recipient without delay.
Quality control (QC) is defined as measures that must be included during each assay run to verify that the test is working properly.
Internal quality control (IQC) is monitoring the haematology test procedures to ensure continual evaluation of the reliability of the daily work of the laboratory with validation of tests before reports are released
Urinalysis for detection of abnormal constituentsrohini sane
An illustrative presentation on Urinalysis for detection of abnormal constituents for medical ,dental , pharmacology and biotechnology students to facilitate easy-learning.
Urinary Stone analysis
A kidney stone is a hard mass developed from crystals that separate from the urine and build up on the inner surfaces of the kidney.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
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An inherited enzyme deficiency leading to the disruption of normal bodily metabolism.
Accumulation of a toxic substrate.
Impaired formation of a product normally produced by the deficient enzyme.
Hemolytic anemias share the following features:
A shortened red cell life span below the normal 120 days
Elevated erythropoietin levels and a compensatory increase in erythropoiesis
Accumulation of hemoglobin degradation products that are created as part of the process of red cell hemolysis
Dr. Sachin Verma is a young, diligent and dynamic physician. He did his graduation from IGMC Shimla and MD in Internal Medicine from GSVM Medical College Kanpur. Then he did his Fellowship in Intensive Care Medicine (FICM) from Apollo Hospital Delhi. He has done fellowship in infectious diseases by Infectious Disease Society of America (IDSA). He has also done FCCS course and is certified Advance Cardiac Life support (ACLS) and Basic Life Support (BLS) provider by American Heart Association. He has also done a course in Cardiology by American College of Cardiology and a course in Diabetology by International Diabetes Centre. He specializes in the management of Infections, Multiorgan Dysfunctions and Critically ill patients and has many publications and presentations in various national conferences under his belt. He is currently working in NABH Approved Ivy super-specialty Hospital Mohali as Consultant Intensivists and Physician.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
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Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
2. Interference occurs when a substance or process
falsely alters an assay result.
These altered results may lead to repeat tests,
incorrect diagnoses, and treatments with potentially
unfavorable outcomes for the patient.
2
4. Endogenous interference originates from
substances found naturally in the patient sample.
Hemolysis
Bilirubin
Lipids
Paraproteins
Excessive analyte concentration
4
5. Exogenous interference results from
substances not naturally found in the patient’s
specimen.
Drugs
Poisons
Herbal products
IV fluids
Substances used as therapy (Antibodies)
Collection tube components
(Anticoagulant)
Test sample additives (Preservatives)
5
6. Hemolysis is the release of hemoglobin and other
intracellular components of erythrocytes and
other blood cells to the surrounding plasma
following damage of the cell membrane.
Hemolysis occurs in about 3% of all specimens
received in the laboratory and accounts for 40%
to 70% of all unsuitable specimens.
Hemolysis may occur either in vivo or in vitro.
6
7. In vivo hemolysis can originate from:
7
Inherited hemolytic anemia
Defect in hemoglobin production
(Thalassemia, Sikckle cell disease)
Defect in RBC membrane
(Spherocytosis, Elliptocytosis, PNH)
Defect RBC metabolism
(G6PD, Pyruvate kinase deficiency)
9. Usually less than 2% of all the specimens with
hemolysis may be due to in vivo hemolysis.
In vivo hemolysis does not depend on the
technique of the healthcare provider and it is thus
virtually unavoidable and cannot be resolved.
9
10. In vitro hemolysis can occur beginning at the
patient’s bedside and continue through sample
handling, processing and storage.
Leading causes of in vitro hemolysis:
Patient dependent
Operator dependent
Device dependent
Handling of the specimen
Transport of the specimen
Sample processing
Sample storage
10
11. 11
Differentiating between in vivo and in vitro
hemolysis is vitally important to patient
management
In vitro hemolysisIn vivo hemolysis
Haptoglobin↓ Haptoglobin
↑ AST
↑ Unconjugated
Bilirubin
↑ K↑Reticulocytes
↑ LDHLDH↑
13. Additive: Several constituents are normally present in large
amounts within the red blood cells. When the red blood cells
burst these substances will be released and their values will
become falsely elevated (LDH, K, AST).
13
E/P RatioPlasmaErythrocytesSubstance
16036058000LDH, U/L
22.84.4100.0Potassium, mmol/L
2025500AST, U/L
73.022.0APs, U/L
530150ALT, U/L
14. Dilutional: release of intracellular fluid into the
surrounding extracellular area, the extracellular fluid
becomes more dilute and analytes will appear falsely
low (Na, Cl, Ca).
14
E/P RatioPlasmaErythrocytesSubstance
0.110.01.0Calcium, mg/dL
0.11140.016.0Sodium, mmol/L
0.5104.052.0Chloride, mmol/L
15. Chemical: by hemolysis there is several substances in
the solution that may cross-reacting with the analyte.
Adenylate kinase (CK and CKMB)
Pseudoperoxidase activity of hemoglobin (Bilirubin)
Heme group (Iron)
15
16. Spectral: Hemoglobin shows strong absorbance
at 415 nm and have two peaks at 540 and 570
nm. Therefore it may greatly interfere with
measurement at these wavelengths.
16
17. 17
Hemolyzed
Sample
Quantification of Hemolysis
Clinically or analytically
Significant
Clinically or analytically
Insignificant
Perform analyses and report
result without warnings
Analyses unaffected
by hemolysis
Do not perform analyses and
ask for an additional Sample
Analyses Affected
by Hemolysis
perform analyses and report
result with warnings
If the recollected specimen is also hemolyzed,
perform analyses and report result with warnings
18. 18
Test to be
suppressed
Free
Hemoglobin
Degree of
Hemolysis
• LDH
• Potassium
• AST
25-50 mg/dLSlightly
• CK & CKMB
• ALP
• ALT
50-200 mg/dLModerate
Virtually all test200 mg/dL≤Sever
The amount of hemolysis needed to affect a test is
dependent on the test being performed.
19. 19
Lipemia is the presence of a fine emulsion of
fatty substance in the blood.
It is characterized by turbidity of samples which
may range from slightly opaque through
transparent, turbid to milky appearance.
22. The overall frequency of lipemic samples ranges
from 0.5-2.5 %, depending on the type of hospital
and proportion of inpatient and outpatient samples.
22
31. 31
Extraction
Extraction of lipoproteins into hydrophobic
phase
Polyethylene glycol
Cyclodextrin
Lipoclear
32. 32
Sample dilution
Sample can be diluted only enough to remove the
turbidity interference (2 or 3 fold).
33. 33
Icterus is the yellowish discoloration of skin
and mucous membrane and body fluids,
resulting from increased level of bilirubin in
the plasma (Hyperbilirubinemia).
Patient dependent (Fragile veins, difficult venous access)
Operator dependent (Skill of the operator, Location of needlestick, Traumatic blood draw, Missing the vein, Drawing from a hematoma, capillary collection, antiseptic used, prolonged tourniquet, Tube underfilling)
Device dependent (Small gauge needles, Butterfly devices, Use of the lancet)
Handling of the specimen (No mixing or insufficient mixing, excessive mixing, syringe transfer)
Transport of the specimen
Sample processing
Sample storage
The upper reference limit for free hemoglobin is 5 mg/dL for serum.
Visually, hemolysis is defined as free hemoglobin concentration > 50 mg/dL.
Because lipids are water-insoluble molecules, they cannot be transported in aqueous solutions, such as plasma. For that reason, lipids are transported in plasma as macromolecular complexes known as lipoproteins Lipoproteins are spherical structures that consist of a hydrophobic core containing lipids (i.e. triglycerides and/or cholesterol esters), and an amphophilic (i.e. both hydrophobic and hydrophilic) outer layer of phospholipids, free cholesterol, and proteins that forms a protective envelope surrounding the lipid core
Plasma lipoproteins differ in their physical and chemical characteristics such as size, density, and composition. Canine lipoproteins can be divided based on their hydrated density into four major classes: (1) chylomicrons, (2) very low-density lipoproteins (VLDL), (3) low-density lipoproteins (LDL), and (4) high-density lipoproteins (HDL)
not all classes contribute equally to the turbidity. The largest particles, chylomicrons, with sample size of 70-1000 nm, have the greatest potential in causing turbidity of the sample. Accumulation of small particles, high density lipoproteins (HDL), low density lipoproteins (LDL) and small very low density lipoproteins (VLDL) doesn’t result with lipemic samples
Bilirubin may interfere by acting as a reducing substance as it is easily
oxidized to biliverdin and bilipurpurin with a reduction in absorbance.
Assays that utilize oxidase/peroxidase based reactions to produce hydrogen
peroxide, may produce lower results because bilirubin reacts with the
H2o2 formed in the test system. The reduction in H2o2 is relative to the
concentration of bilirubin present. This is true for enzymatic procedures
that are used for the measurement of glucose, cholesterol, triglycerides
and uric acid.
In albumin assays that employ dye binding, bilirubin can competitively
bind to the dye and produce lower albumin results.
Bilirithin. Elevated concentrations of bilirubin are another
source of endogenous interference. Part of the
interference arises from the spectral properties of bilirubin,
another part from bilirubin’s ability to react
chemically with reagents. Bilirubin reacts with peroxidase-
catalyzed reactions, as are used in the detection
systems for glucose, cholesterol, and uric acid (32). Bilirubin
causes a negative interference with the Jaff#{233}
method for creatinine, as measured with the Paramax
(Baxter), the Dimension (DuPont), or the Chem-1
(Bayer-Technicon) analyzers (37, 38). Also, bilirubin
causes a negative interference with the enzymatic
method for creatinine that is based on creatinine, creatinase,
and sarcosine oxidase and detects H2O2 with peroxidase
(39). Bilirubin interferes with determinations of
uric acid, cholesterol, and triglycerides that use peroxidase-
coupled reactions (40). Part of the interference is
chemical, thought to be caused by the destruction by
bilirubin of a reaction intermediate, which is partially
corrected by adding ferrocyanide to the reagents (40).