A importância das medidas de pressão arterial e da velocidade da onda de pulso no desenvolvimento da hipertrofia ventricular esquerda e no espessamento médio-intimal de carótidas em pacientes idosos / The importance of arterialpressure measurement and of pulse wave velocity n the development ao left ventricular hypertrophy and in carotid intima-media thickening in elderly patients

Objetivo: O objetivo deste estudo foi avaliar três grupos de indivíduos idosos, estratifcados segundo a MAPA em: normotenso (Grupo 1);provavelmente hipertenso sistólico isolado (Grupo II); e provavelmente hipertenso sisto-diastólico (Grupo III), na tentativa de identificar, entre as variáveis estudadas, aquelas que se correlacionavam com o determinismo das LOA definidas como HVE e ESPCED.Métodos: foram selecionados 89 indivíduos que se submeteram a exames laboratoriais, ao ECG com o objetivo de se excluir doença coronariana evidente, e à MAPA para a estratificação dos grupos. As variáveis analisadas para essas correlações compreenderam as medidas de PA casual e ambulatorial; as medidas de ESPCE e/ou ESPCD, através de ultr-som de carótidas; as medidas de MVE e IMVE, através da ecocardiografia; e medidas da VOP.Resultados: Os três grupos apresentaram distribuição semelhante em relação à idade, ao sexo, e aos índices antropométricos, bem como em relação à análise das médias dos parâmetros bioquímicos. Demostrou-se distribuição similar de ESPCED e de HVE, nos dois grupos de hipertensos, porém, com valores estatisticamente superiores em relação ao grupo de normotensos. As variáveis analisadas com significado estatístico e correlação positiva com a MVE foram: PAS24h, PP24h, PASVIG, PASSONO, PADSONO, e VOP; e a de correlação negativa foi a DESCPAS. As de correlação positiva com o ESPCED foram: PAS24h, PP24h, VS24h, PASVIG, PASSONO e VOP; e as de correlação negativa foram: DESCPAS e DESCPAD. Analisando o determinismo das LOA, observa-se que a PAS24h foi a única variável que manteve associação com a HVE(p igual0,0161), e a VOP com o ESPCED(p igual 0,033).Conclusões: demonstrou-se que a análise das variáveis de PA e VOP são de extrema validade na investigação de LOA em indivíduos idosos

Three-year experience in using total laboratory automation system.

We implemented a total laboratory automation (TLA) system, currently used in Chungnam National University Hospital (CNUH), designed around the A&T Corporation to perform the general and specific laboratory testing throughout the system in a timely and cost-effective manner. The system consists of two major lines: chemistry and hematology. The analyzers attached to the hematology line include one SE 9000 hematology analyzer (Sysmex Corporation, Kobe, Japan), one SP-100 slide maker (Sysmex), and one R9000 reticulocyte counter (Sysmex). The chemistry line consists of preanalytic system and linked analyzers. The analyzers attached to chemistry line are one Hitachi 747 chemistry analyzer (Hitachi, Ltd., Tokyo, Japan), one A&T 502X analyzer (A&T Corporation, Tokyo, Japan) and one Architect i2000 immunochemistry analyzer (Abbott Diagnostics Division, Santa Clara, USA). The preanaytic system including start stocker, centrifuge, de-cap unit and aliquoting unit were connected with analyzers. The turn around time (TAT) of all tests was shortened in comparison to manual systems. Consequently it makes feasible one-day care clinic and makes reduced inherent errors in sample identification, dispensing, and reporting. In addition, real-time re-run can make test quality more reliable. As many as 12 departments can be reduced to 7 departments. The subsidiary advantages of smaller size were incorporated into reduced working steps facilitating workflow. Overall, better qualified and quicker results can be provided to the clinicians, and proper cost-effectiveness and better quality services can be anticipated as a result of much easier system management and higher reliability. In conclusion, the TLA has been successful within our laboratory.

Quality of dry chemistry testing.

Since the development of the qualitative test paper for urine in 1950s, several kinds of dry-state-reagents and their automated analyzers have been developed. "Dry chemistry" has become to be called since the report on the development of quantitative test paper for serum bilirubin with reflectometer in the end of 1960s and dry chemistry has been world widely known since the presentation on the development of multilayer film reagent for serum biochemical analytes by Eastman Kodak Co at the 10th IFCC Meeting in the end of 1970s. We have reported test menu, results in external quality assessment, merits and demerits, and the future possibilities of dry chemistry.

Compact dry chemistry instruments.

Compact dry chemistry instruments are designed for use in point-of-care-testing (POCT). These instruments have a number of advantages, including light weight, compactness, ease of operation, and the ability to provide accurate results in a short time with a very small sample volume. On the other hand, reagent costs are high compared to liquid method. Moreover, differences in accuracy have been found between dry chemistry and the liquid method in external quality assessment scheme. This report examines reagent costs and shows how the total running costs associated with dry chemistry are actually lower than those associated with the liquid method. This report also describes methods for minimizing differences in accuracy between dry chemistry and the liquid method. Use of these measures is expected to increase the effectiveness of compact dry chemistry instruments in POCT applications.