News
MissingType | Canadian Blood Services
Canadian Blood Services is uniting with blood donor organizations across 21 countries to highlight an almost 30 per cent international drop in people becoming blood donors compared to a decade ago.
The campaign – first held in England and North Wales by NHS Blood and Transplant in 2015 – this year brings together 25 blood services from 21 countries covering one billion of the world’s population who are each calling for new donors to ensure blood donation for future generations.
Throughout the campaign As, Bs and Os, the letters of the main blood groups, will disappear in everyday and iconic locations. The letters will be disappearing from famous locations in Australia, United States, Japan, Canada, United Kingdom, and many more countries. Celebrities from around the world are also going to show their support.
"Blood transfusions save lives and transform health for millions across the world," says Susan Matsumoto, Director, Canadian Blood Services. "But they are dependent on people donating blood. Whether it is patients receiving treatment for cancer, blood disorders, after crashes or during surgery, or new moms who lost blood in childbirth, blood is an absolutely essential part of modern healthcare. And right now, too many As, Bs and Os are missing in Canada. We need Canadians to come forward and register to become blood donors at missingtype.ca."
On-the-spot strep throat tests offered at some Shoppers Drug Mart pharmacies
A number of pharmacies in Canada have started to offer an on-the-spot strep throat test but some experts are concerned about the safety of bypassing traditional laboratory testing.
At Shoppers Drug Marts in Alberta, Nova Scotia and British Columbia, patients can have their throat swabbed by a pharmacist (approx. $15). "In less than 10 minutes for the whole procedure, we can tell them if they are positive or negative for the strep," pharmacist Azita Rezaei said. "We strongly believe that pharmacists offering these types of services help to provide earlier access to care for patients and a savings to the health care system," said company spokeswoman Tammy Smitham.
While the service seems convenient, some experts are skeptical, such as Dr. Etienne Mahe, clinical assistant professor at the University of Calgary's department of pathology and laboratory medicine. He is concerned about the sensitivity of rapid strep tests and the fact they are done without a detailed physical exam. Another concern is that a false positive can contribute to the over-prescription of antibiotics and antibiotic resistance. A false negative could lead to other life-threatening conditions, such as scarlet fever. There are also no guidelines governing the use of tests in drugstores. It is unclear how many independent pharmacies and doctor’s offices are using this technology at this time.
Malaria test wins prestigious award
More than three billion people are at risk of malaria, according to the World Health Organization (WHO). WHO estimated 214m cases of malaria and almost 450,000 deaths in 2015. Sub-Saharan Africa had 88% of malaria cases and 90% of malaria deaths.
llumigene Malaria, a highly accurate malaria test has won the Journées Internationales de Biologie prize for innovation in emergency treatment and point of care testing. Developed by Meridian Bioscience, the test is up to 80,000 times more sensitive at detection of the malaria parasite than conventional tests, with results available in less than an hour.
The test uses loop mediated isothermal amplification (LAMP), a DNA amplification method. It combines the accuracy of molecular testing while reducing diagnosis time, use of complicated materials and temperature changes.
Mike Shaughnessy, President for Global Diagnostics at Meridian Global Diagnostics, said "This product fits both emergency and decentralisation needs as it aids in the immediate clinical diagnostic. This test provides an extremely accurate result in less than 1 hour – a new lab technician can perform this test."
Hematology
Disseminated intravascular coagulation scores predict venous, arterial thrombosis risk in AML
"Venous thromboembolism is a common complication in patients with cancer," said Frank W.G. Leebeek, MD, PhD, professor of hematology at Erasmus University Medical Center in the Netherlands. "Among patients with hematological malignancies, those with acute lymphoid leukemia and multiple myeloma are particularly prone to develop venous thromboembolism (VTE), with incidences of 6% during induction chemotherapy and 10% to 28% during induction chemotherapy, respectively."
Leebeek and colleagues sought to study the incidence of these complications in newly diagnosed patients. The study included data from 272 adult patients treated for acute myeloid leukemia (AML) at Erasmus University Medical Center. The researchers assessed markers of disseminated intravascular coagulation — including fibrinogen, D-dimer levels, alpha-2-antiplasmin, antithrombin, prothrombin time and platelet counts — and the associations they had on the incidence of VTE and arterial thrombotic events (ATE) during follow-up.
"Our study clearly revealed that we were able to identify [patients with AML] at high risk for thrombosis by measuring disseminated intravascular coagulation parameters at diagnosis of AML," Leebeek wrote. "It seems, therefore, of potential clinical interest to perform prospective studies to evaluate the potential role of prophylactic anticoagulation therapy in patients at high risk of thrombosis, especially during the first month after start of treatment."
Microbiology
Vaccine watches bacteria, strikes only when trouble stirs
A new vaccine allows pneumonia-causing bacteria to colonize inside the body, springing into action only if the bacteria pose a threat. The breakthrough approach, coupled with the protein-based vaccine’s potential to counteract more than 90 strains of the bacteria, has the makings to override how vaccines have worked since the days of Louis Pasteur. Moreover, it offers what could be the most direct and broad response to pneumonia as well as meningitis, sepsis and other serious infections caused by Streptococcus pneumoniae, a bacteria more commonly known as pneumococcus.
Traditional vaccines, which identify pneumococcus by a sugar coating that surround the bacteria, are 56-88% effective. The new type of vaccine takes a different approach by identifying strains of proteins attached to the surface of pneumococcus.
Published in the Proceedings of the National Academy of Sciences, the new vaccine allows bacteria to exist as long as it causes no harm to body. It instructs the immune system to attack only when the surface proteins break free of the bacterial coating. Laboratory tests show the new vaccine can defend against more than 12 strains and that it’s 100% effective at promoting the appropriate immune response. Computer simulations indicate the vaccine would be effective against all strains but additional tests are needed to confirm that.
Anatomic Pathology
Study details sources of discrepancies between initial and final pathology reports
A University of Colorado Cancer Center study published in the International Journal of Surgical Pathology explores the hospital procedures that lead to discrepancies between initial, intraoperative evaluation and the results of the final, less pressured examination. Specifically, the study evaluated 1,042 frozen sections, finding only differences between initial and final evaluation in 4.6% of cases (rarely affecting patient treatment decisions).
Working with Joshua Wisell, MD, Sharon Sams, MD, MPH, investigator at the CU Cancer Center and assistant professor at the School of Medicine Department of Pathology, found that within a six month retrospective review, 54% of the discrepancies were due to "process" errors while 46% were "interpretation" errors. Overwhelmingly, the process errors were associated with selecting the correct area for sampling or inherent technical difficulties in freezing tissue. The interpretation errors included false negatives (16.7%), false positives (20.8%), and misclassification (8.3%) within the interpretation errors. "Really, the number of discrepancies is so small in any hospital that I don't see this kind of analysis dramatically transforming pathology practices. But it's still useful to see where these discrepancies are coming from," Sams says.
Molecular Biology
BCIT Forensic DNA Lab earns world-class accreditation
Over the last nine years, the Pacific Northwest coastline was the site of a disturbing, unexplained phenomenon. Seventeen human feet washed up on the shores of British Columbia (BC) and Washington State - without a body attached. This mystery was solved (victims of marine accidents and suicide) with help from the British Columbia Institute of Technology (BCIT) Forensic DNA Laboratory. Using advanced forensic profiling technology, the lab was able to generate DNA profiles for each of the human feet recovered.
The lab recently earned forensic lab accreditation from the Standards Council of Canada - the same level of accreditation held by the RCMP’s Forensic DNA lab. BCIT is the only academic institute in Canada to hold this distinction. Reaching this milestone was an important step for the lab, adding credibility to the team’s DNA-based investigative work and ensuring their findings hold up to scrutiny when used as evidence in court. According to Chantal Guay, vice president of the Standards Council of Canada, “accredited forensic test results are trusted by government and industry regulators and by the courts.” Lab founder Dr. Dean Hildebrand said, “Our lab has served as an important resource for the BC Coroners office… We’re proud of our humanitarian and investigative work.”
Research
Study finds utilization management prevents genetic testing order errors
Researchers based at Seattle Children's Hospital and the University of Washington (WU) have found that a laboratory utilization management program prevents genetic testing order errors, especially those made by clinicians without specialty training, before reaching the patients and becoming diagnostic errors. Read the article for process details.
The study, published in the American Journal of Clinical Pathology, found that about 5% of orders from non-geneticists that were slated for review had some kind of error, Dr. Patrick Mathias, assistant professor of laboratory medicine and associate director of informatics at UW said. "The impact [of the error] is quite variable, but [the rate is] still pretty high," he added. They also noted that the error rate was high when a test was recommended by a geneticist, but ordered by a non-geneticist, Mathias said.
Additionally, the team observed that the inpatient order error rate (7% of total inpatient orders) was three times the rate observed in outpatient orders. Most importantly though, the researchers were able to confirm that one-fourth of the orders with errors (~1% of all genetic test orders) could have had diagnostic implications for the patient if the order was not corrected. Limiting these mistakes is important for better patient outcomes.
Cord blood outperforms matched donor in bone marrow transplants
Jonathan Gutman, MD, the senior investigator and lead author, said, "Our results show that, long term, receiving a cord blood transplant is less likely than receiving a transplant from an unrelated, matched donor to result in graft-versus-host disease. As a result, we have chosen to use cord blood as our first choice in cases where a matched, related donor is unavailable."
Scientists at the University of Colorado Denver compared 51 patients receiving umbilical cord blood transplants (CBT) with 57 patients receiving matched, unrelated donors (MUD). The study was published in Bone Marrow Transplantation. The incidence of severe chronic graft-versus-host disease was 44% in patients who had received transplants from MUD and 8% in patients who had received CBT. At three years post-transplant, in addition to other difference in severe chronic graft-versus-host disease (cGVHD), overall rates of cGVHD were 68% following MUD and 32% following CBT. Again at three years, patients receiving CBT had been off immunosuppression since a median 268 days from transplant; patients receiving MUD had not ceased immunosuppression to a degree that allowed scientists to determine the median.
Thank you!
We appreciate that you have taken the time to read LabBuzz. This is a CSMLS venture to provide relevant medical laboratory news to its members.
We need your help to grow this newsletter! Please pass along the subscription link to any colleague you think would benefit from hearing about med lab news.
If you have any suggestions to improve LabBuzz, we would love to hear from you. In fact, if you have a news or publication link you would like us to consider for a future issue, please send it to labbuzz@csmls.org