Impact of Flow Cytometry on Blood Disorders

Among its many clinical uses, fluorescence-based flow cytometry aids laboratories in the diagnosis of blood cancers and other disorders. The Division of Hematopathology within the Department of Laboratory Medicine and Pathology at Mayo Clinic in Rochester, Minnesota, performs both basic and specialized hematology testing via six specialty labs. Its Cell Kinetics Laboratory, in particular, uses flow cytometry as a primary technology to diagnose leukemias and lymphomas from blood, bone marrow, fluid, and tissue specimens. Clinical diagnosis of most hematological diseases, especially malignant forms, requires clinicopathologic correlation, and flow cytometry can play an important role in pathological diagnosis. The processes employed by flow cytometry help distinguish abnormal from normal conditions and provide an expedient method of establishing clonality and aberrant antigen expression on abnormal populations.

The Cell Kinetics Lab employs 28 staff and utilizes 9 flow cytometers to manage its volume demand. The lab analyzes high volumes of mostly malignant samples sent from all over the world in addition to those from patients at Mayo Clinic. All specimens must be preprocessed, and the lab purchases monoclonal antibodies that attach to one type of cell antigen (ie, cluster of differentiation [CD]), multiples of which can be found on each cell surface. These acquired antibodies are pre-conjugated with one or more fluorescent markers, and there are many color options for each CD marker, adding flexibility to panel makeup. Monoclonal antibodies can be expensive but can have a substantial shelf life of 6 to 18 months. The Cell Kinetics Lab stocks anywhere from 70 to 80 different antibodies in refrigeration for use in flow cytometry processes.

Read more: Impact of Flow Cytometry on Blood Disorders

Source: MedLabMag

Watch Video: Flow Cytometry Animation

Validation of Hematology Analyzers

Perhaps the most common laboratory procedure performed for hospital patients and outpatients is complete blood count (CBC) or CBC with differential. CBC serves as a screening and diagnostic test for a wide range of conditions and diseases as well as a monitoring tool for treatment and disease status. Given its foundational nature and despite its relative simplicity, the veracity of this basic blood testing is essential. Therefore, thorough validation testing on all new hematology analyzers must be performed to ensure patient safety.

It is reasonable to assume that a newly acquired piece of diagnostic equipment would run as intended, as manufacturers perform their own validation testing to prove intended use and to fulfill regulatory requirements prior to launching a product in the market. However, the ultimate responsibility of verifying instrument performance specifications and characteristics prior to the patient testing falls to the end-user laboratory.

Read more: Validation of Hematology Analyzers

Source: MedLabMag

Transfusion-Related Thrombocytopenia In a Chronic Renal Failure Patient

Hemostasis is a process to stop bleeding that requires coordinated activities of vascular, platelet, and plasma factors. Under normal conditions, blood vessel injury will trigger endothelial cells to secrete factors that promote adhesion and activation of platelets. First, platelets bind to von Willebrand’s factor (vWF) secreted by endothelial cells through vWF receptors. Attached platelets then undergo degranulation and release factors such as serotonin, which causes vascular constriction. Activated platelets also release other mediators to attract additional platelets for aggregation at the injured sites.

Read more: Transfusion-Related Thrombocytopenia In a Chronic Renal Failure Patient

Source: MedicalLaboratoryObserver

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.

Read more: How Does Alcohol Affect My 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.

Source: MedicalNewsToday

Sepsis And The Hematology Laboratory

An affordable, widely available test can impact today`s biggest healthcare challenge.

Sepsis, the inflammatory response to infection, is quickly becoming one of the biggest healthcare problems worldwide. No matter the perspective one takes, the numbers are staggering. Currently the number of diagnosed cases per year in the United States is at least 750,000; some estimates surpass one million. Worldwide mortality estimates are as high as 20 percent, and thus we are dealing with one of the biggest drivers of mortality in modern medicine. Sepsis kills nearly as many people as heart attack, HIV, and breast cancer combined.

Viewed from the perspective of health economics, the average in-hospital cost per case is approximately $20,000 dollars, and yearly estimates of sepsis-related expenses in the U.S. alone exceed $20 billion.

Read more: Sepsis And The Hematology Laboratory

Source: MedicalLaboratoryObserver

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.

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

Source: MedicalLaboratoryObserver

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.

Read more: Liver Cancer Risk Influenced By Blood Selenium Levels

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

Source: medicalnewstoday

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.

Read more: Stroke Could be Better Predicted with Biomarker Discovery

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

Source: medicalnewstoday

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.

Read more: Test That Differentiates Between Bacterial, Viral Infections in Development

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.

Source: medicalnewstoday

Donor Blood Test May be Holding Back Heart Transplantation

A blood test used to determine whether a heart is suitable for donation may be leading to unnecessary rejections, and its use should be reviewed. This is the conclusion of a new study published in the journal Circulation: Heart Failure.

Heart failure occurs when the heart is unable to pump enough oxygen-rich blood around the body to help other organs function.

According to the Centers for Disease Control and Prevention (CDC), in the United States, around 5.7 million Americans have heart failure.

In some cases, heart failure can be treated with lifestyle changes - such as a healthy diet, exercise, and quitting smoking - and medications. For end-stage heart failure, however, a heart transplant may be the only option.

Read more: Donor Blood Test May be Holding Back Heart Transplantation

Determining whether a heart is suitable for transplantation based on donor troponin I levels may be
causing unnecessary rejections, say researchers.

Source: medicalnewstoday

Blood Test Advances Diagnosis Of HELLP Syndrome

A laboratory blood test for the diagnosis of a rare genetic red blood cell disorder also shows promise in identifying HELLP syndrome, a life-threatening high blood pressure condition affecting 1% of all pregnant women.

HELLP is an acronym for hemolysis, elevated liver enzymes and low platelets and is a severe variant of pre-eclampsia whose pathogenesis remains unclear. Recent evidence and clinical similarities suggest a link to atypical hemolytic uremic syndrome, a disease of excessive activation of the alternative complement.

Read more: Blood Test Advances Diagnosis Of HELLP Syndrome

A model of the principle underlying the modified Ham test

Source: labmedica

Color Atlas of Hematology: Practical Microscopic and Clinical Diagnosis (English)

Publisher Description: A Flexibook for both the specialist and non-specialist, the new book offers accessible information on hematology in a succinct format. In addition to providing basic methodology, the book utilizes more than 260 color illustrations to detail the most up-to-date clinical procedures. Numerous tables and flow charts are included to assist in differential diagnosis, making this a valuable didactic reference for nurses, practicing physicians and residents preparing for board examinations.

Notes: Thieme international - clinical sciences

Author Biography: H. Theml, H. Diem, T. Haferlach

Review: The Color Atlas of Hematology is a pocket book edition that follows the best tradition of pocket handbooks in the field of hematology. Microphotographs are highly useful for faithfully presenting the real appearance of hematopoietic cells in blood and bone marrow smears. This handbook provides characteristic clinical pictures of particular hematologic diseases, a key to rapid recognition of blood cells, typical cell changes, complete diagnostic methods, and easy visual orientation. [The authors] have offered us a valuable and precious help in the diagnosis of hematologic diseases for both specialists and nonspecialists as well as for all those interested in learning more about blood cell morphology.--Acta Clinica Croatica

Details: ISBN 3136731026; AUTHOR Harald Klaus Theml; PUBLISHER Thieme Publishing Group; YEAR 2003; EDITION 2nd; ISBN-103136731026; ISBN-139783136731024; FORMAT Paperback; PUBLICATION DATE 2003-12-10; IMPRINT Thieme Publishing Group; ; PLACE OF PUBLICATION Stuttgart; COUNTRY OF PUBLICATION Germany; DEWEY 616.15; PAGES 208; LANGUAGE English; SUBTITLE Practical Microscopic and Clinical Diagnosis; REPLACES 9781588901934; ILLUSTRATIONS 262; DIMENSIONS 4862mm x 3080mm x 184mm

Read more: Color Atlas of Hematology: Practical Microscopic and Clinical Diagnosis (English)

Source: 1. http://www.grsmu.by

             2. https://books.google.com

Proper QC of Hematology Critical Values

The reporting of critical values—laboratory results that indicate a possible life-threatening situation for a patient—requires rapid clinical intervention in order to avert significant patient morbidity and mortality. Given the imperative of clear, accurate, and expeditious communication of critical value results from the laboratory to clinicians, one method of ensuring prompt handling is to create a protocol that optimizes workflow by eliminating waste and placing checks and balances throughout the process.

As with most vital aspects of laboratory work, managing hematology critical values depends largely on the acumen and aptitude of staff. Thus, an instituted protocol will only be successful if staff technologists are properly trained, gain sufficient knowledge of all involved systems and automation, and are equipped with tools to recognize the effectiveness of checks and balances.

Read more: Proper QC of Hematology Critical Values

Source: medlabmag

How a single blood test could identify your entire viral infection history

Researchers have created what they say is a "one-stop shop" for diagnosing infections - a test that can determine an individual's complete viral history just by scanning a single drop of blood.

The test, called VirScan, was created by Stephen Elledge and colleagues from the Howard Hughes Medical Institute (HHMI).

"We've developed a screening methodology to basically look back in time in people's [blood] sera and see what viruses they have experienced," explains Elledge. "Instead of testing for one individual virus at a time, which is labor intensive, we can assay all of these at once. It's one-stop shopping."

Read more: How a single blood test could identify your entire viral infection history

VirScan can pinpoint past and present viruses in a person's blood by identifying the peptides antiviral
antibodies bind to.

Source: medicalnewstoday

Complete Blood Count in Primary Care

Key points

To provide an overview of the use of the complete blood count in primary care and to provide advice on appropriate follow-up for abnormal results.

Introduction

The complete blood count (CBC) is the most frequently requested blood test in New Zealand. The primary points of interest in the CBC are often whether a patient is anaemic, whether the white count shows evidence of infection and whether the platelets are at a level that may affect haemostasis.

GPs have told us they are reasonably comfortable interpreting CBC results with marked abnormalities, but would like guidance when the results show only subtle abnormalities or when the clinical picture is not clear.

This is a consensus document

This is not a comprehensive document covering all causes of abnormal results; it is a consensus document produced in conjunction with specialist haematologists, providing an overview for some scenarios encountered in primary care.

Background

Haematopoiesis - Cell development

All blood cells are produced within the bone marrow from a small population of stem cells. Less than one in 5000 of the marrow cells is a stem cell. These cells represent a self-renewing population.

Download here: Complete Blood Count in Primary Care

Source: Best Practice Advocacy Centre New Zealand