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Articles by James H. Nichols
Showing articles by "James H. Nichols"
Article
October 2009
Clinical aspects of pleural fluid pH
Pleural effusion, defined as excess fluid in the pleural space, can complicate the course of a large and pathologically diverse range of pulmonary and non-pulmonary diseases. Laboratory analysis of pleural fluid provides much useful information for the clinician whose diagnostic challenge is the patient presenting...
Point-of-care testing
Blood gases/acid-base
Glucose
Lactate
Hemoglobins
Article
July 2009
Clinical aspects of the anion gap
The anion gap (AG) is a calculated parameter derived from measured serum/plasma electrolyte concentrations. The clinical value of this calculated parameter is the main focus of this article.
Both increased and reduced anion gap have clinical significance, but the deviation from normal that has most clinical...
Electrolytes
Blood gases/acid-base
Glucose
Lactate
Creatinine/urea
Kidneys/fluids
Article
June 2009
D-dimer as a rule-out test for deep venous thrombosis: Gold standards and bias in negative predictive value
Recent studies of D-dimer as a “rule-out” test for deep venous thrombosis (DVT) frequently have used duplex ultrasound rather than venography as the gold standard.
Because duplex ultrasound has limited ability to image the calf veins, there is potential for ultrasound studies to classify patients with calf DVT as...
Coagulation/fibrinolysis
Hemoglobins
D-dimer
Article
April 2009
Using "lean" process mapping to integrate testing to point(s) of care in the clinical enterprise
As point-of-care applications of lab testing demand more rapid and clinically integrated order entry and results-reporting processes, it becomes paramount for the laboratory to investigate entire clinical processes.
Direct observation and process mapping of these clinical applications – end to end - are "lean" tools...
Blood gases/acid-base
Point-of-care testing
Process optimization
Creatinine/urea
Article
April 2009
Reference intervals (2) - some practical considerations
This is the second of two articles focusing on the reference interval, the most widely used tool for interpretation of patient test results.
The first [1] was an introduction to the theoretical concepts that underpin the significance, construction and use of reference intervals. Here consideration is given to the...
Quality assurance
Information management
Point-of-care testing
Hemoglobins
Article
April 2009
Perspectives on the impact of point-of-care testing for cardiac markers on healthcare professional working relationships
Applications of point-of-care testing (POCT) for diagnostic biomarker measurement in healthcare have increased significantly in recent years in a wide range of clinical scenarios. These include infectious disease, critical care, cardiology and other areas of emergency medicine.
Traditionally, routine clinical...
Cardiac markers
Point-of-care testing
Troponins
Article
January 2009
C-reactive protein and procalcitonin in the assessment of infection response to antibiotic therapy
Definite diagnosis of infection requires microbiological
documentation; however, the identification of a specific etiology
is frequently missing. In addition, bacterial cultures require at
least 24-48 hours for a final result, which is too long for a
decision to start antibiotics.
Currently, the evaluation of the...
Infection/sepsis
Article
January 2009
An introduction to reference intervals (1) - some theoretical considerations
The population-based reference interval is the most
widely used tool for interpretation of individual patient
laboratory test results. The clinical value of those results
depend crucially on the reference intervals with which they are
compared, and all efforts directed at ensuring analytically
precise and accurate...
Blood gases/acid-base
Point-of-care testing
Process optimization
Hemoglobins
Article
October 2008
Parameters that reflect the carbon dioxide content of blood
Updated with new information from a 2008 article! Health demands that despite quite significant variation in its rate of production, the amount of carbon dioxide in blood is maintained within well-defined narrow limits.
The homeostatic mechanisms that maintain the normal content of carbon dioxide in blood are...
Blood gases/acid-base
Creatinine/urea
Hemoglobins
Article
October 2008
Iatrogenic anemia - a downside of blood testing
All clinical procedures and treatments are associated with potential adverse effects of greater or lesser significance.
The undisputed value of blood testing for both diagnosis and monitoring of disease is tempered by the recognition that repeated blood sampling can result in blood loss of sufficient magnitude to...
Preanalytical phase
Hemoglobins
