Mode of Delivery's Effect on Newborn Stress Hormones

Mode Of Delivery Affect On Stress Response At Birth And...
Mode of Delivery Affects on Stress Response at Birth and Possible Shift of HPAAxis Nicole Miller
Eastern Michigan University Abstract Several journal articles were reviewed regarding the effects
that mode of delivery had on cortisol (CORT) and adrenocorticotropic hormone (ACTH) at birth
and its possible long term effects on the hypothalamic–pituitary–adrenal axis (HPA). Umbilical cord
blood was collected immediately following delivery with a time frame of up to 20 minutes and
analyzed for hormone concentrations. Studies indicate that significant differences in hormone
concentrations can be seen between vaginal and caesarean delivery. Follow up studies indicate that
that stress related biochemical change ... Show more content on Helpwriting.net ...
Schuller et al. (2012) showed that pain and stress responses in newborns can be measured by
physiological parameters such as heart rate, blood pressure, and cortisol concentrations within
bodily fluids. The body's reaction to stress is governed by the hypothalamic–pituitary–adrenal axis
(HPA). A major part of the neuoendorine system which consists of the interactions between the
hypothalamus, pituitary gland, and adrenal glands. Rothenberg et al. (1996) found that exposure to
stress either prenatally or during birth alters the hypothalamic–pituitary–adrenal axis (HPA) and
influences the newborns further development. Similarly Kapoor et al. (2006) and Dean et al. (2001)
found in animal and in human studies that prenatal stress causes increased cortisol concentrations at
birth which may alter the circuitry of the HPA axis. Furthermore, Gitau et al. (2004) found that fetal
cortisol levels decreased in newborns delivered by cesarean section when compared to those
delivered vaginally. In contrast Mears et al. (2004) reported elevated cortisol concentrations in
assisted vaginal deliveries. Research has documented that there is some evidence supporting that
birth mode determines stress response. (Taylor et al. 2000) As stated previously stress is
psychosomatic, and causes or exacerbates a range of serious health issues. Knowledge of how our
initial stress response at birth can modulate our reactions to stress could improve,
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Reflection Paper
Holy Moly, I cannot believe that I am finally finished with college. I have learned so much at Brown
Mackie, and I actually remember all of the skills! I thought that when it came time to go out on
externship that I would forget everything and panic! However, I believe I am doing great! I have
noticed several differences in the way I was taught in the classroom, and the way they do things out
in the real world. In the classroom we are taught how to do things the proper way, the by the book
way. In the classroom we are taught we first need to call the patient back and verify their name and
date of birth. Then to get their vital signs. We are taught to document the correct way and how to
correct out mistakes if I mess up. I was taught how to write in charts, how to word things properly.
Let's use Phlebotomy as an example. In Phlebotomy I was taught how to properly draw blood. I was
taught that first you tie the tourniquet around the patients preferred arm, then you feel for a vein.
After finding the vein you release the tourniquet and gather the appropriate needle. You then
assemble the equipment, retie the tourniquet around the arm, feel for the vein one more time, then
you clean it with an alcohol pad, and stick the patient. When you collect the desired amount of
blood you release the tourniquet, and in one swift move you pull the needle out and place a cotton
ball on the site where the needle was. You then ask the patient to hold the cotton ball while you
safety the

Clinical Studies : High Dose Tigecycline Essay
Tigecycline, the first member of the glycylcycline class of antimicrobial agents, was approved by
the US Food and Drug Administration (FDA) for the treatment of complicated intraabdominal
infections (cIAI), complicated skin and skin structure infections (cSSSI) and community acquired
pneumonia (1). Given an expanded spectrum of in vitro antibacterial activity, tigecycline is also
considered as one of the selected agents for difficult–to–treat infections in critically ill patients,
although there are very limited published data of pharmacokinetics in this population. FDA issued a
black box for the increased risk of mortality during tigecycline treatment for severe infections,
especially for hospital–acquired pneumonia or ventilator–associated pneumonia (2). Further
assessment of the cause of excess deaths in these trials may in part be attributed to suboptimal
tigecycline dosing. Due to these findings, several clinical studies were conducted by increasing
tigecycline dosing and obtained positive efficacy compared with other dose regimens (3, 4). High
dose tigecycline may be a desirable treatment strategy, but the degree of increment of tigecycline for
different infections cannot be generalized in a fixed high dosing. Optimization of tigecycline high–
dose regimens for dissimilar infections is needed. Early results of animal models indicated that the
ratio of the 24 h area under the curve to the minimum inhibitory concentrations (AUC0–24/MIC)
was chosen as the

Order Of Draw : The Beginning Of Phlebotomy
Carol Rozell
Tonya Goodwin
Phlebotomy
8 April 2016
Order of Draw
The beginning of phlebotomy has been well documented before the 5th century B.C. It was thought
that all aspects of the body's health came from the four body humors: blood, phlegm, yellow bile,
and black bile (wikipedia/humorism). In times of illness, health was restored by purging, starving,
vomiting, and bloodletting. Astrology played a big part in healing according to the phases of the
moon. Healing was mostly controlled by priests, and then passed along to barbers who took over the
daunting tasks of body healing. The red and white stripes of the barber's pole signified a place of
healing. Red represented the blood, and white represented the tourniquet. Using tools called "spring
loaded lancet," "scarificator," and "fleam," the body was to be brought back to a normal state
(Mestel, wikipedia). The barbers were armed with tools to amputate, pull teeth, and remove blood
(Ford, Graham). Little did they know that the popularity of draining the body of between 1 to 4 pints
of blood could be deadly. Leeches were another popular bloodletting instrument. After engorging
themselves, they would then fall off the body where the blood would continue to ooze out due to
clot inhibitor they left behind (Mestel). Another popular procedure called cupping involved making
a cut into a vein and applying a heated vacuum flow cup over the incision. In 1799, our first
president George Washington, was drained of nine

Arterial Lines
Arterial Lines 3/8/05
1– What is an a–line? 2– What are the parts of an a–line? 3– Does it matter if the flush setup is
made with saline or heparin? 4– What are a–lines used for? 5– What do I have to think about before
the a–line goes in? 6– What is an Allen test? 7– Where can a–lines go besides the radial artery? 8–
Who inserts a–lines? 9– How is it done? 10– What kinds of problems can happen during a–line
placement? 11– How do I use an a–line to monitor blood pressure? 12– How should I set the alarm
limits? 13– How do I draw blood samples from a–lines? 14– What order ... Show more content on
Helpwriting.net ...
4– What are a–lines used for?
Two things mainly: blood pressure monitoring, and for patients who need frequent blood draws.
Any patient on more than a small amount of any vasoactive drip really needs to have an a–line for
proper BP management – if they're sick enough to be put in the unit and need pressors, then they're
sick enough for an a–line. Non–invasive automatic blood pressure cuffs are useful, but if a person is
labile – push for an a–line.
Certain situations absolutely require an a–line for BP monitoring: any use of any dose of nipride, for
example. This is a truly powerful drug – it works very quickly, and your patient can rapidly get into
all sorts of trouble unless you're monitoring BP continuously.
I've heard lately that there's a trend towards using fewer a–lines – it seems silly (and painful) to have
your patient get stuck what seems like twelve times in a shift for labs and ABGs. Remember that it's
always been our unit's policy for nurses to send ABGs after every vent change, or for any clinical
change that the patient makes.
Update – this has changed a little: ABGs probably don't seem to be necessary for vent changes that
are only going to affect oxygenation: changes in FiO2 or PEEP, since the O2 sat will keep you

Reception And Outpatient Are The Reception Area
a. Reception/Outpatient Area: The reception area was taken care of by the Veterinary Assistants and
the Veterinary Technicians. This is where they have their main computer and any files or folders for
outpatients. Majority of the folders for patients just coming in are hung on their cages since
normally they are in and out before they can be filed away, and to help keep employees updated
throughout their shift. The patents folders include; chief complaint, any medications given/when to
give them, any IV fluids given/ and vitals.
b. Treatment/Triage Area: There is not a specific area for this. The receptionist relays the
information to the Veterinarian and Veterinary Technician so they can decide who needs to be
treated next. The worst ... Show more content on Helpwriting.net ...
They have an Orthopedic Surgery Suite and a Common Surgery Suite. They are generally set up the
same except the orthopedic suite has a wall of cabinets which occupy all of their supplies needed for
surgery. The common surgery suite has very minimal in it because they have a "pass through
window." Each suite contained Pulse Oximeter, Multi–perimeter machine, blood pressure, ECG
machine, surgery table, chair, and suction machines.
e. Laboratory/Diagnostic Area: This area is within the main ICU/Hospital Area. There is a wall
dedicated to Laboratory work. The wall is lined with posters of parasites, how to do a PCV,
microscope, sink, dyes for staining slides, and fecal analysis directions.
2. CRASH Cart Contents:
a. Top of the CRASH cart consisted of electrocardiograph, pulse ox, a blood pressure unit/multi–
perimeter unit, and gloves.
The top drawer was intubation supplies, endotracheal tubes, laryngoscope handles, and blades of
various sizes. Also had orange strings and a spool of mesh for tying the endotracheal tubes in place
to the patient.
The second drawer was mostly drugs for drug therapy. Epinephrine, atropine, and Dextrose 50%.
This facility doesn't keep Vasopressin in the CRASH cart because they find they don't need to use it
as often. The other side of this drawer was preassembled needles and syringes. The wall behind the
crash cart had drug charts and also there was a stack inside of this drawer for when the CRASH Cart
is

Nonalcoholic Fatty Liver Disease (Nafld), Is A Form Of
Nonalcoholic fatty liver disease (NAFLD), is a form of chronic liver disease ranging in severity
from simple fat infiltration (steatosis) to an advanced form, nonalcoholic steatohepatitis (NASH,
steatosis with liver inflammation) with subsequent progression to fibrosis.1 The relationship
between gut flora and the development of NAFLD have been under study for almost the last decade.
Uncontrolled growth of gut bacteria and translocation of gut microorganisms from the intestinal
lumen predispose patients to multiple bacterial infections. 2
The portal vein carries blood containing digested products and gut microbiota products to the liver.3
Factors like increased gut permeability, and increased bacterial endotoxins, especially ... Show more
content on Helpwriting.net ...
liver damage and mitochondrial dysfunction will follow which contribute to fat accumulation and
development of NAFLD.9
Therefore, the liver–gut interaction is central to understand the pathophysiology of liver diseases,
including non–alcoholic fatty liver disease (NAFLD) and hepatic encephalopathy. Current
knowledge on the association between gut microbial composition and NASH is incomplete. Liver
malfunction leads to altered genetic composition of gut microbial, and in the meantime specific
bacterial species are present during liver pathogenesis, and the abundance of some bacteria is
correlates with grade of liver disease, implying the term "gut–liver axis".
Toll–like receptors (TLRs) constitute very important players in this microbiome balance. TLRs are
trans membrane non–catalytic receptor proteins that prompt activation of innate and adaptive
immune responses to microorganisms through recognition of conserved molecular patterns of
organisms. In order to maintain immune tolerance to the luminal microorganisms the expression of
TLRs by intestinal epithelial cells is normallyat its minimal.

Subject Identification And Enrollment For Alzheimer 's...
Subject identification and enrollment Subjects recruited for this study consisted of individuals aged
60 to 85, with 10 or more years of education or more. Those diagnosed with Alzheimer's disease
(AD) and mild cognitive impairment (MCI) were recruited to the study at the Memory Clinic of the
Jewish General Hospital (JGH) in Montréal, and normal community elderly volunteers were
recruited through advertising. Subjects received standardized clinical, mental status,
neuropsychological, and cognitive evaluation. Depression was excluded via the Yesavage Geriatric
Depression Scale (Geriatric Depression scale > 15) [37]. None had evidence of cerebral infarct on
CT, and all subjects scored less than 4 on the Hachinski ischemic scale [38]. No individuals had
evidence of significant heart disease, alcoholism, or drug use and all showed normal routine blood
work. Subjects were classified as normal if they lacked subjective memory complaints, and scored
at or above 26 on the Montreal Cognitive Assessment test [39], and scored above 25 on the Folstein
Mini–mental state exam (MMSE) [40]. Their average MoCA score was 27 (range 25–29). The AD
patients received the diagnosis of mild, moderate, or severe probable AD according to standard
clinical criteria [41]. They had mild, moderate, or severe probable AD [42], scored below 26 on the
Montreal Cognitive Assessment test [39], scored between 4 and 25 on the Folstein Mini–mental
state exam (MMSE) [40], and showed

Essay on Point-of-Care Coagulation Platforms for...
Thrombophilia defines inherited and acquired conditions associated with an increased thrombotic
risk, which predispose to venous thromboembolism (VTE), cardiopulmonary bypass (CPB) and
stroke. Thromboembolic events have long been treated with the most commonly used anticoagulant
drug, heparin that is rapidly replaced by low molecular weight heparin (LMWH). A variety of
point–of–care (POC) coagulation platforms have been commercially available for many years now,
providing more control over the patient's anticoagulation management such as heparin and warfarin.
While the measurement for anticoagulation by POC devices has relied mainly on the clotting time
tests, innovative platelet function tests, and factor–specific assays based on ... Show more content
on Helpwriting.net ...
While the prevention of a thrombotic event achieved by an anticoagulant, over– or under–dosing
can give rise to excessive bleeding or severe clotting respectively, therefore closely link therapy
with monitoring is essential. Several techniques have been developed to address the disadvantages
of large sample volumes, by multiplexing of the assays in which various parameters or analytes are
measured concurrently from a single sample.
While laboratories became unable to provide results in time frames needed to allow rapid
turnaround that would allow timely intervention of anticoagulant therapy, the requirement for POC
coagulation monitoring techniques became essential (Harris, Castro–López and Killard, 2013).
In this review, I will focus on the availability of POC diagnostic tests for monitoring the
anticoagulant therapy for thrombophilia. I will first describe the conventional clot–based assays and
then, I will attempt to address current advances in microfluidic POC tests used for monitoring
thromboembolic–related events and highlight new fluorescence–based anti–Factor Xa (FXa)
microfluidic POC assay platform for monitoring both unfractionated and low molecular weight
heparins and fluorescence–based blood coagulation assay platform for monitoring activated partial
thromboplastin time (aPTT). Also, I will

Venipuncture Procedure
As difficult as this procedure might seem, performing a routine venipuncture is a relatively easy and
quick procedure. The word venipunture in medical terminology is defined as "puncture to the vein"
which often is performed by a phlebotomist; this healthcare professional is a trained individual who
specializes in drawing blood. Let's face it, many of us are afraid of needles, even I would have never
thought of performing this procedure myself. So if I did, so can you.
Let's begin by proceeding with the first and most important step, greet and identify the patient.
Always ask his or her name and date of birth. It is necessary to make the patient feel welcomed and
secure. Verifying their identity is a procedure for assurance that all given tests are not performed on
wrong patients, this could result in wrong test results for the patient.
Start with gathering the following supplies: A pair of gloves, needle, vacutainer (tube holder), blood
collection tube, tourniquet, alcohol, gauze and band Aids. When choosing the tubes, determine this
according to the physicians order given to you by the patient. When choosing the needle size,
determine this based on the physical appearance of the vein, this will not only make it easier but it
will also make your technique better. ... Show more content on Helpwriting.net ...
Now explain the procedure to the patient so that when the moment arises they are prepared as to
what to expect. First you will put your gloves on, sit the patient down and apply the tourniquet to
palpate the vein. The key to puncturing the vein is not by seeing it but rather by palpating it; this is
the proper technique that is used when venipuncture. You will take a few second to examine and feel
the vein; this will give you a clear vision of the depth and width. This step should not take longer
than one minute. After you are positive about the puncture site, proceed with cleansing the area and
allow the area to dry for thirty

Causes And Symptoms Of Hantavirus Pulmonary Syndrome
Hantavirus Pulmonary Syndrome
I. Background
CW, an 18–year–old Caucasian male, presented at a rural hospital located in northwest New
Mexico. CW complained of flu–like symptoms including a headache, chills, vomiting, diarrhea,
fever, and myalgia for the previous two to four days (Staff, 2014). He stated within the past 24 to 48
hours he had developed a productive cough, a tightening in his chest, and shortness of breath. When
questioned what, his activities were prior to the onset of symptoms he stated he was a student and
played tight–end for the football team. When probed further he stated one to two weeks prior he
cleaned some sheds on his parent's farm. While waiting on lab results from the bloodwork, CW
went into respiratory distress. He was intubated and sent to the ICU for supportive care.
II. Physical and Laboratory Findings
On examination, the physician listened to CW's lungs, noting there was diminished lung sounds
with crackling. Chest X–ray showed acute pneumonia in both lungs. The physician also noted
swelling in CW's chest and neck area (Cunha, 2015). Blood was drawn with a heparinized
vacutainer tube and a serum separator vacutainer for serology, and reverse transcriptase–
polymerase chain raction testing. While CW was in intubation there were lung tissue samples
obtained for the immunohistochemistry. The serum lab results showed, on a smear, there was
evidence of immature leukocytes (Cunha, 2015), as well as an increase in virus–specific IgM. An
acute–and

Venipuncture: Blood and Vein
When blood is removed from a vein, it is called venipuncture or phlebotomy. Venipuncture should
be performed with care. The veins of a patient are the main source of specimens for testing, the
entry point of medications, and the site for IVs and blood transfusions. Because there are only a
limited number of easily accessible veins in a patient, it is important that everything be done to
preserve their good condition and availability. Universal precautions should be observed at all times.
Gloves should always be worn when obtaining blood specimens. BEFORE BEGINNING ANY
PROCEDURE–ACCURATELY IDENTIFY THE PATIENT ! Follow the proper protocol to identify
the patient make positive identification of the patient by checking hospital armband for ... Show
more content on Helpwriting.net ...
The median basilic, at the inner edge of the arm, may have tendency to roll and is near a main artery
and nerve. This part of the arm is very tender. The cephalic vein also has a tendency to roll and the
skin over it is often tough. Using the index or middle finger, palpate the arm, feeling for the best
vein. If a vein cannot be found try the following suggestions. Gently pat the site to enlarge the veins,
massage the arm, wrap the arm in a warm towel, check both arms, always select the most suitable
vein for puncture. When selecting a vein, seek another site for puncture if any of the following
conditions exist: edema, burn, hematoma, I.V. If another site is not available, consult the supervisor.
Scrub the site of the puncture with a alcohol pad. Use a circular scrubbing motion, from inside to
outside only. Cover a wide area around the selected site, 3 to 4 inches. This may have to be repeated
depending on the cleanliness of the patient. Cleansing the site prevents chemical or microbial
contamination of specimen and patient. Do not touch this area again. Let the area air dry. Do not
blow on or fan the area. The alcohol should be allowed to dry to avoid hemolysis and/or burning
sensation when the venipuncture is performed. It is better to use syringes if veins are small. butterfly
collection sets are also available and useful if multiple tubes are needed. If a syringe is used, move
the plunger up and down in the barrel once or

Evidence Collection Guidelines
Evidence Collection Guidelines
This document provides evidence collection guidelines for the following types of evidence. Your
agency 's policies may vary. Please check with your supervisor if you have any questions.
Contents
Blood Stains Seminal Stains Hair Fibers and Threads Glass Paint Flammable Liquids Firearms
Evidence Tool Marks ws Questioned Documents Latent Fingerprints
In all cases, evidence must be photographed prior to collection attempts. At least one photo should
include a scale for reference, but initial photos should be free of any markings.
Blood Stains
Blood that is in liquid pools should be picked up on a ... Show more content on Helpwriting.net ...
These samples are not retained for long periods by the hospital, so it is important to act promptly.
Also, make sure that some bloodstained garment worn by the individual has been air dried and
frozen to serve as a secondary standard.
Handling and Storage of Physiological Fluid Evidence
(Obligation under People vs Nation and Hitch that a reasonable and good faith effort be made to
preserve perishable evidence) Stains and Controls 1. Air dry 2. Package in paper 3. Freeze
Consider special handling of non–absorbent items on (metal or plastic). Any condensation from
thawing could disturb or destroy such evidence. Such items should be kept at room temperature and
submitted to the lab as soon as possible. Liquids (generally standards) Blood Refrigerate, do not
freeze standards collected in yellow stoppered vacutainers.
Submit to the lab as soon as possible.
Saliva
Collect on a sterile gauze pad or swabs, allow to air dry and package in paper. Do not use plastic
containers.
Seminal Stains

Seminal stains are often, but not always, found on clothing, blankets, sheets. Allow any stains to air
dry, wrap in paper, and package evidence in paper bags. Do not use plastic bags.
For sex offense cases, the victim should always be examined by a physician. A Sexual Assault
Evidence

Placebo And Red Bull Experiment
The purpose of this study is comparing the effects of Red Bull and a non–caffeinated drink with
endurance cycling TT performance. The hypothesis of this experiment is that the Red Bull and the
non–caffeinated drink will improve the performance between each trial compared to the placebo.
There were 12 subjects, but one withdrew from the experiment due to stomach problems. The 11
participants are male, age between 25–37 years old, no height represented, weighing between 76–88
kg and the participant was a cyclist or athlete. Each participant went to the laboratory 6 different
times. The first visit of the experiment was to let the participant do a cycle ergometer test for
exhaustion. After the first visit, the participant had to do 2 more visits ... Show more content on
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Also, the participants didn't drink any alcohol or do strenuous exercise before each trial. The TT
(time–trial) improved for both caffeine and Red Bull compared to the placebo. The caffeine was
.043 and Red Bull was .039. The average of TT times also improved for caffeine, Red Bull and
placebo. The caffeine improved by 3.1% between 120 to 292 seconds. The Red Bull improved by
2.8% between 109 to 262 seconds. The trend of HR, RPE, and quadriceps muscle pain increased
rapidly. The average HR for caffeine vs. placebo was .068. The average HR for Red Bull vs. placebo
was .086. The amount of leg pain with caffeine vs. placebo was .085. The amount of leg pain with
Red Bull vs. placebo was .052. The HR value and amount of leg pain values failed to reach the
amount of statistical significance. The gastric discomfort had a rating greater than 5 on a scale of 10
from 2 participants from ingesting Red Bull. The participants said the pain was very sharp feeling
nauseated. The rest of the participants has a minor discomfort from the experiment less than 3 on a
scale of 10. The plasma caffeine and glucose wasn't different between all 3 different conditions with
caffeine, Red Bull and placebo. The participants were blinded and couldn't guess the order of which
each variable was given to the participant during the experiment. Only 1 participant guessed the
right order of how each variable was given through the trial. The results of the experiment was to
compare the effects of Red Bull with an equal amount of caffeine with TT endurance cycling
performance. The hypothesis was proven right that the Red Bull and the non–caffeinated drink did
improve the participant's performance compared to the placebo containing Gatorade and carbonated
water. The results also vary that the ingredients doesn't alter the plasma caffeine, glucose,
quadriceps muscle pain, HR, or

Evaluation Of A Blood Test
Patient 2 was a 65 year old female who had arrived with her blood test request form for a
coagulation screen, which includes INR (prothrombin time), APTT (activated partial thromboplastin
time) and fibrinogen. A prothrombin test measures how long it takes for blood to clot, or, coagulate.
APTT is a screening test done which evaluates the function of a patient's intrinsic clotting system,
the factors of prothrombin and fibrinogen that are involved, as well as prekallikrein (PK) and high
molecular weight kininogen (HK). Additionally, Patient 2's heparin anticoagulant therapy needed to
be monitored; heparin being an anticoagulant which is administered intravenously or by injection in
order to treat blood clots. A single CITRATE tube of the colour light blue was used for the patient's
blood collection; this tube contains sodium citrate as an anticoagulant and is used for drawing blood
for the purpose of coagulation studies.
Blood collection procedures begin with the health practitioners, for example doctors, generating a
blood test request form during a patient's visit. The request form contains important information
regarding the patient, their doctor and the tests required. In terms of the patient information, details
include; registered family name and given names, their gender, contact details, address, date of birth
and NHI (national health index) number. Additionally, particular request forms can include vital
clinical details about a patient's medical history or any

Preanalytical Reflection Paper
Preanalytical Reflection Paper Jaime Stayton Module G April 5, 2017 Jennifer Upsher In the
medical industry, a venipuncture procedure is the "process of obtaining intravenous access for the
purpose of intravenous theory or for the blood sampling of venous blood" (Harbert, 2013). This
procedure can be done by many individuals such as: paramedics, phlebotomist, medical laboratory
scientist, and other nursing staff. There are several steps an individual must take when preforming a
venipuncture procedure. The first step is to identify yourself to your patient. During this step, the
phlebotomist should walk to the assigned patient and discuss: who you are, what you are doing,
where you are from, get the patient's permission to do the venipuncture, as well as see ... Show more
For this procedure, prepare the site, and discuss with the patient what is going on and what will
happen. Once everything is set up the phlebotomist will complete the venipuncture procedure by
order of draw either by ETS venipuncture or syringe venipuncture (Harbert, 2013). In order to
maintain a sanitary environment and reduce the risk of infection, the next step is generally to
dispose of all contaminated materials and clean the puncture site and area; this is a controllable
situation. Once the patient and drawing area have been attended and taken care of, the next step for
the phlebotomist is to invert and accurately label all the specimens drawn with the patient's
identification, date of time (DOT), and signature of the phlebotomist. If the phlebotomist performed
the proper order of draw, this part should be completed fairly quickly. Lastly, the phlebotomist needs
to send the collected specimens off to the lab by doing so, this will ensure the specimens retain their
qualities long enough for testing. Although, this is controllable, once it goes to the lab the phase
goes to the analytical

Comparative Value Of Real Time And Conventional Pcr
Comparative Value of Real Time and Conventional PCR in Antenatal Gender Determination
Naglaa Ibrahim Azab1, *, Rabab Fawzi Salim1, Mohamed A. Hadi Farag2
1 Department of Medical Biochemistry, Faculty of Medicine, Benha University, Benha – Egypt.
2 Department of Gynecology and Obstetrics, Faculty of Medicine, Benha University, Benha –
Egypt.
*Corresponding author naglaa1270@yahoo.com, naglaa.azab@fmed.bu.edu.eg
ABSTRACT
Invasive procedures including chorionic villus sampling and amniocentesis in sex–linked diseases
increase the risk of fetal loss. Therefore, Noninvasive fetal gender determination using cell–free
fetal DNA (cffDNA) in maternal plasma may be promising. Fifty pregnant women with gestational
age between sixth to tenth weeks were included. cffDNA were extracted from maternal plasma and
amplified by real time PCR and conventional PCR for detection of SRY, DYS14 and DAZ genes as
specific genetic markers for male–bearing pregnancies. In general, sensitivity and specificity of real
time PCR was better than conventional PCR. However, sensitivity of DYS14 gene and specificity of
SRY gene by real time PCR was equal to those of conventional PCR. Sensitivity of DYS14 gene
was the highest and sensitivity of SRY gene was the lowest. However, combination of the three Y–
chromosome sequences in the diagnosis increased the test accuracy, which is suitable for clinical
application.
Keywords: Fetal gender determination, cell free fetal DNA, SRY gene, DYS14 gene, DAZ gene,

Coexistence of Autoimmune Disease with Type I Diabetes...
MATERIAL AND METHODS The prospective clinical study was undertaken on 849 patients
admitted in endocrine department of Tripoli Medical Center from December 2007 to July 2008.
From the patients files, the concomitant disease presence or absence was also recorded; especially
with reference thyroid function. The important investigations as prescribed by the physician were
also recorded. patient's serum level of T4, T3, FT4, FT3 and TSH were measured for 748 patients.
The venous blood samples were taken from all the subjects in the morning after fasting overnight
while TPOAb and TGAb level were measured abroad. 101 of patients with type1 diabetes mellitus
were included in this study were investigated for celiac disease and Addison disease. Both diseases
were diagnosed abroad. Celiac disease patients have been diagnosed by finding a positive anti–
tissue transglutaminase (TTG) test and Addison disease diagnosed by finding positive 21–OH
antibody. The present study was approved and done according to ethics guidelines of Tripoli
Medical Center. Specimen collection and preparation for analysis Blood samples were collected into
polyethylene test tubes. SST tubes were used for serum collection. From BD Vacutainer CO.,
Belliver Industrial Estate, Plymouth. Serum was separated by centrifuge for 5 min at 3,000 rpm to
eliminate cell debris using Heraeus centrifuge from Germany. Serum samples were stored at –20°C
until assay.T4; T3, FT4, FT3 and TSH were measurement by the

Hexokinase Lab Report
Principle
Hexokinase is an enzyme that catalyzes the reaction between ATP and glucose. This reaction
produces ADP and glucose–6–phosphate. When glucose –6 –phosphate is present with NAD it is
oxidized by glucose–6–phosphate dehydrogenase to a phosphogluconate and NADH. The
concentration of NADH is proportional to the glucose concentrations and can be measured by a
spectrophotometer at 340nm (CDC,2003–2004).
Clinical Significance
Measuring glucose levels in human serum has proved valuable in diagnosing and treating diabetes
mellitus. Patients with increased levels of glucose in their serum are not absorbing the glucose due
to either a lack of insulin or the inability of the body to use its insulin. Decreased levels of glucose
in an individual can be due to the improper release of stored glucose by the body. High levels of
glucose in serum can lead to blood vessel damage, and disease if left untreated. Low glucose serum
levels can lead to shock and coma.
Specimen
1. Patient fasting blood samples are collected.
2. The minimum collection volume is 0.2ml and the optimum is 1.5ml. 3–5ml of whole blood must
be collected in a gray ringed vacutainer collection tube with NaF as preservative.
3. Whole blood is obtained from vein via venipuncture. Samples must be centrifuged for 10 minutes
immediately upon collection.
4. If specimen ... Show more content on Helpwriting.net ...
Controls should be left out of refrigerated storage for a minimum of 30 minutes before used as a
calibrating agent. Glucose levels for calibration should be within 145mg/dl–158mg/dL. All control
values should be within the 95% acceptable range. If the values are outside the set limits recalibrate
the instrument per manufacturer instructions. Calibrations should be run daily and when a new
reagent lot number is obtained. Once correctly calibrated patient samples can be confidently run on
the

Biology Admission Essay
Having a passion about the human biology is to endeavor into a dimension of science, bound to
undiscovered founding and limitless exploration. Being intrigued about the human body, as we are
seen being the most advanced creatures on earth and beyond the surface of the world, we rely on
intelligence and boundless eagerness to sustain our existence. The human body is being recognized
as one of the most amazing things in the world and beyond the speck of the earth, this is based on
the fact of how many millions of cells we are designed to carry and how they are created to carry
out their jobs. I am esteemed of how much humanity has been shaped by medical discoveries and
advanced drugs, paving a new path for the incurable diseases. Parallel to, the need to apply to a
biology and chemistry based science to medical use, the liberty to further study to quench my
curiosity to widen my knowledge of the complexity ... Show more content on Helpwriting.net ...
I volunteered in various health sectors: nurseries, Sunday schools and GP surgery. During my
summer holidays, I helped out in my local GP surgery. Under the guidance of a Nurse practitioner,
where I observed communications between a patients and a nurse practitioner, based on minor
illness and often engaged into the conversation. Additionally, I also had a day where I learnt
phlebotomy, where blood sample's are taking from the vain using vacutainer or finger pricked with a
sharp and blood specimen is taking for a minute checking for blood glucose or HIV. This enable me
to gain few clinical skills and enables to communicate between patient and family members, which
only nourished my hunger and desire to partake in a role that strives to improve healthcare in my
local community. Furthermore, I had the opportunity to work at my local pharmacy. This developing
experience affected me to comprehend the importance of different pharmaceutical drugs and how
they work to maintain of our complex

Case Study Nicole Brown Simpson
Introduction: The Scenario "On June 13, 1994, Nicole Brown Simpson and Ronald Goldman were
found dead outside of Nicole Brown Simpson's condo in Brentwood, California at approximately
midnight" (Case). "A few days later on June 17, 1994, as police go to arrest OJ Simpson as a suspect
in the murders, Simpson and a friend attempted to flee in Simpson's white Bronco but Simpson was
eventually apprehended at his house after the chase concluded" (Linder). "On July 22, 1994,
Simpson pleaded not guilty to charges of two counts of first degree murder" (Linder). The trial
lasted from "January 29th, 1995 to October 3rd, 1995" when Simpson was ultimately found not
guilty for the murders because there was not sufficient enough evidence to convict Simpson ... Show
more content on Helpwriting.net ...
"Blood found on the socks contained genetic markers associated with both OJ Simpson and Nicole
Brown Simpson" (List). As we learned in class the blood evidence was very important because of its
role as a body fluid containing DNA. This evidence should have been critical in linking OJ Simpson
to the crime scene and with Nicole Brown Simpson. According to the defense Nicole Brown
Simpson's blood was planted on Simpson's socks to implicate him. "One of the defense's claims was
that from the blood samples collected on the sock there was EDTA present" (Matheson). In class we
learned that EDTA is used in the purple topped vacutainer vials that are used to collect blood. The
EDTA helps to stop the blood from coagulating and instead keeping it a liquid form. "According to
the FBI analysis the levels of EDTA found were only 1/1000 that of what would be in a vacutainer
vial" (Matheson). Given this information I would reasonably conclude that this is probably not
blood from a vacutainer vial and that the evidence was not likely planted by someone. "Another
claim that the defense had was that the blood had soaked all the way through the socks which would
not have been possible if OJ Simpson would have been wearing the socks" (List). One of the things
we studied in class was blood stain patterns. In particular one of the patterns was a wipe. If OJ
Simpson had taken the socks off and left them on the floor it would make sense that if the volume of
blood on the socks was substantial, like the amount of blood at the scene, that the blood could still
be wet enough to wipe blood from the front of the socks to the back of the socks and soak through.
A lot of this would depend on how much time it took between the murders and OJ Simpson
removing his socks, because if the blood had already started to dry before he took them off the
blood likely wouldn't

Becton Vacutainer Essay
1. How has the healthcare industry changed from pre–1983 to post–1983? What are the implications
for the Vacutainer Division?
2. How has Becton–Dickinson managed to be so successful (market share–wise) in this market?
How important is the APG contract?
3. What are the interests of the key stakeholders in the terms of the Vacutainer–APG negotiations?
4. What should Becton–Dickinson do with respect to the demands from APG?
Value Proposition | For (customer), (company) offers its (product), which unlike the (competition)
provides the owner with (benefit). | 5Cs | 4 P's | Customer * Material mgrs of hospitals * Healthcare
professionals * Medical research institutions * Industry – hospitals, medical laboratories, non
hospital ... Show more content on Helpwriting.net ...
Direct Sales | Collaborators * Affiliated Purchasing Group (negotiated price w/ BD) * BD product
distributors (negotiated price w/ BD) * American Scientific Products (ASP) * Curteon – Matheson
Scientific (CMS) * | Promotion * Use of bottom up sales strategy (p7) | Competition * Terumo,
Japanese company * Sherwood Medical Corp, US based | | SWOT Analysis | Strengths * Blood
collection systems were designed to meet hundreds of different needs – product assortment * Color
coding schemes to make jobs easier * This evacuated – tube blood collection superior to needle –
and – syringe: specimen integrity, convenience, lower costs, sterile for safety, backed by in depth
clinical and research studies, company stands behind every tube you use * BD was the pioneer in
converting the market to evacuated tubes * 80% market share in USA, and in USA 100% venous
blood collection was done using evacuated tubes * Other suppliers needles and lancets * BD had a
broadest line of blood collection products in the industry * Among bench people VACUTAINER is
the best known product * Quality aggression – due to its vertical integration BD could keep a tight
hold on quality | Weaknesses * < 40% of the blood collections in ROW were done using
evacuated tubes | Opportunities * Bench people – lab technicians are the most concerned and need
to be targeted * 70% of blood tests are done in hospitals * Significant revenue for commercial labs
came from

Diabetic Foot Ulcer Research Paper
Diabetic foot ulcer (DFU) is a major complication of diabetes mellitus [2]. Non–healing ulceration
usually progress to amputation in spite of standard care. DFUs result from interaction of
;neuropathy, peripheral vascular disease and foot deformity. 80% of diabetic persons with foot
ulcers present with peripheral neuropathy which is the greatest risk of foot ulceration [3].
Neuropathy in DM shows variable degrees of autonomic, sensory, and motor functions changes[4].
Motor neuropathy causes atrophy of the foot muscles resulting in clawing of the toes, sensory
neuropathy results in repetitive trauma to the foot, and autonomic neuropathy changes skin
consistency so accelerating ulcer formation [5] .40 to 50% of all patients show ischemic
manifestations with the most having neuroischemic ulcers, and only few of them has purely
ischemic ... Show more content on Helpwriting.net ...
Materials and methods This study was conducted on 30 subjects: 15 with diabetic foot ulcers and 15
with varicose vein ulcers as a comparison group. The study protocol was done according to the local
ethics committee of the Menoufia University. Informed consents were taken from the subjects
before the start of the study. For all subjects, the followings were done: history taking and clinical
examination, clinical evaluation of the ulcers, complete blood count, preparation of platelet rich
plasma (PRP) and quantification of Platelet count in it, preparation& application of PRP gel on
ulcers, quantification of platelet derived growth factor (PDGF–AB) in PRP prepared before and
after activation ,using CaCl2, by sandwich–based enzyme–linked immune–sorbent assay (ELISA)
(Ray Biotech – USA)

Analysis Of Blood Exo DNA
Blood Exo DNA ProTeck™
Vacutainer blood collection tube for stabilizing extracellular vesicle DNA in a whole blood sample
Research Use Only.
Store at room temperature (18 to 25⁰C)
Catalog #
0019273 9 × 10 mL tubes
0019273 100 × 10 mL tubes
Intended Use
Blood Exo DNA ProTeck™ is a 10 mL vacutainer blood collection tube for stabilization of
extracellular vesicle DNA in a whole blood sample at room temperature for at least 30 days.
Extracellular vesicle DNA is extensively used for in vitro noninvasive prenatal and cancer
diagnostic assays. This product is intended to provide a means of inhibiting post–phlebotomy
extracellular vesicle release from blood cells in a ... Show more content on Helpwriting.net ...
This increased non–target background DNA may severely hamper the detection of target DNA
within a blood sample. Chemical composition present in Blood Exo DNA ProTeck™ will prevent
blood cells from releasing extracellular vesicles after blood draw stabilizing extracellular vesicle
DNA in a blood sample for more than 30 days at room temperature. This will enable clinics and
small laboratories to ship blood samples to central laboratories for blood processing and DNA
analysis.
Storage and Stability
1. This product, prior to blood draw, is stable until the expiration date written on the tube when
stored at room temperature (18 to 25⁰C).
2. Once blood is drawn into Blood Exo DNA ProTeck™ tube, extracellular vesicle DNA is
stabilized for at least 30 days when stored or shipped at room temperature (18 to 25⁰C).
Instructions for use
Blood Collection
1. For blood collection by venipuncture follow guidelines given by CLSI H3–A6 (3).
2. Take all possible precautions to prevent backflow since Blood Exo DNA ProTeck™ contains
chemicals. Follow the given instructions to prevent backflow.
(i) Patient's arm should be in a downward position.
(ii) Should hold the tube with the stopper uppermost.
(iii) Make sure to release tourniquet once blood starts to flow into the tube.
(iv) Make sure to fill the tube completely. Short draws may cause hemolysis.
(v) Remove the tube from the adaptor

Ebola Epidemic : A Deadly Disease Caused By Five Different...
History The Ebola Haemorrhagic Fever is a deadly disease caused by five different strains of the
Ebola viruses. Whilst the Reston virus only causes illness in animals, the rest cause severe illness in
humans and animals (Stanford Edu, 2014). The Ebola virus was discovered in 1976 in the
Congolese rainforest in central Africa, by a young Belgian scientist named Peter Piot (BBC News,
2014). Piot discovered the first known strain of Ebola, known as Ebola – Sudan (SUDV). Ebola–
Sudan was discovered in the regions of Sudan and Zaire in Africa, with a mortality rate of 53%. A
few months late the second strain of Ebola emerged, known as Ebola – Zaire (EBOZ), and had a
high mortality rate of 88% (CNN, 2014). Throughout the years up until 2014 there have been over
10 Ebola epidemics that have killed more than 3,600 people, mainly in African countries (REF).
However, the 2014 Ebola epidemic is the largest in history, affecting multiple countries. As of
September, around 2,000 people had died from the disease, and as of early November there had
been nearly 5000 deaths (CDC, 2014). The Ebola Virus needs to be addressed as it is beginning to
spread to other countries, and with no cure this will result in alarming death rates (Prevention,
2014). The Centre of Disease Control and Prevention is predicting up to 21,000 cases by early next
year (Stanford edu, 2014). Figure 1: Timeline of Deaths due to the Ebola Virus Structure The
structure and pathogenesis of the Ebola virus is

Pfa 100: Platelet Function Assay
PFA –100® Platelet Function Assay
Jennifer Dorman
I, Jennifer Dorman, have not received any unauthorized aid on this assignment.
PFA –100® Platelet Function Assay
Equipment
The platelet function assay performed in McLendon Clinical Laboratories at UNC Hospitals utilizes
the PFA –100® system manufactured by Siemens Healthcare, Inc. (1, 2)
Indications
The platelet function assay is a screening test for detecting platelet dysfunction during platelet plug
formation in primary hemostasis. (3) This test has replaced the invasive and unreliable bleeding time
method, which was used to monitor clot formation in patients before surgical procedures. (4)
Patients can present with inherited platelet dysfunction, or most commonly, platelet ... Show more
Siemens. PFA–100® System [Internet]. Malvem: Siemens Medical Solutions USA, Inc.; c2017
[cited 2017 Mar 24]. Available from: https://usa.healthcare.siemens.com/hemostasis/systems/pfa–
100
3. McLendon Clinical Laboratories. (McLendon Clinical Laboratories, UNC Hospitals at Chapel
Hill). [Platelet Function Screen (PFA–PLTS); Coagulation Clinical Rotation Handout]. 1p.
4. McKenzie SB, Williams JL. Clinical Laboratory Hematology. 3rd ed. Upper Saddle River:
Pearson; 2015. p. 754–755.
5. Platelet Function Screen (PFA, PFA–100) [Internet]. Chapel Hill: McLendon Clinical
Laboratories.; c2017 [cited 2017 Mar 24]. Available from: http://www.unchealthcare.org/mclendon–
clinical–laboratories/available–tests/platelet– function–screen–pfa–pfa–100/
6. Platelet Function Testing: PFA–100 [Internet]; c 2013 [cited 2017 Mar 26]. Available from:
http://practical–haemostasis.com/Platelets/platelet_function_testing_pfa100.html
7. McKenzie SB, Williams JL. Clinical Laboratory Hematology. 3rd ed. Upper Saddle
River: Pearson; 2015. p. 680–684.

8. Cristobal C. Coag Rotation Paper [Internet]. Message to: Dorman J.
2017 Mar 23 [cited 2017 Mar 25]. [1

Hepatocellular Carcinoma Essay
Introduction: Hepatocellular carcinoma (HCC) is the fifth most common malignancy worldwide and
the second cause of cancer–related mortality in eastern and western countries [1]. Each year,
>700,000 patients diagnosed as HCC and morbidity rates of HCC continue to increase, possibly due
to deterioration of environment, unhealthy dietary habits and other related factors [2]. Reversion–
inducing–cysteine–rich protein with kazal motifs, also known as RECK, is a human gene, thought to
be a metastasis suppressor against activated ras oncogenes [3]. It is a promising goal for controlling
tumor invasion and angiogenesis. Although RECK mRNA is expressed in most of normal human
tissues and untransformed cells, the protein level is low or ... Show more content on Helpwriting.net
...
Sampling: Under complete aseptic conditions, 8 ml of venous blood were collected .Each blood
sample was divided and divided as follows: Tube A :4 ml were collected in plain tube, left to clot at
37ºC ,then centrifuged ,clear sera were separated and divided into 3 aliquots; the first one was used
to determine liver function tests(total &direct bilirubin, AST, ALT, GGT,ALP, total protein and
albumin) by using AU640 autoanalyzer. The second was used for measurement of alpha feto–
protein by enzyme–linked immunosorbent assay using Human AFP ELISA kits supplied by Glory
Science(Immunospec Corporation, 7018 Owensmouth Ave. Suite 103 Canoga Park, CA, 91303) and
the third one used for detection of hepatitis markers antibodies (HBsAg, and HCV antibody) by
direct sandwich assay using the ELISA Kit supplied by Adltis, Germany. The specimens were kept
frozen at –20 ˚C until the time of assay, Tube B: 2 ml were collected in a sterile sodium citrate
vacutainer tubes for immediate assay of prothrombin time, concentration and INR and Tube C: 2ml
were collected in sterile vacutainer tubes containing EDTA for DNA extraction. Evaluation of
RECK gene polymorphisms DNA analysis: Polymerase chain reaction–restriction fragment length
polymorphism PCR–RFLP method was used to

Practicum Report
Samantha Corp Medical Assistant Externship Medical Assistant Practicum Report In my externship,
I split my time between the lab at the hospital and the office. A typical day for me began at 7 in the
morning. I started at the lab drawing blood out of patients. Usually on Mondays, it was the busiest.
An order would come in through the window, once the patient had registered. On this order, there
was the patient's hospital ID number and their demographics, which included: name, address,
insurance information, and their primary care physician. If it was a recent order from the doctor,
then it would have the script with the registration page. If it was a standing order, such as a
Prothrombin Time, it would just have the registration page, ... Show more content on
Helpwriting.net ...
If they were to be run at a larger hospital, then they would have to order them through that hospitals
system. A courier stops by twice a day to pick up the specimens that are to be run there. I also
needed to verify that the patient's results were faxed to the appropriate offices and that the results
were added to that patients file. In the lab, it is really important that all of their information stays
together and confidential from those not authorized to see the patient's medical information. In my
first few weeks at the hospital, I also got to see some surgeries. This helped me to understand the
reasoning behind a sterile field. In the operating room, it is crucial that every piece of equipment
that touches a patient is sterile. If it is not, then the patient is exposed to several kinds of nasty
infections. Before the surgery/procedure starts, a nurse checks the patients file and then scans in
every piece of equipment that is used in the operating room, to insure that nothing gets left in the
patient. My Minor Office Surgery class prepared me for the sterile aspect of the medical field.
Sometime during the day, I would head over to the physician's office. Once there, I would log into
the system and check the daily schedule to see how many patients will be seen in the office that day.
Once the patient was checked in, then it would change a colored block on my screen, letting me
know that I could take the patient back. I always

Michael Curtis Soule Case Study
The straightforward case, State of Montana vs. Michael Curtis Soule, appeared to be Vehicular
Homicide While Under the Influence. But costly mistakes that happened on the law enforcement
end, ultimately altered the case into a complex situation of who done it. Such small errors like
missing evidence and being caught up in the moment can change the outcome of any case to guilty
or not guilty. In this particular case, investigators doubted their skills or second guessed evidence
that could have been the game changer.
It all started on January 25th, 2012, Michael and his wife, Jennifer Soule were traveling on
Interstate Highway 90 at about 2:00 a.m. Approximately at this time a vehicle rollover accident
occurred, launching both Michael and Jennifer ... Show more content on Helpwriting.net ...
When arrived, he instructed nurses to take possessions of Michael's clothes and to put them in a
locked locker. Trooper Josh Brown became the primary investigating officer of the crash. He went
to the accident scene early afternoon the next day after the crash. Showing up to the scene a day
later, Brown did not see the vehicle or the state of the vehicle. He was involved in witness
interviews, measurements of the crash scene, assisted with serving a search warrant of the vehicle,
downloaded the control module of the airbag and prepared an accident report. On February 22nd,
2012, Brown participated in the processing of the vehicle with Joe Pasternak from the Montana
Crime Lab. Brown testified Pasternak collected a swab of stain on the driver's side dash and marked
it as Item 15. Brown could not located the evidence to deliver to the Crime Lab. Brown has attended
a basic accident investigation training at the Montana Patrol Academy. He relied on Hospital tests
rather than the State Crime Lab's test on Michael's blood. Hospital results are to be directly for
medical purposes and must not be used for legal testing. Brown later admitted he is not familiar with
drug screening test and should have consulted with a toxicologist. Brown who has received the
accident training did no calculations and never used a computer to assume who was the driver. He
also later admitted, that the State never collected any evidence from the guardrail. His opinion was
that Michael was driving the vehicle due to the fact he was found near the driver's door. He
interviewed Gloria Wells who describe Michael as being in front of the vehicle and was "scooting".
Gloria then drew a diagram and showed Michael in front of the vehicle. Brown described the forces
created inside the vehicle were a forward motion. DNA testing revealed Michael's DNA was found
on the driver's side airbag. Brown

Discovering Cancer Cells In Peripheral Blood Focusing On
Discovering Cancer Cells in Peripheral Blood Focusing on Breast Cancer
Taylor Mitchell
Thomas University
Abstract
The discovery and use of tumor cells in pertinent to the development, diagnosis and treatment of
cancer. This paper will show specific research not only about tumor cells but also about circulating
tumor cells (CTC). It is important to understand how these cells are discovered and the recent
development in finding them in peripheral blood in a minimal amount of time. The Chemistry,
Pathology and Laboratory departments conduct a study on 90 specimens from 24 patients, all who
have been diagnosed with breast cancer. Using flow cytometry, this article will go into detail about
the usage and findings of CTCs. ... Show more content on Helpwriting.net ...
This also correlates to the response white blood cells have in peripheral blood (Jia et al., 2015).
Tumor markers and cancers cells are both produced by cancer that is the tale tell sign for the
appropriate diagnosis. Tumor markers can help detect, diagnose and treat certain kinds of cancer.
Doctors will biopsy, measure and test tumors to discover whether or not it is malignant or benign
("Tumor Markers). Tumor markers can reveal the stage along with the prognosis of the patient.
Tumor markers not the only sign that can be used to discover cancer in a patient. Circulating tumor
cells is also a useful tool. It is defined by the CellSearch assay, that CTC is a cell that is "EpCAM
positive, cytokeratin positive, CD45 negative, and nuclear stain positive (Zhao et al., 2013)."
The Department of Chemistry, Laboratory and Pathology at the University of Washington in Seattle,
WA conducted a study to increase the automated number of the counting method for CTCs in whole
blood using their own recently developed ensemble–decision aliquot ranking or eDAR. While these
cells were reported about 150 years ago, they have continued to be a useful tool in diagnosis cancer
and its treatment (Zhao et al., 2013). These particular cells has been discovered in patients with
different kinds of cancer (Zhao et al., 2013). Unfortunately, however, observation of these cells
comes at a timely cost. Up until recently it took

Material And Methods Of Blood Lac At Arrival As Potential...
Materials and methods
Part 1: Blood LAC at arrival as potential predictor variable in feedlot calves with BRD.
A total of one hundred thirty five charolais feedlot calves were transported to the commercial
feedlot located in South Farms– Beef Cattle and Sheep Field Laboratory at university of Illinois at
Urbana– Champaign– USA. All selected animals (n= 104; mean 439.93 LB) were considered to be
in good condition with no apparent injuries or disease at the time of arrival at the feedlot unit. The
selected calves did not receive antimicrobials drugs for control of BRD at the barn before or during
processing. All calves in this group were processed within 48 hrs after arrival. During processing,
each calf was individually weighed and ... Show more content on Helpwriting.net ...
This program software displayed spectrogram of recorded sounds, preprocessed lung sounds to
remove heart sounds and potential interference from the environment and classified acoustic
patterns in lung scores ranging from 1 to 5 (1 = normal, 2 = mild acute, 3 = moderate acute, 4 =
severe acute, and 5 = chronic). Following the calves examination, blood samples were obtained
from each calves in vacutainer tubes by jugular vein puncture using a 20G needle on labeled test
tube, blood LAC was recorded for each calf using Lactate Plus handheld lactate meters (Nova
Biomedical, Waltham, MA). This portable clinical analyzer has been found accurate and reliable
compared with the reference method (Hauss et al., 2014). The Lactate Plus analyzer reports LAC
values from 0.3 to 25mmol/L with a single drop of blood. The result is displayed within 13 s after a
drop of whole blood has been placed on the lactate strip. Following processing the calves will be
maintained in the beef unit according to established management and health care protocols.
Following entry, the calves were monitored daily by the unit managers and staff for detection of
clinical signs of respiratory disease (e.g. changes in mentation, anorexia, ocular or nasal discharge,
cough and altered breathing pattern) according to the unit health management protocols. A BRD
case was defined as a calf presenting a rectal temperature >40◦C

Nature of B2B Demand
"The nature of the demand for industrial products or services is different compared with consumer
products and poses unique challenges". Do you agree or disagree with the statement? Support your
position with reference to an example of a company chosen from one of the following industries –
automotive, telecommunications, information technology (computing), fast moving consumer goods
and medical equipment.
The nature of business to business marketing differs in many areas with business to consumer
marketing. The different nature of business to business marketing poses unique challenges and
raises issues that differ from issues arising from consumer marketing. The nature of demand, or the
characteristics of demand for business products ... Show more content on Helpwriting.net ...
Another characteristic that differentiate between business–to–business market demand and
business–to–consumer is that business–to–business products tend to have inelastic demand (Hutt
& Speh, 2010). This principle shows that business–to–business product has demand
characteristics with no correlation with price. BD had increased the price of its evacuated blood
collection tube between 1979 to 1985 from 6 cents per unit to 8 cents per unit, where as its
competitor, Terumo, a Japanese firm has kept its price at 6.5 cents per unit. However, BD has not
lost its market share, which was kept at roughly 80 per cent while Terumo had increased its market
share from 10 per cent to 20 per cent (Cespedes & Rangan, 1993). This change in market share
for Terumo, can be explained by other means rather than arguing that Terumo, by keeping its price,
absorbing any cost increases and inflation, has created an elastic demand like in business–to–
consumer. This argument is highlighted in the fact that in the market for blood collection needles in
the same period, even though both BD and Terumo had kept its per unit price at 7.5 cents, BD
market share has dropped from 40 per cent to 30 BD while Terumo doubled its market share from
25 per cent to 50 per cent (Cespedes & Rangan, 1993).
Finally, a global market perspective must be taken by a marketer in business to business marketing.
The demand for many business

Nursing Reflective Essay
A. Analyze your experience: One event/challenge, problem or ethical issue I encountered today was
... The computer system created a dilemma for me. Even though I had been in urgent care before,
the layout was different. It was not allowing me to access patient information much less open charts.
The computer system was giving me access to a different clinic in town. I informed my preceptor
immediately. However, my preceptor didn't know how to fix it. My preceptor than asked another
nurse for assistance, which she was able to fix the current issue. As the day progressed there were
other computer issues I came across to. For example, the computer wasn't allowing me to chart
medications that I had given with my preceptor. How I dealt with ... Show more content on
Helpwriting.net ...
She was crying while holding her right hand using her left hand. While I was interacting with the
child, she continued to cry. Even though she was attempting to answer my questions concerning her
injury. I then began to wonder how long she had been holding her injured hand up with her good
hand. I then stated, "I then stated, "I bet your hand really hurts". Without realizing it I used the
therapeutic technique of sharing observation. She nodded her head. I then grabbed a pillow and
asked her if I could place the pillow under her injured arm. I explained to her that it would make her
hand more comfortable and she wouldn't have to hold it up with her right hand. She agreed, after
placing the pillow under her left hand she seemed to relax a little bit. She still had tears, but she was
able to communicate more with me concerning the events that lead to her injury. This incident
reminded me that its always important to attempt to take care of pain first or at least attempt to make
the patient as comfortable as possible first. The more relaxed the patient is the better experience it
will be not only for the patient, but it will also help the nurse know how to help the patient. This is
because the patient will feel more comfortable and willing to

Mode of Delivery's Effect on Newborn Stress Hormones

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