[Performances of rapid antigen detection kits for group A Streptococcus]. / Performances des trousses de dépistage rapide des streptocoques du groupe A.

The group A streptococcus rapid antigen detection kits used to test throat swabs are frequently used by doctors for the screening of pharyngitis caused by bacteria. The Swiss Centre for Quality Control (CSCQ) has organised External Quality Assessment Schemes (EQAS) for these kits since 1997. From 2004 to 2008, negative, positive, and moderate positive antigen containing samples were sent to the laboratories. After analysing the samples, 7749 results obtained with more than 14 different test kits were returned to the CSCQ. The correct results ranged between 84.8 and 99.8% which shows that all the test kits gave good results during the EQAS. However, in case of a negative result with clinical suspicion of a bacterial pharyngitis, the result is to be confirmed by culture.

Numerical predictions and experiments for optimizing hidden corrosion detection in aircraft structures using Lamb modes.

To increase the sensitivity of Lamb waves to hidden corrosion in aircraft structures, a preliminary step is to understand the phenomena governing this interaction. A hybrid model combining a finite element approach and a modal decomposition method is used to investigate the interaction of Lamb modes with corrosion pits. The finite element mesh is used to describe the region surrounding the corrosion pits while the modal decomposition method permits to determine the waves reflected and transmitted by the damaged area. Simulations make easier the interpretation of some parts of the measured waveform corresponding to superposition of waves diffracted by the corroded area. Numerical results permit to extract significant information from the transmitted waveform and thus to optimize the signal processing for the detection of corrosion at an early stage. Now, we are able to detect corrosion pits down to 80-mum depth distributed randomly on a square centimeter of an aluminum plate. Moreover, thickness variations present on aircraft structures can be discriminated from a slightly corroded area. Finally, using this experimental setup, aircraft structures have been tested.

A combined finite element and modal decomposition method to study the interaction of Lamb modes with micro-defects.

This paper presents a combined finite element and modal decomposition method to study the interaction of Lamb waves with damaged area. The finite element mesh is used to describe the region around the defects. On the contrary to other hybrid models already developed, the interaction between Lamb waves and defects is computed in the temporal domain. Then, the modal decomposition method permits to determine the wave reflected and transmitted by the damaged area. Modal analysis allows also identifying the mode conversions induced by the defects. These numerical results agree with previous finite element results concerning the interaction of Lamb modes with a notch. Experiments, carried out with gauged defects on an aluminum plate, are also compared to numerical predictions to validate the simulation. Compared to classical techniques of simulation, this new method allows us to investigate the interaction of Lamb modes generated at high frequency-thickness product with micro-defects as corrosion pitting.

External quality control of direct antigen tests to detect group A streptococcal antigen.

Presented here are the results of an external quality control survey organized by the Swiss Center for Quality Control (CSCQ) to evaluate the performance of direct antigen tests (DATs) widely used in Swiss medical practices and laboratories for the diagnosis of group A streptococcal pharyngitis. Twice yearly over a 4-year period, just over 100 participants were requested to analyze positive, weakly positive and negative samples provided to them by the CSCQ with their routinely used DATs and to send the results to the CSCQ. For 1,620 samples distributed, the CSCQ received 1,484 (91.6%) results obtained with 17 different DATs. The specificity of all DATs for negative samples was >91%. For samples containing abundant group A streptococcal antigen, sensitivities ranged from 59.1% to 95.5%; however, for samples containing low levels of antigen, the sensitivity was much lower for all DATs, ranging from 8.7% to 69.8%. Therefore, negative DAT results should be verified with well-performed cultures in order to assure the optimal care of patients with pharyngitis.

Different effects of prostacyclin and phentolamine on delivery-dependent O2 consumption and skin microcirculation after cardiac surgery.

Inadequate tissue oxygen uptake autoregulation has been reported during the first hours after extracorporeal circulation for cardiac surgery. In the present study, we examined whether a dependence of oxygen consumption (VO2) on oxygen delivery (DO2) can be detected 24 hr after cardiac surgery using two different vasodilating agents. Cardiac output in triplicate was measured by thermodilution. Oxygen saturation of arterial and mixed venous blood was measured using a CO-oximeter. Oxygen consumption was assessed from the reverse Fick equation. In addition skin blood flow was assessed continuously by laser Doppler flowmetry. To investigate the VO2/DO2 relationship in 15 patients an increase in cardiac output and DO2 of at least 15% was achieved by systemic vasodilatation with iv prostacyclin (5-10 ng.kg-1.min-1) or phentolamine (5-10 g.kg-1.min-1). Infusion of phentolamine produced a 29 +/- 2% (mean +/- SE) increase in DO2 which was associated with a 20 +/- 6% increase in VO2. In contrast, prostacyclin produced a 22 +/- 3% increase in DO2 without change in VO2. Phentolamine did not alter skin microvascular blood flow, whereas prostacyclin increased skin microvascular blood flow by 33 +/- 3%. The results of the present study demonstrate a supply-dependency of VO2 in clinically stable patients 24 hr after cardiac surgery, suggesting the presence of an inadequate tissue O2 uptake autoregulation. The type of the vasodilator used to increase DO2 seems to play an important role in detecting such a supply-dependency of VO2, as well as changes of skin blood flow.

Health care in the developing world: need for appropriate laboratory technology.

Health care technology is rapidly advancing, and the development of equipment based on new principles has had a strong impact on laboratory services in Western countries. The use of such technologies frequently creates problems in countries of the Third World, because the effects of several interacting elements are not always taken into account. Not only technical factors but also socioeconomic and political factors, as well as differences in diseases in developing countries, must be considered. Standardization of equipment and methodology, and adaptation to local health systems, will facilitate improvement of laboratory services. Training and incentives for local initiatives are fundamental elements for the provision of cost-effective health care.

Guidelines (1988) for training in clinical laboratory management. International Federation of Clinical Chemistry (IFCC) Education Division and International Union of Pure and Applied Chemistry (IUPAC) Clinical Chemistry Division Commission on Teaching of Clinical Chemistry.

Trainees in laboratory medicine must develop skills in laboratory management. Guidelines are detailed for laboratory staff in training, directors responsible for staff development and professional bodies wishing to generate material appropriate to their needs. The syllabus delineates the knowledge base required and includes laboratory planning and organisation, control of operations, methodology and instrumentation, data management and statistics, financial management, clinical use of tests, communication, personnel management and training, and research and development. Methods for achievement of the skills required are suggested. A bibliography of IFCC publications and other material is provided to assist in training in laboratory management.

International Federation of Clinical Chemistry (IFCC), Education Division. Guidelines (1988) for training in clinical laboratory management.

Trainees in laboratory medicine must develop skills in laboratory management. Guidelines are detailed for laboratory staff in training, directors responsible for staff development and professional bodies wishing to generate material appropriate to their needs. The syllabus delineates the knowledge base required and includes laboratory planning and organisation, control of operations, methodology and instrumentation, data management and statistics, financial management, clinical use of tests, communication, personnel management and training, and research and development. Methods for achievement of the skills required are suggested. A bibliography of IFCC publications and other material is provided to assist in training in laboratory management.

International Federation of Clinical Chemistry Education Division and International Union of Pure and Applied Chemistry Clinical Chemistry Division Commission on Teaching of Clinical Chemistry. Guidelines (1988) for training in clinical laboratory management.

Trainees in laboratory medicine must develop skills in laboratory management. Guidelines are detailed for laboratory staff in training, directors responsible for staff development and professional bodies wishing to generate material appropriate to their needs. The syllabus delineates the knowledge base required and includes laboratory planning and organisation, control of operations, methodology and instrumentation, data management and statistics, financial management, clinical use of tests, communication, personnel management and training, and research and development. Methods for achievement of the skills required are suggested. A bibliography of IFCC publications and other material is provided to assist in training in laboratory management.

Guidelines (1988) for training in clinical laboratory management.

Trainees in laboratory medicine must develop skills in laboratory management. Guidelines are detailed for laboratory staff in training, directors responsible for staff development and professional bodies wishing to generate material appropriate to their needs. The syllabus delineates the knowledge base required and includes laboratory planning and organization, control of operations, methodology and instrumentation, data management and statistics, financial management, clinical use of tests, communication, personnel management and training and research and development. Methods for achievement of the skills required are suggested. A bibliography of IFCC publications and other material is provided to assist in training in laboratory management.

Nicotine induced haemodynamic changes during cigarette smoking and nicotine gum chewing: a placebo controlled study in young healthy volunteers.

Because cigarette smoking is a definite risk for the development of cardiovascular disease and nicotine induced vasoconstriction may be a possible pathogenetic factor the haemodynamic effects of smoking cigarettes with high or low nicotine content were compared with those induced by chewing nicotine gum in a placebo controlled, crossover study in six healthy volunteers. The three stimuli induced similar increases in heart rate (about 20%) and systolic blood pressure (about 7%) and a decrease in digital blood flow. Although the mean haemodynamic changes parallelled the mean plasma nicotine concentration increases, no correlation was found between them when the individual values were considered. It is concluded that the nicotine induced haemodynamic changes probably occur as a result of the (local) release of vasoactive mediators such as adrenaline or noradrenaline after a threshold plasma nicotine concentration has been reached. Such a threshold may explain the large interindividual variability in susceptibility to smoking induced cardiovascular diseases.