News
Funding from Ontario Government to Assist Internationally Trained MLTs Successfully Integrate into the Workforce
The CSMLS is extremely pleased to announce receipt of funding from the Ontario Ministry of Citizenship and Immigration in support of two exciting initiatives.
The first, "Diversity Supports for Medical Laboratory Technologists (MLTs)" aims to create a suite of tools and resources for use by the entire MLT community. The content and format of these supports will be based on the specific diversity needs identified by the CSMLS membership through an online survey administered in June, 2018.
"Much of the work we have undertaken in the past has been focussed on helping internationally educated MLTs become certified" comments Project Manager, Keith Johnson. "This project is particularly special as it will improve the integration of these individuals into the workforce even after they receive their license to practice."
A multi-disciplinary Advisory Committee comprised of clinical educators, members, an internationally educated MLT, employers and representatives from immigrant serving agencies, has been assembled to provide ongoing guidance and oversight to the project.
In parallel, the CSMLS is also developing an online practice exam resource which will be made available to all certification exam candidates. CSMLS subject matter experts will be writing over 600 new practice test questions designed to mirror the high-stakes version.
Reflecting on this work, CSMLS CEO Christine Nielsen indicates that "the number one request we get from internationally educated MLTs is for a high-fidelity practice test to prepare for the CSMLS Certification Exam."
The CSMLS expects that introduction of a practice exam will help to alleviate exam anxiety for all exam candidates especially internationally educated individuals who may have had little or no exposure to the multiple-choice style of testing.
New Canadian guideline expands HCV screening to baby boomers
The Canadian Association for the Study of the Liver, or CASL, released a guideline on June 4th that now recommends screening patients born between 1945 and 1975 for hepatitis C virus.
The recommendation, published in the Canadian Medical Association Journal, corresponds with current guidance from other national and international organizations, including the European Association for the Study of the Liver (EASL), the American Association for the Study of Liver Disease and the Infectious Diseases Society of America. However, it differs from guidance issued by the Canadian Task Force on Preventive Health Care (CTFPH) in April 2017, which does not recommend HCV screening in low-risk patients, including baby boomers.
Previously, the CTFPH said its decision to recommend against screening baby boomers was based on several factors, including the low prevalence (between 0.64% and 0.71%) of HCV in the Canadian population not at an elevated risk for chronic infection and the lack of direct evidence of the benefits and harms of screening. However, Hemant Shah, MD, MScCH(HPTE), co-author of the new CASL guideline, said new developments have emerged since this recommendation, warranting a change in guidance.
According to recent data, approximately 252,000 people in Canada were chronically infected with HCV in 2013. Prevalence is highest among baby boomers, who account for 62.7% of all HCV infections in Canada, Shah and colleagues reported. However, up to 70% of these patients are unaware of their infection.
End-to-end blood testing device could save practitioners time
Researchers at Rutgers University in the US have developed an end-to-end blood test device that combines robotic phlebotomy with downstream sample processing to draw blood and provide diagnostic results with rapid turnaround times at the point of care.
The device has the potential to accelerate hospital work-flow and enable practitioners to devote more time to treating patients.
Research regarding the test has been published in a paper in the journal TECHNOLOGY.
Senior author of the paper Dr Martin Yarmush said: “This device represents the holy grail in blood testing technology. Integrating miniaturized robotic and microfluidic systems, this technology combines the breadth and accuracy of traditional laboratory testing with the speed and convenience of point-of-care testing.”
The researchers wanted to create a device that could address the current issues with manual blood tests. These issues include draw success rates being dependent on clinician skill and patient physiology as well as the time it takes to generate results in centralised labs from large-volume samples using labour-intensive analytical techniques.
To address these issues, the team of researchers designed the blood test device so it included an image-guided venipuncture robot able to address the challenges of routine venous access, with a centrifuge-based blood analyser to obtain quantitative measurements of haematology.
In the paper, the researchers presented results for a white blood cell assay, using a blood-mimicking fluid containing fluorescent microbeads. Studies were conducted on the integrated device, from blood draw to analysis, using blood vessel phantoms. High accuracy and repeatability of the cannulation and resulting white blood cell assay was demonstrated.
First author of the paper Dr Max Balter said: “When designing the system, our focus was on creating a modular and expandable device. With our relatively simple chip design and analysis techniques, the device can be extended to incorporate a broader panel of assays in the future.”
Clinical Chemistry
Urinary markers predict bone problems after hip replacement
In a study published in the Journal of Orthopaedic Research, investigators have identified urinary markers that differentiate total hip replacement patients who eventually develop bone tissue destruction, or osteolysis, from patients who do not.
For the study, researchers used a repository of 24-hour urine samples collected prior to surgery and annually thereafter in 26 patients, 16 who developed osteolysis and 10 who did not.
The levels of certain markers helped the investigators identify patients at risk for osteolysis long before the emergence of signs through imaging tests–in some cases 6 years before a diagnosis was made. Although single markers showed moderate accuracy, the combination of α-CTX, a bone resorption marker, and IL-6, an inflammatory marker, led to high accuracy in the differentiation of patients who eventually developed osteolysis from those with no signs of osteolysis.
“We are hopeful that early biomarkers for implant loosening will alert surgeons to be especially vigilant in their follow-up of at-risk patients and may eventually lead to treatments delaying or avoiding the need for revision surgery,” said senior author Dr. D. Rick Sumner, of Rush University Medical Center, in Chicago. “Perhaps even more intriguing is that the two biomarkers we identified also differed before surgery among patients who eventually developed peri-implant osteolysis and those who did not, supporting the concept that other researchers have proposed of genetic risk factors for loosening.”
Cytogenetics
New chromosome study can lead to personalized counseling of pregnant women
Foetuses with a so-called new balanced chromosomal aberration have a higher risk of developing brain disorders such as autism and mental retardation than previously anticipated. The risk is 20 per cent for foetuses with these types of aberrations according to a new study from the University of Copenhagen.
These chromosomal aberrations are seen in the foetus in one out of 2,000 pregnant women. Until now, when such an aberration has been found, the medical doctors have told the pregnant woman that the foetus' risk of developing congenital malformations is 6-9 per cent.
The study is the largest systematic survey of these rare chromosomal aberrations in foetuses, and it also evaluates the methods that can be used for examining them. These chromosomal abnormalities are diagnosed through chorionic villus sampling or amniocentesis by classical chromosomal analysis, where the genetic material is examined in a microscope. This method has been used for the last 40 years, and it is still the method used in most pregnancies globally.
However, in Danish hospitals the method is increasingly being replaced with another method, chromosomal microarray, which exclusively tests for loss and gain of the genetic material. Chromosomal microarray therefore cannot discover the rare balanced aberrations studied here. In contrast, the study reveals that modern genome sequencing in most cases will be able not only to detect these balanced chromosomal aberrations but also show whether genes have been damaged.
Research
Some blood stem cells are better than others
In your body, blood stem cells produce approximately 10 billion new white blood cells, which are also known as immune cells, each and every day. Even more remarkably, if some of these blood stem cells fail to do their part, then other blood stem cells pick up their slack and overproduce whichever specific type of immune cell is lacking, according to a new USC Stem Cell study published in the journal EMBO Reports.
USC PhD student Lisa Nguyen and colleagues in the laboratory of Rong Lu observed this phenomenon by tracking the individual blood stem cells that reside in the bone marrow of mice. To create the tracking labels, the scientists attached a unique piece of genetic code to each blood stem cell. During blood production, each blood stem cell passes its unique genetic label onto its progeny--which include two types of immune cells, known as B cells and T cells.
To test the contributions of these uniquely labelled blood stem cells, the scientists performed a series of bone marrow transplantations in mice. Mice received a combination of normal blood stem cells and deficient blood stem cells with a genetic mutation that prevented them from producing either B cells only, or both B and T cells.
The scientists found that the normal blood stem cells compensated for the B and T cell deficiencies. When co-transplanted with B-deficient stem cells, the normal stem cells overproduced B cells to keep the immune system in balance. And when co-transplanted with B- and T-deficient stem cells, the normal stem cells compensated by overproducing both B and T cells to maintain a balanced immune system.
UCalgary researchers develop field test for drug-resistant malaria
Dr. Dylan Pillai and Abu Naser Mohon, PhD candidate, members of the Snyder Institute for Chronic Diseases at the Cumming School of Medicine (CSM) have developed an inexpensive field test that can be performed anywhere, without the need for electricity or specialized lab equipment. The kit is portable and battery powered. Results are available in an hour, allowing health-care workers to administer the right treatment to patients sooner.
“This test is very sensitive, up to 1,000 times more sensitive than traditional tests involving the use of labs and microscopes,” says Pillai, associate professor at the CSM. “Part of the problem with drug-resistant malaria is that current tests can’t diagnose the disease early on and confirming the diagnosis can take days or even weeks. Those people with drug-resistant infections often get the wrong treatment, get sicker, and sometimes die.”
“Recently, scientists discovered a particular gene that causes or is linked to artemisinin resistance — the primary drug used worldwide to treat malaria,” says Mohon. “We’ve developed a test that can detect that resistance at the molecular level. It’s basically a DNA-based test.”
The team hopes to test the kit in the field soon to validate the findings seen in the lab.
Just For Fun!
Blood, Part 1 - True Blood: Crash Course A&P #29
We'll start by outlining the basic components of blood -- including erythrocytes, leukocytes, platelets, and plasma -- as well as the basic process of hemostasis that stops bleeding, and how antigens are responsible for the blood type that you have. By the end of this episode, you should be totally prepared for your next blood drive.
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