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FEATURE ARTICLES

Assay to assess bleeding risk in haemophilia A and B patients: a case study

A coagulation laboratory in Cambridge is part of a pan-European study looking at the in vitro diagnostics potential for automated thrombin generation testing in the routine laboratory setting.

Forward-thinking software and instrumentation transform NHS pathology services

The need to share, analyse and compare data across numerous laboratories is becoming more relevant as plans for larger NHS pathology networks unfold. Here, North West London Pathology and Stago illustrate how this can be facilitated.

Putting it all together, building the measurement uncertainty budget

The seventh and final article in this series by Stephen MacDonald on individual aspects of the assessment of uncertainty of measurement provides an example of how to set, assess and review measurement uncertainty in any situation in the laboratory.

Rapid diagnosis of toxigenic Clostridium difficile using a novel LAMP technology

The identification of C. difficile carriers who have the potential to produce toxin can take up to four days, delaying patient isolation and increasing the chance of nosocomial spread of infection. Here, Laura Nottle considers the performance and benefits of a tcdB gene detection assay.

Loop-mediated isothermal amplification: diagnostics closer to the patient

The development of new nucleic acid amplification techniques is bringing molecular diagnostics closer to the patient for faster results and improved patient management. A prime example of this near-patient capability is LAMP technology.

Multiple myeloma and molecular pathology: a selection of articles in the current literature

Multiple myeloma accounts for about 1% of all types of human cancer and 13% of all haematological malignancies. Much molecular study currently is being undertaken on the disease, as the following selection of articles illustrates.

Tissue handling for molecular pathology: a topic of increasing importance

Louise Jones and Clare Craig reflect on the outputs of a workshop held last year, which looked at how best to handle surgical specimens from the point of removal, such that optimal results will be obtained from molecular analysis as well as conventional microscopy and immunohistochemistry.

Bacillus Calmette-Guérin: from TB prophylaxis to tumour Immunotherapy

The use of BCG is best known as a vaccination against tuberculosis. However, its role in bladder cancer immunotherapy goes back almost four decades, and its success has prompted increasing interest in the manipulation of the immune system against tumours.

Clinical and Laboratory Haemostasis: a blood coagulation EQA update

Ian Jennings reports on proceedings of the second day of the UK NEQAS for Blood Coagulation scientific and participants’ meeting, which is held annually at The Atrium at Sheffield Hallam University.

Pre-eclampsia testing: support for the use of the sFlt-1/PlGF ratio

Results of recent studies into pre-eclampsia testing have informed the latest National Institute for Health and Care Excellence guidance, which recommends use of the sFlt-1/PlGF ratio test to help rule-out this form of gestational hypertension.

Research in brief

Research in the medical laboratory provides opportunities both for the seasoned professional and also those in the early stages of their career. The work reported below reflects first on an audit of the use of order communications and the need for effective training of clinicians, and second the potential problem of false-positive bloodspot results in inherited metabolic disease screening.

Expression of uncertainty in measurement: more budget topics

The sixth in this series of articles by Stephen MacDonald on individual aspects of the assessment of uncertainty of measurement considers the impacts created when contributors are not measured in the same units.

Semen Analysis with Machine Intelligence: evolution of technology

Mathew Tomlinson makes a case for SAMi, the latest development in computer-assisted semen analysis, which can provide reliable and reproducible results for sperm concentration and the more objective estimation of motility.

Susceptibility testing study: an evaluation of i2a antibiotic disks

Antimicrobial susceptibility testing methods must be robust, easy to perform, reliable and cost-effective. Here, Becky Walker reports on a comparative study to assess the performance of antibiotic disks and automated zone reading technology.

Biotin beware: a brief overview of interference in some immunoassays

Recent studies and case reports are driving awareness that biotin can interfere with laboratory testing, producing misleading test results in some documented cases. Patients, laboratories and clinicians may not know about the presence of biotin, so laboratories must decide on appropriate action to reduce potential for diagnostic errors, as Gordon Avery explains.

Tissue block archiving and storage: examples of revolution in practice

Different logistical and traceability issues related to tissue block storage problems prompted two laboratories to investigate the benefits of a cost-effective system that offers assurance of quality and security.

Research in brief

Research and the reporting of interesting cases provide publication opportunities both for the seasoned professional and also those in the early stages of their career. The work reported below reflects first on the ongoing research into the role of T follicular helper cell subset analysis in primary immunodeficiency, and second on a patient with undetectable HbA1c which proved to be due to blood loss from a tumour.

Identifying the ‘Big Four’ carbapenemases in the routine laboratory

The continued increase in the incidence of CPEs is creating workload issues for reference laboratories, but the diagnostics industry is responding with simple, more affordable identification methods that can be adopted by front-line microbiology laboratories, speeding confirmation and reporting.

Pre-emptively treating invasive aspergillosis: rapid diagnosis by PCR

The importance of treating Aspergillus before it has taken hold, and the challenges currently facing clinical diagnostics laboratories, cannot be over-emphasised. Here, Lewis White and Rosemary Barnes explain their approach to molecular testing and diagnosis.

Bacteriology: a selection of open-access articles in the current literature

A PubMed search using the terms ‘Carbapenemase-producing Enterobacteriaceae’ and ‘Disk-diffusion testing’ found many recently published open-access articles, a small selection of which are included below.

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