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Laboratory Medicine

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https://www.readbyqxmd.com/read/28525630/laboratory-integration-and-consolidation-in-a-regional-health-system
#1
Jim Cook
Health systems face intense pressure to decrease costs and improve services as the health care delivery system in the United States undergoes tremendous change due to health care reform. As health systems grow, like any business, they are forced to explore standardization to realize and maintain efficient practices. Clinical services, such as laboratory medicine, are more difficult to integrate due to wider variation in acceptable practice and culture, compared with other services. However, changes to laboratory service are imperative if health care professionals expect to survive and thrive in the new business environment...
May 19, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28520972/r634w-kit-mutation-in-an-adult-with-systemic-mastocytosis
#2
John M Astle, Michal G Rose, Frederick K Racke, Christopher A Tormey, Alexa J Siddon
Mastocytosis is a clonal neoplasm with the potential to affect various organs within the body. It can range in clinical severity from benign to extremely aggressive. Mastocytosis can be separated into cutaneous, systemic, and leukemic forms, as well as mast-cell sarcoma and extracutaneous mastocytoma. It is most often an acquired condition but can be inherited; the most commonly identified genetic aberrations leading to mastocytosis are activating mutations involving codon 816 of the KIT gene. Herein, we present the case of a 30-year-old Caucasian man with systemic mastocytosis discovered to have a p...
May 18, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28460053/utilizing-the-kcnj11-gene-mutations-in-spotting-egyptian-patients-with-permanent-neonatal-diabetes-who-can-benefit-from-treatment-shift
#3
Dina M Ahmed, Soha M Abdel Dayem, Mona Abdel Kader, Rania H Khalifa, Dalia H El-Lebedy, Solaf A Kamel, Shereen M Shawky
Background: Neonatal diabetes mellitus (NDM) is a monogenic form of diabetes mellitus. Until now, patients in developing countries who had this condition had been misdiagnosed as having type 1 diabetes mellitus and accordingly directed to erroneous, ineffective, and costly therapeutic regimens. Objective: To detect Egyptian patients who harbor pathological variant in the KCNJ11 gene, so that their treatment regimen can be modified as needed to increase its effectiveness...
April 27, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28398583/clsi-based-validation-of-manufacturer-derived-reference-intervals-on-the-cobas-8000-platform
#4
Veronika Leitner-Ferenc, Johanna Atamaniuk, Sonja Jansen-Skoupy, Brigitta Stöckelmeier, Katharina Grohs, Manuela Födinger
Background: Reference intervals provided by diagnostic test manufacturers should be transferred to clinical laboratories after validation. Although protocols exist, laboratories rarely perform and report on results of validation studies. Methods: We validated reference intervals (RIs) of 87 analytes on a Cobas 8000 platform according to standards published by the Clinical and Laboratory Standards Institute (CLSI). Results: For 8 analytes, decision limits were provided in the package inserts...
April 8, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28398535/diagnostic-utility-of-new-equation-for-active-tuberculosis-based-on-parameters-of-interferon-%C3%AE-release-assay
#5
You La Jeon, Min-Jeong Kim, Woo-In Lee, Myeong Hee Kim, So Young Kang
Background: We derived a new equation to include interferon-γ (IFN-γ) levels in the QuantiFERON-Gold In-Tube (QFT-GIT) assay to discriminate active tuberculosis (ATB) infection from latent TB, and compared the diagnostic performance of the QFT-GIT assay and the new equation. Methods: From January 2013 through May 2015, we retrospectively enrolled 159 and 408 patients with and without ATB, respectively, in this study. Discriminant analysis was performed to derive an equation to distinguish the ATB group from the non-ATB group...
April 8, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28398496/underestimation-of-low-density-lipoprotein-cholesterol-with-the-friedewald-equation-versus-a-direct-homogenous-low-density-lipoprotein-cholesterol-assay
#6
Ishwarlal Jialal, Michael Inn, David Siegel, Sridevi Devaraj
Background: Low-density lipoprotein cholesterol (LDL-C) concentrations are the primary therapeutic target in patients with atherosclerotic cardiovascular disease (ASCVD). However, at low LDL-C concentrations, there is a significant underestimation using the Friedewald equation compared with ultracentrifugation. Methods: In this pilot study, we compared LDL-C concentrations obtained using the Friedewald equation (LDL-F) vs those concentrations from a direct LDL-C (LDL-D) assay in 152 consecutive specimens from patients with triglyceride levels between 200-399 mg/dL and LDL-F <100 mg/dL...
April 8, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28379418/histoplasmosis-in-pleural-effusion-in-a-23-year-old-man-with-mixed-phenotype-acute-leukemia
#7
Sudha Sharma, Priya Singh, Kamal Kant Sahu, Arvind Rajwanshi, Pankaj Malhotra, Shano Naseem
Histoplasmosis has been observed in patients with immunosuppression in the form of isolated pulmonary involvement and disseminated disease. However, very few cases of this type that involved pleural effusion have been reported, and none have been reported in a case individual with mixed-phenotype acute leukemia (MPAL). Herein, we report a case involving a 23 year old Punjabi man having fever and breathlessness in the postinduction therapy period for mixed-phenotype acute leukemia (MPAL) with diagnosis of histoplasmosis based on the results of pleural fluid cytologic testing...
April 1, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28379422/surepath-specimens-versus-thinprep-specimen-types-on-the-cobas-4800-platform-high-risk-hpv-status-and-cytology-correlation-in-an-ethnically-diverse-bronx-population
#8
R C Naeem, D Y Goldstein, Mark H Einstein, G Ramos Rivera, K Schlesinger, S N Khader, M Suhrland, A S Fox
Objective: To compare the cytologic preparations of 130 cervical specimens (from women of various ethnicities at high risk for human papillomavirus [HPV] infection) using the SurePath (SP) collection system with specimens gathered using the ThinPrep (TP) system, as processed on the Cobas 4800 analyzer, to determine which collection method more accurately identifies HPV infection. Methods: In our prospective study, specimens were collected from 130 women of various ethnicities residing in or near Bronx County, NY...
March 30, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28340166/complete-blood-count-reference-ranges-from-a-rural-haitian-ambulatory-care-clinic
#9
Robert F Downey
Background: At rural healthcare centers in developing countries, it is difficult to recruit healthy individuals for reference range studies. So, in this study, I evaluated complete blood count (CBC) data to determine reference ranges for a rural Haitian population. Methods: A convenience sample of laboratory records was reviewed to obtain CBC results for 157 adult patients with normal screening examination results. Central 95% reference ranges were determined for male and female subjects...
March 10, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28444398/plasma-transfusion-demystified-a-review-of-the-key-factors-influencing-the-response-to-plasma-transfusion
#10
Allen W Bryan, Elizabeth M Staley, Timothy Kennell, Alexander Z Feldman, Lance A Williams, Huy P Pham
Many studies have suggested that inappropriate plasma usage is common. An important factor contributing to futile plasma administration in most patients is the nonlinear relationship between coagulation-factor levels and the volume of plasma transfused. In this review, a validated mathematical model and data from the literature will be used to illuminate 3 key properties of plasma transfusion. Those properties are as follows: the effect of plasma transfusion on international normalized ratio (INR) is transient; for the same volume of transfused plasma, a greater reduction in INR is observed at higher initial INRs; and the effect of plasma transfusion on INR correction (ie, the difference between initial and final INRs) diminishes as more plasma is transfused...
May 1, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28419268/the-american-society-for-clinical-pathology-s-2015-wage-survey-of-medical-laboratories-in-the-united-states
#11
Edna Garcia, Patrick B Fisher
Objectives: To inform the pathology and laboratory field of the most recent national wage data from the American Society for Clinical Pathology (ASCP). Historically, the results of this biennial survey have served as a basis for additional research on laboratory recruitment, retention, education, marketing, certification, and advocacy. Methods: The 2015 wage survey was conducted through collaboration between the ASCP's Institute of Science, Technology, and Policy in Washington, DC, and the ASCP Board of Certification in Chicago, Illinois...
May 1, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28387842/association-of-cholesterol-ester-transfer-protein-taq-ib-polymorphism-with-acute-coronary-syndrome-in-egyptian-national-patients
#12
Sahar M Abdel Maksoud, Wael T El-Garf, Ola S Ali, Gamal M Shaaban, Noha N Amer
Background: The association between cholesterol ester transfer protein (CETP) Taq IB polymorphism and coronary artery disease (CAD) has been studied in different populations. Acute coronary syndrome (ACS) is a group of clinical symptoms within acute myocardial ischemia, including unstable angina (UA) and myocardial infarction (MI). Because there are no data reported in the literature concerning the cholesteryl ester transfer protein (CETP) Taq IB polymorphism in Egyptians, our study aimed to investigate the frequency of different CETP Taq IB genotypes in Egyptian patients with ACS and in healthy control individuals...
May 1, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28371883/feasibility-of-counting-smudge-cells-as-lymphocytes-in-differential-leukocyte-counts-performed-on-blood-smears-of-patients-with-established-or-suspected-chronic-lymphocytic-leukemia-small-lymphocytic-lymphoma
#13
Gene Gulati, Vandi Ly, Guldeep Uppal, Jerald Gong
Background: Lymphocytosis and smudge cells are commonly observed on the blood smears of patients with an established or suspected diagnosis of chronic lymphocytic leukemia/small lymphocytic lymphoma. Excluding smudge cells from the manual differential count (MDIFF), a common laboratory practice, yields unreliable results and consequently necessitates performing the MDIFF testing on an albuminized blood smear. Objective: To assess the reliability of counting smudge cells as lymphocytes in the MDIFFs on nonalbuminized smears and automated differentials (ADIFFs) as a substitute for MDIFFs...
May 1, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28371852/improvement-in-the-quality-of-hba1c-determination-by-using-commutable-specimens-with-ifcc-assigned-values
#14
Rui Zhou, Zhi-Qi Gao, Qing Tong, Chang Zuo, Zhi-Xin Song, Wei Wang, Qing-Tao Wang
Background: To assess the usefulness of commutable secondary reference materials with International Federation of Clinical Chemistry (IFCC)-assigned values, for improving the quality of hemoglobin A1c (HbA 1c ) determination. Methods: We recalibrated and evaluated 3 point-of-care-test (POCT) devices via 3 different method-specific central laboratory analyzers that were calibrated using commutable specimens with IFCC-assigned values. The staff members who performed POCT were also evaluated before and after training...
May 1, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28340248/irradiation-of-red-blood-cells-and-alloimmunization
#15
Christopher A Tormey, Jeanne E Hendrickson
Background: Animal models suggest that red blood cell (RBC) damage incurred during storage can increase immunogenicity to some RBC antigens. We hypothesized that RBC irradiation, a source of oxidative damage, may result in higher RBC alloimmunization rates among transfusion recipients. Methods: Individuals receiving 1 or more gamma-irradiated RBC units, with follow-up antibody screening, were studied. We recorded diagnosis at the time of first irradiated RBC-unit transfusion, total irradiated RBCs received, and alloantibodies detected before and after irradiated RBC transfusion...
May 1, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28340232/a-proposed-set-of-metrics-to-reduce-patient-safety-risk-from-within-the-anatomic-pathology-laboratory
#16
Peter Banks, Richard Brown, Alex Laslowski, Yvonne Daniels, Phil Branton, John Carpenter, Richard Zarbo, Ramses Forsyth, Yan-Hui Liu, Shane Kohl, Joachim Diebold, Shinobu Masuda, Tim Plummer, Eslie Dennis
Background: Anatomic pathology laboratory workflow consists of 3 major specimen handling processes. Among the workflow are preanalytic, analytic, and postanalytic phases that contain multistep subprocesses with great impact on patient care. A worldwide representation of experts came together to create a system of metrics, as a basis for laboratories worldwide, to help them evaluate and improve specimen handling to reduce patient safety risk. Method: Members of the Initiative for Anatomic Pathology Laboratory Patient Safety (IAPLPS) pooled their extensive expertise to generate a list of metrics highlighting processes with high and low risk for adverse patient outcomes...
May 1, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28340217/establishment-of-reference-interval-for-alkaline-phosphatase-in-healthy-children-of-various-ethnicities-aged-0-12-years
#17
Gu Wanjian, Hu Jie, Ge Liang, Wang Cheng, Xu Tian, Shen Jianjiang, Zhang Chunni
Background: To establish a reference interval of alkaline phosphatase for healthy children of various ethnicities, aged 0 years to 12 years in China. Methods: According to the Clinical and Laboratory Standards Institute guideline C28-A3, blood specimens were collected in the morning after overnight fasting from 502 healthy children to determine the alkaline phosphatase (ALP) level, using the Beckman AU5800 automatic biochemical analyzer. Children were grouped by sex and age...
May 1, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28340153/establishing-a-stand-alone-laboratory-dedicated-to-the-care-of-patients-with-ebola-virus-disease
#18
Jing Cao, Christine Senn, Pedro Castaneda, Sheree Humphries, Amy B Karger
Objective: To describe the process for establishment of a stand-alone laboratory dedicated to testing for Ebola virus disease (EVD). Methods: We selected 2 neighboring rooms for the EVD unit: 1 for patient care and 1 for laboratory testing. A limited test menu was developed after consultation with the team of healthcare providers treating patients with EVD, Centers for Disease Control and Prevention (CDC) recommendations, and other sites with EVD expertise. Results: We selected several point-of-care (POC) devices and manual assays to provide necessary testing...
May 1, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28340071/variable-potassium-concentrations-which-is-right-and-which-is-wrong
#19
Talent Theparee, Robert C Benirschke, Hong-Kee Lee
Reverse pseudohyperkalemia is a term used to describe in vitro, falsely elevated potassium concentrations in plasma specimens that occur in association with extreme leukocytosis and are commonly associated with hematologic malignant neoplasms. Tumor lysis syndrome is an in vivo lysis of tumor cells that leads to elevated levels of potassium, uric acid, phosphate, and lactate dehydrogenase, as well as decreased calcium concentrations. Herein, we report a case of a 66-year-old Caucasian man with stage IV mantle-cell lymphoma who has elevated levels of potassium, uric acid, and phosphorus, as well as a white blood cell (WBC) count greater than 100,000 cells per mm3...
May 1, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28339785/a-food-debris-like-component-in-the-urine-sediment-from-a-urostomy-pouch
#20
Michiko Yamashita, Masaki Hotta, Kiyoshi Yoshino, Yoh Hidaka, Tadashi Kimura
Microscopic examination of urine sediment is a basic, common method of detecting diseases of the urinary tract. We experienced a case involving a patient who had developed a fever after undergoing a urinary-diversion operation. Results of the microscopic examination of the urine collected from the urostomy pouch of the patient showed a food debris-like component. Based on this finding, we suspected a fistula between the urinary and intestinal tracts. However, after performing an experiment to verify the results, we determined that no fistula was present...
May 1, 2017: Laboratory Medicine
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