Transfusion-Transmitted Infections

As long as blood has been donated from one person to another, risk of transmitting pathogens has existed.
The primary diseases at issue are hepatitis B and C, HIV/AIDS, Human T-lymphotropic virus (HTLV), syphilis, West Nile virus and Chagas disease. A new transfusion-transmitted infection on the world's stage is Dengue virus.

Read full article from ADVANCE

Transfusion-Transmitted Infections on ADVANCE for Medical Laboratory Professionals



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External quality assessment schemes for virology and transfusion medicine
Labquality, www.labquality.fi

2011-03-20 Sunday Survey - External Quality Assessment

Sunday survey - External quality assessment EQAS (proficiency testing PT)
Result summary


This time 64 people participated.

1. Participation to EQAS: 58 laboratories are participating EQAS and 6 not.

2. What is the most important role of external quality assessment schemes (EQAS)?
Correct answer: To give information about measurement accuracy and differences between methods.

3. What are the benefits of external quality assessment?
Correct answer: All given items are benefits of EQAS.

Questions, answers and conclusions of the survey are my personal opinions based on used source materials.
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External quality assessment schemes for all medical laboratory expertise
Labquality, www.labquality.fi


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Previous surveys

Hepatitis serology - What is the most suitable clinical interpretation?


What are the white blood cells in the pictures?

Which one is a normal female karyotype?
 
What is the most suitable ISO accreditation standard for medical (clinical) laboratories?


What of the following things can cause hemolysis?


If your blood group is A and your partners B, what are the possible blood groups of your children?


Which one of the following microbes is most unlikely to cause meningitis?


What is the correct order of sample tubes in multiple blood draw?


What of the following Westgard rules have been violated?


What white blood cell is in the picture?

'




 

The phenotypic and genetic assessment of antithrombin deficiency

COOPER, P. C., COATH, F., DALY, M. E. and MAKRIS, M. , The phenotypic and genetic assessment of antithrombin deficiency. International Journal of Laboratory Hematology, no. doi: 10.1111/j.1751-553X.2011.01307.x

Abstract

Antithrombin (AT) deficiency is associated with an increased risk of deep vein thrombosis and pulmonary embolism which are major causes of morbidity and death. The incidence of deficiency in healthy populations has been reported to vary from 1/600 to 1/5 000, with the variation being due to the different populations studied and detection methods used. When reduced activity levels are identified it is important to measure the AT antigen levels to differentiate type I from type II disorders, as type II defects have varying thrombotic risk.
Functional AT assays detect the ability of AT to inactivate thrombin or factor Xa, and AT antigen assays detect the quantity of AT in plasma. In functional assays, reducing the incubation time of sample with enzyme/heparin reagent may increase sensitivity to type II defects. An excess of antigen over activity level suggests the presence of functionally defective AT, which can be characterized further by assaying AT in the absence of heparin, electrophoresis to investigate the ability of heparin to bind to AT, and gene sequencing.

Many patients with AT deficiency have a type II defect and these defects may not be detected by all routine diagnostic assays. Assays using human thrombin may lack specificity and assays that use factor Xa may fail to detect the common variant, AT Cambridge II, which can be detected by assays using bovine thrombin, especially if activity is compared to antigen by ratio. Factor Xa based assays may be particularly sensitive to certain heparin binding defects, and sensitivity of assays to both heparin binding and reactive site defects can be improved by shortening the incubation time with enzyme.

AT activity assays are essential for the detection of AT deficiency because type II defects are relatively common in patients with heritable deficiency. No one functional assay can be assumed to detect all forms of AT deficiency, and assays can sometimes be improved by reducing reaction time of AT with thrombin or factor Xa.

Read full article from Whiley on-line library:

The phenotypic and genetic assessment of antithrombin deficiency - COOPER - 2011 - International Journal of Laboratory Hematology - Wiley Online Library

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External quality assessment service (EQAS) for hematology and coagulation
Labquality, www.labquality.fi

What's New in Blood Testing for TB Infection?

CDC Expert Commentary Series on MedScape - Video

Dr. Kenneth Castro, Director of the Division of Tuberculosis Elimination at CDC, provides information about the new CDC guidelines on tuberculosis blood tests and outline the advantages and limitations of using such tests. Then, he will highlight recommendations on how to use these diagnostic tools.

The Mantoux tuberculin skin test, also known as the TST, has been for many years the standard method of determining whether a person is infected with Mycobacterium tuberculosis. More recently, blood tests called interferon gamma release assays (IGRAs) have also been approved for the detection of M tuberculosis.

View the video and read more from Medscape Today:

What's New in Blood Testing for TB Infection?


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External Quality Assessment Schemes (EQAS) for microbiology and TB
Labquality, www.labquality.fi

African Society for Laboratory Medicine

ASLM

A three-day stakeholders' meeting was held in Addis Ababa, Ethiopia on March 14 to launch the African Society for Laboratory Medicine (ASLM), an organization that will advance the laboratory profession and networks in Africa, advocate for the critical role and needs of laboratory medicine and develop institutional capacity critical for strengthening and sustaining health systems.

The meeting brought together officials from eight African Ministries of Health, and leading organizations specializing in strengthening laboratory systems from Africa and around the world. Noted speakers and attendees include former U.S. President Bill Clinton via video stream, Ambassador Eric Goosby, head of the U.S. President's Emergency Fund for AIDS Relief (PEPFAR) and representatives from the African Union, UNAIDS, and the World Health Organization (WHO).

ASLM will serve as a professional body to guide laboratory network development and strengthen efforts in Africa; guide the process of certification of laboratory medicine training; and work with WHO-AFRO and other partners to develop and implement laboratory policies and guidelines in the African region, as stipulated by Resolutions 58 and 59 of WHO-AFRO.

Read more from ASLM web site

African Society for Laboratory Medicine



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External quality assessment service (EQAS) for laboratory medicine
Labquality, www.labquality.fi

Sunday Survey - Hepatitis B serology

Sunday survey - Microbiology, virology - Hepatitis B serology
Result summary 

There were 36 participants this time. Correct answers about 60%.

1. Patient 1: What is the most suitable clinical interpretation?
Correct answer: Active infection (e-antigen positive)

2. Patient 2: What is the most suitable clinical interpretation?
Correct answer: Recent infection (IgM anti-HBc positive, HBsAg positive, but not HBcAg any more)

 3. Patient 3: What is the most suitable clinical interpretation?
Correct answer: Active infection (HBeAg positive)

 4. Patient 4: What is the most suitable clinical interpretation?
Correct answer: Carrier (HBsAg positive and antibodies)

 5. Patient 5: What is the most suitable clinical interpretation?
Correct answer: Past infection. (only IgG antibodies are positive)

 6. Patient 6: What is the most suitable clinical interpretation?

Correct answer: Vaccinated (Only HBsAb is positive, Anti -HBc is missing).

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Previous surveys

What are the white blood cells in the pictures?

Which one is a normal female karyotype?
 
What is the most suitable ISO accreditation standard for medical (clinical) laboratories?


What of the following things can cause hemolysis?


If your blood group is A and your partners B, what are the possible blood groups of your children?


Which one of the following microbes is most unlikely to cause meningitis?


What is the correct order of sample tubes in multiple blood draw?


What of the following Westgard rules have been violated?


What white blood cell is in the picture?

'

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External quality assessment schemes for virology
Labquality, www.labquality.fi

Nonfasting Lipids, Lipoproteins, and Apolipoproteins in Individuals with and without Diabetes

Whether lipid profiles should be collected from fasting or nonfasting individuals is controversial, particularly in the diabetic population. We examined the influence of normal food intake on lipid profiles in diabetic and nondiabetic individuals.
"We assessed plasma concentrations of lipids, lipoproteins, apolipoproteins, and albumin as a function of time since the last meal in 58 434 individuals (participation rate 45%) from the general population, 2270 of whom had diabetes mellitus."

Read full article from Clinical Chemistry

Nonfasting Lipids, Lipoproteins, and Apolipoproteins in Individuals with and without Diabetes: 58 434 Individuals from the Copenhagen General Population Study -- Langsted and Nordestgaard 57 (3): 482 -- Clinical Chemistry



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External quality assessment schemes for lipids and lipoproteins
Labquality, www.labquality.fi

Treatment of LGL leukemia

Large granular lymphocyte (LGL) leukemia is characterized by a clonal expansion of either CD3⁺ cytotoxic T or CD3^– NK cells. Prominent clinical features of T-LGL leukemia include neutropenia, anemia and rheumatoid arthritis .
The majority of these patients eventually need treatment because of severe or symptomatic neutropenia, anemia, or rheumatoid arthritis. No standard therapy has been established because of the absence of large prospective trials.
As there are no curative therapeutic modalities for T-LGL leukemia, new treatment options are needed.

Read full article from Blood

Blood -- How I treat LGL leukemia

Full text pdf 



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External quality assessment service for hematology
Labquality, www.labquality.fi

International Biomedical Laboratory Science Day April 15, 2011

April 15th is International Biomedical Laboratory Science Day

This year's topic is "The Role of Biomedical Laboratory Scientists in the Global Management of Communicable Diseases"

The purpose with the BLS Day is to increase 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.

Read more and print a poster

International Federation of Biomedical Laboratory Science







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External quality assessment schemes EQAS
Labquality, www.labquality.fi

Sperm Quality Deteriorates, Testicular Cancer Rates Rise in Finland

A prospective trial of Finnish men born in 3 different periods since 1979 shows a progressive decrease in the quality and quantity of sperm that coincides with a rise in the incidence of testicular cancer, investigators say in an article published online March 2 in the International Journal of Andrology. "These simultaneous and rapidly occurring adverse trends suggest that the underlying causes are environmental and, as such, preventable," they write.

Read more from Med Scape Today

Sperm Quality Deteriorates, Testicular Cancer Rates Rise in Finland


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External quality assessment schemes (EQAS) for andrology
Labquality, www.labquality.fi

WHO Celebrating 100 years of achievements for women and health

March 8, 2011 marks the 100th anniversary of International Women's Day.
In honour of the centenary, WHO invited people all over the world to submit their opinions on the greatest achievements in women's health over the past century. Submissions from people in many countries around the world make up this photo story.
The photo story is not a chronological or comprehensive account of events, nor is it a listing of individuals. Rather, it highlights some achievements that have improved the lives and health of women and girls.
Open the photo story here

WHO | Celebrating 100 years of achievements for women and health

World Metrology Day - 20 May 2011

World Metrology Day celebrates the signature by representatives of seventeen nations of The Metre Convention on 20 May 1875. The Convention set the framework for global collaboration in the science of measurement and in its industrial, commercial and societal application. The original aim of the Metre Convention - the worldwide uniformity of measurement - remains as important today, in 2011, as it was in 1875.

Read more and print poster (several lanquages included)

World Metrology Day - 20 May 2011






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External quality assessment schemes (EQAS) for clinical chemistry
Labquality, www.labquality.fi

Online Lab Test Resource

A laboratory test selection support tool with nearly 2,000 lab tests categorized into disease-related topics.

ARUP Consult is a web-based laboratory test selection tool that provides point-of-care diagnostic and interpretive information to clinicians and physicians. ARUP Consult is organized into disease-related categories and provides clinical background and diagnostic information, pharmacogenetics content, screening and monitoring suggestions, laboratory tests and relevant references. Expert-authored content is congruent with the latest medical guidelines and literature, and more than 50 algorithms supplement disease topics and support clinical decision-making.

Excellent site to explore and study lab tests.

ARUP Consult, Your Online Lab Test Resource



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External quality assessment schemes for all clinical laboratory expertise
Labquality, www.labquality.fi

Risk factors for ANA positivity in healthy persons

The finding of antinuclear antibody (ANA) positivity in a healthy individual is usually of unknown significance and in most cases is benign. However, a subset of such individuals is at risk for development of autoimmune disease. We examined demographic and immunological features that are associated with ANA positivity in clinically healthy persons to develop insights into when this marker carries risk of progression to lupus.

Read full article from Arthritis Research and Therapy

Risk factors for ANA positivity in healthy persons



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External quality assessment schemes for immunology
Labquality, www.labquality.fi

2011-03-06 Sunday Survey - Blood Cell Morphology

Sunday Survey Result Summary
Peripheral blood cell morphology

This time 98 participants.

Question 1: What is the white blood cell in the picture A?
Correct answers: Lymphocyte and reactive lymphocyte. It is a reactive lymphocyte from mononucleosis patient.

Question 2: What is the white blood cell in the picture B?


Correct answer: Myeloblast. Also lyphoblast is acceptable answer.

Question 3: What is the white blood cell in the picture C?


Correct answer: Lymphocyte. Those cells are normal LGL cells (Large granulated lymphocytes).

Questions, answers and conclusions of the survey are my personal opinions based on used source materials.
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Previous surveys

Which one is a normal female karyotype?
 
What is the most suitable ISO accreditation standard for medical (clinical) laboratories?


What of the following things can cause hemolysis?


If your blood group is A and your partners B, what are the possible blood groups of your children?


Which one of the following microbes is most unlikely to cause meningitis?


What is the correct order of sample tubes in multiple blood draw?


What of the following Westgard rules have been violated?


What white blood cell is in the picture?

'

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External quality assessment schemes for hematology
Labquality, www.labquality.fi

Human chorionic gonadotropin (hCG) testing — Part II

Serum quantitative assays: The principle of the modern laboratory hCG immunoassay is based on the sandwich technique whereby a capture antibody binds one site on hCG, immobilizing it and a signaling antibody — labeled with an enzyme (EIA) or with radioactive iodine (RIA) — binding a distant site on hCG, labeling the immobilized complex. The immobilized and labeled complex can then be quantified, with the signal being directly proportional to the amount of complex or concentration of hCG.
Point-of-care(POC) testing: The dual antibody-sandwich techniques are also the basis of all urine POC rapid pregnancy tests. In each test, one antibody (capture) is immobilized in a translucent line in the result window, and one antibody (signal) mixes with the serum or urine and is labeled with a blue or red dye or gold matrix dye.

Read full article (including part I) from

Medical Laboratory Observer


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External quality assessment schemes for clinical chemistry
Labquality EQAS, www.labquality.fi,

Nontuberculous Mycobacteria in Respiratory Infections | CDC EID

To characterize the distribution of nontuberculous mycobacteria (NTM) species isolated from pulmonary samples from persons in Asia and their association with pulmonary infections, we reviewed the literature. Mycobacterium avium complex bacteria were most frequently isolated (13%–81%) and were the most common cause of pulmonary NTM disease (43%–81%). Also pathogenic were rapidly growing mycobacteria (M. chelonae, M. fortuitum, M. abscessus). Among all NTM isolated from pulmonary samples, 31% (582/1,744) were considered clinically relevant according to American Thoracic Society diagnostic criteria. Most patients were male (79%) and had a history of tuberculosis (37%). In Asia, high prevalence of rapidly growing mycobacteria and a history of tuberculosis are distinct characteristics of pulmonary NTM disease. This geographic variation is not well reflected in the American Thoracic Society criteria for NTM infections and could be incorporated in future guidelines.

Read more from CDC

Nontuberculous Mycobacteria in Respiratory Infections | CDC EID


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External quality assessment schemes for microbiology
Labquality EQAS, www.labquality.fi

Physical Activity Alters Various HDL-Modifying Genes

Common genetic variants that are linked with HDL-cholesterol levels are modified by physical-activity levels, according to the results of a new study. The effects of common variations in the hepatic lipase (LIPC) and cholesteryl ester-transfer protein (CETP) genes on HDL-cholesterol levels were larger among active women, whereas the opposite was observed for a common variant in the lipoprotein lipase (LPL) gene, with the effects on HDL-cholesterol largest among less active women, report investigators.

Read full article from Medscape today

Physical Activity Alters Various HDL-Modifying Genes



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External quality assessment schemes for clinical chemistry
Labquality EQAS, www.labquality.fi

External Quality Assessment Services (EQAS) for microbiology

Labquality is an impartial organization owned by Hospitals and associations.
The aim of External Quality Asessment Schemes is to improve quality in clinical laboratories by supplying data to the laboratories on their performance compared with other laboratories.
Labquality is a member of EQALM (External Quality Assessment in Laboratory Medicine) and cooperates with other EQA organizers in Europe.

Labquality EQAS

www.labquality.fi


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External quality assessment schemes for medical laboratories
Labquality EQAS, www.labquality.fi

Targeted Drug-Resistance Testing Strategy for MDR TB

The Peruvian National Tuberculosis Control Program issued guidelines in 2006 specifying criteria for culture and drug-susceptibility testing (DST), including district-level rapid DST. All patients referred for culture and DST in 2 districts of Lima, Peru, during January 2005–November 2008 were monitored prospectively. Of 1,846 patients, 1,241 (67.2%) had complete DST results for isoniazid and rifampin; 419 (33.8%) patients had multidrug-resistant (MDR) TB at the time of referral. Among patients with new smear-positive TB, household contact and suspected category I failure were associated with MDR TB, compared with concurrent regional surveillance data. Among previously treated patients with smear-positive TB, adult household contact, suspected category II failure, early relapse after category I, and multiple previous TB treatments were associated with MDR TB, compared with concurrent regional surveillance data. The proportion of MDR TB detected by using guidelines was higher than that detected by a concurrent national drug-resistance survey, indicating that the strategy effectively identified patients for DST.

Read full article from CDC

Targeted Drug-Resistance Testing Strategy for MDR TB | CDC EID

External Quality Assessment Services - EQAS

The aim of External Quality Asessment Schemes is to improve quality in clinical laboratories by supplying data to the laboratories on their performance compared with other laboratories.
Labquality is an impartial organization owned by Hospitals and associations.
Labquality is a member of EQALM (External Quality Assessment in Laboratory Medicine) and cooperates with other EQA organizers in Europe.

EQA programme

Labquality News 1/2011 (pdf)




Read more from Labquality´s web site

External Quality Assessment Services - EQAS - Labquality Oy