Canada’s Premier Laboratory Science Conference to Take Place in Ottawa
LABCON2018, the national conference of the Canadian Society for Medical Laboratory Science (CSMLS), will bring together over 300 laboratory professionals from across the country. The conference will be held in Ottawa from May 24 - 27, 2018 at the Brookstreet Hotel.
Friday’s keynote presentation will be delivered by the internationally renowned Phlebotomy expert, Dennis Ernst. In addition to being the Director of the Center for Phlebotomy Education, Inc, Dennis is the author of over 50 articles on phlebotomy, two textbooks and three desk references.
Saturday’s featured speaker is Jason Tetro, a visiting scientist at the University of Guelph with over 25 years of experience in health-related microbiology and immunology. Better known as The Germ Guy, Jason regularly writes for The Huffington Post Canada and is a regular with media outlets worldwide.
“LABCON attracts the best and brightest from all facets of our profession,” says Christine Nielsen, CSMLS Chief Executive Officer. “It provides an opportunity for laboratory professionals, lab directors, educators and students to come together to share their knowledge, ideas and common challenges.”
This Little Known Health Profession Is One Of The Most Valuable
Although most Canadians have gone through a sample collection at least once in their lives, few realize what happens once the samples have been taken. Those cups and tubes head into a fascinating realm of healthcare known as medical laboratory science. Here, a group of committed professionals work diligently to examine, analyze and detect a variety of different molecules, cells, and at times, pathogens.
Medical laboratory science is not as well-known as other sectors of healthcare but its importance can't be ignored. Without laboratory testing, doctors would be unable to provide accurate diagnoses of a variety of infectious illnesses, including antibiotic resistant bacteria. The information also is critical to detect chronic diseases such as cancer. The laboratory also can identify health concerns due to genetics in a more accurate manner than home kits can provide.
The medical laboratory professional has been a part of healthcare for over 6,000 years. Back then, the Ancient Egyptians performed only urine tests. Since then, the scope and number of tests performed have increased such that a medical laboratory professional now has an arsenal of options to understand the human condition.
Their work will end up in compilation of data — usually a series of numbers — that in the hands of a doctor, tell a story about what is happening inside the human body. More importantly, the information can provide guidance on how to improve a person's health. Until recently, the value of these individuals was not given due credit. After all, they work outside of the view of the public and the patient. But now that has changed thanks to the most recognized health authority, the World Health Organization.
Earlier this week, they released a list of the most vital diagnostic tests for human health. The information is a laundry list of techniques performed in medical laboratory science demonstrating their importance to our overall health.
First-ever WHO list of essential diagnostic tests to improve diagnosis and treatment outcomes
WHO published its first Essential Diagnostics List, a catalogue of the tests needed to diagnose the most common conditions as well as a number of global priority diseases.
“An accurate diagnosis is the first step to getting effective treatment,” says Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “No one should suffer or die because of a lack of diagnostic services, or because the right tests were not available.”
The list concentrates on in vitro tests - i.e. tests of human specimens like blood and urine. It contains 113 products: 58 tests are listed for detection and diagnosis of a wide range of common conditions, providing an essential package that can form the basis for screening and management of patients. The remaining 55 tests are designed for the detection, diagnosis and monitoring of “priority” diseases such as HIV, tuberculosis, malaria, hepatitis B and C, human papillomavirus and syphilis.
Some of the tests are particularly suitable for primary health care facilities, where laboratory services are often poorly resourced and sometimes non-existent; for example, tests that can rapidly diagnose a child for acute malaria or glucometers to test diabetes. These tests do not require electricity or trained personnel. Other tests are more sophisticated and therefore intended for larger medical facilities.
“Our aim is to provide a tool that can be useful to all countries, to test and treat better, but also to use health funds more efficiently by concentrating on the truly essential tests,” says Mariângela Simão, WHO Assistant Director-General for Access to Medicines, Vaccines and Pharmaceuticals. “Our other goal is to signal to countries and developers that the tests in the list must be of good quality, safe and affordable.”
Coming Tuesday in Quebec: Your digital health file at your fingertips
Carnet santé Québec will be available on computers, tablets and smartphones, Health Minister Gaétan Barrette announced last week.
“The online service is a tool for the patient that will be simple, safe, secure — and free,” Barrette said. Much like an online bank account, only the client will be able to access his or her health data, he added.
Announced in December, the government is to roll out the program during the next two years, starting with an online registration process that went live this week.
Initially, patients will be able to consult their “carnet” or health booklet for a list of medications received from the pharmacy going back five years, laboratory results for urine and blood tests, and medical imaging tests such as X-rays.
As of September, patients will be able to see how much their doctor billed for each procedure and medical intervention. Eventually, the system is to include all medical interventions done in offices, clinics and hospitals — for example, an operation to remove an appendix will be broken down according to fees for surgery, hospitalization, medication and staff.
By 2019, patients will be able to see their progress on wait lists for surgery.
Rectal Swabs an Optional Diagnostic Tool for Clostridium difficile
In simple Clostridium difficile (C. difficile) diagnostic tests, dry rectal swabs were an effective substitute for the use of stool samples, according to new findings.
C. difficile infection confirmation is almost always done through the analysis of stool specimens, but instead, a research team from Germany wanted to examine other methods. Researchers examined the way rectal swabs with liquid transport medium and nylon flocked dry swabs performed in the detection of C. difficile infection, and evaluated the impact of storage temperature on the swabs.
The investigators collected 60 clinical stool samples that tested positive for C. difficile by PCR and used them to simulate rectal swabs. Then, researchers dipped both wet and dry swabs into the stool and tested by PCR 3 times.
The first test took place immediately after the simulation “swab,” then after 1 month and 3 months storage at -80°C. When the researchers tested the frozen samples, they first thawed them at room temperature for 15 minutes and the liquid swabs were vortexed for 30 seconds.
Testing all of the dry swabs 100% successfully detected C. difficile, an equal rate of the stool sample testing. This was true for all 3 phases of testing, and the researchers learned that no significant differences were found on the samples after they were frozen and thawed.
The detection rate for the other 30 liquid swabs was lower, at 83.2% accuracy. However, the researchers determined temperature and the freezing and thawing of these samples did not have any significant impact.
Scientist wants all Canadian kids with cancer to receive genetic test for drug reactions
A scientist who developed a lab test to predict whether children with cancer are susceptible to potentially life-threatening side effects from three chemotherapy drugs is now focusing on five other medications so parents and doctors can discuss safer, personalized treatment.
Bruce Carleton, director of the Pharmaceutical Outcomes Programme at B.C. Children's Hospital, said adverse reactions linked to the five medications include bone disease, pancreatitis, anaphylaxis, nerve damage in the limbs, and inflammation of the mucous membranes, including those that may prevent patients from swallowing.
The four-year project is part of a Genome Canada study that will include the creation of a publicly available genetic database that could be accessed by researchers around the world, Carleton said. He and his colleague Colin Ross have already identified genetic variants linked to three commonly prescribed drugs that cause heart failure, hearing loss or suppression of bone marrow, which reduces the body's ability to fight infections.
For the last two years, cancer patients Carleton has seen at a B.C. Children's Hospital clinic have been given a genetic test to determine if they are at risk for reactions. Carleton said he would like children at all cancer centres in Canada to be genetically tested for adverse reactions to the potent medications. They include anthracycline, which plays a role in dramatically improving survivability rates of many cancers, but also causes heart failure in some cases.
"I think that we can begin the conversations before treatment begins about what the adverse effect means, instead of waiting for it to occur and saying, 'Well, this happens sometimes,'" Carleton said. "Often, parents say to me that the adverse effects of cancer chemotherapy were harder for them to manage and deal with than the survival questions because they're not prepared for it."
Their research includes analysis of over 6,100 DNA samples as they work to discover genetic susceptibility to side effects from the five drugs in the expanding field of pharmacogenomics.
Modified Gloves Can Help To Reduce The Risk Of Hospital-acquired Infections
About two million hospital-acquired infections (HAIs) occur in the US every year, which leads to up to 100,000 annual deaths. Approximately one-third of these infections may be prevented by infection control measures such as improved hand hygiene. Cross-contamination via the hands of healthcare workers (HCWs) is the most significant source of infection. Therefore, the use of medical gloves as barrier protections against pathogens is recommended. Despite the use of medical gloves, HCWs can still contaminate themselves in two cases:
- 2% of medical examination gloves have pre-existing pinholes
- 53% of HCWs contaminate themselves during glove removal
It is highly recommended to sanitize hands after glove use. However, compliance with hand hygiene guidelines is at 50% therefore a modified glove (Doffy ™ Glove) was tested in this field study.
A total of 317 HCWs at the Hannover Medical School were randomized for the use of standard gloves or the modified product (Doffy™ Gloves). Doffy™ Gloves have a textured doffing aid in the wrist area that can be grabbed during removal. After gloving a fluorescent solution was distributed on the gloves in order to simulate hand disinfection. Then the gloves were removed and contamination spots were evaluated inside a UV box.
When performing a multivariate regression analysis, Doffy™ Gloves were independently associated with significantly lower contamination rates than were standard gloves.
Medical Laboratory Education
CSMLS exams to go digital with Prometric
The Canadian Society for Medical Laboratory Science (CSMLS), the national professional society for Canada's medical laboratory professionals, has entered into a multi-year agreement to have all four of its certification examinations delivered by Prometric, a global leader in candidate service and computerized testing.
As the national certifying body for Canada's medical laboratory technologists and medical laboratory assistants, the CSMLS is implementing computer-based testing using Prometric's integrated test platform, highly secure testing network, and candidate-focused approach that is best in class.
"The move to computer-based exams with Prometric will allow CSMLS to offer the most progressive, state-of-the-art exam delivery method, in line with best practices for high-stakes exams," stated Christine Nielsen, CEO, CSMLS. "It enables enhanced exam security as well as faster scoring and reporting. Students will benefit from more flexibility in scheduling time and choice of writing location, as well as greater consistency in the exam writing environment."
"We are extremely excited to play a part in fueling the professional careers of thousands of medical laboratory practitioners through our CSMLS partnership," said Charlie Kernan, president and CEO, Prometric. Our collaboration will set new standards in streamlining the entire candidate experience for the digital age, offering candidates greater convenience, access and flexibility when it comes to scheduling and taking their exams while ensuring the highest security protocols."
Rutgers Trailblazer to Become Nation's First Doctor of Clinical Lab Science
On May 16, Brandy Gunsolus will be the first graduate of a doctoral program that is the first of its kind in the nation – Rutgers School of Health Professions’ advanced practice doctorate in clinical laboratory science (DCLS). The school launched the program in 2014 to address an ongoing need for greater accuracy and cost efficiency in lab testing.
Gunsolus saw firsthand the need to integrate lab science into the health care system. A medical lab manager in Louisiana, she was frequently asked what lab tests to order and if she could help interpret the results. Her desire to be fully prepared to answer those questions fueled her decision to get a master’s degree in clinical laboratory science at the School of Health Professions in 2013 and then to enroll in the doctoral program.
“There is a gap between practicing physicians and labs not understanding the correct tests to order or how to interpret them. For patient safety, we need to fill this gap,” she said.
In addition to performing rounds at the hospital with the medical team, Gunsolus reviews all laboratory test orders and is part of the hospital’s diagnostic management team as well as a nationally sponsored consumer information response team that answers patient questions about lab tests. During her residency, she documented nearly $700,000 in savings that came from consulting with clinicians and health care providers about lab tests. But what most excites her is being part of the attending health care team.
“At first it was a bit scary. I didn’t know if I’d be accepted, but overwhelmingly there’s been a positive result,” said Gunsolus, who has written a blog about her journey in the Rutgers doctoral program. “I’ve had physicians say, ‘I want you to do the rounds with me every day.'”
She looks forward to beginning her paid job June 1 at the Augusta, Georgia, hospital as the nation’s first doctor of clinical lab science.
Scientists develop a new test to diagnose peanut allergies
Medical Research Council scientists have developed a new laboratory test to diagnose peanut allergy. The test has 98 per cent specificity and, unlike current options, it doesn’t run the risk of false-positives or causing allergic reactions such as anaphylactic shock.
The simple blood test is five times more cost-efficient compared to the oral food challenge (OFC) – the standard food allergy test – and could be adapted to test for other food allergies.
Peanut allergies are among the most common food allergies in children. Currently, doctors diagnose peanut allergy using a skin-prick test or specific IgE test but this may result in over-diagnosis or false-positives and it cannot differentiate between sensitivity and true food allergy.
When skin-prick and IgE test results are unclear, allergists rely on an OFC, which consists of feeding peanut in incrementally larger doses to a patient in a highly-controlled setting in hospital to confirm allergy to the food.
While the test is the gold-standard for diagnosing food allergies, there is risk of causing severe allergic reactions. Now, the researchers have developed a safer, accurate blood test in the lab.
The new test, called the mast activation test (MAT), could act as a second line tool when skin-prick test results are inconclusive and before referring children and their families to specialists for an OFC, according to researchers from the MRC & Asthma UK Centre in Allergic Mechanisms of Asthma. Their new study was published in the Journal of Allergy and Clinical Immunologyopens in new window.
Dr Alexandra Santos, an MRC Clinician Scientist at King’s College London, paediatric allergist and study lead author, said: “The current tests are not ideal. If we relied on them alone, we’d be over diagnosing food allergies – only 22 per cent of school-aged children in the UK with a positive test to peanuts are actually allergic when they’re fed the food in a monitored setting.
“The new test is specific in confirming the diagnosis so when it’s positive, we can be very sure it means allergy. We would reduce by two-thirds the number of expensive, stressful oral food challenges conducted, as well as saving children from experiencing allergic reactions.”
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