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Westmead, Australia

Favaloro E.J.,ICPMR | Lippi G.,University of Parma
Clinical Chemistry and Laboratory Medicine

The advent of modern instrumentation, with associated improvements in test performance and reliability, together with appropriate internal quality control (IQC) and external quality assurance (EQA) measures, has led to substantial reductions in analytical errors within hemostasis laboratories. Unfortunately, the reporting of incorrect or inappropriate test results still occurs, perhaps even as frequently as in the past. Many of these cases arise due to a variety of events largely outside the control of the laboratories performing the tests. These events are primarily preanalytical, related to sample collection and processing, but can also include post-analytical events related to the reporting and interpretation of test results. The current report provides an overview of these events, as well as guidance for prevention or minimization. In particular, we propose several strategies for the post-analytical reporting of hemostasis assays, and how this may provide the final opportunity to prevent serious clinical errors in diagnosis. This report should be of interest to both the laboratory scientists working in hemostasis and clinicians that request and attempt to interpret the test results. Laboratory scientists are ultimately responsible for these test results, and there is a duty to provide both accurate and precise results to enable clinicians to manage patients appropriately and to avoid the need to recollect and retest. Also, clinicians will not be in a position to best diagnose and manage their patient unless they gain an appreciation of these issues. © 2010 by Walter de Gruyter. Source

Doggett S.L.,ICPMR | Dwyer D.E.,University of Sydney | Penas P.F.,Westmead Hospital | Russell R.C.,University of Sydney
Clinical Microbiology Reviews

Since the late 1990s, bed bugs of the species Cimex lectularius and Cimex hemipterus have undergone a worldwide resurgence. These bed bugs are blood-sucking insects that readily bite humans. Cutaneous reactions may occur and can start out as small macular lesions that can develop into distinctive wheals of around 5 cm in diameter, which are accompanied by intense itching. Occasionally, bullous eruptions may result. If bed bugs are numerous, the patient can present with widespread urticaria or eythematous rashes. Often, bites occur in lines along the limbs. Over 40 pathogens have been detected in bed bugs, but there is no definitive evidence that they transmit any disease-causing organisms to humans. Anemia may result when bed bugs are numerous, and their allergens can trigger asthmatic reactions. The misuse of chemicals and other technologies for controlling bed bugs has the potential to have a deleterious impact on human health, while the insect itself can be the cause of significant psychological trauma. The control of bed bugs is challenging and should encompass a multidisciplinary approach utilizing nonchemical means of control and the judicious use of insecticides. For accommodation providers, risk management procedures should be implemented to reduce the potential of bed bug infestations. © 2012, American Society for Microbiology. All Rights Reserved. Source

Doggett S.L.,ICPMR | Orton C.J.,University of New South Wales | Lilly D.G.,Ecolab | Russell R.C.,University of Sydney

Australia has experienced a sudden and unexpected resurgence in bed bug infestations from both Cimex lectularius L. and Cimex hemipterus F. A survey in 2006 revealed that infestations had increased across the nation by an average of 4,500% since the start of the decade. In response, a multi-disciplinary approach to combat the rise of this public health pest was implemented and involved the coordinated efforts of several organizations. The key components of the strategy included the introduction of a pest management standard 'A Code of Practice for the Control of Bed Bug Infestations in Australia' that defines and promotes 'best practice' in bed bug eradication, the development of a policy and procedural guide for accommodation providers, education of stakeholders in best management practices, and research. These strategies continue to evolve with developments that lead to improvements in 'best practice' while bed bugs remain problematic in Australia. © 2011 by the authors; licensee MDPI, Basel, Switzerland. Source

Human papillomavirus (HPV) is a highly transmissible infection responsible for a range of diseases in women including cervical carcinomas, vulval carcinomas, anogenital carcinomas and genital warts. In men it is associated with penile carcinomas, anogenital carcinomas and oropharyngeal carcinomas. The history of the development of HPV vaccines includes a significant Australian input and represents a tremendous advancement in our understanding of HPV virology as well as further elucidating the overall contribution of viruses to carcinogenesis. Prophylactic HPV vaccines were licensed for use in Australia in 2007 in order to protect against development of future cases of cervical carcinoma and early results are promising. The benefit of the vaccine will not be restricted to cervical lesions and cross protection amongst a variety of HPV subtypes is described. The development of the HPV vaccine and its ultimate incorporation into our National Immunisation Schedule is reviewed. © 2011 Royal College of Pathologists of Australasia. Source

Favaloro E.J.,ICPMR | Dorothy M.,Esoterix Inc | Lippi G.,Clinical Chemistry and Hematology Laboratory
Laboratory Medicine

The use of modern laboratory instrumentation with high levels of test reliability and appropriate quality assurance measures will lead to very few analytical errors within hemostasis testing. Nevertheless, incorrect or inappropriate test results are still reported, often due to events outside the control of the laboratories performing the tests. This is due primarily to pre-analytical events associated with sample collection and processing, as well as post-analytical events related to the reporting and interpretation of test results. This review focuses on the pre-analytical phase, highlighting contributory elements and providing suggestions on how problems can be minimized or prevented, thereby improving the likelihood that reported test results actually represent the true clinical status of the patient rather than that of an inappropriate sample. This review should be of value to both laboratory personnel and clinicians because an appreciation of these issues will enable the optimal clinical management of patients. © 2012 by The American Society for Clinical Pathology. Source

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