Towards Harmonisation of Critical Laboratory Result Management - Review of the Literature and Survey of Australasian Practices

Timely release and communication of critical test results may have significant impact on medical decisions and subsequent patient outcomes. Laboratories therefore have an important responsibility and contribution to patient safety. Certification, accreditation and regulatory bodies also require that laboratories follow procedures to ensure patient safety, but there is limited guidance on best practices. In Australasia, no specific requirements exist in this area and critical result reporting practices have been demonstrated to be heterogeneous worldwide.Recognising the need for agreed standards and critical limits, the AACB started a quality initiative to harmonise critical result management throughout Australasia. The first step toward harmonisation is to understand current laboratory practices. Fifty eight Australasian laboratories responded to a survey and 36 laboratories shared their critical limits. Findings from this survey are compared to international practices reviewed in various surveys conducted elsewhere. For the successful operation of a critical result management system, critical tests and critical limits must be defined in collaboration with clinicians. Reporting procedures must include how critical results are identified; who can report and who can receive critical results; what is an acceptable timeframe within which results must be delivered or, if reporting fails, what escalation procedures should follow; what communication channels or systems should be used; what should be recorded and how; and how critical result procedures should be maintained and evaluated to assess impact on outcomes.In this paper we review the literature of current standards and recommendations for critical result management. Key elements of critical result reporting are discussed in view of the findings of various national surveys on existing laboratory practices, including data from our own survey in Australasia. Best practice recommendations are made that laboratories are expected to follow in order to provide high quality and safe service to patients.     

Highly Accurate Structure-Based Prediction of HIV-1 Coreceptor Usage Suggests Intermolecular Interactions Driving Tropism

HIV-1 entry into host cells is mediated by interactions between the V3-loop of viral glycoprotein gp120 and chemokine receptor CCR5 or CXCR4, collectively known as HIV-1 coreceptors. Accurate genotypic prediction of coreceptor usage is of significant clinical interest and determination of the factors driving tropism has been the focus of extensive study. We have developed a method based on nonlinear support vector machines to elucidate the interacting residue pairs driving coreceptor usage and provide highly accurate coreceptor usage predictions. Our models utilize centroid-centroid interaction energies from computationally derived structures of the V3-loop:coreceptor complexes as primary features, while additional features based on established rules regarding V3-loop sequences are also investigated. We tested our method on 2455 V3-loop sequences of various lengths and subtypes, and produce a median area under the receiver operator curve of 0.977 based on 500 runs of 10-fold cross validation. Our study is the first to elucidate a small set of specific interacting residue pairs between the V3-loop and coreceptors capable of predicting coreceptor usage with high accuracy across major HIV-1 subtypes. The developed method has been implemented as a web tool named CRUSH, CoReceptor USage prediction for HIV-1, which is available at http://ares.tamu.edu/CRUSH/.     

Microbial transformations of N-(4-chlorphenyl)-benzoisothiazolone

Summary The microbial degradation of N-(4-chlorphenyl)-benzoisothiazolone (1) was studied by Streptomyces species in analogy to the metabolism of this drug in animals. As main metabolite 2-thiomethyl-N-(4-chlorphenyl)-benzamide (3) was found. The corresponding sulfoxide (4) and the sulfone (5) were obtained as further transformation products. The unmethylated 2-sulfhydryl compound (2) could be isolated in only small amounts. The degradation pathway follows by these results via a reductive cleavage of the S-N-bond of the isothiazolone ring with subsequent methylation of the sulfhydryl group and further oxidation of the resulting thiomethyl substituent.     

Microbial transformation of 3-desoxy-dihydromorphinanes

Summary 3-Desoxymorphinanes should be transformed by microbial hydroxylation of the aromatic ring to morphinanes. Instead of this reaction the investigated N-derivatives (H, CH₃, COCH₂OH and COCH₂OCH₂CH₃) are reduced by several fungi to the 6-(R)-hydroxy structures. Rhizopus achlamydosporus cleaved additionally the ethoxy-acetyl-group to a hydroxy-acetate.     

Biotransformations of industrial use

Biotransformations represent a useful tool for the production of various chemical compounds because of their main advantages: attack of non-activated positions, regio, stereo and enantio-selectivity, and the mild reaction conditions. Organic chemistry can use these advantages in various enzymatic type reactions. One of the most interesting and promising groups of these biotransformations are the various oxidative reactions. The following article intends to give a short insight in the present state of this part of the broad field of biotransformations. Examples of technically interesting processes, preferably results of newer developments, should illustrate

• a the variety of enzymatical oxidative reactions used.
• b the various structures of educts for aimed oxidative modifications and.
• c the application in the pharmaceutical, food and chemical industries.

     

中国番茄黄化曲叶病毒——双生病毒的一个新种

用 2 0个单抗对中国番茄黄化曲叶病毒 (TYLCV CHI)和其他双生病毒进行了测定 ,在血清学水平上证实中国番茄黄化曲叶病毒与中国烟草曲叶病毒有较大的亲缘关系 ;同时报道了TYLCV CHI部分共同区、外壳蛋白N端基因和AV1基因的PCR及其克隆和序列分析 ,从分子水平上证实TYLCV CHI与世界各地的其他双生病毒不同 ,是一种新的粉虱传双生病毒     

体外细胞核组装中核纤层与核膜的关系

采用非洲爪蟾卵提取物非细胞体系,以外源Lambda DNA诱导细胞核的体外组装,以此实验模式为基础,研究了细胞核体外组装过程中核纤层的组装,结果表明核纤层蛋白参与细胞核的体外组装过程,核内骨架的组装与核纤层的组装在时间上是有序的,核内骨架的组装可能为核纤层的装配提供了先决条件.在非洲爪蟾卵提取物非细胞体系中加入抗核纤层蛋白抗体,抑制核纤层的正常装配过程,核膜组装发生异常.结果提示核纤层的组装与核膜的组装是密切相关的.     

昆虫抗药性和昆虫毒理动力学(英文)

不断地使用一种杀虫药剂防治昆虫,会导致昆虫产生抗药性。对昆虫抗药性资料进行广泛综述时,发现了仅单独的解毒作用不能被解释为家蝇对有机氯杀虫药剂产生高抗性原因。作为一个基因。家蝇可以对有机氯产生比对有机磷杀虫剂更高的抗药性,尽管有机磷杀虫剂一般在虫体内是不太稳定的。考虑到昆虫毒理的动力学,杀虫药剂的穿透作用更显示出其实际的重要性。根据穿透和解毒的速率,慢的穿透作用是解毒作用的一个限制因子。防治敏感和抗性昆虫的观察结果,可以划出物理和生物因子之间关系的几种相关曲线图解。这些相关性不仅能说明家蝇对有机磷和有机氯杀虫剂的抗性程度,而且也助于选择出新的杀虫毒剂。