Webinar: Urine sediment microscopy

Webinar 11 January 2017: Comparing automated microscopy data to manual review

In this webinar, Dr. Michael Samoszuk will discuss the correlation between images of urine sediment particles captured on the iRICELL3000 and images viewed manually under the microscope using actual patient samples. Attendees will learn how these images compare and how automated microscopy helps to reduce user subjectivity in microscopy by standardizing the process.

Register to webinar:
Webinar: Comparing Automated Microscopy Data to Manual Review

Source: Beckman Coulter, Inc.

Chemistry Graffiti

Wonderful street art in Sardinia

Medical laboratory professionals 2017

Happy New Year - Feliz 2017
by Sigrid Maria

Chemistry Xmas tree

A perfect Christmas tree for the laboratory scientists
by Sigrid Maria

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

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

Chemistry humour

Na Na Na Na Na Na Na Batman....

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

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

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

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

Abnormal MCH effects to HbA1c level

Mean corpuscular hemoglobin (MCH) and mean corpuscular volume (MCV) correlated negatively with Hb A1c. Fasting glucose, MCH, and age emerged as predictors of Hb A1c in a stepwise regression that discarded sex, hemoglobin, MCV, mean corpuscular hemoglobin concentration (MCHC), serum creatinine, and liver disease. Mean Hb A1c in MCH interdecile intervals fell from 6.8% (51 mmol/mol) in the lowest (≤27.5 pg) to 6.0% (43 mmol/mol) in the highest (>32.5 pg), with similar results for MCV. After adjustment for fasting glucose and other correlates of Hb A1c, a 1 pg increase in MCH reduced the odds of Hb A1c–defined dysglycemia, diabetes and poor glycemia control by 10%–14%.

For at least 25% of patients, low or high MCH or MCV levels are associated with increased risk of an erroneous Hb A1c–based identification of glycemia status. Although causality has not been demonstrated, these parameters should be taken into account in interpreting Hb A1c levels in clinical practice.

Read more:
Impact of Mean Cell Hemoglobin on Hb A1c–Defined Glycemia Status 

Source: Clinical Chemistry

New finding: Biobank storage time affects blood test results

The amount of time a blood sample has been stored at a biobank may affect the test results as much as the blood sample provider’s age. These are the findings of a new study from Uppsala University, which was published in the scientific journal EBioMedicine. Until now, medical research has taken into account age, sex and health factors of the person providing the sample, but it turns out that storage time is just as important.

They analysed 380 different samples from 106 women between the ages of 29 and 73. To study the impact of storage time, only samples from 50-year-old women were used in order to isolate the time effect. 108 different proteins were analysed. In addition to how long a sample had been frozen, the researchers also looked at what year the sample was taken and the age of the patient when the sample was taken.

‘We suspected that we’d find an influence from storage time, but we thought it would be much less’, says Professor Ulf Gyllensten. ‘It has now been demonstrated that storage time can be a factor at least as important as the age of the individual at sampling.’

Blood from biobanks has been used in research aimed at producing new drugs and testing new treatment methods. The results of this study are important for future drug research, but it is not possible or necessary, to repeat all previous biobank analyses.


Read more:
New finding: Biobank storage time affects blood test results

Source: Uppsala University, Sweden

Alcohol is a solution

Statement in a  pub in east London

Source: Twitter by Dr Legido-Quigley

Paper-based Test Identifies Bogus and Poor Quality Drugs

Counterfeit and substandard medications are a serious problem in the developing world, potentially harming patients who desperately need medical treatment.

Some of these drugs, including the antibiotics ciprofloxacin and ceftriaxone, have been deemed essential by the World Health Organization for the treatment of infections. However, chemists in developing countries often do not have expensive instruments to determine whether a pill is genuine.

Now, a simple paper-based test may be the answer.

Instead of a $30,000 machine, a $1 paper card can test a drug in three minutes to determine whether the medication is inactive or of substandard quality. The tests come in 20-card packets.

Read more:
Paper-based Test Identifies Bogus and Poor Quality Drugs

Source: VOA
Photo: Courtesy of Lieberman and Bliese

Blood Test for Colorectal Cancer - Epigenomics AG

Despite recommendations, many people in the target age group are not getting screened for colorectal cancer. However, a new blood-based screening test may help boost those rates because of its simplicity and convenience for the patient. The downside is that the new test is not as sensitive or accurate as a colonoscopy or the other recommended screening approaches.

Approved in April 2016, the Epi proColon (Epigenomics AG) is the first blood-based colorectal screening test to get a thumbs-up from the US Food and Drug Administration (FDA).

This molecular test detects methylated Septin 9 DNA in plasma, which is increased in colorectal cancer and can be found in tumor DNA that has been shed into the bloodstream from both colon and rectal sites. This makes it a differential biomarker for the early detection of colorectal cancer, according to the manufacturer.

Available in Europe since 2012, it is also being marketed in other countries, including China.

Read more:
Blood Test for Colorectal Cancer: The Last Resort?

 Source: Medscape

POC drug screening quiz

Why might some providers want to use point-of-care (POC) urinary drug screen testing in pain management clinics?

• The most common reasons are convenience and fast turnaround time. Having immediate test results fosters patient engagement and satisfaction by reducing wait time and enabling practitioners to provide immediate consultations. The positive versus negative screen result is also easy for providers and patients to understand. 
• Another reason is cost. In the eyes of general practitioners, it is
  cheaper to purchase urinary drug test cups than to send a test to a
  central or reference laboratory. However, proper pain management testing
  often requires additional mass spectrometry–based drug testing.

The utilization of a POC urinary drug screen test in a pain clinic is very limited and the information it provides is often not sufficient to enable proper patient consultation. Because most providers need assistance in interpreting toxicology tests, the use of POC urinary drug screening is likely to cause more confusion. AACC addresses this problem with a pain management compliance test that offers decision support for pain management drug testing.

Take the quiz and check your knowledge.


Related CLN article:
Pitfalls of Point-of-Care Urinary Drug Screening for Pain Management

Source: AACC

It´s Helium past Neon

A perfect clock for a chemistry lover.

Source: Facebook via Chemistry lovers

Clinical Chemistry´s Free Clinical Case Studies

Clinical Chemisty´s free #MedEd series 'Clinical Case Studies' has reached milestone- one million downloads. Congratulations!

Clinical case reports form a vital part of education and help develop problem-solving skills. They may include unusual biochemical manifestations of a disease, unusual presentation of a disease, situations where laboratory medicine is vital in making a diagnosis, or occasionally help in understanding the pathophysiology of a disease etc.

Open studies here and enjoy:
Clinical Case Studies

Source: AACC, Clinical Chemistry