NAIRO MASSAKAZU SUMITA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/03 - Laboratório de Medicina Laboratorial, Hospital das Clínicas, Faculdade de Medicina
LIM/03 - Laboratório de Medicina Laboratorial, Hospital das Clínicas, Faculdade de Medicina
9 resultados
Resultados de Busca
Agora exibindo 1 - 9 de 9
- Validation protocol for multiple blood gas analyzers in accordance with laboratory accreditation programs(2015) EBNER, Pérsio A. R.; ROMANO, Paschoalina; SANT’ANNA, Alexandre; MENDES, Maria Elizabete; OLIVEIRA, Magna; SUMITA, Nairo M.Introduction: The results of blood gas analysis using different instrumentation can vary widely due to the methodological differences, the calibration procedures and the use of different configurations for each type of instrument. Objective: The objective of this study was to evaluate multiple analytical systems for measurement of blood gases, electrolytes and metabolites in accordance with the accreditation program (PALC) of Sociedade Brasileira de Patologia Clínica/Medicina Laboratorial (SBPC/ML). Materials and methods:20 samples were evaluated in three ABL800 Flex (Radiometer Medical ApS, Denmark) blood gas analyzers, and the results were compared with those of the device in use, which was considered the reference. The analysis of variance (Anova) was applied for statistical purposes, as well as the calculation of mean, standard deviation and coefficient of variation.Results:The p values obtained in the statistical analysis were: pH = 0.983, pO2 = 0.991, pCO2 = 0.353, lactate = 0.584, glucose = 0.995, ionized calcium = 0.983, sodium = 0.991, potassium = 0.926, chlorine = 0.029. Conclusion: The evaluation of multiple analytical systems is an essential procedure in the clinical laboratory for quality assurance and accuracy of the results.
- The critical value concept in clinical laboratory(2016) ROCHA, Bruna Cláudia B.; ALVES, José Adilson R.; PINTO, Félix Pedro D.; MENDES, Maria Elizabete; SUMITA, Nairo M.ABSTRACT The critical value is a laboratory result representing a pathophysiological state that offers risk to a patient's life. The communication of these results is a laboratory responsibility and, according to the literature, 95% of physicians consider it useful in decision-making and patient management. Two-thirds of critical results lead to some change in therapeutic approach. The communication of critical results is a requirement for laboratory accreditation programs. Thus laboratories should establish a list of tests, their critical values, and the procedure describing the communication flow. The performance indicator for this activity should consider the time between results release and their effective communication, and the percentage of successful communication. There is no standardization of laboratory parameters that need to have critical values established, not even the ranges to be considered for notification purposes. The frequent update of test lists and critical value ranges based on literature reviews and on experience exchange among clinical laboratories ensure the continuous improvement process for this procedure and patient safety.
- Evaluation of PSA requests in men under 40 years of age(2020) ARAÚJO, Fernando Antonio G. R; BITTENCOURT, Luana A; SUMITA, Nairo M; BARROSO JR., Ubirajara OABSTRACT Objectives: To evaluate the frequency of PSA requests in men under age 40 years; and to observe the possible influence of medical specialty of the requesting physician. Material and method: This is an observational, cross-sectional study using the database of a national clinical laboratory on PSA requests from October 1, 1997 until December 31, 2016. Descriptive statistics were used. The work was approved by the Ethics Committee of our institution. Results: 2,514,375 PSA requests were evaluated, 158,399 (6.3%) in men younger than 40 years old. These percentages did not vary significantly when observed over time (1998-2016). The prevalence of requests for patients under 40 years of age, was 18.2% among general practitioners; 16.5% among cardiologists, 8.4% among geriatricians and 6.8% among urologists. Conclusion: There is a very high frequency of PSA requests in men with low probability of benefiting from the test. It is necessary to invest in the dissemination of best practices related to prostate cancer screening, especially among clinicians and cardiologists.
- As interferências e as limitações metodológicas na dosagem da hemoglobina glicada (A1C)(2012) SUMITA, Nairo M.
- Practical aspects of the use of FMEA tool in clinical laboratory risk management(2013) MENDES, Maria Elizabete; EBNER, Pérsio de Almeida Rezende; ROMANO, Paschoalina; PACHECO NETO, Maurílio; SANT’ANNA, Alexandre; SUMITA, Nairo MassakazuINTRODUCTION: This paper presents the failure modes and effects analysis (FMEA) tool in a clinical laboratory through the introduction of new technology for blood gas and serum ionized calcium in multi-parameter analyzers such as Point of Care Testing (POCT). OBJECTIVE: To present FMEA as a tool for risk managing and improvement with the introduction of new technologies in a public laboratory. METHODS: The change of multiparameter gas analyzer type POCT was defined and described as a process. Subsequently, the criteria were presented to the risk assessment and its quantification. We studied the failure modes that might occur in this process. We established three action plans involving improvements to be made in the technological change. FMEA was applied in two stages: at the beginning of the project and after the implementation of the proposed measures. RESULTS: The first plan involved administrative measures related to the bidding process; the second preventive action involved the possibility of which supplier would win the bid by studying the efficiency of the analyzer and its impact on productivity; the third set of actions was directed to improvements in the relationship with the clinical staff in order to minimize occasional complaints. The last actions referred to employing new employees to meet the growing demand. CONCLUSION: FMEA proved to be a reliable tool for performance improvement, which proactively identifies, prioritizes and mitigates patient risks.
- The measurement of serum osmolality and its application to clinical practice and laboratory: literature review(2017) FARIA, Daniel K.; MENDES, Maria Elizabete; SUMITA, Nairo M.ABSTRACT Introduction: Serum osmolality is an essential laboratory parameter to understand several clinical disorders such as electrolyte disturbances, exogenous intoxication and hydration status. Objective: This study aims to update knowledge about the osmolality examination through research papers published to date. Materials and methods: The survey was conducted on PubMed database. It highlights main concepts, both historical and physiological aspects, and the clinical applications of the serum osmolality test. In addition, an extensive survey of formulas for the serum osmolality calculation was conducted. Discussion: The measurement of serum osmolality is relevant in changes in intracellular and extracellular balance, as a trusted and valuable indicator of solute concentration in the blood. The mathematical equations for serum osmolality calculation acquire relevance in health services where serum is not available, and situations in which calculation of the osmolal gap is necessary, but the variability of the formulas is a significant bias. Conclusion: The measurement of serum osmolality is useful in cases of dehydration, sodium and potassium disorders, glucose alteration, exogenous poisoning, adrenal insufficiency, neurological injury, physical exercise and others.
- Improving serum calcium test ordering according to a decision algorithm(2019) FARIA, Daniel K.; TANIGUCHI, Leandro U.; FONSECA, Luiz A. M.; FERREIRA-JUNIOR, Mario; AGUIAR, Francisco J. B.; LICHTENSTEIN, Arnaldo; SUMITA, Nairo M.; DUARTE, Alberto J. S.; SALES, Maria M.Aim To detect differences in the pattern of serum calcium tests ordering before and after the implementation of a decision algorithm. Methods We studied patients admitted to an internal medicine ward of a university hospital on April 2013 and April 2016. Patients were classified as critical or non-critical on the day when each test was performed. Adequacy of ordering was defined according to adherence to a decision algorithm implemented in 2014. Results Total and ionised calcium tests per patient-day of hospitalisation significantly decreased after the algorithm implementation; and duplication of tests (total and ionised calcium measured in the same blood sample) was reduced by 49%. Overall adequacy of ionised calcium determinations increased by 23% (P=0.0001) due to the increase in the adequacy of ionised calcium ordering in non-critical conditions. Conclusions A decision algorithm can be a useful educational tool to improve adequacy of the process of ordering serum calcium tests.
- Avaliação da interferência do ácido ascórbico na detecção da glicosúria(2012) COSTA, Jaime Murilo Fernandes; MENDES, Maria Elizabete; SUMITA, Nairo MassakazuINTRODUCTION: Ascorbic acid (vitamin C) is commonly used as a vitamin supplement. It is a water soluble vitamin, which is excreted through urine and may interfere in laboratory tests as well as redox reactions for urinary glucose detection. OBJECTIVE: This study aims to assess ascorbic acid interference in glycosuria detection by dry chemistry method (reagent strips). MATERIAL AND METHODS: Urine samples were evaluated by using Clinitek Atlas chemistry analyzer (Siemens Healthcare Diagnostics Inc., USA). Four urine samples with different glucose concentrations were selected: 100 mg/dl, 250 mg/dl, 500 mg/dl and > 1,000 mg/dl. 5 aliquots were created for each glucose concentration and a solution of ascorbic acid 200 mg/dl was added, sufficient to obtain a final ascorbic acid concentration of 20 mg/dl in the first tube, 50 mg/dl in the second tube, 270 mg/dl in the third tube, 1,000 mg/dl the fourth tube, and 2,000 mg/dl in the fifth tube. After the addition of ascorbic acid, the samples were reassessed by using Clinitek Atlas chemistry analyzer. RESULTS: There was no interference at concentrations of 20 mg/dl. However, there was ascorbic acid interference at concentrations higher than or equal to 50 mg/dl, which was characterized by false-negative results for urinary glucose detection. CONCLUSION: The results corroborated the interference of ascorbic acid in dry chemistry method (reagent strips) inasmuch as it underestimates urinary glucose levels.
- Laboratory Tests Ordering Pattern by Medical Residents From a Brazilian University Hospital(2016) SALES, Maria M.; TANIGUCHI, Leandro U.; FONSECA, Luiz A. M.; FERREIRA-JUNIOR, Mario; AGUIAR, Francisco J. B.; SUMITA, Nairo M.; LICHTENSTEIN, Arnaldo; DUARTE, Alberto J. S.Objectives: The adequacy of laboratory test orders by medical residents is a longstanding issue. The aim of this study is to analyze the number, types, and pattern of repetition of tests ordered by medical residents. Methods: We studied all tests ordered over a 1-year period for inpatients of an internal medicine ward in a university hospital. Types, results, and repetition pattern of tests were analyzed in relation to patients' diagnoses. Results: We evaluated 117,666 tests, requested for 1,024 inpatients. The mean number of tests was 9.5 per day. The test repetition pattern was similar, regardless of patients' diagnoses, previous test results, or duration of stay. The probability of an abnormal result after a sequence of three normal tests was lower than 25%, regardless of the diagnosis. Conclusions: Number of tests and repetition were both high, imposing costs, discomfort, and risks to patients, thus warranting further investigation.