Art and Science of Laboratory Medicine

Art and Science of Laboratory Medicine

Monday, September 29, 2014

Chromosome Jeans

Genetic lab humor

Orihginal image

Tuesday, September 23, 2014

Shigella Steals Host Nutrients... Economically

Intracellular pathogens face many daunting problems, among them how to obtain enough energy and nutrients for active growth while, preferably, keeping the host cell alive for as long as possible. This issue is especially acute for pathogens that grow at a fast rate and reach large numbers. When they succeed at this task, however, these fast-growing pathogens often cause serious infectious disease. A fine example of an organism with marked strategic skills is Shigella flexneri, the agent of life-threatening bloody diarrhea. This is the endemic form of shigellosis or bacillary dysentery that is prevalent among children in developing countries and results in the highest mortality rate for diseases caused by members of this genus. Infection begins when a small dose of 10 ‒ 100 bacteria reaches the human colon epithelial cells, where it progresses to very high loads. This rapid proliferation is achieved in part via a plasmid that delivers several virulence factors through a Type 3 secretion system. These factors include the Invasion Plasmid Antigen Proteins (Ipa's) that facilitate entrance of the bacteria into host cells, and IcsA, which triggers actin polymerization in the host cell, helping cell-to-cell spread of the pathogen.

Read more:
Shigella Steals Host Nutrients... Economically

Source: Small Things Considered

Monday, September 22, 2014

New National Strategy for Antibiotic Resistance

The United States government proposed several important steps last week that, if accomplished, will significantly change how this country attempts to counter the advance of antibiotic resistance, bringing us within reach of the more complete programs which exist in Europe. But as significant as it is, the new program has some perplexing gaps that left experts attending to the issue disappointed.

What’s the problem? Exerting control over the misuse of antibiotics in animal production. This is significant, because agriculture uses more than three times as many antibiotics in the United States every year as people do — and the more antibiotics go out into the ecosystem, the more pressure is exerted on bacteria to mutate away from being susceptible to the drugs.

Read more:
White House Actions on Antibiotic Resistance: Big Steps, Plus Disappointments

Fact sheet:
Obama Administration Takes Actions to Combat Antibiotic-Resistant Bacteria

National Strategy .pdf

Newborns have stronger immunity than first thought

Contrary to what was previously thought, newborn immune T cells may have the ability to trigger an inflammatory response to bacteria, according to a new study led by King’s College London. Although their immune system works very differently to that of adults, babies may still be able to mount a strong immune defense, finds the study published in the journal Nature Medicine.

The team discovered that whilst T cells in newborn babies are largely different to those in adults, it is not because they are immunosuppressed; rather, they manufacture a potent anti-bacterial molecule known as IL8 that has not previously been considered a major product of T cells, and that activates neutrophils to attack the body’s foreign invaders.

Read more.
King's College London - Newborns have stronger immunity than first thought

Source: King´s College London

Saturday, September 20, 2014

Bad Cold or Enterovirus 68?

Enterovirus 68 is a virus that causes cold-like symptoms that is currently being seen in the USA Midwest. It has been around since the 1960’s and first discovered in California with just a few cluster of cases. Now, it is showing itself again and is slowly creeping across the country. It’s hard to tell the difference between the two, but Pia Pannaraj, MD, Infectious Diseases specialist at Children’s Hospital Los Angeles speaks on how parents should treat their kids’ symptoms and when to seek medical attention.

Read more:
Bad Cold or Enterovirus 68?

Source: Childrens Hospital Los Angeles

Friday, September 19, 2014

Baltic Congress in Laboratory Medicine - BALM 2014

The 12th BALM 2014 Congress was held in Riga, a citymof great beauty, on 18-20 September, 2014, and hosted by the Latvian Society of Laboratory specialists.

Read more:
Scientific program

Wednesday, September 17, 2014

Fungal Colonies

A variation of fungal colonies

Original image:

Source: Medical Microbiologist

Monday, September 15, 2014

New Blood Test to Identify TB in Children

A novel blood test offers a fast and appropriate tool to diagnose tuberculosis in kids, new proof-of-concept research shows. The recently designed examine (TAM-TB assay) is the initial efficient immunodiagnostic assay to identify active tuberculosis in kids. The test features fantastic specificity, an identical sensitivity as culture assessments in combo with speed of a blood examine. The ensuring results are a main advance for the diagnosis of tuberculosis in kids, especially in tuberculosis-endemic areas.

Read more:
New Blood Test to Identify TB in Children

Source: Clinical Research Society

Sunday, September 14, 2014

Next Generation Blood-Cleansing Device

An external device that mimics the structure of a spleen can cleanse the blood of rats with acute sepsis, ridding the fluid of pathogens and toxins.

A microfluidic device filled with magnetic nanometer-sized beads that bind a plethora of pathogens and toxins was able to clear these invaders from the blood of rats with sepsis, improving their outcomes, according to a paper published today (September 14) in Nature Medicine. The design of the extracorporeal device was inspired by the small vessels and sinusoids within the spleen, through which blood “trickles slowly, almost like in a wetlands, efficiently capturing pathogens” said lead study author Donald Ingber, a professor at Harvard Medical School and founding director of the Wyss Institute in Boston.

Read more:
Next Generation: Blood-Cleansing Device

Source: The Scientist Magazine®

Sunday Parasitology Challenge

Case: 22 years old male from Jordan is suffering painful urination and sometimes there is blood in urine. Urinalysis shows blood 3+ and leukocytes 2+. Urine microscopic analysis findings are in the image.

Can you identify these particles?

CORRECT ANSWER: Schistosoma heamatobiom eggs (2)
Read all the given comments here.

POCT - Self-monitoring of Chronic Anemia

The disposable self-testing device analyzes a single droplet of blood using a chemical reagent that produces visible color changes corresponding to different levels of anemia. The basic test produces results in about 60 seconds and requires no electrical power. A companion smartphone application can automatically correlate the visual results to specific blood hemoglobin levels.

Because of its simplicity and ability to deliver results without electricity, the device could also be used in resource-poor nations.

Read more:
One-minute point-of-care anemia test shows promise in new study

Source: Georrgia Tech

Saturday, September 13, 2014

Accuracy of Genetic Analyses

Physicians envision a future in which genomic data from patients is heavily used to manage care — but experts have questioned the accuracy and reliability of these analyses. Now, a study by 150 researchers in 12 countries finds real strength and agreement across RNA genomic sequencing techniques and laboratories — as well as ways to improve what little variability exists to set a new high standard.

“It seems very likely that decisions about patient care are going to be influenced by genomic data, derived from sequencing both RNA and DNA from patient samples, and we now know the extent to which these sequence-based analyses can be relied upon within a given laboratory or from laboratory to laboratory.”

Read more:
Worldwide Study Demonstrates Accuracy of Genetic Analyses

Source: Mayo Clinic

ABO blood group system - The Acquired B phenotype

Routine ABO testing is performed in two distinct (but usually simultaneous) stages, known as "red cell grouping" (forward grouping or "front type") and "serum grouping" (reverse grouping or "back type"). Here's an example of how it works: If a person's red blood cells (RBCs) react strongly with reagent anti-A but not anti-B, we would interpret their red cell grouping as blood group A. If there is no ABO discrepancy, that same person's serum should have no reaction with reagent group A1 RBCs and strong reaction with reagent group B RBCs (demonstrating the expected presence of anti-B in the serum). Thus, the serum grouping interpretation would also be blood group A, and no ABO discrepancy would exist

ABO discrepancies occur any time the interpretations of a person's red cell and serum grouping do not agree. ABO discrepancy takes on many forms, and acquired B is a great, if not terribly common, example.

Read more:
Transfusion Medicine Education

Source: Blood Bank Guy

Friday, September 12, 2014

Medical Laboratory Science

 I <3 labwork

Severe vitamin B12 deficiency mimicking thrombotic thrombocytopenic purpura

43-year-old man with chronic alcoholism presented to a rural medical center with a 2-week history of confusion, fever, dyspnea, dizziness, and fatigue associated with diarrhea and hematochezia. Laboratory results were notable for a platelet count of 19 × 109/L, hemoglobin of 5.0 g/dL, hematocrit of 15.1%, white blood cell count of 3.2 × 109/L, a reticulocyte count of 5.9%, mean corpuscular volume of 118 fL, and normal creatinine. A peripheral blood smear was interpreted at the outside facility as having marked schistocytes. A diagnosis of presumed thrombotic thrombocytopenic purpura/hemolytic uremic syndrome was given. Further testing revealed a decreased vitamin B12 level of 93 pg/mL with unremarkable iron studies.

Read more:
Severe vitamin B12 deficiency mimicking thrombotic thrombocytopenic purpura

 Source: Blood Journal

Thursday, September 11, 2014

Can Your Blood Type Affect Your Memory?

People with blood type AB may be more likely to develop memory loss in later years than people with other blood types, according to a study published in the September 10, 2014, online issue of Neurology®, the medical journal of the American Academy of Neurology. People with AB blood type made up 6 percent of the group who developed cognitive impairment, which is higher than the 4 percent found in the population.
Read more:
Can Your Blood Type Affect Your Memory?

Source: American academy of neurology

QC vs. Clinical Limits

QC and clinical limits are different. 

QC limits are set to control the process. For an assay with a high process capability clinical limits will always be much wider than QC limits. And for an assay that is out of control (values that exceed QC limits), results may still be within clinical limits. But it is nevertheless important to detect an out of control process because the process may become so out of control so that results fail clinical limits.

For a process that is in control (all values that within QC limits), can results be outside of clinical limits (potentially cause patient harm?) YES!

Read more:
QC vs. Clinical Limits 

Source: Krouwer Consulting

Wednesday, September 10, 2014

Listeria-infected cold cuts kill 12 in Denmark

An outbreak of listeria tied to contaminated Danish meat has killed 12 people since September last year, with most of the deaths coming in the past three months, Danish health authorities said on Tuesday.  The Ministry of Food, Agriculture and Fisheries said the source of the outbreak was finally traced on Monday to a popular type of cold cut called Rullepolse, which means rolled sausage in Danish, produced by a food manufacturer near Copenhagen. Listeria can lead to fatal infections especially in young children, the elderly and those with weakened immune systems. Infection can have particularly harmful effects for pregnant women, including miscarriage and stillbirths.

Read more:
Listeria-infected cold cuts kill 12 in Denmark

Source: Reuters
Image credits: CDC

Could bacteria from bees replace antibiotics?

Raw honey has been used against infections for millennia, before honey - as we now know it - was manufactured and sold in stores. So what is the key to its’ antimicrobial properties? Researchers at Lund University in Sweden have identified a unique group of 13 lactic acid bacteria found in fresh honey, from the honey stomach of bees. The bacteria produce a myriad of active antimicrobial compounds.

These lactic acid bacteria have now been tested on severe human wound pathogens such as methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa and vancomycin-resistant Enterococcus (VRE), among others. When the lactic acid bacteria were applied to the pathogens in the laboratory, it counteracted all of them.

Read more:
Bacteria from bees possible alternative to antibiotics 

Source: Lund University

Tuesday, September 9, 2014

Ovarian Cancer Oncogene in "Junk DNA"

Most of those studies have focused on the portion of the human genome that encodes protein – a fraction that accounts for just 2 percent of human DNA overall. Yet the vast majority of genomic alterations associated with cancer lie outside protein-coding genes, in what traditionally has been derided as “junk DNA.” Researchers today know that “junk DNA” is anything but – much of it is transcribed into RNA, for instance -- but finding meaning in those sequences remains a challenge.

Now a team led by Lin Zhang, MD, research associate professor in the Department of Obstetrics and Gynecology at the Perelman School of Medicine at the University of Pennsylvania, has mined those sequences to identify a non-protein-coding RNA whose expression is linked to ovarian cancer.

Read more:
Ovarian Cancer Oncogene in "Junk DNA"

Source: Penn Medicine

This Bacterium Shoots Out Wires From Its Body To Power Itself

In the absence of oxygen, a number of common soil bacteria species grow tiny nanowires, along which they push electrons to nearby rocks. This movement of the electrons produces energy, which the bacteria use to make ATP -- the molecule all cells use to power everything they do. However, this energy production strategy is rather unusual; outside of these species, most cells, including human cells, produce their energy using internal processes, not external ones.

Read more:
This Bacterium Shoots Out Wires From Its Body To Power Itself 

Source: Popular Science

Monday, September 8, 2014

Synthetic Platelet-like Particles

A new class of synthetic platelet-like particles could augment natural blood clotting for the emergency treatment of traumatic injuries – and potentially offer doctors a new option for curbing surgical bleeding and addressing certain blood clotting disorders without the need for transfusions of natural platelets.

The clotting particles, which are based on soft and deformable hydrogel materials, are triggered by the same factor that initiates the body’s own clotting processes. Testing done in animal models and in a simulated circulatory system suggest that the particles are effective at slowing bleeding and can safely circulate in the bloodstream. The particles have been tested with human blood, but have not undergone clinical trials in humans.

Read more:
Platelet-like particles augment natural blood clotting for treating trauma

Source: Georgia Tech

Sunday, September 7, 2014

Vision-guided Robotic Phlebotomist

VascuLogic, a medical device start-up and research lab based in New Jersey, has developed the VenousPro, a robotic phlebotomist that improves the accuracy and safety of the venipuncture procedure by autonomously performing blood draws and other IV procedures in less than two minutes with close to 100% first-stick accuracy. VenousPro operates by imaging and mapping in real time the 3D spatial coordinates of peripheral forearm veins to robotically direct a needle into the designated vein.

Read more:
VenousPro Overview

Source: Vasculogic

The Berlin patient - Only person who has been cured of HIV

Timothy Brown was diagnosed with HIV while living in Berlin in 1995, and was treated with anti-retroviral drugs for more than ten years. In 2007 he was diagnosed with acute myeloid leukemia. When the disease did not respond to chemotherapy, Brown underwent stem cell transplantation, which involves treatment with cytotoxic drugs and whole-body irradiation to destroy leukemic and immune cells, followed by administration of donor stem cells to restore the immune system. When his leukemia relapsed, Brown was subjected to a second stem cell transplant.

Read more:
The Berlin patient

Source: Virology Blog
Image credits: Toby Burditt

Sunday Blood Cell Quiz

Peripheral blood cell morphology challenge

Case: 36 years old female from The Netherlands has fever and and she feels herself very week. She has returned from India one week ago. Basic blood count shows slightly decreased haemoglobin and elevated leukocytes. Blood smear was taken and the findings are in the image.

Can you identify these blood cells?

CORRECT ANSWER: Plasmodium Vivax (gametocytes), normal lymphocyte and normal monocyte. This patient has malaria.

View all given comments here

Saturday, September 6, 2014

Make Blood Draw Easier

Displaying Veins Beneath the Surface Can Make Blood Draw Procedure Easier

Hemoglobin in the blood absorbs infrared light. When AccuVein’s device is held above the skin and activated, it can detect the difference in the hemoglobin concentration between the veins and surrounding tissue, and projects a map of the veins on the skin above them. Locating the point of needle placement is suddenly simplified for phlebotomy techniques.

Read more:
Phlebotomist, Blood Draw, Phlebotomy Techniques, Blood Draw Procedure

Source: Accuvein

Scientists discover how to switch off autoimmune diseases

Scientists were able to selectively target the cells that cause autoimmune disease by dampening down their aggression against the body’s own tissues while converting them into cells capable of protecting against disease. This type of conversion has been previously applied to allergies, known as ‘allergic desensitisation’, but its application to autoimmune diseases has only been appreciated recently.

By specifically targeting the cells at fault, this immunotherapeutic approach avoids the need for the immune suppressive drugs associated with unacceptable side effects such as infections, development of tumours and disruption of natural regulatory mechanisms.

This treatment approach could improve the lives of millions of people worldwide

Read more:
Scientists discover how to ‘switch off’ autoimmune diseases

Source: Bristol University

Thursday, September 4, 2014

INR Failure

It´s never a good day when your INR is the same than your haemoglobin.

Hb = 13,5 g/dL, INR.....

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