Art and Science of Laboratory Medicine

Art and Science of Laboratory Medicine

Wednesday, April 30, 2014

It´s 1st of May, the labor....atory day

Happy Labor Day to all medical laboratory professionals.
Keep on doing valuable work for all mankind.

Juha Wahlstedt

iPad Rack for the Laboratory Scientists

Great innovation by Yolee Verdejo

Source: facebook
Image credits: Yolee Verdejo

Tuesday, April 29, 2014

How does the Schilling test work?

If you are able to absorb B12 normally, you will absorb it through your gut cells and it will get into your bloodstream where it will circulate throughout your body and do its job. If you can’t absorb it correctly, then it won’t get in through your gut mucosa, and it will just stay in your gut and be excreted in your feces.

So, the Schilling test is kind of ingenious because it uses radioactive B12 (so you can measure where it comes out). Also, the patient gets injections of regular (non-radioactive) B12 at the same time to saturate any open B12 binding sites throughout the body.

Read more:
How does the Schilling test work?

Source: Pathology Student

Whole Genome Sequencing as a Diagnostic Test

Extraordinary technological advances and decreases in the cost of DNA sequencing have made the possibility of whole genome sequencing (WGS) as a highly accessible clinical test for numerous indications feasible. There have been many recent, successful applications of WGS in establishing the etiology of complex diseases and guiding therapeutic decision-making in neoplastic and nonneoplastic diseases and in various aspects of reproductive health. However, there are major, but not insurmountable, obstacles to the increased clinical implementation of WGS, such as hidden costs, issues surrounding sequencing and analysis, quality assurance and standardization protocols, ethical dilemmas, and difficulties with interpretation of the results.

WGS should be carefully implemented in the clinic to allow the realization of its potential to improve patient health in specific indications. To minimize harm the use of WGS for all other reasons must be carefully evaluated before clinical implementation.

Read more:
Whole Genome Sequencing as a Diagnostic Test: Challenges and Opportunities

Source: Clinical Chemistry

Monday, April 28, 2014

Neutrophil-Lymphocyte Ratio in Patients With Familial Mediterranean Fever

Blood neutrophil-to-lymphocyte (N/L) ratio is a simple marker of inflammation that can be easily obtained from the differential leucocyte count and has been used to determine disease activity and diagnosis in patients with ulcerative colitis and acute appendicitis.

Familial Mediterranean Fever (FMF) is a recurrent, autosomal recessive autoinflammatory disease characterized with fever and serositis, which is accompanied by pain in the abdominal area, chest, and joints and the disease, is common among Mediterranean communities including Turks, Armenians, Jews, and Arabs.

This study shows that N/L ratio is higher in patients with active FMF compared with FMF patients in remission and controls, and a cut-off value of 2.63 can be used to identify patients with active FMF.

Read more:
Neutrophil-Lymphocyte Ratio in Patients With...

Source: PubMed
Image credits: Pathologyoutlines

Daily Hematology quiz questions

Improve your hematology skills and take the quiz daily.

Open quiz:
Wisr - Daily Hematology Quiz Questions 

Source: Wisr
Image credits: The Windsor Star

What’s New with Hyperlipidemia in 2014?

AHA statistics 2014 in USA
  • 787,000 deaths from Cardiovascular disease (CVD)
  • 1 of every 3.0 deaths in U.S. is from CV disease
  • 1 death q. 40 sec from CVD
  • CVD kills more than ALL forms of cancer combined
  • Number 1 killer of women
  •  ~50% of African‐American adults have some CVD
Read more:
What’s New with Hyperlipidemia in 2014?

Source: Brian V. Reamy, MD, FAAFP, Col(Ret), Associate Dean for Faculty & Professor of Family Medicine Uniformed Services University, Bethesda, MD
Image credits: Nur Jameel C.

Sunday, April 27, 2014

Sunday Gram Staining Challenge

CASE: 74 years old farmer from Poland has high fever one week after thoractomy. Gram staining sample from Pleural fluid was taken and the findings are in the image.

What are the findings? (Click image to enlarge)

Correct answer: Neutrophils (4+) and gram positive cocci (3/4+).
Staphylococcus aureus.

Bloody Mary Vials

Perfect party idea for laboratory people

Source: Pottery Barn

Blood Smear Nails

"As a laboratory scientist, I spend at least one day a week at the microscope counting cells. The little red blood cells look like pink cheerios. They come in different shapes depending on the condition of the patient. We count and differentiate the white blood cells into categories in order to give the doctors a good idea of a diagnosis. I painted my nails to resemble what we see when we look at a stained blood smear."

Read more: 
eleven shakes of a persimmon tree: science

Source: Eleven shakes of persimmon tree
Image credits: Emily

Handmade Blood Cells

Beautiful red blood cell, leukocyte and platelet
by Kylee´s Kraft Closet

Source: Facebook/Kylee´s Kraft Closet
Image credits: ChaoticKylee

Saturday, April 26, 2014

When QC Fails

We all know this feeling...

Source: Facebook via Medical Microbiologist

Lab Week Decorations

Lab scientists are so creative..

Source: Facebook
Image credits: Cindy Allen

My Friends at the Lab

Lab glove art by Valeska C Cisternas Rodriguez

Source: Facebook
Image credits: Valeska C Cisternas Rodriguez

Manual Microscopy: Not a Lost Art

Dr. Natasha Sharda (NS), from the Division of Nephrology, University of Arizona, discusses her abstract for the National Kidney Foundation’s 2014 Spring Clinical Meetings. Open poster: Manual Microscopy: Not a Lost Art

We currently live in the era of technology, constantly surrounded by man-made machines, hand held devices and internet access to which the hospital is no exception. In many ways technology has enhanced the practice of medicine from electronic medical records to automated urinanalysis machines. These advances have been made in attempts to enhance efficacy and reduce human error. However, this begs the question what about computer error? Although advantageous in many ways, can a computer system surpass direct observation and cerebral reasoning? Our research project “Manual Microscopy: Not a Lost Art” sets out to answer this question. It compares reported ranges of granular and muddy brown casts using manual microscopy to that obtained by an automated system in a population of admitted patients experiencing acute kidney injury. Overall it is important to quantify these casts as they may provide prognostic insight.

Read more:
Late-Breaking Abstract: Microscopy? Where Do We Stand

Source: American Journal of Kidney Diseases

Thursday, April 24, 2014

Casein Media for Microbes

Casein Plates contain the major milk protein found in milk. Organisms were grown on Casien agar for 72 hours at 37C to look for the presence of the exoenzyme proteases/caseases . Pseudomonas aeruginosa, casein hydrolysis, as noted by a zone of clearing around the organism, as well as a green diffusable pigment pyocyanin. Serratia marcesens, casein hydrolysis as well as red colony pigment prodigiosin E. coli, growth but no casein hydrolysis.

Read more:
Casein Media

Source: Reblogged from Microbeworld
Image credits:  Tasha Sturm

The heart of blood

I love haematology

Source: Facebook
Image credits: Valeska C Cisternas Rodriguez

Wednesday, April 23, 2014

Born Lab

Awesome tattoo of Krista Bailey

Source: Facebook
Image credits: Krista Bailey

The 2014 Laboratory of the Year

It's finally here! Every year, nominations are entered into the ADVANCE Laboratory and Laboratory Professional of the year contest. The laboratorians are judged based on leadership, commitment, passion and excellence in the work place; while the laboratories are judged based on how they have demonstrated innovation, a drive to improve, teamwork and support for their employees. ADVANCE continues to highlight these individuals and facilities in celebration ofMedical Laboratory Professionals Week.

Littleton Regional Healthcare, Laboratory of the Year:
In his nomination, Robert Mach, MBA, RT(R), executive director of operations at Littleton Regional Healthcare (LRH), describe the LRH laboratory as routinely going "above and beyond." This isn't simply an indication of the staff's success in patient care or in their active role in the surrounding community. Instead, he referred to the dedication to improvement each member of the laboratory tem displays on a daily basis, regardless of any singular area of performance - especially when it comes to putting the patients first.

Read more: 
And the Winners are...

Source: Advance
Image credits: LRH

Tuesday, April 22, 2014

Strange Laboratory Experiments

I don´t want to know...

Original image:
People in white coats

Source: People in white coats
Image credits: Benoit Leblanc

Lab Pencil

Laboratory scientists are so creative...

Source: Facebook
Image credits: Suny Collado

Monday, April 21, 2014

Gram Stain Cookies

Awesome cookies for the celebrations

National Medical Laboratory Professionals Week
20-26 April, 2014

View original image:
Micro Lab Techs have a Baking Contest 2010! 

Sourse NMLPW Blog


I just love this cartoon :)

Image credits: Mueller

TB or not TB?

A 56-year-old man diagnosed as having acquired immunodeficiency syndrome was admitted to a hospital with fever, progressive cachexia, and multiple skin lesions. He complained of a cough productive of yellow sputum but no hemoptysis. An erythematous fluctuant mass located on the right thigh was aspirated, yielding purulent fluid. A Gram stain of this fluid revealed an abundance of leukocytes but no bacteria. Numerous unstained bacillus footprints or ghost bacilli were noted (figure).

Read more:
Ghost mycobacteria on Gram stain

Source: Journal of Clinical Microbiology

Easter Bunny Monocyte

Happy Easter!

Source: Facebook
Image credits: Paula Foran

Evolution of the Liquid Biopsies Spaces

The focus of this GEN Market & Tech Analysis report is to present some of our most recent analysis of publication trends across a number of biomarker classes with an eye toward categorizing them into segments especially as they relate to liquid biopsies.

This is the first report in a series of several to be published by GEN over the coming months focusing on the emerging and rapidly evolving field of liquid biopsies. Focused herein are the various classes of circulating biomarkers, which provide the starting material for the development of liquid biopsies We’ve focused on circulating tumor cells (CTCs), circulating DNA, circulating RNA, and exosomes for the analysis presented herein. These four analyte classes represent the current state of the art vis-à-vis circulating biomarkers, and there is much debate as to which marker[s] will provide prognostic and predictive utility across a wide swath of disease classes in the future—hence the vigorous research interest in all these spaces.

Evolution of the Liquid Biopsies Space, Part One

Source: GEN


Sunday, April 20, 2014

I Fucking Love Lab Medicine

The best profession on earth

Source: Toy Remix

Smartphone App Uses Selfies to Check Your Cholesterol Level

A team of engineers has designed a smartphone accessory and app that allows users to monitor their own blood cholesterol levels. Think of it as a sort of cholesterol selfie — or maybe a healthie?

As researchers from Cornell University explain in a paper in the journal Lab on a Chip, all you need — aside from their attachment and a smartphone — is a reagent test strip and a willingness to draw your own blood. Cholesterol tests tend to rely on reagent strips that turn different colors, depending on the cholesterol levels of the blood placed on them. The researchers’ achievement was to design an attachment to be placed over the smartphone flash and camera that can illuminate and capture the color of the strip, rendering unnecessary specialized equipment or an in-person health professional. The lab is working on a smartphone app that can determine vitamin D levels, too.

Read more:
Smartphone App Uses Selfies to Check Your Cholesterol Level

Source: Mashable

Equation That Keeps Laboratory Scientists Running

E (energy) =  m (milk) x c² (coffee)

Cell fish

Fish shaped erythrocyte by Adrian Garciduenas

Source: Facebook
Image credits:  Adrian Garciduenas

Fungal Art

Beautiful fungal colonies

View more:

Source: Etsy
Image credits: elinart

Saturday, April 19, 2014

Lego Clinical Chemistry Analyzer

Biomedical laboratory scientists are analyzing blood samples.

Erythrocytes with coarse basophilic stippling

 In the latest Case Record of the Massachusetts General Hospital, a 59-year-old man was admitted to the hospital because of fatigue, abdominal pain, new anemia, arthralgias, abnormal liver function, and emotional lability. A peripheral-blood smear showed polychromasia and coarse basophilic stippling of erythrocytes.

Acute abdominal pain has a broad differential diagnosis that includes both intraabdominal and extraabdominal causes. Life-threatening intraabdominal catastrophes, such as gastrointestinal perforation, intestinal infarction, and a ruptured abdominal aortic aneurysm, cause illness within minutes or hours.

Read more:
Case 12-2014 — A 59-Year-Old Man with Fatigue, Abdominal Pain, Anemia, and Abnormal Liver Function 

Source: NEJM

Scientists Create World's Tiniest Bunny

Scientists in Japan recently used a promising new 3D printing material to create objects so small that they are the size as a single bacteria. The researchers were able print shapes that are measured in mere micrometers, including the world’s tiniest rabbit. While the demonstration may be playful, the application certainly isn’t – this new technology may someday be used to print cells and micro-electrodes for medical purposes.

Read more:
Scientists Create World's Tiniest Bunny Using New 3D Shaping Material 

Image credits: Optical Materials Express

How the immune system protects children from malaria

According to a study published today in PLOS Pathogens, children who live in regions of the world where malaria is common can mount an immune response to infection with malaria parasites that may enable them to avoid repeated bouts of high fever and illness and partially control the growth of malaria parasites in their bloodstream. The findings may help researchers develop future interventions that prevent or mitigate the disease caused by the malaria parasite.

Each year, approximately 200 million cases of malaria occur worldwide, resulting in roughly 627,000 deaths (mostly children less than the age of 5 years living in sub-Saharan Africa). In 2013, 97 countries had ongoing malaria transmission, according to the World Health Organization. Unlike individuals who are newly exposed to malaria, people living in malaria-endemic regions often do not experience malaria-induced fever and manage to control parasite numbers in the bloodstream. To better understand why, researchers analyzed immune cells from children in Mali who are bitten by malaria-infected mosquitos more than 100 times per year, yet experience malaria fever only two times per year on average. The scientists collected blood samples from children on three occasions: before the start of the six-month malaria season; seven days after each child had been treated for his or her first malaria fever of the season, when symptoms had cleared; and after the subsequent six-month dry season, when little to no malaria transmission occurs.

Read more:
Study Sheds Light on How the Immune System Protects Children from Malaria

Source: NIH News
Image credits: NIAID

Friday, April 18, 2014

Red Cell Cupcakes

Awesome cupcakes by Rosita Leonor Perez Camargo

Source: Instagram
Image credits: Rosita Leonor Perez Camargo

Thursday, April 17, 2014

Osmosis and Optimism

Why doesn´t osmosis work like this?

A dream of an unknown medical laboratory science student

Pathology Bunny

Happy Easter & Seasons Greetings to All Laboratory Scientists!

Juha Wahlstedt

Meditation @ Microbiology Lab

A stunning tower of petri plates and peace of mind.

Read more:
Hitting the red button of evolution

Source: Student science
Image credits: Zachary Blount

A Malaria Outbreak Without Mosquitoes

A Taiwanese businessmen traveled to Nigeria in 1995 and inadvertently caused a small outbreak in a general teaching hospital in Taipei, a country free of malaria since its eradication in the 1960s. Until this uncommon outbreak, every single case of malaria in Taipei had been directly traced to an individual’s recent travels to an endemic region.

Two weeks after the hospital admission of this ill businessman, an additional four patients developed unusual fevers that were identified as being malarial in origin. Yet none of these group of five patients shared a history of blood transfusions nor any common exposures, aside from treatment within the same hospital, that would predispose them to malaria.

Read more:
Microbial Misadventures: A Malaria Outbreak Without Mosquitoes - Body Horrors 

Source: Discover Magazine
Image credits: Wikimedia

Wednesday, April 16, 2014

Dirty Kiss

Amazing petri dish art via Medical Microbiologist

Source: Medical Microbiologist

Atlas of Clinical Hematology - Free eBook

From the reviews of the sixth edition: "With over 1000 illustrations the 6th revised edition covers the whole spectrum of haematology. The quality of the illustrations and the clarity of the accompanying texts make the Atlas a valuable companion to the haematology and oncology professions."

This 6th edition of the atlas has integrated the 2001 WHO classification and made use of figures and descriptions to document recently described types of leukemia and lymphoma. The latter include leukemias of dendritic cells, rare lymphomas and persistent polyclonal B lymphocytosis, which takes a special place in the classification.

The volume covers all the microscopic methods in hematology that form the basis of diagnosis as well as the results of modern immunologic, cytogenetic and molecular-genetic investigation. Special emphasis is placed on the cytogenetic and molecular-genetic characterization of biological entities that might form the basis for innovative therapies.
Normal results and pathological findings are compared, and the various findings made during therapy are depicted. All in all the Atlas of Clinical Hematology represents a complete and helpful reference work which should be present in every hematologic and oncologic department as well as in clinical laboratories for online diagnostics and scientific research.

L. Heilmeyer, "Atlas of Clinical Hematology" - Free eBooks

Source: Alaa M. Khudair , Teacher Assistant – Medical Technology Department – IUG

Artificial blood made from human stem cells

Prof Mark Turner has devised a technique to culture red blood cells from induced pluripotent stem (iPS) cells – cells that have been taken from humans and ‘rewound’ into stem cells. Biochemical conditions similar to those in the human body are then recreated to induce the iPS cells to mature into red blood cells.

There are plans in place for the trial to be concluded by late 2016 or early 2017, he said. It will most likely involve the treatment of three patients with Thalassaemia, a blood disorder requiring regular transfusions. The behaviour of the manufactured blood cells will then be monitored.

Read more:
Artificial blood 'will be manufactured in factories' 

Source: The Telegraph
Image credits: Alamy

My first spectrophotometer

Have you seen a spectrophotometer with analog dosplay?

I was using this Beckmann gray photometer during my trainee at hospital laboratory. This instrument was vintage already, but still in routine use.

Like this it goes:
  1. Warm up
  2. Adjust zero
  3. Select wavelenght
  4. Blank adjust
  5. Read standard and specimen and avoid parallax error
  6. Clean up
Manual and fun. Golden memories

Image credits: Trivox tripod

Tuesday, April 15, 2014

International Biomedical Laboratory Science Day

International Federation of Biomedical Laboratory Science (formerly known as IAMLT) established BLS Day in 1996 at the World Congress in Oslo, Norway to promote and celebrate the key role of Biomedical Laboratory personnel in diagnostic and preventive health care systems.

The purpose with the BLS Day is to increase the awareness of the role that Biomedical Laboratory Scientists have in providing health care. BLS' play an important role in diagnosis, quality development and assurance, treatment, research, development, and public health care.

International BLS Day gives our profession a day to promote and celebrate ourselves as a profession.

The theme is selected by the International Body (IFBLS) related with health issues and support the WHO Millennium Development Goals.

BLS Day is the day for Laboratory personnel to promote awareness of our profession and the key role played by Biomedical Laboratory Scientists in the diagnosis and treatment of patients and research in the modern medical sciences.

Read more:

International Biomedical Laboratory Science Day, April 15th

Source: IFBLS

Monday, April 14, 2014

Lab Graffiti

Recycled glove box stencils and gram stain 'paint'.. Lab graffiti!
by Dayna McPherson

Source: Facebook
Image credits: Dayna McPherson

Positve Lab Test

Once upon a time at the Pepsi company

You are fired Jack!
The lab results just came back, and you tested positive for Coke

Source: Artizans
Image credits: Dan Reynolds

Sunday, April 13, 2014

WBC Counter Mobile Application

This app is WBC differential Counter

- touch cells
- count
- notice 100, 200, 500 ,1000 cells count
- calculate real number!

You can select vibration and/or sound.

Download here:
WBC Counter for Android phones

Source: Google play/Android

What Do Scientists Really Exclaim?

A cartoon postcard to clarify what the scientists are really exclaiming...

Read more:
So I made a postcard of the Truth about...

Source: Tumblr.
Image credits:  Twisted Doodles

Vintage Cell Counter

Clay Adams 5 Key Single Knob Counter

A counter with six window readout. Perfect working order, 5 key range 0-999. The 6th window is a running Total with a bell ring at increments of 100. Dual reset knobs. Includes 5 paper "key name" inserts.

Do you remember these?


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