Biomedical Laboratory Science

Tuesday, November 1, 2016

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.

Source: MedLabMag

Watch Video: Flow Cytometry Animation

Saturday, October 29, 2016

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

Male Birth Control Shot Shows Promise

When it comes to birth control methods, women have more options than ever before. However, for men, the choice is limited to condoms, withdrawal, and vasectomy. A new study - published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism - has established that a male birth control shot is effective at preventing pregnancy.

In the last 40 years, studies have demonstrated that reversible hormonal suppression of spermatogenesis - the process of sperm cell development - in men can prevent pregnancies in their female partners, although the commercial development of the product has been stalled.

In previous studies, testosterone management in men demonstrated birth control efficacy comparable with female methods. However, participants had to be given much greater doses than are typically found in the body and the method caused long-term adverse effects in healthy men.

While giving progesterone alongside can reduce the dose of testosterone, there have been few studies that have evaluated the efficacy and safety of such a combination. With 40 percent of all pregnancies worldwide unintended in 2012, better birth control options are required for men.

The male birth control shot may provide more choice for controlling male fertility in the future.

Source: MedicalNewsToday

Evaluation of Diabetic Marker HbA1c and Anemia in the Context of Kidney Disease

Each year, more than 100,000 people in the United States are diagnosed with kidney failure, the final stage of kidney disease.1 The most common cause is diabetes, accounting for nearly 44 percent of new cases. Often, a consequence of kidney disease is anemia. This occurs when kidneys fail to generate enough erythropoietin hormone to trigger adequate red blood cell production. For decades, clinicians have successfully used the hemoglobin A1c (HbA1c or A1C) assay to monitor long-term blood glucose control for patients with chronic diabetes. More recently, researchers have studied the HbA1c assay’s use as a potential diagnostic marker for diabetes complications such as kidney disease.

The HbA1c test measures average plasma glucose—hemoglobin in a red blood cell that was combined with glucose over the previous eight to 12 weeks. The higher the HbA1c value, the greater the risk that the diabetes patient will develop kidney disease, and perhaps, anemia, a common consequence of renal disease. However, a chemically modified derivative of hemoglobin called carbamylated hemoglobin (CHb) can affect the accuracy of the HbA1c test results. Studies have shown that the formation of CHb due to abnormal urea concentration is linked to both the severity and the duration of renal failure. Research findings have inspired conflicting viewpoints on the efficacy of HbA1c test results in the presence of CHb and on the level of CHb it takes to affect results. This article explores the links between diabetes and renal failure. It discusses what research has discovered about the effect of CHb on HbA1c testing. Finally, it shows how testing technology has improved to ensure HbA1c testing accuracy.

Source: MedicalLaboratoryObserver

Breast Cancer: The Body of Knowledge Grows

Scientists’ understanding of the genetics/genomics of breast cancer continues to grow; a revolution is underway both in terms of categorizing breast cancers and targeting treatment that will be effective in individual cases. New perspectives are being offered on the interpretation of biopsies, too. Here is a round-up of some very recent studies.

Genetic variants alter cells’ response to estrogen

An international study of almost 120,000 women has newly identified five genetic variants affecting risk of breast cancer, all of which are believed to influence how breast cells respond to the female sex hormone estrogen.

Estrogen acts as a trigger, binding to a molecule known as an estrogen receptor in most breast cells and triggering a cascade of signals that cause the cell to behave normally. However, the estrogen receptor is switched off in some cells and these do not respond to the hormone.

Source: MedicalLaboratoryObserver

Biochemistry Lecture Notes - Uremia: Background, Pathophysiology, Etiology

Background

Uremia is a clinical syndrome associated with fluid, electrolyte, and hormone imbalances and metabolic abnormalities, which develop in parallel with deterioration of renal function. The term uremia, which literally means urine in the blood, was first used by Piorry to describe the clinical condition associated with renal failure.

Uremia more commonly develops with chronic kidney disease (CKD), especially the later stages, of CKD, but it also may occur with acute kidney injury (AKI) if loss of renal function is rapid. As yet, no single uremic toxin has been identified that accounts for all of the clinical manifestations of uremia. A number of toxins, such as parathyroid hormone (PTH), beta2 microglobulin, polyamines, advanced glycosylation end products, and other middle molecules, are thought to contribute to the clinical syndrome.

Source: Medscape

Biochemistry Lecture Notes - Azotemia: Background, Pathophysiology, Etiology

Background

Azotemia is an elevation of blood urea nitrogen (BUN) and serum creatinine levels. The reference range for BUN is 8-20 mg/dL, and the normal range for serum creatinine is 0.7-1.4 mg/dL.

Each human kidney contains approximately 1 million functional units known as nephrons, which are primarily involved in urine formation. Urine formation ensures that the body eliminates the final products of metabolic activities and excess water in an attempt to maintain a constant internal environment (homeostasis). Urine formation by each nephron involves 3 main processes, as follows:

Filtration at the glomerular level
Selective reabsorption from the filtrate passing along the renal tubules
Secretion by the cells of the tubules into this filtrate

Perturbation of any of these processes impairs the kidney’s excretory function, resulting in azotemia.

Source: Medscape

Sunday, October 16, 2016

Cervical Screening of ‘Limited’ Use in Under 25s

The National Cervical Screening Program (NCSP) has been successful for the most part, except for those aged 20-24, according to a new report from Cancer Council NSW.

Incidence of squamous cell carcinoma and overall cervical cancer rates have declined dramatically in women aged 25-plus since the inception of the program in 1991.

“Squamous cell cancer rates in women aged 25 years or more fell by more than 50% but have now plateaued among women aged 25-69 years,” writes Megan Smith and Professor Karen Canfell in the MJA.

But among those aged 20-24, screening has made no difference to cancer rates.

Source: 6minutes

Cancer Awareness Month

With a broken heart

💔 and tears

😢 in my eyes, nothing is more painful than trying to smile and remain positive, but after many tests, being poked and prodded, chemo and radiation, the person physically changes and they suffer with sadness. I know many of you do not give a hoot about this message because, of course, the cancer has not affected you. You do not know what it's like to have fought the fight, or have a loved one who leads or has led a battle against cancer.

💜

For all the men and women I know, I ask you a small favor- I know only some of you will do it. If you know someone who has led a battle against cancer, still struggling, or who passed, please add this to your status for one hour as a mark of support, respect, and remembrance.

💚

❤️

Copy and paste to support those affected by cancer. Do Not Share. From your phone or tablet, hold your finger on the message to copy and paste.

Source: Facebook

#CancerAwarenessMonth

#screwcancer

Saturday, October 15, 2016

Unnecessary Endoscopies Could Be Avoided with Fecal Blood Test

The majority of primary care patients referred for bowel endoscopy do not have significant colorectal disease (SCD), and are unnecessarily exposed to a small but realistic risk of severe endoscopy-associated complications.

Serious colorectal diseases, including colorectal cancer, are difficult to diagnose as the signs and symptoms are not always clear.

The Quantum Blue rapid test allow for the immediate measurement of fecal calprotectin
(Photo courtesy of Bühlmann Laboratories).

Source: LabMedica

Biomedical Laboratory Science