Biomedical Laboratory Science

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Showing posts with label Blood. Show all posts
Showing posts with label Blood. Show all posts

Saturday, November 23, 2019

How to Increase Laboratory Accuracy with Direct HbA1c Testing !



Diabetes is a global epidemic affecting in the region of 425 million people according to the International Diabetes Federation. Worryingly, this figure is on the rise with forecasts suggesting diabetes will affect up to 629 million people globally by 2045. Such a dramatic increase highlights the fundamental need for better disease management. When we look at the worldwide prevalence of diabetes, the United States is one of the most prominent countries affected.


HbA1c - an important biomarker for diabetes management and control !

HbA1c, also known as hemoglobin A1c or glycated hemoglobin, is an important blood test used to determine how well diabetes is being controlled. It develops when hemoglobin, a protein within the red blood cells that carries oxygen throughout the body, joins with glucose in the blood, becoming “glycated.” The concentration of HbA1c in the blood of diabetic patients increases with rising blood glucose levels and is representative of the mean blood glucose level over the preceding six to eight weeks. HbA1c can therefore be described as a long-term indicator of diabetic control, unlike blood glucose which is only a short-term indicator of diabetic control. It is recommended that HbA1c levels are monitored every three to four months.




         


Sunday, June 10, 2018

Serum Iron Test: High, Low, and Normal Ranges !

Having too much or too little iron in the blood can cause serious health problems.
If a doctor suspects that a person does not have a healthy amount of iron in their blood, they may order a serum iron test.


In this article, learn more about the uses of a serum iron test. We also explain the normal ranges of iron in the blood and the treatment options for people whose iron levels are too high or too low.

Friday, June 1, 2018

What is a free PSA test and what is it for?


"The free prostate-specific antigen test, known as the free PSA test, is used to help detect signs of prostate cancer. The test measures the level of unbound prostate-specific antigen in the blood, which can help doctors to diagnose issues like inflammation of the prostate or cancer."
Free PSA tests are often used alongside other PSA tests to confirm a diagnosis or test results. Free PSA tests can also be used instead of a biopsy if the doctor suspects prostate cancer, but a biopsy may still be needed.


This article examines when a free PSA test is used, how it differs from a total PSA test, and what the results mean.

Friday, November 10, 2017

Urinalysis Quality Control at the Point-of-Care !


The goal of any clinical diagnostic test procedure is to provide critical information in a timely manner so that appropriate actions may be taken, ultimately improving patient outcomes. Point-of-care testing (POCT) is a term that has come to describe a multitude of rapid medical tests that can be performed at or near the site of patient care. The most compelling benefit of these tests is that, as opposed to having to wait hours or days for results to arrive from an outside laboratory, clinicians can obtain the results immediately, allowing for clinical management decisions to be made while the patient is still at the care facility. While the implementation of rapid diagnostic tests dates back to ancient history (sweet-tasting urine was once commonly used to diagnose diabetes mellitus), it was not until the 1950s that these rapid diagnostic methods gained any real predictive value. Today, the popularity and demand for POCT are increasing rapidly. TriMark Publications estimates that the global market for POCT was $14.5 billion in 2016, and is expected to grow by seven percent over the next five years.




Urinalysis dipsticks at the point-of-care:


Urinalysis using multi-analyte dipsticks is a point-of-care test performed at any hospital, clinical laboratory, doctor’s office, health clinic, and nursing facility. Various iterations of these tests have existed for decades, and they continue to be among the most commonly performed tests of any kind. Urinalysis dipsticks contain discrete reagent pads to semi-quantitatively test for the presence of bilirubin, blood, creatinine, glucose, ketones, leukocytes, nitrite, pH, protein, specific gravity, and urobilinogen in a urine sample.






Sunday, October 8, 2017

Screening Young Adults for Hepatitis C with Rapid Testing!

Hepatitis C (HCV) is a viral infection that affects the liver and an estimated 3.2 million people in the USA are infected with HCV, and most do not feel ill or know that they are infected. Since 2010, acute cases of HCV have more than doubled, with new cases predominantly among young, white individuals with a history of injection drug use.




The current recommendations are that doctors screen patients at high-risk for contracting HCV, which include but are not limited to people born between 1945 and 1965, those diagnosed with HIV, children born to HCV-positive women and individuals who engage in injection drug use (PWID), among other select populations at high risk. This strategy is called "targeted" screening. "Routine" screening, as defined in the study, tests all individuals in a community with a high prevalence of HCV.


Video: One step Hepatitis C Virus Test Cassette, Raecho International



There are two ways to perform these screenings. Rapid testing is when results are given on the same day that the sample is drawn. Standard testing requires patients to return for a second appointment to get the results. Scientists at Boston Medical Center (Boston, MA, USA) and their colleagues evaluated the clinical benefits and cost-effectiveness of testing strategies among 15 to 30-year-olds at urban community health centers. They developed a decision analytic model to project quality-adjusted life years (QALYs), lifetime costs (2016 USDs) and incremental cost-effectiveness ratios (ICER) associated with nine strategies for one-time testing. The strategies differed in three ways: targeted versus routine testing; rapid finger stick versus standard venipuncture; and ordered by physician versus counselor/tester using standing orders.



Illustration of the Hepatitis C Virus

The team found that compared to targeted risk-based testing (current standard of care), routine testing increased lifetime medical cost by USD 80 and discounted QALYs by 0.0013 per person. Across all strategies rapid testing provided higher QALYs at a lower cost per QALY gained, and was always preferred. Counselor-initiated routine rapid testing was associated with an ICER of USD 71,000/QALY gained. Results were sensitive to offer and result receipt rates. Counselor-initiated routine rapid testing was cost-effective (ICER greater than USD 100,000/QALY) unless the prevalence of PWID was greater than 0.59%, HCV prevalence among PWID less than 16%, reinfection rate greater than 26 cases per 100 person-years, or reflex confirmatory testing followed all reactive venipuncture diagnostics.

Sabrina A. Assoumou, MD, MPH, an infectious disease physician and lead author of the study, said, “When standard testing was applied, patients were less likely to come back for that second appointment to get their results, which in turn meant more people weren't getting the treatment they so desperately needed. Our results indicate that we must initiate rapid testing strategies so that more people will know their status and get treatment more quickly.” The study was published on September 9, 2017, in the journal Clinical Infectious Diseases.


Source: LabMedica

Thursday, September 21, 2017

Tumor Marker Tests Overused in Primary and Secondary Care !

A tumor marker is a biomarker found in blood, urine, or body tissues that can be elevated by the presence of one or more types of cancer. The vast majority of tumor marker tests in primary and secondary care may not be necessary as the tests assisted with a cancer diagnosis in just 2% of patients.

Tumor markers are molecules, which may be present in higher than usual concentrations in the tissue, serum or other body fluids of patients with cancer. There are many different tumor markers, each indicative of a particular disease process, and they are used in oncology to help detect the presence of cancer. A tumor marker can be used to aid diagnosis in specific situations but testing for more than one marker is not recommended.

Scientists at South West Wales Cancer Centre (Cardiff, UK) examined the number of multiple tumor marker requests from primary and secondary care over a six-month period within Abertawe Bro Morgannwg University Health Board (Bagain, Neath Port Talbot, Wales). Multiple requests were defined as more than one tumors marker for a patient in a two-week period. The team looked at how many patients with multiple tumor markers measured were subsequently diagnosed with cancer, and whether the markers assisted with the diagnosis.


Common tumor markers used in the diagnosis of cancer




Source: LabMedica

Differences between Type 1 and Type 2 Diabetes.

Diabetes, or diabetes mellitus (DM), is a metabolic disorder in which the body cannot properly store and use sugar.

It affects the body's ability to use glucose, a type of sugar found in the blood, as fuel. This happens because the body does not produce enough insulin, or the cells do not correctly respond to insulin to use glucose as energy.

Insulin is a type of hormone produced by the pancreas to regulate how blood sugar becomes energy. An imbalance of insulin or resistance to insulin causes diabetes.

Diabetes is linked to a higher risk of cardiovascular disease, kidney disease, vision loss, neurological conditions, and damage to blood vessels and organs.

There is type 1, type 2, and gestational diabetes. They have different causes and risk factors, and different lines of treatment.

This article will compare the similarities and differences of types 1 and 2 diabetes.

People with type 1 diabetes will require supplemental insulin on an
ongoing basis. People with type 2 will likely only need this for the later
stages of the condition. A healthcare specialist will be able to test
a patient for diabetes, even if type 2 diabetes shows no symptoms.




Monday, August 7, 2017

Screen Your Blood Cholesterol Levels For Your Heart Disease Risk!

Researchers have developed a first-of-its-kind rapid assay for measuring effectiveness of a patient’s high-density lipoprotein cholesterol (HDL-C) in cleaning up arterial cholesterol. This HDL-C function test could improve risk assessment and diagnosis, and help provide and monitor more personalized treatments for cardiovascular disease (CVD) patients.

Image: Research suggests a HDL-C function test could improve risk assessment and diagnosis,
and help provide and monitor more personalized treatments for CVD patients
(Photo courtesy of iStock).
While scientists have yet to fully elucidate how HDL-C helps protects against heart disease, one of its chief functions is thought to be mediating the removal of cholesterol from blood vessel walls. Recent studies have indicated that the ability of a patient’s HDL-C to do this – known as its cholesterol efflux capacity (CEC) – is a better gauge of CVD development than HDL-C levels on their own. This means, for example, that a patient with low levels of HDL-C but optimal CEC could be protected against heart disease to a greater degree than a patient with high levels of HDL-C but low CEC. However, the current standard research procedures for measuring CEC involve radioisotope-labeled cholesterol and cultured macrophages, making these methods too complex and time-consuming for clinical testing.

In this study, a team of researchers led by Amane Harada, PhD, of Sysmex Corporation (Kobe, Japan) and Ryuji Toh, MD, PhD, of Kobe University Graduate School of Medicine (Kobe, Japan) has developed a test for HDL-C function that is simple enough for clinical use. With a turnaround time of less than 6 hours, the test determines cholesterol uptake capacity (CUC) – the ability of HDL-C to accept additional cholesterol – which the researchers found correlates with CEC but is easier to measure. 

They evaluated their CUC test in 156 patients who had undergone revascularization (such as a stent or bypass) due to coronary artery disease and who had subsequently decreased their low-density lipoprotein cholesterol to a healthier level of less than 100 mg/dL. The study found that low CUC in these patients after treatment was significantly associated with the recurrence of coronary lesions. The researchers also determined that combining CUC with established CVD risk factors significantly improved the power of established factors to forecast which patients would redevelop heart disease.

If further trials validate this test, it could enable healthcare providers to use CUC in conjunction with HDL-C levels to better predict who is at risk for CVD onset or recurrence. This test could also be used to develop new treatments that increase CEC and to monitor their efficacy in patients.

“A more efficient enhancement of the atheroprotective functions of HDL may decrease the risk of atherosclerosis and [cardiovascular disease], although it has been difficult to develop therapeutic drugs with the expected effects,” wrote Harada and Toh in this paper, “We consider that this can be explained in part by the lack of a convenient assay system to evaluate HDL functionality without complicated or time-consuming procedures. In this respect, our cholesterol uptake assay provides a concise, accurate, and robust system for high-throughput analysis at low cost.”

The study, by Harada A et al, was published in the May 2017 issue of the Journal of Applied Laboratory Medicine.

Source: labmedica

Cardiac Biomarkers and Clinical Decision Making

New video discusses the importance of cardiac biomarkers



In this video, hear from a former operating engineer at the White House who, despite an active lifestyle and basic good health, experienced sudden heart failure. In the context of his healthcare journey, the video highlights the role of cardiac biomarkers in clinical decision making and the diagnosis of a heart attack.

Diagnosed with advanced coronary artery disease, the patient underwent cardiac bypass surgery and was enrolled in a biomarker study during his postoperative course of treatment. “There’s no doubt that biomarkers have completely transformed how we care for our patients in cardiovascular medicine,” says the patient’s cardiologist.

Saturday, February 25, 2017

Before Automating The Blood Bank, Evaluate Compatibility With Existing Systems

Automation in the blood bank can be a turnaround time saver and staffing force multiplier. However, optimizing the testing workflow on the existing platforms should be the first order of business when considering new automation. There are companies that can be hired to do this, and they may present ways to optimize current analyzers with minor adjustments in the workflow process. Beginning with the end in mind, mapping the current workflow processes will provide a baseline for improving operations in any blood bank and laboratory.

Consider the laboratory structure. Is there a core laboratory concept with blood bank and microbiology located in the same workspace? Is it necessary to consider changes to the power, IT connections, and physical space in the planning process for new automation? Many laboratory structures limit the ability to share technologies and products, which creates operational gaps and challenges staffing models. Workflow process mapping will ensure that a lab leader has defined the many interconnected operations that impact the overall efficiency of a laboratory and point out key areas where automation may help make great strides in productivity. Placement of automation can allow for integration and cross training of the technical staff. A well-trained, cross-functional staff can be a great tool in generating efficiencies as well as reducing laboratorian burnout.



Friday, September 23, 2016

What Do We Really Need To Know About Platelets And The Laboratory?

What is a platelet? The anatomic definition of a platelet is well established: According to MedicineNet.com, it is “an irregular, disc-shaped element in the blood that assists in blood clotting. During normal blood clotting, the platelets clump together (aggregate). Although platelets are often classed as blood cells, they are actually fragments of large bone marrow cells called megakaryocytes.” This definition, however, does not do justice to our rapidly expanding understanding of the platelet’s roles, functions, and laboratory applications.

What the numbers say
Laboratories with the ability to detect platelet function defects still tend to focus on identifying the two percent of the population that have heritable platelet function defects and von Willebrand Disease.



Saturday, September 17, 2016

The Best Medicine Against Cholesterol And High Blood Pressure

Cholesterol is a waxy substance that comes from two sources: your body and food. Excess cholesterol can form plaque between layers of artery walls, making it harder for your heart to circulate blood.

Plaque can break open and cause blood clots. If a clot blocks an artery that feeds the brain, it causes a stroke. If it blocks an artery that feeds the heart, it causes a heart attack.

Heart disease, stroke and other cardiovascular diseases are among the leading cause of death and now kill more than 800,000 adults in the US each year. Two main reasons people have heart disease or stroke are high blood pressure and cholesterol.



Source: herb-cookbook

Friday, September 16, 2016

How Does Alcohol Affect My Blood Sugar Levels?

It is not uncommon to enjoy a glass of wine with dinner or to have drinks after work with friends. Alcohol consumption is very prevalent in the United States.

According to the National Institute on Alcohol Abuse and Alcoholism, in 2014:
  • 87.6 percent of people age 18 and older reported drinking alcohol at some point in their lifetime
  • 71 percent reported drinking in the past year
  • 56.9 percent reported drinking in the past month
For many people, a glass of alcohol here and there does not pose a problem. For those with certain health conditions such as diabetes, however, alcohol can affect blood sugar levels and pose a health risk. It is important for them to understand what alcohol is and how it affects blood sugar levels.


The way that alcohol affects the body differs from person to person. People with diabetes and other
blood sugar-related illnesses must be extremely careful when consuming alcohol. Cocktails and
mixed drinks are full of sugar, so should be avoided by people with blood sugar problems.

Monday, September 5, 2016

Point-Of-Care Hemoglobin Testing: Methods And Relevance To Combat Anemia

Anemia is a condition that causes a high degree of personal disability but, historically, has lacked adequate resourcing in many public health systems. This situation is even less understandable when you consider that the main diagnostic, hemoglobin testing, is one of the most commonly used point-of-care (POC) tests, and one of the easiest to perform.

POC hemoglobin testing is often needed in settings where the use of a benchtop laboratory hematology analyzer is not practical. It is ideal for use in settings where resources are poor, or there is a need for mobility and simplicity in field use, or where turnaround time (TAT) for the test result needs to be short, as in acute clinical situations.



Electrical Immunosensor Detects Acute Myocardial Infarction

Heart disease and especially acute myocardial infarction (AMI) are the leading causes of death for both men and women and therefore, a fast and reliable diagnosis of heart attack or cardiac episode are urgently needed.

The most commonly used biomarkers are creatine kinase-MB, myoglobin, cardiac troponin T, and cardiac troponin I (cTnI), which is a subunit of the troponin complex found in cardiac muscle and is a highly specific and sensitive biomarker for the clinical diagnosis of AMI.


The core material used for the new immunosensor that detects proteins in the blood stream following
a heart attack, providing results in just one minute (Photo courtesy of Ulsan National Institute of
Science and Technology).
Source: labmedica

Liver Cancer Risk Influenced By Blood Selenium Levels

The risk of developing liver cancer may be significantly higher for people who have low levels of the nutrient selenium in their blood, suggests a new study published in the American Journal of Clinical Nutrition.

Selenium is a trace mineral present in soil, animal products, and plant-based foods, including seafood, Brazil nuts, organ meats, milk, and eggs.

The selenium content of food varies greatly, as it depends on how much of the element is in the plants animals consume, as well as how much is in the soil in which plants grow.

According to the National Institutes of Health (NIH), selenium is essential for human health, with beneficial roles for reproduction, the immune system, and DNA synthesis.

Studies have also shown that selenium has antioxidant properties, meaning it can protect against oxidative stress - the process by which uncharged molecules called free radicals damage cells.


Low blood selenium levels may put people at greater risk of liver cancer.

Friday, September 2, 2016

Chronic Kidney Disease

WHAT IS CHRONIC KIDNEY DISEASE?

The kidneys function as blood filters that drain waste products while retaining other valuable blood contents like proteins. If these filters are damaged, they initially may become “leaky,” and substances like proteins can seep from blood into urine. At later stages, these filters slowly shut down and lose their ability to filter. When kidney impairment lasts for more than 3 months, it is called chronic kidney disease. This process ultimately results in decreased urine production and kidney failure, with buildup of waste products in the blood and body tissues. One common reason for kidney failure in the United States is diabetes.

Sometimes chronic kidney disease is accompanied by high blood pressure, which not only can be caused by kidney damage but also further accelerates kidney injury and is a major reason for the negative effects of chronic kidney disease on other organs, including increased risk of heart disease and stroke, collection of excess body fluids, anemia, weakening of bones, and impairment of the way the body eliminates medications.


It is estimated that 1 in 10 US adults has chronic kidney disease, and many who have
he disease are not aware of it.
Source: jamanetwork

Saturday, August 27, 2016

Stroke Could be Better Predicted with Biomarker Discovery

Stroke is a leading cause of disability and death in the United States, affecting more than 795,000 Americans every year. But what if doctors were better able to predict who is likely to have a stroke, providing greater opportunity for prevention? Researchers have uncovered four biomarkers that could help do just that.

In a study published in the journal Neurology, researchers found that individuals who had higher levels of four inflammatory biomarkers in their blood were at greater risk for stroke than those with lower levels.

Study co-author Dr. Ashkan Shoamanesh, of McMaster University in Canada, and colleagues say that - while further research is needed to determine whether these biomarkers could be used in clinical practice - their findings could pave the way for better prevention and treatment of stroke.

Stroke occurs when the flow of oxygen-rich blood to the brain is reduced, causing brain cell death.


Researchers have pinpointed four biomarkers that they say could help predict stroke risk.

Thursday, August 25, 2016

Test That Differentiates Between Bacterial, Viral Infections in Development

An international team of scientists - led by researchers at Imperial College London - has discovered two genes that are switched on when a child has a bacterial infection. This revelation could allow the team to develop a rapid test for doctors' surgeries and hospitals to identify infections such as meningitis, and assist with the growing threat of antibiotic resistance.

The study, published in JAMA, found that the two genes, called IFI44L and FAM89A, only shifted to an "on" state when a bacterial infection was present. This knowledge could enable doctors to distinguish between bacterial and viral infections, and identify early cases of severe infections that could be deadly.

While viral infections are more common than bacterial infections, bacterial infections are often more serious.

Meningitis, septicemia, and pneumonia all occur as a result of a bacterial infection. Differentiating between these potentially life-threatening conditions and viruses can allow health providers to provide quicker, more accurate treatments.


Doctors usually have to send samples away to diagnose bacterial or viral infections. The new test
could provide a rapid way for doctors to test patients immediately.
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