Art and Science of Laboratory Medicine

Art and Science of Laboratory Medicine

Tuesday, November 29, 2016

Free guide to quantify uncertainty

Quantifying Uncertainty in Analytical Measurement, 3rd Edition

Eurachem guide provides explicitly for the use of validation and related data in the construction of uncertainty estimates in full compliance with the formal ISO Guide principles set out in the ISO Guide to the Expression of Uncertainty in measurement. The approach is also consistent with the requirements of ISO/IEC 17025:2005.

Read more:
Quantifying Uncertainty

Source: Eurachem

Plasma Creatinine Poor Predictor of Acute Kidney Injury in Pediatric ICU

Acute kidney injury develops in more than one quarter of children and young adults admitted to intensive care units. And in severe cases, it increases the odds of death by 77%, according to a new international observational study conducted in 32 hospitals.

The analysis, reported Friday at the annual meeting of the American Society of Nephrology in Chicago and online by the New England Journal of Medicine, also found that plasma creatinine, by itself, was not an effective method for diagnosing the problem. It failed in 67.2% of patients with low urine output.

Read more:
Creatinine Poor Predictor of Acute Kidney Injury in Pediatric ICU

Soure: MedScape

Sunday, November 27, 2016

Just Science

Beautiful drawing by Saranya Singaravel


Source: Twitter via Saranya Singaravel

Platelet Activation and Factors for Clot Formation

Great animation of coagulation process

View in YouTube
Platelet Activation and Factors for Clot Formation


Source: YouTube

Should you have a break every now and then?

Microscope work involves sustained static postures of the head, neck and body. Adjust your workstation to minimize awkward postures and improve comfort. Risks are
  • Forward bending-strains back musculature
  • Leaning on arms-strains upper shoulders/neck
  • Forearm contact pressure on table top

Learn how to improve ergonomics at microscope work:
Microscope Ergonomics

Source:UBC Human Resources
Image: Facebook via Trust me I´m a biologist

Thursday, November 24, 2016

Level of certain blood proteins may affect to ageing process

Researchers in California plan to launch a clinical trial of the radical – and highly experimental – approach in the next six months, after a small study in mice found the treatment had promise.

People who take part in the trial will have their blood passed through a machine that resets abnormal levels of proteins seen in older blood. The scientists believe these high levels of certain proteins can hamper the growth and maintenance of healthy body tissues, and so contribute to their deterioration in old age.

Read more:
Scientists to 'reset' blood proteins in attempt to slow ageing process 

Source: The Guardian

Wednesday, November 23, 2016

New testing options for Trichomonas vaginalis

According to epidemiologic research, Trichomonas vaginalis remains the most prevalent non-viral sexually transmitted infection (STI) globally.

There have been many exciting technological advances in the diagnosis of T. vaginalis over the last five years. New nucleic acid amplification test (NAAT) options, some laboratory-based and others not, continue to be developed in this rapidly changing arena of molecular diagnostics. Several new assays are now available and the list is ever changing and evolving.

New assays offer a wide variety of solutions that make it possible to provide testing for trichomonas in almost any setting.
  • RNA-based transcription mediation amplification assays
  • DNA-based transcription mediation amplification assays
  • Point-of-care (POC) assays
Read more:
New testing options for Trichomonas vaginalis respond to growing awareness

 Source: MLO

Sunday, November 20, 2016

Saturday, November 19, 2016

I love my microbiome

Let's face it. We live in a world full of bacteria. From the food you eat to the door knob you just turned, these tiny critters are everywhere. Many people think of bacteria as dangerous and dirty, and I'm sure if you're the type who uses hand sanitizer every five minutes, you probably already feel creepy-crawly. While there are many bad bugs that can have serious health consequences, the bacteria in our gut play a critical role in keeping us healthy. These bacteria are our friends not our foes.

The gut is one of the most complex ecosystems on the planet. In fact, your gut is home to trillions of bacteria. There are 10 times more microorganisms in and on our body than there are human cells! 10 times!! These tiny microorganisms, called intestinal flora, have many important functions, from supporting your immune system and digestive system to playing large role in our emotions and mental health. If you look after your little friends, you are guaranteed better health. Here's what you need to know about your microbiome.

Read more:
Say Hello To Your Little Friends. What You Should Know about Gut Bacteria — Sprouting From The Soul


Source: Sproyting from the soul

Serum Protein Electrophoresis

Serum protein electrophoresis (SPEP) is an easy, inexpensive method of separating proteins based on their net charge, size, and shape. The 2 major types of protein present in the serum are albumin and the globulin proteins. Albumin is the major protein component of serum and represents the largest peak that lies closest to the positive electrode. [1] Globulins comprise a much smaller fraction of the total serum protein but represent the primary focus of interpretation of serum protein electrophoresis. Five globulin categories are represented: alpha-1, alpha-2, beta-1, beta-2, and gamma, with the gamma fraction being closest to the negative electrode.

Serum protein electrophoresis is generally considered in any patient with an elevated total protein, especially those with elevated globulin level relative to albumin, or any signs and symptoms suggestive of an underlying plasma cell disorder such as multiple myeloma, Waldenstrom’s macroglobulinemia, or primary amyloidosis. [3] These include any of the following:
  • Unexplained anemia, back pain, bone pain, fatigue
  • Unexplained pathologic fracture or lytic lesions
  • Unexplained peripheral neuropathy
  • Hypercalcemia secondary to possible malignancy
  • Hypergammaglobulinemia
  • Rouleaux formation noted on peripheral blood smear
  • Renal insufficiency with bland urine sediment
  • Unexplained proteinuria
  • Bence Jones proteinuria
  • Recurrent infections
Read more:
Serum Protein Electrophoresis: Reference Range, Interpretation, Collection and Panels

(Click image to enlarge)


Source: Medscape

Friday, November 18, 2016

Urine strip test — Understanding its limitations

Routine urinalysis is a cost-effective, non-invasive test used as an indicator of health or disease for metabolic and renal disorders, infection, drug abuse, pregnancy, and nutrition. Urine chemistry can be completed in a number of different ways, ranging from manual reading of a visual urine test strip to the use of semi-automated analyzers to loading the sample on a fully automated urine chemistry analyzer. There is one thing that all methods have in common: a urine chemistry reagent strip.

Urine chemistry reagent strips comes in many different configurations, depending on their use. The most common tests include bilirubin, urobilinogen, glucose, ketones, protein, blood, nitrite, leukocyte esterase, and pH. In addition, some manufacturers include urine chemistry reagent pads for specific gravity, ascorbic acid, microalbumin, creatinine, and color. While urine chemistry testing is common, it is important to understand the test and its limitations to ensure accuracy of the test and recognize the factors that can cause incorrect results. Manufacturers have improved urine chemistry analysis by including additional tests to easily identify common interferences.

  • Bilirubin
  • Urobilinogen
  • Ketones
  • Glucose
  • Protein
  • Blood
  • Nitrites
  • Leukocytes
  • pH
  • Specific gravity
  • Ascorbic acid
  • Color
Read more about the factors that can cause incorrect results.:
Rediscovering urine chemistry—and understanding its limitations


Source: MLO

Candy DNA

Building delicious A- T and G - C pairs


Source: Twitter via

Thursday, November 17, 2016

Platelet Satellitism

Platelet satellitism was first reported in the early 1960's. It is a rare condition that occurs when an IgG antibody forms in the presence of EDTA, the anticoagulant that is used for the collection of hematology blood specimens. The IgG antibody is directed against the glycoprotein IIb/IIIa complex on the platelet membrane. As the antibody coats the platelets, the platelets rosette around segmented neutrophils, bands, and sometimes around monocytes. Antibody-coated platelets that are huddled around white blood cells (WBCs) will not be counted as platelets by automated equipment and the platelet count will be falsely decreased. If a peripheral blood smear is reviewed, platelets will be observed attached to WBCs. The image on the right illustrates platelet satellitism with platelets adhering to a neutrophil.

Read more:
Pseudo-thrombocytopenia: Platelet Satellitism and Platelet Clumping - LabCE.com, Laboratory Continuing Education


Source: LabCE.com, Laboratory Continuing Education
Image: A Dull Day at Work

Tuesday, November 15, 2016

WHO - World Antibiotic Awareness Week

This year World Antibiotic Awareness Week will be held from 14 to 20 November 2016. It will be marked by public, policy maker, human & animal health professional, & student engagement through social media & local awareness-raising events around the world.

Antibiotic resistance has become one of the biggest threats to global health & endangers other major priorities, such as development. It is rising to dangerously high levels in all parts
of the world, compromising our ability to treat infectious diseases & undermining many advances in health & medicine.

Read more:
WHO | World Antibiotic Awareness Week

Source: WHO



Sunday, November 13, 2016

Capillary blood sampling

National recommendations on behalf of the Croatian Society of Medical Biochemistry and Laboratory Medicine

Capillary blood sampling is a medical procedure aimed at assisting in patient diagnosis, management and treatment, and is increasingly used worldwide, in part because of the increasing availability of point-of-care testing. It is also frequently used to obtain small blood volumes for laboratory testing because it minimizes pain. The capillary blood sampling procedure can influence the quality of the sample as well as the accuracy of test results, highlighting the need for immediate, widespread standardization. A recent nationwide survey of policies and practices related to capillary blood sampling in medical laboratories in Croatia has shown that capillary sampling procedures are not standardized and that only a small proportion of Croatian laboratories comply with guidelines from the Clinical Laboratory Standards Institute (CLSI) or the World Health Organization (WHO). The aim of this document is to provide recommendations for capillary blood sampling. This document has been produced by the Working Group for Capillary Blood Sampling within the Croatian Society of Medical Biochemistry and Laboratory Medicine. Our recommendations are based on existing available standards and recommendations (WHO Best Practices in Phlebotomy, CLSI GP42-A6 and CLSI C46-A2), which have been modified based on local logistical, cultural, legal and regulatory requirements.

Read more:
Capillary blood sampling: national recommendations on behalf of the Croatian Society of Medical Biochemistry and Laboratory Medicine

Source: NCBI, Biochemica Medica
Image: Facebook via diagnosci.pl

Saturday, November 12, 2016

This USB Stick can perform an HIV Test

Scientists in the UK have developed a USB stick that can quickly and accurately measure the amount of HIV is in a patient’s blood.

The medical device was created by scientists at Imperial College London and tech firm DNA Electronics, and all it needs is a simple drop of blood to measure HIV-1 levels. It then creates an electrical signal that’s fed into a computer, laptop, or handheld device. The disposable test could be used by HIV patients to monitor their own treatment and help patients in remote regions of the world, where more standard HIV tests are inaccessible.

The timely detection of viremia in HIV-infected patients receiving antiviral treatment is key to ensuring effective therapy and preventing the emergence of drug resistance. In high HIV burden settings, the cost and complexity of diagnostics limit their availability. Scientists in the UK have developed a novel complementary metal-oxide semiconductor (CMOS) chip based, pH-mediated, point-of-care HIV-1 viral load monitoring assay that simultaneously amplifies and detects HIV-1 RNA. A novel low-buffer HIV-1 pH-LAMP (loop-mediated isothermal amplification) assay was optimised and incorporated into a pH sensitive CMOS chip. Screening of 991 clinical samples (164 on the chip) yielded a sensitivity of 95% (in vitro) and 88.8% (on-chip) at >1000 RNA copies/reaction across a broad spectrum of HIV-1 viral clades. Median time to detection was 20.8 minutes in samples with >1000 copies RNA. The sensitivity, specificity and reproducibility are close to that required to produce a point-of-care device which would be of benefit in resource poor regions, and could be performed on an USB stick or similar low power device.

Read more:
Novel pH sensing semiconductor for point-of-care detection of HIV-1 viremia

Source: Nature: Scientific reports
Image: Imperial College London/DNA Electronics

Thursday, November 10, 2016

Win a copy of Tietz Textbook of Clinical Chemistry and Molecular Diagnostics

International Pathology Day 2016 Labs Are Vital Photo Contest

Pathologists and laboratory professionals are vital to improving patient care around the world. Help your colleagues celebrate International Pathology Day on Nov. 16, 2016, by participating in  IPD 2016 Labs Are Vital Photo Contest!

Tell the world why you are vital to health care by printing and completing 
“I AM VITAL BECAUSE”

Read more and participate to photo contest:
Labs are vital - Photos

Source: Labs Are Vital!

Blood Type O

Haematology joke

Source: Common sense evaluation

Tuesday, November 8, 2016

Proteins in blood can predict type 1 diabetes

Certain proteins in the blood of children can predict incipient type 1 diabetes, even before the first symptoms appear. A team of scientists at the Helmholtz Zentrum München, partners in the German Center for Diabetes Research (DZD), reported these findings in the ‘Diabetologia’ journal.

The study group were able to identify 41 peptides from 26 proteins that distinguish children with autoantibodies from those without, reports Dr. Christine von Toerne, a scientist in the Research Unit Protein Science who shared first authorship of the work with Michael Laimighofer, a doctoral candidate in Jan Krumsiek's junior research group at the Institute of Computational Biology. Striking in their evaluations: A large number of these proteins are associated with lipid metabolism. Two peptides - from the proteins apolipoprotein M and apolipoprotein C-IV - were particularly conspicuous and were especially differently expressed in the two groups, von Toerne adds. In autoantibody-positive children, it was furthermore possible to reach a better estimate of the speed of the diabetes development using the peptide concentrations of three proteins (hepatocyte growth factor activator, complement factor H and ceruloplasmin) in combination with the age of the particular child.

The biomarkers that they have identified allow a more precise classification of this presymptomatic stage and they are relatively simple to acquire from blood samples

Read more:
press information – Helmholtz Zentrum München

Source: Helmholz Zentrum München

Monday, November 7, 2016

Petri dish paintings

Some fun for medical laboratory scientists

Read more:
Microbiology: Petridish #fun#lab#



Source: Mulpix via I love microbiology

Sunday, November 6, 2016

Saturday, November 5, 2016

Laboratory’s role in healthcare quality

Healthcare providers depend on accurate and precise lab results in order to do their jobs well and give patients the best possible care. Often, laboratory results are the decision point in a patient’s treatment. With so much on the line, it’s no surprise that laboratories everywhere are committed to constant improvement.

USA is having Healthcare Quality Week in October. This week is designated to celebrate and acknowledge the work of healthcare quality professionals perform all year round. Quality professionals address many issues in the healthcare workplace including risk management, patient safety, and quality improvement.

Let’s have a closer look at some of the ways that laboratories contribute to patient safety and healthcare quality every day:
  • Quality control
  • External quality assessment (Proficiency testing)
  • Specially trained personnel
  • Top level documentation
  • Internal audits
Read more:
The Laboratory’s Central Role in Healthcare Quality

Source: LabTestingMatters
Image: Lego


CML Cookies

Beautiful blood cell cookies by Kristine Krafts

Here we have a neutrophilic leukocytosis with a left shift (there’s a myelocyte, top left, a metamyelocyte, bottom left, and a promyelocyte, center) and a basophilia (right). Check out how mature the chromatin is in the myelocyte, metamyelocyte, and segmented neutrophil – but how fine it is (you can even see nucleoli!) in the promyelocyte). Also, the granules in the promyelocyte are in the cytoplasm and over the nucleus as well. The basophil granules are kinda obscuring the nucleus, but that’s what happens in real life, so we’ll call it artistic rendering.

Read more
Blood cookies! - Pathology student

Source: Pathology student
Image credits: Kristine Krafts, M.D.

Candida auris - New superbug in US

Just five months after federal health officials asked hospitals and physicians to be on the lookout for an often-fatal, antibiotic-resistant fungus called Candida auris, 13 cases have been reported, the CDC announced 4 November, 2016.

It is the first time that the fungus, which is easily misidentified in lab tests as a more common candida yeast infection, has been found in the USA, and four of the first seven patients with it have died.

Candida auris’s emergence and apparent global spread, it was first identified in Japan in 2009 and since then has been found in a dozen countries on four continents, put the pathogen on the ever-growing list of superbugs, disease-causing microbes that are resistant to many and, in some cases, all antibiotics.

C. auris is difficult to identify with standard laboratory methods and can be misidentified in labs without specific technology. CDC encourages all U.S. laboratory staff who identify C. auris strains to notify their state or local public health authorities and CDC at candidaauris@cdc.gov. Find answers to frequently asked questions about C. auris on our questions and answers page and in the Candida auris: Interim Recommendations.

Read more:
Health officials find first cases of new superbug in USMore information:
Candida auris | Fungal Diseases | CDC

Source: CDC

Friday, November 4, 2016

A lot of blood, for no reason?

Curbing genetic testing for clot-prone patients is just one example of how to improve spending of health care dollars through better ordering of tests. A half billion dollars, at least, gets spent each year on blood tests to see which hospital patients have a genetic quirk that makes their blood more likely to form dangerous clots.

Writing in the Journal of Hospital Medicine , they review what’s known about testing for the trait called inherited thrombophilia, and call for a drastic cut in the test’s use by doctors across America.

After all, they write, hospitalized people who have already had such dangerous clots, called venous thromboembolisms or VTEs, don’t need a positive genetic test to justify taking medication and making other changes to prevent future ones.

And there’s no evidence that medication to prevent clots will help hospital patients who haven’t yet had a VTE. Testing their DNA for inherited thrombophilia won’t change that.

In other words, the authors say, ordering inherited thromboembolism testing on inpatients is something doctors do for little or no reason. And according to the team’s analysis of data pulled from medical records, they do it hundreds of thousands of times a year in Medicare patients alone.

Can we call this predictive, preventive and personalised laboratory medicine?

Read more:
A lot of blood, for no reason? U-M team concludes that common, costly clot test has few benefits | University of Michigan Health System

 Source: University of Michigan Health System

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