Publications by authors named "J H Howanitz"
Paraproteins are a common cause of interferences with automated chemistry methods.
Arch Pathol Lab Med
February 2008
Context: Previous studies have shown that paraproteins caused spurious results on individual analytes including total bilirubin (TBIL), direct bilirubin (DBIL), or HDL-cholesterol (HDL-C). Studies demonstrating paraprotein interferences with multiple analytes measured by different analyzers have not been reported.
Objective: To systemically investigate interferences of paraproteins on TBIL, DBIL, and HDL-C measured by the Roche MODULAR and the Olympus AU2700.
Context: Apparent hemoglobinopathies caused by blood transfusions rarely have been reported in the scientific literature.
Objective: To interpret the abnormal hemoglobins appearing as small peaks on hemoglobin chromatograms or electrophoresis membranes.
Design: In the clinical laboratories of a university hospital and a metropolitan hospital affiliated with a medical school, we interpreted hemoglobin chromatograms and electrophoresis membranes; correlated them with patients' medical, laboratory, and transfusion records; and when possible, identified the abnormal hemoglobin in the donors' transfusion segments.
Laboratories are required to have a critical values policy as a patient safety measure. Serum sodium commonly is included in critical results lists, but a wide range of values are used. We studied all critical serum and whole blood sodium results called to clinicians during a 6-month period.
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- Laboratories must have a critical values policy for tests like total serum calcium, but the justification for current critical ranges is unclear.
- A study analyzed critical serum calcium results over 3 months to assess the appropriateness of the management and outcomes of affected patients.
- Results showed a small percentage of critical values, significant patient morbidity, and a high mortality rate, supporting existing critical limits as appropriate and necessary to ensure adequate patient care.
High-performance liquid chromatography (HPLC) is replacing electrophoresis for identification of hemoglobin variants. Our objective was to identify unknown tall peaks with elution times and shapes of hemoglobin Barts found on hemoglobin chromatograms that could not be confirmed by alkaline and acid gel electrophoresis. Of 90 specimens identified with this peak, 86 were from patients with hemoglobin SS.
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