Art and Science of Laboratory Medicine

Art and Science of Laboratory Medicine

Friday, February 28, 2014

I Love Microbiology

Wonderful petri dish art - Pure E. coli colonies.

Source: Facebook via Medical Microbiologist

Urinemicro to your mobile phone

The "Urine Microscopy App" intends to be a guide for the microscopic particle identification of urinary sediments. It is based on European Urinalysis Guidelines, dealing with a basic and an advanced level. 188 images are demonstrating representative microscopic elements during most important clinical situations.

For iPhone
Urinemicro on the App Store on iTunes

For Android phones
Urinemicro - Android

Source: Diakonhjemmet sykehus

Should we wear gloves during the blood draw?

There are differend standards and recommedations about the phlebotomy procedure all over the world. Let´s have a short survey about the goves usage.



Quality Indicators in the Preanalytical Phase of Testing in a Stat Laboratory

Study objective: To quantify performance in the preanalytical phase in a stat laboratory using quality indicators, and compare our results with those in the literature to improve laboratory services.

During the 1-year period, a total of 168,728 samples and 88655 requests forms were received in stat laboratory. The total number of preanalytical errors was 1457, accounting for 0.8% of the total number of samples received in a year. Of the total preanalytical errors, 46.4% were hemolysed samples (biochemistry), 43.2% were clotted samples (hematology), 6.4% were samples lost-not received in the laboratory, 2.9% samples showed an inadequate sample-anticoagulant ratio, 0.7% were requests with errors in patient identification, 0.3% were samples collected in blood collection tubes with inappropriate anticoagulant and 0.1% were requests with errors–missing test requests.

Read more:
Quality Indicators in the Preanalytical Phase of Testing in a Stat Laboratory

 Source: Lab Medicine

New Diagnostics for Common Childhood Infections

The implementation of preventive strategies and effective treatment has substantially reduced the incidence of malaria across many parts of Africa. The introduction of Haemophilus influenzae type b vaccine and, more recently, pneumococcal conjugate vaccine should dramatically reduce the incidence of serious bacterial infections among children. Historically, these pathogens accounted for a substantial proportion of childhood deaths in regions of Africa where malaria is endemic. High coverage with these measures will also affect the burden and spectrum of the common childhood febrile diseases. Consequently, case-management guidelines — which are currently designed to maximize sensitivity over specificity, resulting in widespread use of low-cost antimalarial or antimicrobial agents to avert adverse outcomes — will need to be revised. However, most research underpinning such guidelines was undertaken two to three decades ago. The advent of rapid diagnostic tests and molecular diagnostics has expanded the potential to identify causes of disease and may inform future management strategies for common childhood diseases. Nevertheless, few such pathogenic data are available from sub-Saharan Africa.

Read more: 
New Diagnostics for Common Childhood Infections 

Source: NJEM

Mouth Pipetting Has Changed Over Time

Occupational hazards in the laboratory.

Do not try this at your lab!

Monoclonal B-cell lymphocytosis in healthy blood donors

Monoclonal B-cell lymphocytosis (MBL), an essential precursor to chronic lymphocytic leukemia (CLL), is a surprisingly common finding in healthy blood donors, thus raising concerns about the potential risk infusion of these blood products may present to recipients.

MBL is defined as <5000 monoclonal B cells per μL of blood and no lymph node involvement. Low-count MBL (low risk of development of CLL, although risk may be affected by other factors) has <500 cells per μL and clinical MBL (increased risk of CLL) has >500 cells per μL. SLL, small lymphocytic leukemia. Professional illustration by Marie Dauenheimer.

Read more:
Monoclonal B-cell lymphocytosis in donors

Source: Blood
Image credits: ASM image library 

Thursday, February 27, 2014

Your Pipette is Your Friend - Video

In collaboration with the brave employees at the department of Human Genetics (Radboud University Nijmegen Medical Centre), the Pipette Liberation Front (PLF) and the Association for the Promotion of Proper Pipetting Protocols and Prohibition of People Panhandling Poor Pipettes for Prodigious Production (APP10) present LIFE OF PIPETTE. A heart-rending tale of the everyday hardships our favourite labcompanions have to endure. Confronted with these true stories of ergonomic tragedy, lab agression, pipetting inaptitude and even gruesome abuse, we hope the viewer of LIFE OF PIPETTE understands the need for spreading a more positive message. YOUR PIPETTE IS YOUR FRIEND!

Source: Youtube/ Pleb R.

Polio-like paralysis in California

Recently a number of children in California have developed a poliomyelitis-like paralysis. The cause of this paralysis is not yet known, and information about the outbreak is scarce. Here is what we know so far:

  • At least 5, and perhaps as many as 20 children have suffered weakness or paralysis in one or more limbs. The median age of the patients is 12 years and the cases have been reported since 2012.
  • One group of 5 patients recently presented at the American Academy
    of Neurology Annual meeting developed full paralysis within 2 days, and
    have not recovered limb function in 6 months.
  • The cases are all located within a 100-mile radius.
  • A mild respiratory illness preceded paralysis in some of the children.
  • Enterovirus type 68 has been recovered from the stool of some of the patients.
Read more:
Polio-like paralysis in California

Source: Virology Blog

Record: 26 vials of blood

General (thorough) checkup. 7 vials of blood later, feeling fine. Eric Northman would be proud. Asked the lab tech what the most had been: 26 vials.

What is your record?

Read more:
7 vials of blood. General (thorough) checkup

Source: Zadi Diaz

The Death Test

A new screening technology reveals a signature of mortality in blood samples.Researchers have identified four biomarkers that help to identify people at high risk of dying from any disease within the next five years.

Researchers from Finland and Estonia have discovered novel biological markers that are strongly indicative of risk of dying from any disease within the near future. Blood samples from over 17 000 generally healthy people were screened for more than a hundred different biomolecules. The health status of these study volunteers was followed for several years. The researchers looked for measures in the blood that could reflect who had died within the following 5 years after the blood sample was taken. In a study published in PLOS Medicine today they describe identification of four such biomarkers of death.

Read more:
Novel blood screen reveals risk of dying among healthy people 

Source: FIMM

PSA testing for prostate cancer: balancing the benefits and harms

International consensus committees are divided in their recommendations about PSA testing. The New Zealand Ministry of Health recommends that all men over 50 should check for symptoms and undergo annual PSA testing. In the UK, however, routine PSA screening is not recommended, and men over 50 are only entitled to a PSA test if they have first discussed the benefits and harms with their doctor. The US Preventive Services Task Force (USPSTF) advises against PSA screening; co-chair Michael LeFevre highlights that:

“There is a very small potential benefit and significant potential harms”

Read more:
PSA testing for prostate cancer: balancing the benefits and harms

Source: BioMed Central Blog

Image credits: Lewis McChord via Creative Commons

Flow Cytometry Course Including Young Investigator Award


The 2014 IFCC/ESCCA Beckman Coulter Flow Cytometry Course (Vienna-AT, April 24-26, 2014) main topic is "Harmonisation and Standardisation in Flow Cytometry", focusing on immune monitoring, leukaemia and microparticles. The course will last three full days and will include morning lectures and afternoon sessions with practical hands-on experience.

Young Investigator Award

3 places, course fees and travel expenses included

For further information please contact: regarding course content

Read more:
IFCC/ESCCA Beckman Coulter Flow Cytometry Course

Source: IFCC/Beckman Coulter

Video Training in the Lab

Visualized tools can save time, labor, resources and money

Moshe Pritsker, CEO and co-founder of the Journal of Visualized Experiments (JoVE), was pursuing a PhD at Princeton University when he had a light bulb moment that would change the course of his career.

"I saw that everyone working in labs has the same problem: They have to learn experiments done by others to integrate new technologies into their work," Pritsker explained. "So they read a scientific article from a journal and try to reproduce what they've read at their laboratory bench. Once, twice, three times and it doesn't work. Typically they repeat it nine or 10 times, and then they have no choice. They have to find someone who has done this experiment and who knows the techniques, and this usually means they have travel to learn all the small details that are often left out in written descriptions but exist in real life in the lab."

Vatch example training video: Capsular Serotyping of Streptococcus pneumoniae Using the Quellung Reaction

Read more:
Video Training in the Lab

Source: Advanced

Wednesday, February 26, 2014

Bad Blood Drawing

Who can fail four times in a row?

Source: Xingled out

Statistical errors

P values, the 'gold standard' of statistical validity, are not as reliable as many scientists assume.

For a brief moment in 2010, Matt Motyl was on the brink of scientific glory: he had discovered that extremists quite literally see the world in black and white.

The results were “plain as day”, recalls Motyl, a psychology PhD student at the University of Virginia in Charlottesville. Data from a study of nearly 2,000 people seemed to show that political moderates saw shades of grey more accurately than did either left-wing or right-wing extremists. “The hypothesis was sexy,” he says, “and the data provided clear support.” The P value, a common index for the strength of evidence, was 0.01 — usually interpreted as 'very significant'. Publication in a high-impact journal seemed within Motyl's grasp.

But then reality intervened. Sensitive to controversies over reproducibility, Motyl and his adviser, Brian Nosek, decided to replicate the study. With extra data, the P value came out as 0.59 — not even close to the conventional level of significance, 0.05. The effect had disappeared, and with it, Motyl's dreams of youthful fame.

Read more:
Scientific method: Statistical errors : Nature News & Comment

Source: Nature

Tuesday, February 25, 2014

Superbug: Hypervirulent KPC Created In Lab

Highly virulent and nearly completely resistant to antibiotics, a pathogen that occurred in nature at least once and created with shocking ease in the lab poses a "catastrophic threat" to the U.S. health care system, the lead investigator of the research tells Hospital Infection Control & Prevention.

Chiang and colleagues combined a carbapenem-resistant Enterobacteriaceae (CRE) enzyme Klebsiella pneumoniae carbapenemase (KPC) -- which has increased dramatically in the U.S. -- with a highly virulent but drug susceptible isolate of K. pneumonia from Asia. The resulting conjugated microorganism retained the high drug resistance of the KPC and the full virulence of the Asian K. pneumoniae isolate.

Read more:
Superbug: Hypervirulent KPC Created In Lab, Reported In Nature

Source: Advanced

Sunday, February 23, 2014

Fun with Microtubes

"This is what I do at work in between labeling rows and rows of tubes, pipetting various amounts of clear, colorless liquids into them, and then waiting as said liquids react mysteriously over a period of time."

Read more:
Fun with Microcentrifuge Tubes 

Source: A Glimpse of Wistfulness
Image credits: Linda

Bacterial Flower

A beautiful petri dish.

Yellow = Pseudomonas aeruginosa
Pink = E.Coli
Blue = E.Faecalis
Middle = S. aureus

Source: Facebook/Medical microbiologist

Parasitology Challenge

Can you identify these particles?

Case: 17 year old farmer´s  daughter from Mexico has been suffering abdominal pain, diarrhea, cramps, and weight loss lately. Stool sample was taken and findings are in the image. The particles in stool are around 60 x 40 micrometers.

CORRECT ANSWER: Human hookworm (Necator americanus or Ancylostoma duodenale, they cannot be distinguished morphologically). In this case it has been confirmed to be N. americanus.

View all given comments here

Lab Chess

Amazing chess game by Mariam Zoabi 

Source: Facebook/Trust me I´m biologist
Image credits: Mariam Zoabi

Saturday, February 22, 2014

Anatomical Heart Necklace

This Anatomical Heart is undoubtedly one of the most detailed and anatomically correct hearts you'll find. Now available in White Bronze with a thick Silver plate finish. Just like the original bronze version that is also in my shop, this heart is perfect in every anatomical detail - if it's the real thing you're looking for you may well just have found it.

Read more:
Anatomical Heart Necklace Antique Silver Anatomical


Source: Etsy
Image credits:

You and Me are Chemistry

While I love all the papers in the new Idea Book, my favorite is Superhero. Not only does it have the cool comic book papers but it also has this Periodic Table chemistry themed paper - LOVE IT! Its just a great paper for boy projects!

View more:
You + Me Chemistry

Source: Paige Dolecki - Stampologist

Ion selective electrodes and lipemic sample

Would you analyze sodium (S-Na) and potassium (S-K) of this sample using direct ISE?

Source: Facebook
Image credits: Rubel Nath

Prescriptions for Viral Infections Threaten Effectiveness of Antibiotics

A vast majority of people who see their doctors for sore throats or acute bronchitis receive antibiotics, yet only a small percentage should, according to analyses of two major national surveys being presented at IDWeek 2013™. Those illnesses usually are caused by viruses, and antibiotics – which only treat bacterial infections – do not help.

Harvard University researchers analyzed the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey and determined that doctors prescribed antibiotics in 60 percent of visits for sore throats and 73 percent of visits for acute bronchitis. The antibiotic prescribing rate should be about 10 percent for sore throats and nearly zero for acute bronchitis.
Read more:
Antibiotics Drastically Overprescribed for Sore Throats, Bronchitis, Analyses Show

Source: IDweek2014

Friday, February 21, 2014

Iron deficiency may increase stroke risk

Iron deficiency may increase stroke risk by making the blood more sticky, scientists have discovered. Every year, 15 million people worldwide suffer a stroke. Nearly six million die and another five million are left permanently disabled. The most common type, ischaemic stroke, occurs because the blood supply to the brain is interrupted by small clots. In the last few years, several studies have shown that iron deficiency, which affects around two billion people worldwide, may be a risk factor for ischaemic stroke in adults and in children.

Read more:
Iron deficiency may increase stroke risk through sticky blood 

Source: Science Daily
Image credits: Blackwell Publishing

Where does von Willebrand Factor come from?

A question about von Willebrand Factor – where is it stored?
All that I can gather is that it’s stored in ‘Weibel-Palade bodies’, but where are they? Are they in the vessel wall, in the platelet, free-floating in the blood? It’s confusing me a little bit.

Von Willebrand Factor is a huge multimeric protein that is made by megakaryocytes and endothelial cells. It functions in both the initial, platelet-plug phase of hemostasis (in which it glues the platelets to the endothelium), and in the second, fibrin-forming phase of hemostasis (in which it serves as a carrier molecule for factor VIII that keeps factor VIII from being prematurely degraded).

Read more: 
Where does von Willebrand Factor come from?

Source: Parhology Student
Image credits: Kristine Krafts, M.D.

Critical models for the anemia of inflammation

A model of the pathophysiology of the anemia of inflammation based on the findings in Kim et al and Gardenghi et al. Injection of heat-killed B abortus stimulates an inflammatory response including increased production of hepcidin and IL-6. Hepcidin binds to the iron exporter ferroportin resulting in internalization of the protein, increased macrophage iron storage, and subsequent hypoferremia. Recovery from the inflammatory response lowers hepcidin and IL-6 levels leading to increased release of iron from the macrophages to the developing erythrocytes and relief of the block in erythroid development.
Read more:
Critical models for the anemia of inflammation

Source: Blood
Image credits: ASH Image bank

Staphylococcus aureus on MSA Plate

Nostril sample on Mannitol Salt Agar plate.

Read more:
S. aureus on MSA Plate

Source: Microbeworld

Thursday, February 20, 2014

Have you met the blood-drawing robot phlebotomist?

Drawing blood should be a routine procedure. Unfortunately complications can be common either in  the elderly, who may have a compromised vasculature, or in children who are literally scared out of their minds. A startup based in Mountain View, California aims to replace your friendly phlebotomist with a robot. If this new device can gain patient confidence and perform well under ideal conditions, perhaps it can also be of service in more demanding conditions as well.

Read more:
Meet your new blood-drawing, needle-wielding robot phlebotomist  

Source: ExtremeTech

Music from the heart

An eye-catching wrist tattoo

Source: Cuded

Wednesday, February 19, 2014

Amazing Knitted Bacteria

 Penicillin takes out Salmonella with the rest of the menagerie looking on.

Original image:
Penicillin takes out Salmonella ...

Source: Twitter
Image credits: Christina Switzer

International Biomedical Laboratory Science Day

International BLS DAY 15 April, 2014

This day is for the promotion and celebration of the key role Biomedical Laboratory Scientists have in diagnosis and treatment of patients. The theme for the day is selected by the IFBLS Board of Directors and is related to health issues and support the WHO Millennium Development Goals (MDG’s). BLS Day is an opportunity to promote public awareness of the theme and the contributions made by the profession as it relates to health care. The theme for 2014 is "Ethics"

Biomedical Laboratory Scientists are one of the largest groups of health-care professionals, yet our role in medicine is poorly understood. Patients, families and even colleagues within health care have a poor understanding of the vital role Biomedical Scientists have in medicine and public health. The best person to promote our profession is a confident Biomedical Laboratory Scientist. We are the experts and understand our role in healthcare and are the best to carry our message.

Read more:
International BLS Day 2014

Source: IFBLS

Tuesday, February 18, 2014

Happy Tuesday Laboratorians

Dogtor or what?

Image credits: Avantipress

Pediatric Reference Intervals

All laboratory professionals are aware of the importance of reference intervals (RI). Without appropriate reference intervals, a test result is just a number. A numeric result for any given analyte cannot be used to diagnose or monitor treatment of disease unless there is an accompanying reference interval indicating what amount of that analyte should normally be present. In pediatrics, that’s even more important because as an infant develops through childhood and into adulthood, his or her biochemistry changes, adapts and develops with him or her. Using an adult RI to interpret a test result from an infant or child is likely to result in misinterpretation of the test, including misdiagnosis of disease states.

Read more:
Pediatric Reference Intervals

Source: A blog for medical laboratory professionals
Image credits: Washingtong pediatrics

Monday, February 17, 2014

Body kills ‘spontaneous’ blood cancers on a daily basis

Immune cells undergo ‘spontaneous’ changes on a daily basis that could lead to cancers if not for the diligent surveillance of our immune system, Melbourne scientists have found. The research team from the Walter and Eliza Hall Institute found that the immune system was responsible for eliminating potentially cancerous immune B cells in their early stages, before they developed into B-cell lymphomas (also known as non-Hodgkin’s lymphomas). The results of the study were published today in the journal Nature Medicine

Read more:
Walter and Eliza Hall Institute of Medical Research

Source: Walter+Eliza Hall

Single Red Blood Cell

Red blood cell on a needle, coloured scanning electron micrograph (SEM).
Amazing piece of art.

Read more:
Composite SEM of a single red blood cell on the top of a needle.

Source: Follow pics
Image credits: sciencephotolibrary

Sunday, February 16, 2014

Visualizing Viruses

Observing viruses infecting cells is essential for making plans to defeat them, but the two main methods for viewing viral DNA in host cells have limitations.

Genetically engineering the virus to contain sequences that can be bound by fluorescent proteins may interfere with the structure and behavior of the viral DNA, says Urs Greber, a virologist at the University of Zurich. And with the other popular technique, fluorescence in situ hybridization (FISH), “one is never sure if every [viral] DNA in the cell is equally accessible” for labeling, he says, adding that the harsh denaturing and permeabilizing conditions required for FISH may also destroy or remove viral DNA.

Read more:
Visualizing Viruses

Source: The Scientist Magazine

Totally in Love With Microbiology

Feliz tarde de San Valentin by Cristina Fuentes Gonzalez


Source: Facebook
Image credits: Cristina Fuentes Gonzalez

Message Via Bacteria

An awesome piece of petri dish art

Source: Facebook

Sunday Blood Cell Challenge

Peripheral blood cell morphology - What are the findings here?

Case: A 35 year old female from Sudan has high fever. Bacic blood count shows leukocytosis and low haemoglobin (112 g/L). Blood smear was taken and findings are in the image (Giemsa-stained).

Correct answer: Two neutrophils (slightly toxic granulation), red cells with Howell-Jolly bodies and a target cell. This patient does not have a spleen.

Post-analytical Quality - Clinicians and Measurement Uncertainty

Jan Krouwer (Krouwer Consulting): "In any case, I have never seen a lab report that provides measurement uncertainty estimates and I believe that clinicians pretty much believe lab results as is and would not use measurement uncertainty estimates, were they provided."

What do you think? 

Read more:
Clinicians and measurement uncertainty

Source: Krouwer Consulting

Lovely Valentine from Poland

My friend Marusza found love from bone marrow and she wants to share it with all of you. Happy Valentine´s laboratory scientists!

Source: Facebook
Image credits: Marusza Ostrowska

Trichuris vulpis

Trichuris vulpis (whipworm) is type of intestinal parasites commonly affecting dogs. The whipworm lives in the large intestine, where it bites the tissue and embeds its head inside. Like the hookworm, the whipworm sucks the host's blood for sustenance. Whipworms are even smaller than roundworms and ovas are rarely seen in the stool. But here we have a positive case.

"See, It is a Trichuris egg" and the patient can confirm the finding.

Source: tumblr:Bunnyfood

Saturday, February 15, 2014

Love Is All Around

Surprise in the EDTA tube

Source: Facebook
Image credits: Jamie Leming Waldrop

I´ve Got Love in My Veins

Even the neutrophils can tell it

Source: Facebook
Image credits: Tina Townsend

Free eBook - Tietz Fundamentals of Clinical Chemistry

A condensed, student-friendly version of Tietz Textbook of Clinical Chemistry, this text uses a laboratory perspective to provide you with the chemistry fundamentals you need to work in a real-world, clinical lab. Accurate chemical structures are included to explain the key chemical features of relevant molecules. Offering complete, accurate coverage of key topics in the field, it's everything that you expect from the Tietz name!

Series: Fundamentals of Clinical Chemistry (Tietz)
Hardcover: 976 pages
Publisher: Saunders; 6 edition (November 20, 2007)
Language: English
ISBN-10: 0721638651
ISBN-13: 978-0721638652

eBook  has been published by Comanche County Memorial Hospital School of Medical Technology

Download here:
Tietz Fundamentals of Clinical Chemistry 

Source: Comanche County Memorial Hospital School of Medical Technology

Piss Poor Job - Test Tube Labeling

What is the worst labeling you have seen?

Source: Facebook
Image credits: Lab humor

Friday, February 14, 2014

Glowing Bacteria Boost My Valentine's Day

Since quorum sensing is a critical topic in biology, why not immortalize it on Valentine's Day, with bacteria using this very process to generate beautiful light in the darkness.

Read more:
Preaching Microbial Supremacy!: A Bioluminescent Valentine's Day!

Source: All Creatures Great AND Small: Preaching Microbial Supremacy!
Image credits: Mark O. Martin

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