Medical Laboratory and Biomedical Science: September 2013

Wednesday, September 18, 2013

DNA Party Decorations

For lab geeks only

Images by Vivi Einy

Art and Science of Laboratory Medicine

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Point-of-care testing: where is the evidence?

Point-of-care testing (POCT) has had rapid technological development and their use is widespread in clinical laboratories to assure reduction of turn-around-time and rapid patient management in some clinical settings where it is important to make quick decisions. Until now the papers published about the POCT have focused on the reliability of the technology used and their analytical accuracy.

This study showed a satisfactory correlation between methods when similar analytical reactions were used. Only 13% of the studies evaluated the impact of POCT on clinical practice. POCT decreases the time elapsed for making decisions on patient management but the clinical outcomes have never been adequately evaluated.

Read more:
Point-of-care testing: where is the evidence? A systematic surve

Source: Unbound medicine
Image credits: Prolog.org

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Tuesday, September 17, 2013

It’s Time for Salmonella

If one were to ask, “What happens when Salmonella infects the gut?” it might not be obvious that you’d also need to ask, “What time is it?” But indeed you’d need to know the latter to appropriately address the former. An invading Salmonella, intent on setting up camp, is trying to pitch its tent on a landscape that is changing throughout the day. The mammalian gut, like most eukaryotic and some prokaryotic cells, uses an internal timing device to control its physiological functions. The circadian, or 24-h (circa diem, about a day) clock employs an endogenous oscillator to control gene expression, metabolism, and other cellular processes in such a way that individual genes, pathways, and their components ebb and flow in activity with distinctive daily programs, meshing together to execute the enterprise of the cell. Among circadian regulated processes are aspects of the immune system, including components of the inflammatory response. Included are changes in the expression of several inflammation-related (“proinflammatory”) cytokines by macrophages not only in the animal but also ex-vivo. Not coincidentally, Salmonella thrives in the inflamed gut.

Read more:
It’s Time for Salmonella

Source: Small Things Considered
Image credits: pubmed

Art and Science of Laboratory Medicine

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Individualized Quality Control Plan (IQCP)

The Clinical and Laboratory Standards Institute (CLSI) document EP23-A - "Laboratory Quality Control Based on Risk Management:

1. Do all labs in USA need to purchase the EP23 guideline, booklet, and worksheet?
2. Do you need to use any Risk Management tools to comply with EP23 and IQCP?
3. Will Deemed Accreditation Organizations have to implement IQCPs?
4. Will inspectors be able to assess and even challenge the Risk QC of a laboratory?

Read more:
5 Questions we still have about IQCPs

Source: Westgard QC
Image source: www.westgard.com

Art and Science of Laboratory Medicine

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Sunday, September 15, 2013

Drawing Blood

Amazing piece of art directly to the heart of biomedical laboratory scientists and phlebotomists by Nykolai Aleksander.

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Drawing Blood

Source: inPRINT
Image credits: Nykolai Aleksander

Art and Science of Laboratory Medicine

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Antibody Cake

The big mess at the middle is an IgM pentamer, which just means five IgM antibodies bound together into an immunological ninja star. IgM is usually the first antibody to respond to an infection. The reason you can be tested for Lyme disease and they can tell the difference between an active infection and a past infection is that the IgM will be present if your body is still fighting in its initial encounter with the bug, while the IgG antibodies will persist for life, hanging around ready to multiply if you're ever re-infected.

"I'm pretty certain that cake doesn't have much effect on the immune system, but it sure made us happy."

Read more:
Antijenic Drift: Antibody Cake!

Source: Antijenic Drift
Image credits: Jen

Art and Science of Laboratory Medicine

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White Blood Cell Glass Magnets

Includes a set of 6 hand made glass magnets. Each magnet measures about 1" across. Made with 1/2 inch diameter, super-strong Neodymium magnets that can hold several sheets of paper. They are the perfect touch on refrigerators, white boards and filing cabinets.

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Blood smear white blood cell glass magnets

Source: Etsy - PtownPaperAndMagnets
Image credits: Michelle DeCourcey

Art and Science of Laboratory Medicine

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Amazing Laboratory Cupcakes

Did you see SGM´s amazing cupcakes as part of CVN meeting?
TB, virus, pipettes.........

Original image:
Twitter / PaulHolmes17: @SocGenMicro

Source: Twitter @SocGenMicro
Image credits: Paul Holmes

Art and Science of Laboratory Medicine

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A New Approach to Early Diagnosis of Influenza

A new technology is showing promise as the basis for a much-needed home test to diagnose influenza quickly, before the window for taking antiviral drugs slams shut and sick people spread the virus to others, scientists reported today in Indianapolis. In a presentation at the 246th National Meeting & Exposition of the American Chemical Society (ACS), they described how it also could determine the specific strain of flu virus and help select the most effective drug for treatment.

"Just going to the doctor's office or hospital for diagnosis can be counterproductive during a major flu outbreak," Iyer explained. "It carries the risk of spreading the disease. During the last swine flu outbreak, hospitals in some areas went on TV to tell people not come to the ER. Not only could they spread the virus, but ERs did not have the facilities to test hundreds of worried people."

Read more:
A New Approach to Early Diagnosis of Influenza

Source: Advance
Image credits: alibaba.com

Art and Science of Laboratory Medicine

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Avian Influenza A (H7N9) - Specimen Collection, Processing, and Testing

This document provides interim guidance for clinicians and public health professionals on appropriate specimen collection, storage, processing, and testing for patients who may be infected with avian influenza A (H7N9) virus in the United States. Current influenza A (H7N9) case definitions and recommendations for patient testing should also be consulted.

Read more:
Specimen Collection, Processing, and Testing for Avian Influenza A (H7N9) - CDC

Source: CDC
Image credits: Center for Disease Control and Prevention, C.S. Goldsmith, T. Rowe

Art and Science of Laboratory Medicine

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Saturday, September 14, 2013

A Statue For Eurobasket 2013

A sculpture of a DNA molecule made out of athletic balls specifically tennis balls for the deoxyribose, mini basketballs for the phosphate, and golfballs for the four bases Adenine, Thymine, Guanine, and Cytosine.

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Athletic Helix

Source: Jeremy Tubbs
Image credits: Jeremy Tubbs

Biotechnology, Applying the Genetic Revolution - Free eBook

Unlike most Biotechnology textbooks, Dr. David P. Clark’s ”Biotechnology” approaches modern Biotechnology from a Molecular Basis, which grew out of the increasing biochemical understanding of physiology. Using straight forward, less-technical jargon, Clark manages to introduce each chapter with a basic concept, that ultimately evolves into a more specific detailed principle. This up-to-date text covers a wide realm of topics including forensics and bioethics using colorful illustrations and concise applications.
This book will help readers understand what molecular biotechnology actually is as a scientific discipline, how the research in this area is conducted, and how this technology may impact the future.

Download eBook here:
Biotechnology, Applying the Genetic Revolution

Source: Free Microbiology Books
Image credits: freemicrobiologybooks.com

Art and Science of Laboratory Medicine

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Pipette Tip Flower

Sometimes, when its late at night, and I'm all alone in the laboratory...

Source: Reddit.com
Image credits: duck_incoming

Art and Science of Laboratory Medicine

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MALDI-ToF is Changing Clinical Microbiology

Lasers are the new DNA. It is called matrix-assisted laser desorption/ionization--time of flight (MALDI-TOF) and it uses mass spectrometry to quickly test for hundreds of different pathogens in a small sample using a single automated device. MALDI-TOF is increasingly being used in clinical microbiology laboratories for rapid bacterial and fungal identification.

Participants discuss this new technology and how implementation can drastically change clinical care of some infections.

View video on YouTube:
How MALDI-ToF is Changing Clinical Microbiology - ICAAC 2013 - YouTube

Source: YouTube
Image credits: Children´s Med Dallas

Art and Science of Laboratory Medicine

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Love And Laboratory Work

What would be a better place than lab to visit on your wedding day.
Congratulations Agnieszka Topolska-Wos

Original image:
Wedding day 13.07.2013

Source: Facebook
Image credits: Agnieszka Topolska-Wos

Art and Science of Laboratory Medicine

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Optimizing blood gas testing

Today’s healthcare environment presents many challenges to laboratorians or clinicians responsible for arterial blood gas (ABG) testing. They are expected to do more with less staff, contain testing costs, and comply with increasing regulatory requirements—without sacrificing testing quality.
In addition, due to the nature of ABG testing, clinicians cannot afford to waste time or resources when making decisions based on an ABG sample analysis. To ensure accurate results for such decision-making, it is imperative that the analytical process be as standardized and finely calibrated as possible. For example, variations in technique in the areas of specimen preparation, turnaround time (TAT), handling, and analysis can all affect test results.

Read more:
Optimizing blood gas testing

Source: Medical Laboratory Observer
Image credits: MLO

Art and Science of Laboratory Medicine

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Biclonal Gammopathy

A 53 year old patient presented with backache. A skeletal survey was performed that showed punched out lesions in the skull. The bone marrow aspiration showed 21% plasma cells. The haemoglobin was 10.1g/dL, serum calcium and creatinine were normal. Immunofixation electrophoresis showed a biclonal gammopathy both bands were IgA and λ. The free λ chain level was 179mg/L and the free κ chains level was 27.4 mg/mL with a free light chain ratio of 0.15. The albumin was 2.5g/dL and the β-2 microglobulin 4.9mg/ml. The patients was diagnosed as multiple myeloma stage II by ISS and treated with bortezomib and dexamethasone followed by an autologous stem cell transplant.

Read more:
Biclonal Gammopathy

Source: All About Blood
Image credits: Avinash Deo

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Sunday, September 8, 2013

Knitted Bacteria

Microbes get a bad press. Some of them undoubtedly deserve it. And even although there are many bacteria that perform useful, necessary functions, they somehow have never really made the leap into the cuddly toy category.

Read more:
Cuddly Bacterium Anyone?

Source: Promega Connections
Image credits: Isobel Maciver

Art and Science of Laboratory Medicine

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Total analytic error vs. total error

"My friends and colleagues Jim and Sten Westgard have written an article about total analytical error in which I am mentioned." Their article says that total analytical error (TAE) is important and estimated by the equation TAE=average bias + 2xSD. They later go on to say that higher multiples of the SD are useful for Six Sigma methods.

So what are the problems?

Read more:
Total analytical error vs. total error

Source: Krouwer Consulting
Image credits: jkrouwer

Art and Science of Laboratory Medicine

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Total Analytic Error

Today clinical laboratories have come under increased pressure to implement quality systems and new risk management guidelines for quality control in order to ensure timely and accurate delivery of test results. However, one issue that is often overlooked in these efforts is the actual quality goal or requirement for a laboratory test. In simple terms, the question that laboratory professionals should be asking is: how good does a test need to be? As laboratories attempt to answer this basic question, other questions quickly become evident—how should the laboratory define the quality goal? how should the laboratory validate the analytical methods to satisfy the goal? and what is the best way for the laboratory to assure those goals are achieved in routine testing?

Read more:
Total Analytic Error

Source: Clinical Laboratory News
Image credits: James O. Westgard, PhD, and Sten A. Westgard, MS

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Erlenmeyer Necklace

This plexiglass love potion necklace is from "bugga´s" Back to School Series.This is her favorite as she is a chemical engineer. The erlenmayer flask is attached to silver plated chain which is 80 cms(31.4 inches) long.

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Geek Jewelry,Love Potion Necklace

Source: luulla.com
Image credits: bugga

Art and Science of Laboratory Medicine

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Haematology Quiz 3

Here is the final installment of a really nice quiz one of Pathology Student´s readers sent. This is a quiz recently given to medicine, pediatrics and pathology residents rotating through hematopathology. Give it a try and see how many you get right! Make sure you check out the answers and nice explanations at the end.

Take the quiz here:
Hematopathology quiz 3 - Pathology Student Blog

Source: Pathology student
Image credits:

Art and Science of Laboratory Medicine

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The costs and benefits of genetic testing

Hospital laboratories that are considering an investment should know that while genetic testing comes with a high financial cost, the potential gains from investing in the research could put a hospital on the cutting edge of treatment and patient care, especially in companion diagnostics. This form of testing is unique in that it can predict if a particular patient will respond to a particular drug, thereby providing medically and cost-effective treatments.

It can also help to alleviate potential adverse side effects. Companion diagnostics is a very specific test developed to ensure the safe and effective use of the corresponding drugs. "All of this came to light from cancer therapies in some of the newer biologic drugs were developed for cancer," said Montagna. "A cancer patient deals with medications that cost tens of thousands per treatment regimen, and there's a chance that the drugs he or she is taking are not helping him or her get better. In some cases, the medication might be making him or her even worse."

Saturday, September 7, 2013

Microtome For Pathology Ladies

Leica´s pink microtome at ECP 2013 exhibition.

Source: Medical Laboratory and Biomedical Science
Image credits: Juha Wahlstedt

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One more shot of AB positive blood

Mosquito Bar - Happy Hour

Read more:
130. Declare War on Mosquitoes

Source: 365 Market place
Image credits: Lizluby

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Lab chemist accused of faking test results

The attorney appointed by Massachusetts Governor Deval Patrick to investigate the case of Annie Dookhan, the Massachusetts state drug lab chemist who allegedly faked test results, tampered with evidence and neglected protocols over a several year period, now states more than 40,000 cases may have been affected.
Ms. Dookhan, who apparently also falsely claimed to have a Master’s degree in chemistry, had a reputation for being the most productive tech in the lab; she would routinely process more than 500 cases per month, when an average tech could only process 50-150 cases per month.

Read more:
Lab chemist accused of faking test results may have tainted 40,000 drug cases

Source: The Pathology Plawg
Image credits: AP

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Homozygous hemoglobin C disease

A 44-year-old African American female presented with a pain crisis and a history of hemoglobinopathy, menometrorrhagia secondary to acquired von Willebrand factor (vWF) deficiency, and a history of multiple vaso-occlusive events necessitating lifelong warfarin therapy. Further history revealed that she had four pain crises in the previous year requiring hospitalizations, multiple splenic infarcts with resultant autosplenectomy, one normal pregnancy with no preceding miscarriages, and no history of bone necrosis.

Read more:
Homozygous hemoglobin C disease