LifeLabs brings new blood to OPSEU
Seventy-five LifeLabs employees who work as lab technologists, technicians, assistants, phlebotomists (blood collectors), and support staff in north Simcoe County have voted to join the Ontario Public Service Employees Union (OPSEU). They work out of 11 locations, including Barrie, Orillia, Collingwood, Wasaga Beach, Stayner, and CFB Borden.
"During our organizing drive, it became clear that these employees have had enough of being underpaid," said Sean Allen, chair of OPSEU's Canadian Blood Services and Diagnostics Division. "They were also unhappy with poor working conditions and the way management lacked respect for their qualifications or appreciation for their contributions to the success of the company."
Allen said that workers had met resistance from management around organizing. This group of LifeLabs professionals is the first in Ontario to be unionized.
McMaster researchers develop new way to screen for drugs
McMaster University chemistry researchers have developed a new screening technique that promises to more quickly and accurately test for drugs. A paper outlining the technique is published in the latest copy of Analytical Chemistry.
The hope is this could become commonplace for medical professionals screening patients for drug use. For instance, patients at pain management clinics or psychiatric patients could be quickly tested to see if they're taking their prescribed medication and also if they're self-medicating with other drugs.
Right now, when medical professionals want to test for drugs in someone's system, the first step is usually a urine immunoassay test, which involves testing for antibodies. But the problem is these tests are not entirely reliable and can only test for specific known drugs. For instance, it can detect the presence of opioids, but does not define whether that's heroin or fentanyl. Secondary tests done in a lab are more accurate, but take longer and again can only test for targeted drugs.
The patented technique — multi-segment injection-capillary electrophoresis-mass spectrometry — uses a mass spectrometer to separate ions. The separation reveals any number of drugs.
A boy with leukaemia visited my lab – I had no idea what it would start
I would like to tell you a story about a boy, a hero of mine. Harvey Buster Baldwin was diagnosed with acute myeloid leukaemia aged six and spent many weeks in Worthing hospital, where I worked as a biomedical scientist. As an inquisitive six-year-old he asked questions about his blood. We arranged for Harvey to visit the pathology laboratory to try and answer some of his questions. I took Harvey around the lab, showing him all the specialist equipment we use, and we looked down the microscope to see his own red cells, platelets and white cells. Harvey went away with all the answers to the questions he had been asking, and I felt like I had made a difference to this young man’s life. Over the next 18 months Harvey fought a massive battle with leukaemia. He had help from biomedical scientists, teams of doctors, paediatric nurses and play specialists in the laboratories and Worthing and Royal Marsden hospitals. He also had some bone marrow donated from his brother. Harvey lost his battle aged eight.
I was later told that six other children could benefit from a tour around the lab, to help them understand more about their samples and to empower them with knowledge. This is how Harvey’s Gang began. As scientists, we reflect; what went well, what didn’t and what can we do better. I took this on board when I was thinking about how I could adapt the idea and take it forward. We named it Harvey’s Gang after Harvey. We looked at getting a white laboratory coat that would fit children, a certificate of attendance, an ID badge and a goody bag filled with useful things. A colleague of mine made our first white coat for a child from a threadbare NHS white sheet. We designed a logo and I arranged for the trust’s security department to produce ID badges. I raised the idea of goody bags with the ortho clinical diagnostics department and I shared our story with them. We named our new blood grouping analyser, Harvey. I designed our certificates of attendance, so that children and young people, as well as their parents or guardians, had a reminder of a happy day in hospital.
Read more about Harvey's Gang by clicking on the article title above.
Ordering fewer lab tests can improve quality and lower costs
Ordering fewer lab tests can improve quality and lower costs. Studies show that decreasing repetitive daily laboratory testing did not result in missed diagnoses or increase the number of re-admissions.
Physicians at Johns Hopkins, along with experts from several other institutions across North America, have compiled evidence and crafted an experience-based quality improvement blueprint to reduce repetitive lab testing for hospitalized patients, which they say can contribute to unnecessary costs.
Repeated blood draws for such tests can lead to hospital-acquired anemia and other complications, according to the research, published in Internal Medicine, a journal of the American Medical Association. Unnecessary blood draws can deplete a patient's hemoglobin count, often leading to repeat testing, the research found. And an estimated 20 percent of hospitalized patients can develop moderate to severe hospital-acquired anemia. This spiral, the authors contend, can generate additional unnecessary tests, interventions and costs.
Moreover, published studies show that decreasing repetitive daily laboratory testing did not result in missed diagnoses or increase the number of re-admissions to the hospital.
Citing individual studies in which front-line healthcare workers reduced the number of orders for lab tests by anywhere between 8 and 19 percent, the authors said that cost savings have ranged from $600,000 to more than $2 million per year.
Urinalysis quality control at the point-of-care
Dipper or dropper?
When it comes to selecting QC for urinalysis dipstick testing, the two main formats to consider are dipper- and dropper-style controls. As the names imply, a dipper style control is used by fully immersing the urinalysis dipstick into the control fluid to fully saturate the reagent pads, whereas a dropper-style control is used by dispensing the control fluid dropwise onto the reagent pads. Several manufacturers produce urinalysis dipstick controls in these two basic formats, each with a unique set of stability claims, features, and advantages. Dipper-style controls are typically delivered in tubes with 10-15 mL of fluid. The minimum amount of fluid required to execute a test in a standard 13 x 100 mm borosilicate test tube is about 8.5 mL. This is quite a large volume of control per test, but it is necessary in this format to ensure that reagent pads are immersed.
Single-use dipper-style controls in this format would therefore be rather cost-prohibitive, which is why many control manufacturers allow for multiple dips into the same control tube. There is, however, a limit to the number of tests that can be performed in the same tube, because a variety of chemicals leach out of the reagent pads, potentially leading to erroneous QC results. The blood analyte reaction is particularly sensitive to shifts in pH and exposure to oxidative compounds that become released from the reagent pads. This effect is exacerbated by repeated dips over extended periods of time. Repeated use of this style of control also increases the risk of microbial contamination from frequent handling and multiple testing events.
Dropper-style controls are the most cost-effective because very little volume is required to execute a test. As many of the new generation of urinalysis dipsticks are formulated with specialized reagent pads that help prevent carryover contamination to neighboring reagent pads, they may sometimes be more difficult to fully saturate using a dropper-style control. The drops of control fluid tend to sit on top of the reagent pad until enough material has been delivered to fully penetrate. Failure to thoroughly wet the reagent pad with the control fluid may lead to an erroneous QC result. The glucose reagent pad on some brands of urinalysis dipsticks is particularly difficult to saturate using a dropper-style control because manufacturers have taken steps to prevent the reagents from carrying over to other pads. More specifically, the peroxidase enzyme from the glucose reagent pad can trigger a false-positive result on the blood reagent pad.
Read the entire article to learn more about the pros and cons of each QC type by clicking the title above.
Blood Bank Needs Black Donors
The UK's National Health Service's blood donation program, NHS Blood and Transplant, needs more Black donors — and they aren't shy to say so. But the service has been getting a lot of flak recently for singling out one racial group. So, they took to Twitter to explain.
In a now-viral thread, @GiveBloodNHS made it clear that asking Black people to donate isn't about racism or racial profiling — it's about making sure they have enough blood to treat the Black community. Now, that might sound wrong since we're often told that underneath our skin everyone is the same, but that's a vast oversimplification, according to the NHS. Humans don't all have the same blood regardless of race, and Black people are more likely to have a specific type of blood good for treating sickle cell anemia — a disease that affects mostly the Black community.
Understanding the Complexities of Non-Invasive Prenatal Screening for Pregnant Women
As the use of non-invasive prenatal screening (NIPS) grows, there has been concern within the medical community that a poor understanding of this technique among clinicians and patients could negatively impact pregnancies. A review published in AACC's The Journal of Applied Laboratory Medicine gives an expert overview of NIPS's many nuances, to arm healthcare providers with the information they need to ensure patients benefit from this revolutionary but complex technology.
Using a simple blood sample, NIPS detects common genetic disorders like Down syndrome in utero without the risk of miscarriage that accompanies standard, invasive prenatal tests such as amniocentesis. When NIPS was first introduced, it was recommended for pregnancies at high risk for these chromosomal abnormalities. Then, as more studies demonstrated NIPS's efficacy in even low risk women, the American College of Obstetricians and Gynecologists issued updated guidelines in 2016 recommending that healthcare providers offer NIPS to all expectant mothers. Despite the success of NIPS, however, this technology still has limitations that could lead to serious consequences—such as patients terminating healthy pregnancies—if clinicians do not know about these shortcomings or fail to educate patients about them.
In this review, a team of clinical laboratory experts led by Christina M. Lockwood, PhD, of the University of Washington in Seattle discuss the challenges of NIPS that clinicians must address in order to successfully expand the use of this method to all pregnancies. One of the most significant issues is that NIPS is only a screening test. This means that, while a negative result can rule out the need for further testing, a positive result should not be acted on until confirmed with invasive testing. Lockwood's group recommends that all patients undergoing NIPS receive pre-test and post-test counseling to ensure they understand this, as well as to help with overall interpretation of complicated NIPS results. Another issue is that some labs now offer NIPS for less common genetic disorders in addition to major chromosomal abnormalities. Lockwood cautions healthcare providers against using NIPS for these additional conditions, due to the current lack of evidence supporting the efficacy of NIPS for rare disorders.
Early blood test could indicate risk of miscarriage
A blood test in the first 12 weeks of pregnancy could indicate a risk of miscarriage or premature birth, early research suggests. The proposed blood test screens for molecules called microRNA, which are found in blood cells in the placental bed - a thick membrane that lines the uterus during pregnancy. The team, from the Laboratory for Reproductive Medicine and Immunology in San Francisco, assessed the microRNA cells' ability to predict premature birth, pre-eclampsia, and miscarriage during the first 12 weeks of pregnancy. In total, they looked at 160 births - over a series of four published studies. The results predicted miscarriage and late pre-eclampsia with about 90% accuracy and premature birth before 34 weeks with about 89% accuracy. Daniel Brison, honorary professor of clinical embryology and stem cell biology at the University of Manchester, said the study was "exciting looking" in a much needed area. But he added: "Although the results might seem exciting and cutting edge, there is unfortunately a high risk of them being wrong. "We'd need larger follow-up studies to be sure whether these results are valid."
Related: MicroRNA diagnostic could be big advance in ovarian cancer
New 15-Minute Blood Test Could Drastically Cut Overuse Of Antibiotics
Antibiotics have been overused in both agriculture and human healthcare, and as a result, “superbugs” resistant to almost all common antibiotics have now emerged. If a clever solution to the problem isn’t found soon, this global health emergency will end up costing us millions of lives.
As scientists work hard at trying to break through the newly developed defenses of these microbes, a new standalone blood test has emerged that may see the unnecessary prescription of antibiotics drop off considerably.
The device is an incredibly cheap and straightforward laboratory on a chip – it takes just 15 minutes, and picks up on whether a patient is suffering from a viral or bacterial infection. If it’s the former, then no antibiotics will be given, as they often are when a technical examination like this isn’t made.
Its rapidity means that the test can be conducted in the presence of the patient. For this type of diagnosis, they no longer need their sample sent off to another medical facility for examination. Going by the name FebriDx, this little gadget looks out for two different proteins in the blood. The first, myxovirus resistance A (MxA), shows up when there’s a viral infection. The other, C-reactive protein (CRP), appears when there’s a bacterial infection; its presence in significant quantities is a marker for inflammation in general.
Publishing their results in the Journal of Clinical Medicine, a team – led by Nashville’s Vanderbilt University Medical Center – outline how the device is not yet 100 percent accurate, but it goes a long way towards improving the precision of diagnoses.
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