Laboratory in a needle promises rapid diagnosis
Quote: “A truly practical lab-on-a-chip (LOC) system for point-of-care testing (POCT) hepatotoxicity assessment necessitates the embodiment of full-automation, ease-of-use and “sample-in-answer-out” diagnostic capabilities.”
A research team from the United States and Singapore have produced the necessary design to create a miniature chemistry laboratory inside a needle. The prototype is based on existing LOC technology that is capable of extracting the sample, preparing it, amplifying the mRNA and running the polymerase chain reaction to detect and determine concentration of the gene(s) required for investigation. Two chips are used which are combined to provide the final analysis. The research team utilized the needles for markers in the induction of liver toxicity in mice to provide initial feasibility findings on the prototype. Future studies will involve human participation and it is suspected that if positive results are obtained, that positive changes in clinical practice are ensured.
Abstract: Lab on a Chip
Regulatory inaction persists despite 'Wild West' of medical testing
A federal advisory committee at the U.S. Centers for Disease Control and Prevention is reported to have taken no action after concerns about a growing category of medical tests, Laboratory Developed Tests (LDTs), were described by one member as the "Wild West" of lab testing. Federal regulators made a rebuttal to the accusation, indicating that they don't have the authority or resources to address tests with long-standing quality issues currently in high demand. The article states that thousands of ‘waived tests’ have been developed too quickly and cheaply.
Follow this hot topic and continue the discussion: The Public Health Evidence for FDA Oversight of Laboratory Developed Tests: 20 Case Studies
- The report examines events involving 20 LDTs that illustrate, in the absence of compliance with FDA requirements, that these products may have caused or have caused actual harm to patients.
AACC Urges Congress to Ensure Patient Access to Medical Tests; Calls for Modifications to Draft Legislation for Laboratory Developed Tests
New Hepatitis C Test Can Screen, Detect And Confirm Virus Presence More Quickly
A one step urine test to detect the presence of the hepatitis C virus (HCV) has been developed by researchers from the University of California and provides an advantageous screening alternative to the current blood collection method. The results of this study were presented at the American Associations for the Study of Liver Diseases meeting with initial information released by UC Irvine School of Medicine. With approximately 150 million people worldwide chronically infected with HCV, the ability to detect infection in high risk populations utilizing the proposed methodology greatly reduces the fiscal burden on the healthcare system as well as risk of complications for patients. Also, the urine test increases the likelihood of global adoption due to ease of use, and provides the ability to better control transmission of and treatment for HCV. "Those who are HCV infected can now be cured, before a further liver injury and complications develop, but only if they are diagnosed." said Dr. Ke-Qin Hu, the director of hepatology services.
Test results of fingerprick blood vary from drop to drop
In a first of its kind publication, a study in the American Journal of Clinical Pathology suggests that as many as six to nine drops of blood should be combined in order to achieve consistent test results. Researchers from Rice University suggest that healthcare professionals should be cautious when interpreting results based upon single drop tests. The research tested 20 microliter droplets (six drops of blood) drawn in succession from the same finger in each of the 11 participants. An additional test in a separate participant group was preformed to determine if size impacted the results. All results were compared against blood drawn from the participant’s vein as well. It was concluded that the average test result from six to nine successive droplet tests produced results that were consistent with the vein drawn blood. “Our results show that people need to take care to administer fingerprick tests in a way that produces accurate results because accuracy in these tests is increasingly important for diagnosing conditions like anemia, infections and sickle-cell anemia, malaria, HIV and other diseases," stated Meaghan Bond, student of the lead investigator Rebecca Richards-Kortum, Rice’s Malcolm Gillis University Professor and director of Rice 360°: Institute for Global Health Technologies.
Video: Blood test results vary from drop to drop in fingerprick tests
Press Release: Blood test results vary from drop to drop in fingerprick tests
How to Optimize Antidiabetic Pharmacotherapy Using the Clinical Significance of HbA1c Variations
For patients with diabetes, adherence to a monitoring schedule for HbA1c levels tremendously aids the treatment process. Through the observation of long-term serum glucose regulation, a measure of treatment effectiveness for diabetes, can be achieved. The article summarizes the key discussions from the American Association for Clinical Chemistry’s recent webinar in which Dr. Randie Little of the University of Missouri and Dr. Steven Wittlin of University of Rochester Medical Center spoke. The author provides important details that one needs to be aware of while decoding HbA1c values.
The following practice pearls were identified:
HbA1c readings can be skewed by many factors, such as genetic variants of hemoglobin and disease states.
Very elevated HbA1c is associated with fasting blood glucose levels.
HbA1c closer to goal is associated with postprandial blood glucose levels.
Point-of-care HbA1c testing may not be as accurate as results from a blood draw sent to a lab for HPLC or another method.
FREE Webinar: Using the HbA1c Test Wisely in Clinical Practice
Baffling lab mystery leads to potential new anemia treatment: Researchers can trigger production of oxygen-carrying cells on demand
After completing a routine lab experiment, researchers from the University of Virginia School of Medicine observed a unique phenomenon and found an unexpected new way to trigger the production of red blood cells. The team injected mice with the flu virus and an antibody which blocked a certain molecule expressed by dendritic cells. The result observed was the enlargement of the spleens which was replicated in subsequent experiments. It was concluded that they were inducing stress erythropoiesis. The research teams suggests that this discovery could represent a significant milestone in the battle against anemia, and ability to benefit diabetic, kidney disease and cancer patients.
"In the very basic way, what we've discovered is that the process of regulating stress in the body is mediated -- certainly in part, at least -- by these dendritic cells," Dr. Thomas Braciale explained. "And stress can be a variety of different stresses. It doesn't have to be infection, it doesn't have to be inflammation. It can be anemia. It can be hemorrhage. And these cells act to initiate this response that, until this report, there's been really no evidence that these [dendritic] cells ever participate in making red blood cells."
Related Article: How flu infected mice could mean end of blood transfusions
Original Publication: Stress-associated erythropoiesis initiation is regulated by type 1 conventional dendritic cells
Personalized drug screening on horizon for multiple myeloma patients
A personalized method for testing the effectiveness of drugs that treat multiple myeloma may predict quickly and more accurately the best treatments for individual patients with the bone marrow cancer. The process, developed by scientists at Washington University School of Medicine in St. Louis, may also aid patients with leukemia or lymphoma. The method relies on 3-D tissue-engineered bone marrow (3DTEBM) cultures that Dr Adbel Azab and his colleagues developed using myeloma patients’ bone marrow samples. To more closely mimic outside the body what goes on within, scientists took small samples of a patient’s cells (cancerous and benign) and remodeled them in the lab. This tumor “microenvironment” includes the cancer cells and other neighbouring blood vessels, immune cells and other components whose interaction can help or inhibit the tumor cells’ growth. Drugs were then tested on the remodeled patient cells to determine which treatment is likely to be most effective. The screening method suggests which commonly prescribed multiple myeloma drug, or combination of drugs, a physician should consider first for a particular patient. The test also suggests optimum dosage.
Abstract: 3D tissue-engineered bone marrow as a novel model to study pathophysiology and drug resistance in multiple myeloma
Bacteremia due to Pasteurella dagmatis acquired from a dog bite, with a review of systemic infections and challenges in laboratory identification
An interesting case study about a 74-year-old man with bacteremia caused by Pasteurella dagmatis and complicated by thrombocytopenia was published in the Canadian Journal of Infectious Diseases & Medical Microbiology. Microorganism identification was performed using traditional biochemical profiling, complemented with both the sequencing of the 16S ribosomal RNA gene and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Antibiotic-susceptibility testing was also performed. The patient received the necessary treatment with antibiotics and recovered fully. Other reported cases of bacteremia due to P. dagmatis are reviewed and compared against the current patient. Further information regarding the challenges of relying on standard automatic identification are also discussed.
Blood test detects when hormone treatment for breast cancer stops working
A team of scientists from The Institute of Cancer Research, London, and The Royal Marsden NHS Foundation Trust developed a highly sensitive blood test that can identify when resistance occurs in standard hormone treatment for breast cancer patients. Published in the Science Translational Medicine journal, the test provides an early warning signal by detecting defect mutations to the estrogen receptor gene ESR1. The mutation is identified by a method known as digital PCR analysis. The study was able to detect DNA errors with as much sensitivity as tumour biopsies – a 97% matching rate between the two sample groups. The possible benefits associated with this early detection includes allowing physicians to rapidly diagnose when patients need to be removed from treatment protocols and negates the need for patients to receive additional biopsies.
Related Article: Blood test picks out prostate cancer drug resistance
Related Article: Breast cancer prognostic markers: An overview of a changing menu
Researchers Use Electrical Field To Remove Nanoparticles From Human Blood
Medical nanoparticles are often removed from blood plasma sample via centrifuge; however, this is not possible in true medical situations utilizing a live person. The proposed new method continues to require the removal of blood plasma but no longer demands its chemical alteration or dilution, in addition to being able to remove the nanoparticles without altering the plasma itself. The technology uses an oscillating electric field to easily and quickly isolate drug-delivery nanoparticles from blood. It can serve as a general tool to separate and recover nanoparticles from other complex fluids for medical, environmental, and industrial applications. “This is the first example of isolating a wide range of nanoparticles out of plasma with a minimum amount of manipulation,” said Stuart Ibsen, the primary investigator. “We've designed a very versatile technique that can be used to recover nanoparticles in a lot of different processes.”
Press Release: Electric fields remove nanoparticles from blood with ease
Abstract: Nanoparticles: Recovery of Drug Delivery Nanoparticles from Human Plasma Using an Electrokinetic Platform Technology (Small 38/2015)
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