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To evaluate the newly developed Roche MODULAR Analytics E170 Total Vitamin D and the Siemens ADVIA Centaur Vitamin D Total assays.Assays were evaluated using the Clinical and Laboratory Standards Institute protocols. Split patient samples were compared with LC-MS/MS and DiaSorin LIAISON assays (n=79 including 15 specimens with detectable endogenous 25-OH vitamin D(2)). Assay accuracy was also evaluated using the Vitamin D External Quality Assessment Scheme (DEQAS) samples.The ADVIA Centaur and E170 assays demonstrated maximum total CVs of 14.1% and 5.9%, respectively. Both showed excellent linearity (R(2)0.99). The ADVIA Centaur assay demonstrated interference with bilirubin at 800 μmol/L, hemolysis at 1.25 g/L, and triglycerides at 2.8 mmol/L. Compared to LC-MS/MS, the ADVIA Centaur assay demonstrated a R(2) value of 0.893, average bias of -8.8%; the E170 assay an R(2) value of 0.872, average bias of 14.3% with underestimation of 25-OH vitamin D(2). Compared to the LIAISON assay, the ADVIA Centaur assay demonstrated an R(2) value of 0.781, average bias of -17.3%; the E170 assay an R(2) value of 0.823, average bias of 11.4%. The ADVIA Centaur and E170 assays demonstrated a biases of20% in 10/10 and 8/10 DEQAS samples, respectively.The ADVIA Centaur and E170 vitamin D assays demonstrated acceptable linearity, imprecision, and accuracy. The E170 assay demonstrated consistent underestimation of 25-OH vitamin D(2) levels. Compared with LC-MS/MS, the ADVIA Centaur assay demonstrated a higher R(2) value and a smaller average bias than the E170 assay.

Objectives The objective of this study was to evaluate the newly developed Siemens ADVIA Centaur® enhanced Estradiol (eE2) assay and compare it with a well-established estradiol liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. Design and methods The Siemens eE2 assay was evaluated using the Clinical and Laboratory Standards Institute evaluation protocols. Split patient samples were compared with the eE2 assay, the current ADVIA Centaur E2-6 Ill assay; and LC-MS/MS method by API5000 mass spectrometer. Results Within-run and total imprecision of the eE2 assay demonstrated coefficient of variations of 5.7%, 3.2%, 1.5%, and 10.4%, 7.3%, and 6.8%, at levels of 380, 752, and 2051 pmol/L, respectively. The method comparisons showed: eE2 = 0.903(E2-6 III) –16.2, R 2 = 0.938, average bias = − 12.3%; and eE2 = 0.946(LC-MS/MS) + 19.5, R 2 = 0.925, average bias: 0%. Conclusion The Siemens eE2 assay correlates well with LC-MS/MS. This method is reliable, and appropriate for routine clinical laboratory use.

To shorten the clotting time and resolve the delayed clotting or no clotting on specimens from patients on anticoagulant therapy, Becton Dickinson (BD) recently developed the Vacutainer rapid serum tube (RST). The aim of this study was to systematically compare the new RST tube with the widely used serum separator tube (SST) for routine chemistry and immunoassay tests on 3 common analyser platforms.Blood from 45 people (24 women and 21 men, age 21-77 years) was collected using the SST and RST tubes in sequence. Sera from both tubes were separated and analysed simultaneously for 54, 50, and 10 chemistry and/or immunoassay tests on the Roche Modular, Abbott Architect, and Siemens Centaur analysers, respectively.The results from the RST tube were comparable with those from the SST tube on most analytes. Although the results for a few analytes showed statistically significant differences between the two tubes (p0.05), the differences had no clinical significance for most assays. Only for parathyroid hormone on the Abbott Architect, the RST tube demonstrated clinical significant bias versus the SST tube (-15.3%, p0.01).The RST tube provides acceptable performance for routine chemistry and immunoassay tests.

United States medical facilities located overseas must comply with American laws and the laws that govern the host nation. The Patient Self-Determination Act of 1990 is in direct conflict with Italian law. Honoring the advance directives of American patients on Italian soil constitutes a criminal offense for the physician, who is subject to 15 years of imprisonment. In response to issues identified in this case report, hospital staff have taken proactive steps to improve the management of dying patients overseas by establishing clearer hospital instructions, education, and training and by better managing the psychosocial concerns of family and staff.

Rats were given cued and uncued inescapable shock; their voluntary alcohol intake was compared to a group given a yoked cue but no shock. Results suggested that, unlike uncued inescapable shock, cued inescapable shock caused an increase in voluntary alcohol intake, although the increase was insufficient to produce overt inebriation. It was suggested that the increase which occurred was due to a combination of adjunctive drinking and a gustatory and olfactory discrimination breakdown, both occurring in direct response to shock.

Repetitive traumatic dreams remain a curiosity in our working with patients. If dreams have a sleep protecting or problem solving function, the dream that does not resolve but repeats and that disturbs rather than protects sleep remains an important clinical problem. We see in individual patient experiences and in civilian disasters samples of individuals who are unable to return their dream life to a condition in which it no longer repeats or disturbs their sleep. Clearly the recent experience of combat survivors of Vietnam becomes a major concern.

In 2 studies Gunn rats carrying 2 recessive alleles for jaundice (jj) were compared with their heterozygous littermates (Jj) under varied litter size (4 vs 12 pups) and handling conditions. Handling did not produce long-term effects. Litter size interacted with Genotype to increase the differential response of jj rats by 21, 23, and 50 days of age. A decrease in survival rates and weight gain was found in Jj and especially jj rats from large litters. For jj rats only, being reared in a large litter increased the severity of ataxia. Jaundiced rats from large litters showed less rearing and tended to enter fewer squares than those from small litters whereas Jj littermates showed an equivalent amount of rearing and number of squares entered in large as compared to small litter sizes. Differences between Jj and jj rats in frequency of pivoting were greater in those from large litters than in those from small litters.

Methylphenidate was shown to facilitate both active avoidance and water performance compared to controls. Repetitive errors on both tasks were greater in the drug than the nondrug group and were positively correlated to water maze performance. These results fail to support the view that water maze acquisition is less influenced by performance variables than active avoidance. An unanticipated enhancement of water maze performance was also noted in the control group which had been previously tested on active avoidance compared with naive controls. Moreover, this group made fewer repetitive errors than naive controls, suggesting that previous shock exposure reduced inappropriate responses.