A new test to determine the immunoglobulin class of erythrocyte antibodies is presented. Dithiothreitol (DTT), at a concentration of 0.01 M, has been used in a rapid 15 min, 37°C incubation test system. Dialysis is not required. The accuracy of this new DTT test was compared to a standard 2-ME procedure. Human sera containing saline-acting and incomplete varieties of erythrocyte antibodies were tested. Identical results were obtained by both methods with 292 of 302 (96.7%) test sera. Anion-exchange chromatography was employed to produce erythrocyte antibody solutions of known immunoglobulin class. Incubation of these solutions with DTT decreased the immunologic reactivity of IgM erythrocyte antibodies, without affecting the activity of IgG varieties.
A survey to determine the need for training in medical mycology was sent to 605 US laboratories. Training needs were determined by comparing actual laboratory mycology practices with recommended practices, documenting the extent of mycology training reported by employees, and asking respondents to specify the fungi they considered most difficult to identify. The response rate was 56.7% (with only 316 laboratories providing sufficient information). Results showed a large degree of interlaboratory variation in practices and suggested that more judicious practices could lower costs and improve clinical relevance. Only 55.6% of laboratories reported that at least 1 employee attended a formal mycology continuing education program in the 4 years before the survey. Species of dermatophytes, dematiaceous fungi, and non-Candida yeasts were the most difficult to identify. Training may be needed in basic isolation procedures and in advanced topics such as identification of problematic molds and yeasts and antifungal susceptibility testing. Educators should consider clinical relevance and cost-containment without sacrificing quality when designing courses. Support for additional mycology training may improve if hospital and laboratory administrators are alerted to potential dangers and costs involved in treating patients with invasive fungal infections.
Sera obtained from 103 normal individuals of blood group 0, A, and B were tested in dialyzed and undialyzed 2-mercaptoethanol reduction procedures. The same results were obtained with both technkn with 94 per cent of anti-A and/or anti-B antibodies teattd. In addition, identical results were obtained by both m e t h h with 31 incomplete erythrocyte antibodim. The two reduction procedures had a similar range of sensitivity. It is suggested that dialysis is not necessary when 2-mercaptoethanol reduction L employed to diffmntiak between IgC and ISM antibodien.
As new diseases and new testing methods emerge, clinical laboratories are faced with updating the skills of their personnel. Complex techniques, such as flow cytometry, require both education and experience to achieve a high level of proficiency. One of the ways to determine areas in which training is needed is to assess laboratory practices and compare them with practices recommended in guidelines or by panels of experts. In this paper we describe practices reported in a written survey of 206 laboratories that perform CD4+ T‐cell counts (CD4). We provided a list of alternate practices for each of the key steps in the testing process and asked participants to select the practices they use in their laboratories. Published guidelines and interviews with knowledgeable “key informants” and focus groups of people who perform CD4 testing were used to formulate the questions. We interpreted variations from recommended practices as indicators of training needs. Other factors that can affect performance, such as workload, supervision, and resources, were satisfactory to the respondents. A response rate of 73% (247 of 337 laboratories) revealed that laboratories followed most of the recommended practices. Notable exceptions included some areas of quality control and quality assurance and safety. This paper also describes flow cytometry testing as it was practiced in 1993 shortly after release of some of the testing guidelines and provides a baseline of practices for that time frame. Cytometry 30:181–185, 1997. Published 1997 Wiley‐Liss, Inc.
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