Table of Critical Limits in Laboratory Medicine

Critical limits define boundaries of life-threatening values of laboratory test results. Critical results or values are those that fall outside high and low critical limits. Urgent clinician notification of critical results is the lab’s responsibility. The system of critical value reporting was first implemented in a hospital by George D. Lundberg, MD, and first published in MLO in 1972. These tables are based on three national surveys by Gerald J. Kost, MD, PhD, MS, FACB, of the University of California Davis Health System. Adapted with permission from his articles,1-4 the tables summarize critical limits used by 92 responding U.S. medical centers, including 20 trauma centers, and 39 children’s hospitals. Mean and standard deviation (SD) data are presented. The frequency with which critical limits were listed can be found in the original articles.

Read more: Table of Critical Limits in Laboratory Medicine

Source: ClinicalLaboratoryReference

MicroRNA: A Tiny Molecule Yields Big Insights Into Disease States

Regular readers of this column will know that there are two main categories of nucleic acids—DNA and RNA. They’ll also know that while for living organisms DNA acts as the genetic data repository, RNA has a messenger role (mRNAs, transcribed from DNA to direct protein synthesis). Most will also recall that there are other classes of RNA molecules, particularly tRNAs (used to tag and identify amino acids for protein synthesis) and rRNAs (structural components of the ribosome, the cellular “machinery” for protein synthesis). In addition to these, there’s increasing interest in the molecular diagnostics community in a less widely known but no less common RNA form, the microRNA or miRNA.

Read more: MicroRNA: A Tiny Molecule Yields Big Insights Into Disease States

Source: MedicalLaboratoryObserver

Scientists Fingerprint the Brain

The brain’s structural connections are unique to an individual, a new imaging technique reveals.

Every brain is unique, and scientists now have the means to pin down precisely how unique. Disease, environment, and genetic factors all influence the pattern of connections between neurons, called the local connectome. A new imaging technique quantifies differences between the local connectomes of individual brains, allowing researchers to identify a brain by its connectome “fingerprint.”

The technique uses diffusion MRI to track the movement of water molecules along pathways in the brain’s white matter, creating a fine-scale image of structural connections. The team took repeat MRI scans of a few individuals, and found that they could tell whether two local connectome fingerprints came from the same individual with 100 percent accuracy over the 17,398 identification tests they ran. The team’s findings were reported this week (November 15) PLOS Computational Biology.

Read more: Scientists Fingerprint the Brain

WIKIPEDIA, THOMAS SCHULTZ

Source: TheScientist

Neurometabolic Disorders Could Contribute to Depression

Impairments in the production of neurotransmitters may lead to depression in some patients, preliminary results show, opening new avenues for research.

In 2002, psychiatrist Lisa Pan, a depression and suicide prevention researcher at the University of Pittsburgh Medical Center (UPMC), met Kyle, a 19-year-old suffering from depression (name altered to preserve confidentiality). He was among the estimated 15 percent of depression patients in the U.S. for whom treatments such as antidepressants or therapy do not help. He “had been through every available treatment” including electroconvulsive therapy, but nothing worked, Pan recalls. “At one time, he was on 17 medications simultaneously.” The teenager had attempted suicide, and doctors determined that he was at risk for similar episodes. The next step for him would be state hospitalization.

Read more: Neurometabolic Disorders Could Contribute to Depression

STAVING OFF DEPRESSION: Deficiencies in key compounds that help the body make
neurotransmitters may contribute to the intractability of depression in some people
© ISTOCK.COM/JM1366

Source: TheScientist

Standardization And Implementation of Lab Policies Ensure Hemostasis Sample Quality

How many of us remember the tilt-tube method for basic hemostasis testing? Fortunately, today’s instruments have automated most of these manual steps. However, until recently, assuring sample quality in the pre-analytical phase of testing had remained a manual process and had been difficult to implement and standardize.

Several questions must be considered when evaluating the integrity of a hemostasis sample: Is the sample tube under-filled? Is the sample hemolyzed, icteric, or lipemic? If so, do the levels of the interferent impact the testing results? Is there a clot in the sample?

All labs have policies on sample acceptance and rejection. Inappropriate rejection of acceptable samples—requiring redraw—directly impacts patient care, patient satisfaction, and cost. Failing to reject inappropriate samples can lead to the reporting of erroneous results, impacting the quality of patient care and associated cost. Let’s take a look at the most common pre-analytical quality issue culprits.

Read more: Standardization And Implementation of Lab Policies Ensure Hemostasis Sample Quality

Source: MedicalLaboratoryObserver

Why Is My Urine Bright Yellow? Colors Changes and Causes

Normal urine should be a pale yellow color. It should be clear, without cloudiness or particle deposits.

"Why is my urine bright yellow?" is a question that can be answered if the meaning of bright yellow is clear.

This page will explain the full range of possible colors of urine and why they change. If bright yellow means neon yellow, this has a specific cause.

Read more: Why Is My Urine Bright Yellow? Colors Changes and Causes

If anyone has concerns about urine, it is recommended that they visit a doctor. Some drugs may turn

the urine orange, brown, or green. Urine color may be used to work out hydration levels.

Source: MedicalNewsToday

How to Get Rid of a Stuffy Nose: Eight Possible Treatments

Nasal congestion is a very common condition. In fact, most people get a stuffy nose from time to time.

Nasal congestion can develop when the blood vessels inside the nose become inflamed and the nasal tissues swell. Excess mucus drainage may also occur with a stuffy nose.

This article will look at eight possible treatments for a stuffy nose.

Read more: How to Get Rid of a Stuffy Nose: Eight Possible Treatments

Nasal congestion is very common and can be treated in a variety of ways. A neti pot is of Indian origin
and is used to flush the sinuses. A stuffy nose should clear after 10 days. If symptoms persist, a doctor
should be consulted.

Source: MedicalNewsToday

New Cancer Therapy: Food Poisoning?

Scientists at the Cancer Research Center and the University of Missouri have developed a nontoxic strain of Salmonella to penetrate and target cancer cells. Results from this study could lead to promising new treatments that actively target and control the spread of cancer.

While bacteriotherapy may sound like some new age skin treatment or colon cleanse that you hear about as part of a new Hollywood diet trend on late night infomercials, it is, in fact, a sound medical tool that researchers and clinicians utilize to treat disease. "Bacteriotherapy is the use of live bacteria as therapy to treat a medical condition, like cancer,” explains Robert Kazmierczak, Ph.D., a senior investigator at the Cancer Research Center and a postdoctoral fellow in the Division of Biological Sciences at the University of Missouri (MU) College of Arts and Science.

Read more: New Cancer Therapy: Food Poisoning?

Color-enhanced scanning electron micrograph ofSalmonella strain (red) in cultured human
cells (yellow). [Source: NIAID]

Source: GenEngNews

Watch Video: 50-Year-Old Bacteria Could Be Alternative Treatment Option for Cancer

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