laboratory medicine – Vet Clin Path Journal http://vetclinpathjournal.org/ Sun, 13 Mar 2022 23:20:22 +0000 en-US hourly 1 https://wordpress.org/?v=5.9.3 https://vetclinpathjournal.org/wp-content/uploads/2021/05/cropped-icon-32x32.png laboratory medicine – Vet Clin Path Journal http://vetclinpathjournal.org/ 32 32 London hospitals receive $17.3m to help offset COVID-19 expenses https://vetclinpathjournal.org/london-hospitals-receive-17-3m-to-help-offset-covid-19-expenses/ Fri, 11 Mar 2022 22:57:03 +0000 https://vetclinpathjournal.org/london-hospitals-receive-17-3m-to-help-offset-covid-19-expenses/

London hospitals will receive $17.3 million in provincial funding to help with pandemic-related expenses.

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London hospitals will receive $17.3 million in provincial funding to help with pandemic-related expenses.

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London Health Sciences Center will receive about $14.9 million and St. Joseph’s Health Care London about $2.46 million, the Ontario government announced Friday.

The LHSC will use its share to mitigate the costs of additional intensive care beds and other medical equipment, including ventilators.

“The funding will be well used to support some of the augmented service delivery that we have had to undertake during the pandemic,” LHSC President Jackie Schleifer Taylor said Friday.

“We will thoughtfully assess the full costs and work with the government to close this gap that no one could have foreseen at the start of the pandemic.”

LHSC’s budget from April 1, 2020 to March 31, 2021 was approximately $1.3 billion while St. Joseph’s was $508 million.

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Jackie Schleifer Taylor, President and CEO of London Health Sciences Centre, left, Monte McNaughton, MPP for Lambton-Kent-Middlesex, and Phyllis Retty, Chair of the LHSC Board, pose at Victoria Hospital of the LHSC after McNaughton announced that the LHSC would receive nearly $15 million from the province to help cover pandemic-related costs.  (Supplied/LHSC)
Jackie Schleifer Taylor, President and CEO of London Health Sciences Centre, left, Monte McNaughton, MPP for Lambton-Kent-Middlesex, and Phyllis Retty, Chair of the LHSC Board, pose at Victoria Hospital of the LHSC after McNaughton announced that the LHSC would receive nearly $15 million from the province to help cover pandemic-related costs. (Supplied/LHSC)

During the first weeks of the pandemic, and using their own budgets, LHSC and St. Joseph’s Health Care London equipped their joint laboratory with the equipment needed to process COVID-19 tests.

The pathology and laboratory medicine program has undergone additional expansions and upgrades to increase testing capacity at several times during the pandemic.

The LHSC has also increased its virtual care efforts and launched a COVID-19 outpatient clinic during the pandemic, while increasing critical care bed capacity.

Hospitals not only faced extra expenses during the pandemic, but also hit parking and food and beverage revenue due to visitor restrictions, Schleifer Taylor said.

The Chatham-Kent Health Alliance will receive approximately $2.3 millionFour Counties Health Services in Newbury $112,948 and Strathroy Middlesex General $471,343, Erie Shores Healthcare in Leamington $630,302, Hotel-Dieu Grace Healthcare in Windsor $1.09 million and Windsor Regional Hospital approximately $5.32 million.

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“We have been working with hospitals over the past few months to determine, per hospital, how much money they need,” said Lambton-Kent-Middlesex MPP Monte McNaughton.

The LHSC reported 38 COVID-19 patients on Friday, with five or fewer in intensive care. Of the 38 patients, 15 are being treated for COVID-19. The others have tested positive but are hospitalized for other reasons.

COVID-19 hospitalizations at LHSC are a far cry from the peak of the Omicron wave in January, when the hospital had more than 160 positive patients.

“While there is some uncertainty as to what the next year will bring, we are beginning to embark on our journey to recovery,” said Schleifer Taylor.

“This means increasing our surgical capacity and tackling our backlog, reinvigorating our teaching and academic mission, and integrating our pandemic response into our regular operations.”

jbieman@postmedia.com

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Global warming expected to increase health burden of hyponatremia https://vetclinpathjournal.org/global-warming-expected-to-increase-health-burden-of-hyponatremia/ Tue, 08 Mar 2022 18:17:23 +0000 https://vetclinpathjournal.org/global-warming-expected-to-increase-health-burden-of-hyponatremia/ Global warming is likely to increase the number of people requiring hospitalization due to extremely low blood sodium levels, a condition known as hyponatremia. A new study from the Karolinska Institutet in Sweden predicts that a temperature increase of 2 degrees Celsius would increase the burden of hyponatremia on hospitals by almost 14%. The findings are published in the Journal of Clinical Endocrinology and Metabolism.

“Our study is the first to provide precise estimates of how temperature influences the risk of hyponatremia, findings that could be used to inform health care planning to adapt to climate change,” says Buster Mannheimer. , Assistant Lecturer in the Department of Clinical Sciences and Education. , Södersjukhuset, Karolinska Institutet and the first author of the study.

Climate change is expected to trigger an increase in average global temperatures over the coming decades, leading to myriad heat-related consequences for human health. One of these is hyponatremia, which can result from various diseases such as heart, kidney, and liver failure, as well as excessive sweating or fluid intake that dilutes the sodium concentration in the blood. .

Our bodies need sodium to maintain normal blood pressure, support nerve and muscle function, and regulate water balance in and around our cells. If blood sodium levels drop, it can lead to nausea, dizziness, muscle cramps, seizures, and even coma.

It is well known that cases of hyponatremia increase during the summer months. Yet data on temperature thresholds above which risks amplify are lacking, complicating clinical planning and predictions of health burden in future climate scenarios.

Women and the elderly at risk

In the current study, the researchers linked data on Sweden’s entire adult population to information on average 24-hour temperatures over a nine-year period. During this period, more than 11,000 people were hospitalized with a primary diagnosis of hyponatremia, most of whom were women with a median age of 76 years. Average daily temperatures ranged from -10 to 26 degrees Celsius.

The researchers found an almost tenfold higher risk of hospitalization due to hyponatremia on the hottest days compared to the cooler times. Women and the elderly were at greatest risk, with people aged 80 or older 15 times more likely to be hospitalized for hyponatremia during heat waves. The incidence of hyponatremia was largely stable at -10 to 10 degrees Celsius, but increased rapidly at temperatures above 15.

When the researchers applied the data to a prognostic model predicting global warming of 1 or 2 degrees Celsius, consistent with IPCC climate projections for 2050, they found that hospital admissions due to hyponatremia could increase by 6 .3% and 13.9%, respectively. .

Increased health burden

“We think these estimates are quite conservative because we didn’t take into account secondary diagnoses of hyponatremia, extreme weather events, or an aging population,” says Jonatan Lindh, associate professor in the Department of Laboratory Medicine. , Karolinska Institutet, and co-last author of the study. “Without adaptation measures, this suggests that over the coming decades, rising global temperatures alone will increase the burden of hyponatremia on health systems.”

It should be noted that Sweden is in the continental climatic zone, with buildings suitable mainly for cold temperatures. Therefore, the thresholds observed in this study may be representative only of cold temperate regions.

The study was partially funded by Cebix Incorporated. Two authors report previous consultancy fees from Otsuka Pharma Scandinavia AB, outside of the submitted work.

Source of the story:

Materials provided by Karolinska Institute. Note: Content may be edited for style and length.

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John Trojanowski, pathology and laboratory medicine https://vetclinpathjournal.org/john-trojanowski-pathology-and-laboratory-medicine/ Tue, 01 Mar 2022 11:02:41 +0000 https://vetclinpathjournal.org/john-trojanowski-pathology-and-laboratory-medicine/

John Trojanowski, pathology and laboratory medicine

John Q. Trojanowski, William Maul Measey-Truman G. Schnabel, Jr. Professor of Geriatric Medicine and Gerontology in the Department of Pathology and Laboratory Medicine at the Perelman School of Medicine, died Feb. 8. He was 75 years old.

Dr. Trojanowski was born in Bridgeport, CT, and was one of seven children. His father was a captain in the United States Air Force and Dr. Trojanowski grew up attending military schools as his family moved frequently to various Air Force bases in the United States and overseas. After graduating from high school, he majored in German at Kings College before receiving his medical and doctoral degrees at Tufts University School of Medicine. He completed his university training in Rotterdam, then returned to the United States for his neuropathology residency at Massachusetts General and Harvard Medical School. He met his wife, Virginia Man-Yee Lee, in Massachusetts and they moved to Pennsylvania after Dr. Lee was offered a job at a Philadelphia pharmaceutical company in 1979. Dr. Trojanowski joined the faculty at Penn in 1981.

Dr. Trojanowski shared his scientific and personal life with Dr. Lee, who became the John H. Ware 3rd Endowed Professor in Alzheimer’s Research in the Department of Pathology and Laboratory Medicine at Penn, also in 1981. Their findings identifying different forms tau protein has opened new avenues of research in neurodegenerative diseases. Little was known about Alzheimer’s disease in the 1980s, and homeroom teachers advised Drs. Trojanowski and Lee to avoid the topic, considered a career killer. They and their colleagues at Penn then made a series of groundbreaking discoveries showing that cell-to-cell aggregation and spread of specific pathological proteins is a common mechanism underlying Alzheimer’s disease and related disorders.

Over the decades, Drs. Trojanowski and Lee’s evolving research program kept Penn at the forefront of the field. The focus on the patient in their extensive basic and clinical work has identified many targets for potential therapies and drug treatments. Their lab also won some of the first federal grants to open an Alzheimer’s disease research center, and there they began recruiting and training the next generations of scientists. Dr. Trojanowski helped establish and expand a strong aging research network at Penn. In 1991, he became co-director with Dr. Lee of the Neurodegenerative Disease Research Center. Eleven years later, Dr. Trojanowski was appointed director of the Penn Institute on Aging, which he helped transform into a model center, catalyzing a wide range of groundbreaking work on aging and age-related diseases across the from the Penn campus.

Beyond his far-reaching impact at Penn, Dr. Trojanowski has also worked nationally and internationally, promoting and advancing research on aging, particularly as it relates to neurodegenerative diseases. In 1991 he became director of the National Institute on Aging (NIA) Alzheimer’s Disease Center Core, and elsewhere in the NIA he was active on the Board of Scientific Counselors, the National Advisory Council on Aging, and Neuroscience, Behavior and Sociology. Aging Review Committee. Among many other national leadership positions, he served as president of the American Association of Neuropathologists. Dr. Trojanowski led the Alzheimer’s Disease Neuroimaging Initiative’s Biomarker Core, a longitudinal study that changed the way patients are diagnosed. His pioneering research and transformative leadership helped establish Penn as a leading center for research into neurodegenerative diseases of aging and helped make Penn one of the nation’s top institutions receiving NIA funding. Programs he helped establish at Penn include the Marian S. Ware Alzheimer’s Program, the Penn Alzheimer’s Disease Center, the Morris K. Udall Center of Excellence for Parkinson’s Disease Research, and the NIA Penn U19 Center on Alpha-Synuclein Strains in Alzheimer’s Disease and Related Dementias.

During his illustrious career, Dr. Trojanowski has earned the respect of his peers across the country and around the world. Colleagues remember Dr. Trojanowski as a passionate scientist who was also extremely modest about his accomplishments, noting the collaborative nature of his work and the teamwork that went with it. He has received numerous awards and honors for his work, including his election to the National Academy of Medicine in 2002 and the 2018 Alzheimer’s Association Lifetime Achievement Award. Until almost the end of his life, he was still writing grants and papers, and overseeing tens of millions of dollars of research to better understand the many disease proteins he and his wife had identified or studied during their 45 years together. To read many fond memories of Dr. Trojanowski from friends and peers, visit https://www.alzforum.org/news/community-news/john-trojanowski-75-giant-field-neuropathology.

He is survived by his wife, Dr. Lee; and five siblings. Dr. Lee and his other colleagues are planning a memorial symposium on neurodegeneration in the fall.

To report a death

Almanac appreciates being notified of the deaths of current and former faculty and staff, students, and other members of the University community. Call (215) 898-5274 or email almanac@upenn.edu.

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Bone marrow fibrosis has potential as an independent prognostic factor in MDS https://vetclinpathjournal.org/bone-marrow-fibrosis-has-potential-as-an-independent-prognostic-factor-in-mds/ Sat, 19 Feb 2022 23:11:01 +0000 https://vetclinpathjournal.org/bone-marrow-fibrosis-has-potential-as-an-independent-prognostic-factor-in-mds/ Myelodysplastic syndrome has a variety of clinical presentations, including bone marrow fibrosis. Previously, the presence of fibrosis was not factored into disease risk scoring in MDS, but recent research suggests it may be a valuable risk factor.

Bone marrow fibrosis (BMF) is one of many manifestations of myelodysplastic syndrome (MDS), a malignant blood disease caused by irregularities in blood cell lines in the bone marrow (BM) or inefficient production of blood cells . Outside of current scoring systems used to calculate risk and determine treatments, BMF has been shown to be an independent risk factor in patients with MDS. A recent review suggests that the prognostic impact of BMF should be considered in regular clinical practice.

Currently, standard prognostic systems such as the Revised International Prognostic Scoring System (IPSS-R) are used to assess the severity of MDS. Thus, clinicians often overlook BMF, which has been identified as a distinct risk factor for poor survival, regardless of the patient’s IPSS-R risk level. The BMF is also not commonly included in standardized rating systems.

The study, published in Annals of Laboratory Medicine, reviewed the available literature on patients with MDS and BMF (MDS-F) to provide insight into prognosis and clinical presentation in this subset of patients with MDS.

The IPSS-R for MDS currently classifies the disease from very low risk to very high risk using cytogenetics, BM blasts and laboratory parameters including hemoglobin, platelets and absolute neutrophil count (ANC). ) at the time of MDS diagnosis. BMF is not listed in the IPSS-R and the WHO considers MDS-F an unclassified MDS subtype as of 2016.

“When the IPSS-R prognostic criteria were first established, BMF was considered a potential factor in determining prognostic risk,” the authors wrote. “However, it has been ruled out as an additive factor in predicting survival in MDS due to its low prevalence and differences in assessment of the degree of BMF across institutions.”

Despite its exclusion from grading systems, moderate to severe BMF associated with MDS has been associated with worsening of disease features such as multilineage dysplasia, transfusion dependency, and severe cytopenia. Overall survival (OS) is also worse in these patients, possibly due to increased BM failure or leukemic transformation.

Reticulin fibers and collagen fibers are both related to BMF. Collagen fibers are more significantly linked to abnormal blood counts and poorer outcomes. Reticulin fibrosis is also often reversible with therapeutic intervention, while collagenous fibrosis is more difficult to eradicate.

Patients with MDS-F with moderate to severe BMF who undergo allogeneic hematopoietic stem cell transplantation (alloSCT) are likely to have worse event-free survival, with delayed engraftment after the procedure reported more often in MDS patients with any level of fibrosis. The pathophysiology of BMF is also not well understood, although increased production of cytokines by megakaryocytes and platelets – which have been shown to be higher in patients with BMF – is a possible mechanism.

Yet patients with MDS-F are generally treated with similar strategies as those without fibrosis. Notably, if BMF were considered in severity grading, more patients could be considered for alloSCT, which is the only potentially curative treatment for MDS.

The impact of BMF on the prognosis of patients with MDS is crucial in terms of survival and disease progression. One study found that acute myeloid leukemia transformation rate was higher in BMF patients who had not undergone alloSCT, OS was lower (21 months vs. 42 months), and leukemia-free survival was lower (52 months versus 120 months). Other studies have shown significantly shorter OS in patients with MDS-F, as well as shorter OS in patients with severe BMF compared to mild BMF.

Overall, the study authors suggest that BMF is a poor prognostic variable at any stage of the disease for patients with MDS based on the most recent research. They recommend its inclusion in currently used grading systems and note that patients with moderate to severe BMF should be considered for transplantation as a potential treatment, even if their overall disease is not classified as high risk in the current systems.

Further research is still needed to clarify the pathobiology of BMF and the effectiveness of possible treatments for MDS-F.

Reference

Jain AG, Zhang L, Bennett JM, Komrokji R. Myelodysplastic syndromes with bone marrow fibrosis: an update. Ann Lab Med. 2022;42(3):299-305. doi:10.3343/alm.2022.42.3.299

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New step towards universal blood type organs for transplantation https://vetclinpathjournal.org/new-step-towards-universal-blood-type-organs-for-transplantation/ Wed, 16 Feb 2022 23:21:44 +0000 https://vetclinpathjournal.org/new-step-towards-universal-blood-type-organs-for-transplantation/

A team of Canadian scientists has proven that it is possible to safely convert blood type in donor organs for transplantation. The findings are an important step toward creating universal type O organs, which would significantly improve fairness in organ allocation and reduce patient mortality on waiting lists.

The proof-of-concept study was published in Science Translational Medicine by a team of researchers from UBC, Latner Thoracic Research Laboratories and the University Health Network (UHN) in Toronto.

“With the current matching system, wait times can be significantly longer for patients who need a transplant based on their blood type,” says Dr. Marcelo Cypel, Surgical Director of UHN Ajmera Transplant Center and lead author of the study.

Dr Jayachandran Kizhakkedathu

Donor organs are currently matched to potential recipients based on blood type, among other criteria. Blood type is determined by the presence of antigens on the surface of red blood cells and blood vessels in organs – type A blood has antigen A, B has antigen B, blood AB has both antigens and O has none. If the blood type of a donor organ does not match the blood type of the recipient, this can trigger an immune response and the organ is likely to be rejected.

In 2018, UBC researchers, including Dr. Jayachandran Kizhakkedathu, a professor in the Department of Pathology and Laboratory Medicine, discovered a group of enzymes capable of removing antigens from the surface of cells.

For this new study, the enzymes were delivered to the lungs using the Ex Vivo Lung Perfusion (EVLP) circuit, successfully removing the antigens.

“Enzymes are Mother Nature’s catalysts and they perform particular reactions,” said UBC biochemist Dr. Stephen Withers. “This group of enzymes that we found in the human gut can cleave the A and B antigen sugars on red blood cells, converting them into universal type O cells.”

“In this experiment, it opened a gateway to create universal blood-type organs. This is a great partnership with UHN and I was amazed to learn more about the ex vivo infusion system and its impact on transplants. It’s exciting to see our findings translated into clinical research.

Dr. Kizhakkedathu and Dr. Withers went on to found ABOzymes Biomedicala UBC spin-off company working to commercialize enzyme technology.

“There are already upcoming perfusion technologies for the kidneys, so this technology should be transferable to the kidneys, and potentially to other organs,” says Dr. Kizhakkedathu, also a fellow at UBC’s Center for Blood Research.

Addressing wait times for organs

In 2019, 250 Canadians died while waiting for an organ transplant. Type O patients wait on average twice as long to receive a lung transplant as type A patients, says Dr. Aizhou Wang, scientific associate at Latner Thoracic Research Laboratories and first author of the study.

“That translates into mortality. Type O patients who need a lung transplant have a 20% higher risk of dying while waiting for a matching organ to become available,” says Dr. Wang.

This disparity is also present for other organs where a type O or B patient requiring a kidney transplant will be on the waiting list for an average of four to five years, compared to two to three years for types A or AB.

“If you convert all organs to universal type O, you can eliminate this barrier completely,” says Dr. Wang.

The experience

This proof-of-concept study was performed at the Latner Chest Research Laboratories. The experiment used the EVLP system developed in Toronto as a processing platform. The EVLP system pumps nourishing fluids through the organs, allowing them to be warmed to body temperature, so they can be repaired and improved prior to transplantation.

Human donor lungs not suitable for transplantation from type A donors were placed in the EVLP circuit. One lung was treated with a group of enzymes to remove antigens from the surface of the organ, while the other lung, from the same donor, remained untreated.

The team then tested each lung by adding type O blood to the circuit, which should trigger an immune response and organ rejection. While the untreated lung showed signs of rejection, the lung treated with the enzymes did not.

“Having universal organs means we could break down the blood-matching barrier and prioritize patients by medical emergency, thereby saving more lives and wasting fewer organs,” adds Dr. Cypel, who is also a professor in the Department of surgery from the University of Toronto and holder of the Canada Research Chair in Lung Transplantation.

The study was an interdisciplinary effort across multiple organizations in Canada, including UHN, University of Toronto, University of British Columbia and University of Alberta.

“By exchanging ideas across disciplines and across the country, we have become a collaborative effort to tackle an important problem in organ transplantation,” says Dr. Wang.

The team of researchers is working on a clinical trial proposal within the next 12 to 18 months.

This story is adapted from a press release about UHN website.

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Ontario Hospitals Face Severe Shortage of Blood Collection Tubes https://vetclinpathjournal.org/ontario-hospitals-face-severe-shortage-of-blood-collection-tubes/ Tue, 15 Feb 2022 10:01:20 +0000 https://vetclinpathjournal.org/ontario-hospitals-face-severe-shortage-of-blood-collection-tubes/

Ontario hospitals are facing a critical shortage of collection tubes needed for routine blood tests, forcing some hospitals to order staff to hold on to supplies and reconsider the number of blood tests they order for patients. patients.

But even with conservation strategies in place, some clinicians and lab staff worry that prolonged shortages or a significant disruption in supplies could affect patient care.

They warn that shortages are adding another challenge to hospitals stretched by pandemic pressures, and say monitoring the supply of blood collection tubes will be even more important as hospitals reopen operating rooms to scheduled surgeries that had been interrupted during the Omicron wave.

“This is by no means a stable situation,” said Dr. Catherine Streutker, chief and medical director of laboratory medicine at Unity Health Toronto. “At the moment we are doing well. But we expect the situation to be difficult for a few months.

“These shortages affect the majority of blood tests done at the hospital, and if we are unable to do them, it risks adversely affecting patient care.”

Shortages of blood collection tubes — linked to global supply chain stressors — began affecting hospitals in late December and have intensified in recent weeks, Streutker said.

By the end of January, Unity — which includes St. Michael’s Hospital and St. Joseph’s Health Center — had just a few days’ supply of blood collection tubes left and needed to seek help from nearby hospitals. A memo sent to staff on Jan. 31 outlining the supply issues said the network “was in crisis,” Streutker said, noting the warning had triggered a 10% reduction in tube usage at the hospital. .

“I am concerned about the surge in surgeries; this will increase the use of these tubes, which means we’ll run out of them faster if we can’t supply ourselves. »

Dr. Fahad Razak, a general internist at St. Michael’s, called blood tests a “cornerstone of the delivery of medical care” essential to the diagnosis, assessment and treatment of most hospitalized patients.

“In my career, there has never been a time when routine blood work – the very heart of our testing – has been threatened,” he said. “Right now it is affecting hospitals across the sector. But the supplies used for blood tests are the same ones used by family doctors… And so it will affect medical care in general if we run out of supplies.

Shortage blood collection tubes are known as vacutainers. Sterile glass or plastic tubes with colored rubber stoppers are used for routine blood testing in hospitals and community laboratory centers.

In a statement to The Star, global medical technology company BD (Becton Dickinson and Co.), a supplier of blood tubes used by some Ontario hospitals, noted that the pandemic has tested supply chains and has said COVID has resulted in “an ever-changing demand for the types and volumes of testing needed.

To meet increased demand for blood tubes, the company has ramped up manufacturing capacity and produced “nearly half a billion more blood tubes in 2021 compared to 2020,” a spokesperson said, adding that BD “will produce more hits in the next 12 months than ever.” before.”

The spokesperson added that limited raw material availability, labor shortages, and shipping and transportation delays have limited the company’s ability to scale up production even further.

Lisa Merkley, director of laboratory services operations at Sunnybrook, said BD notified the hospital in late December that it anticipated supply issues with its blood tubes. And while the company has been doing its best to allocate supplies to hospitals, it hasn’t been enough to meet the hospital’s demands, she said.

This led Sunnybrook to adopt strategies to reduce the use of blood tubes, said Dr. Adina Weinerman, medical director of quality and patient safety and staff physician in general internal medicine.

“We’re working in a resource-constrained environment, and it’s different than what you’re used to, and we need you to know that the amount of blood tests ordered at all levels needs to decrease,” Weinerman said, describing the message. handed over to the doctors at the hospital.

Although Sunnybrook hasn’t instituted specific benchmarks for a reduction in blood work, Weinerman said the hospital is following the recommendations of Choosing Wisely Canada, an evidence-based health education campaign designed to reduce unnecessary tests, treatments and procedures. She said there is evidence to suggest that up to 60% of blood tests carried out for hospitalized patients are “medically unnecessary” and that some studies show that the amount of blood drawn from these patients can cause harm.

“The students are showing that we can safely reduce the amount of blood testing we do without causing adverse events,” she said.

On Feb. 10, Health Canada advised manufacturers and suppliers that they must report blood collection tube shortages so the agency can “confirm the actual or potential shortage status of this device,” a doorman said. -word. The notification was triggered by Health Canada’s mandatory reporting of medical device shortages, introduced in 2020 in response to increased demand for medical devices during the pandemic, the statement said.

Marilyn Spagnoli, director of laboratory medicine and diagnostic imaging at Michael Garron Hospital, said in a statement that hospitals across North America are facing vacutainer supply issues, in part due to of the increase in the number of COVID patients leading to an increased demand for laboratory medicine and blood collection service.

She noted that while this is “a concerning challenge”, the hospital “is not currently experiencing any disruption in patient care services due to this shortage”. Spagnoli added that the hospital has contingency plans and efforts to conserve tubing and supplies are supported by Choosing Wisely Canada recommendations.

Unity Health’s Streutker agrees that the public should be aware of these critical shortages and said family physicians should also be aware of the issue “and be careful about ordering them.”

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A smartphone app can vibrate a single drop of blood to determine its coagulation https://vetclinpathjournal.org/a-smartphone-app-can-vibrate-a-single-drop-of-blood-to-determine-its-coagulation/ Fri, 11 Feb 2022 22:19:53 +0000 https://vetclinpathjournal.org/a-smartphone-app-can-vibrate-a-single-drop-of-blood-to-determine-its-coagulation/ Blood clots form naturally to stop bleeding when a person is injured. But blood clots in patients with medical conditions, such as mechanical heart valves or other heart problems, can lead to stroke or heart attack. That’s why millions of Americans take blood thinners, like warfarin, which make it harder for blood to clot.

However, warfarin is not perfect and requires patients to be tested frequently to ensure their blood is in the correct range – blood that clots too easily can still lead to a stroke or heart attack while the blood that does not clot can lead to prolonged bleeding after an injury. To be tested, patients must either go to a clinical laboratory or use an expensive home testing system.

Researchers at the University of Washington have developed a new blood clotting test that uses just a single drop of blood and a vibration motor and smartphone camera. The system includes a plastic attachment that holds a small cup under the phone’s camera.

A person adds a drop of blood to the cup, which contains a small particle of copper and a chemical that triggers the blood clotting process. Then the phone’s vibration motor shakes the cup while the camera monitors the movement of the particle, which slows and then stops as the clot forms. The researchers showed that this method was within the accuracy range of standard instruments in the field.

The team published these results on February 11 in Nature Communication.

“Back then, doctors used to manually rock blood tubes back and forth to monitor how long it took for a clot to form. However, this requires a lot of blood, making it impossible its use at home,” said the senior. author Shyam Gollakota, UW professor at the Paul G. Allen School of Computer Science & Engineering. “The creative leap we’re making here is that we’re showing that by using the vibration motor on a smartphone, our algorithms can do the same thing, except with a single drop of blood. And we get similar accuracy to best available techniques. in trade.”

Doctors can classify blood clotting ability using two numbers:

  • the time it takes for the clot to form, called the “prothrombin time” or PT
  • a ratio calculated from the PT that makes it easier for doctors to compare results between different tests or laboratories, called the “international normalized ratio” or INR

“Most people who take this drug take it for life. But it’s not a set and forget thing – in the US most people are only in what we call the ‘desirable range’ PT/INR levels about 64% of the time,” said co-author Dr. Kelly Michaelsen, assistant professor of anesthesiology and pain medicine at the UW School of Medicine. “That number is even higher. low – only about 40% of the time – in countries like India or Uganda where testing is less frequent. How can we improve this? We need to make it easier for people to test more frequently and take ownership of their healthcare.”

Patients who can monitor their PT/INR levels at home would only need to see a clinician if the test suggested they were outside this desirable range, Michaelsen said.

The researchers wanted an inexpensive device that could work similarly to home blood glucose monitors for people with diabetes: a person can prick their finger and test a drop of blood.

“We started by vibrating a single drop of blood and trying to monitor the waves on the surface,” said lead author Justin Chan, a UW doctoral candidate at the Allen School. “But it was really difficult with such a small amount of blood.”

The team added a small copper particle because its movement was so much more reliable to track.

“As the blood clots, it forms a web that tightens. And in the process, the particle goes from bouncing happily to not moving,” Michaelsen said.

To calculate PT and INR, the phone collects two timestamps: the first when the user inserts the blood and the second when the particle stops moving.

“For the first time, we are looking for the moment when the user inserts a capillary tube containing the sample into the frame,” Chan said. “For the end of the measurement, we look directly inside the cup so that the only movement inside these frames is the copper particle. The particle suddenly stops moving because the blood coagulates very quickly, and you You can observe this difference between the frames. From there, we can calculate the PT, and that can be mapped to the INR.”

The researchers tested this method on three different types of blood samples. As a proof of concept, the team started with plasma, a component of blood that is transparent and therefore easier to test. The researchers tested plasma from 140 anonymized patients at the University of Washington Medical Center. The team also examined plasma from 79 patients with known blood clotting problems. For both of these conditions, the test gave similar results to commercially available tests.

To mimic what a patient at home would experience, the team then tested whole blood from 80 anonymized patients at Harborview and University of Washington Medical Centers. This test also gave results that were within the accuracy range of commercial tests.

This device is still at the proof of concept stage. Researchers have made the code public and are exploring commercialization opportunities along with further testing. For example, currently, all these tests have been carried out in the laboratory. The next step is to work with patients to test this system at home. The researchers also want to see how the system performs in regions and countries with more limited resources.

“Almost every smartphone of the last decade has a vibration motor and a camera. That means almost anyone who has a phone can use it. All you need is a simple plastic attachment, no hardware. ‘additional electronics of any kind,’ Gollakota said. “It’s the best of all worlds – it’s basically the holy grail of PT/INR testing. It makes them frugal and accessible to millions of people, even when resources are very limited.”

Additional co-authors of this article are Joanne Estergreen, clinical laboratory supervisor in the Department of Laboratory Medicine and Pathology at the UW School of Medicine, and Dr. Daniel Sabath, professor of Laboratory Medicine and Pathology at the U.W. School of Medicine. This research was funded by the Moore Foundation Fellowship.

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COLLEGE TAB: Local veterinary tech students are perfect, three years in a row | Lifestyles https://vetclinpathjournal.org/college-tab-local-veterinary-tech-students-are-perfect-three-years-in-a-row-lifestyles/ Thu, 10 Feb 2022 00:08:24 +0000 https://vetclinpathjournal.org/college-tab-local-veterinary-tech-students-are-perfect-three-years-in-a-row-lifestyles/

For the third year in a row, veterinary technology students at Kent State University at Trumbull have achieved the highest three-year average pass rate in Ohio on the National Veterinary Technician Examination (VTNE), administered by the American Association of Veterinary State Boards (AAVSB).

Kent State Trumbull’s 2021 Veterinary Technology graduates have taken the exam and all received 100%. The program, which is administered by Kent State University in Tuscarawas, now has a three-year average pass rate of 100%. The three-year national average score is approximately 70.5%. Kent State Trumbull now holds the prestigious honor of the highest three-year pass rate in Ohio.

“It’s an incredible achievement,” said Melissa Best, program director. “Although our cohorts are smaller, compared to other veterinary technology schools in Ohio, we provide an exceptional education for our students by offering more one-on-one instruction and smaller faculty-to-student ratios.”

According to Best, community partnerships and offsite clinical partners also play an important role in student success.

For more than five years, students have taken many of their classes at the Animal Welfare League of Trumbull County. A few years ago, Kent State opened a vet tech lab that looks like a mini vet clinic inside the shelter, offering radiology, lab, surgery, and pharmacy. Students also gain experience at several large offsite animal farms, exotic facilities, and a laboratory medicine research university.

“We have a great relationship with the Animal Welfare League and the veterinary professionals in the community,” Best said. “It gives our students the opportunity to work in the field and leave our program for a career.”

Kent State Trumbull’s program received initial accreditation in 2018 by the American Veterinary Medical Association’s Committee on Veterinary Technician Education and Activities (AVMA CVTEA).

Kent State Trumbull is now accepting applications for the Fall 2022 Veterinary Technology Program. For more information about the Kent State Trumbull Accredited Veterinary Technology Program, visit www.kent.edu/trumbull/veterinary-technology.

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AACC and Life Diagnostics Partner to Relaunch AACC Middle East https://vetclinpathjournal.org/aacc-and-life-diagnostics-partner-to-relaunch-aacc-middle-east/ Tue, 08 Feb 2022 19:15:00 +0000 https://vetclinpathjournal.org/aacc-and-life-diagnostics-partner-to-relaunch-aacc-middle-east/

News – WASHINGTON – AACC, a global scientific and medical professional organization dedicated to better health through laboratory medicine, is pleased to announce a new collaboration to host AACC Middle East: a partnership between AACC and Life Diagnostics. This event will bring together AACC’s world-renowned educational and scientific programs combined with a dynamic exhibition in Dubai, United Arab Emirates, on November 5-6, 2022.

AACC Middle East was first launched in 2018 as part of AACC’s strategy to improve global health outcomes, and it has garnered an overwhelmingly positive response during its lifetime. first period of 2 years. Like so many in-person events, it was then halted following the emergence of COVID-19. However, as the pandemic lingers and continues to challenge laboratory medicine professionals – the people on the front lines of coronavirus testing around the world – it has become more important than ever that the AACC Middle East resumes to provide lab professionals the educational programming and networking opportunities they need at this crucial time.

AACC looks forward to working closely with Life Diagnostics (Life Dx) – based in Abu Dhabi, UAE – to relaunch AACC Middle East for this purpose. The scientific program of the event will feature experts from the United States and the Middle East who will share reference and actionable information on the latest clinical tests. Attendees will be able to meet safely and in person with leaders in the field to share lessons learned from the pandemic to date. Additionally, the AACC Middle East exhibition floor will showcase the latest innovations in all areas of clinical testing, including coronavirus testing, artificial intelligence, mobile health, molecular diagnostics, mass, next-generation sequencing, point-of-care, and automation.

“We at AACC are thrilled to partner with Life Dx and other content experts from the Middle East to bring this essential conference back to the region,” said AACC President Dr. Stephen R. Master. . “Over the past two years, laboratory medicine professionals around the world have heroically met the challenges we have faced during the pandemic, and I hope this meeting will fuel participant innovation and create new collaborations. of research and connections with colleagues who understand what everyone in the field has been through in recent months.

About AACC Middle East

AACC Middle East offers 2 days packed with opportunities to connect with world leaders in infectious diseases, clinical chemistry, molecular diagnostics, mass spectrometry, translational medicine, laboratory management and others fields of advanced science in laboratory medicine. The meeting will take place from November 5-6, 2022 in Dubai, United Arab Emirates.

About the AACC

Dedicated to improving health through laboratory medicine, AACC brings together more than 50,000 clinical laboratory professionals, physicians, researchers and business leaders from around the world focused on clinical chemistry, molecular diagnostics, mass spectrometry, translational medicine, laboratory management and other areas of laboratory science is progressing. Since 1948, the AACC has worked to advance common interests in the field, providing programs that advance scientific collaboration, knowledge, expertise, and innovation. For more information, visit www.aacc.org.

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A new model to study fibrosis treatments without using animals https://vetclinpathjournal.org/a-new-model-to-study-fibrosis-treatments-without-using-animals/ Tue, 01 Feb 2022 20:51:28 +0000 https://vetclinpathjournal.org/a-new-model-to-study-fibrosis-treatments-without-using-animals/ To find treatments for connective tissue disorders like fibrosis, scientists need models that can replicate the structure and function of human tissue when healthy or unhealthy, and respond to drugs as human tissue would. sick. But most models are animal-based and have significant limitations.

A new lab test model developed by researchers at Brown University uses human cells and replicates not only the structure of human tissue, but also its mechanics.

The researchers describe the model in a Advanced sciences study published on Tuesday, February 1.

“This model gives researchers a new tool to not only explore the mechanisms underlying fibrosis and inherited extracellular matrix diseases, but also to test potential treatments for them,” said lead author Jeff Morgan, professor of pathology and laboratory medicine at Brown University, and of engineering.

This development is crucial, Morgan added, because there is no cure for fibrosis and extracellular matrix disorders like Ehlers-Danlos syndrome and Marfan syndrome need new treatments.

Frame the problem

Key to the functionality of the new model is that it does not include an external artificial ‘scaffolding’ for the cells; it uses a novel approach in which cells are harnessed to make their own natural extracellular matrix.

Most tissue engineering approaches rely on the use of protein or polymer scaffolds, explained study co-author Ben Wilks, who earned a Ph.D. in biomedical engineering at Brown and is now a research fellow at Harvard Medical School and Massachusetts General Hospital. Conventional methods involve culturing cells on plastic, while newer approaches embed cells in a collagen hydrogel to mimic the extracellular matrix. This new approach goes much further: it allows cells to synthesize and assemble their own human extracellular matrix.

Over the past few decades, there has been a shift in the scientific understanding of the tissue extracellular matrix. Not only does the matrix provide structural support, but it also communicates with cells through the transmission of mechanical and biochemical signals. This dynamic, bidirectional communication between matrix and cells plays a crucial role in maintaining cellular homeostasis and tissue function, Wilks said.

“We are interested in how changes in nutrients, growth factors, or drug treatments affect cell synthesis and extracellular matrix remodeling and the resulting mechanical properties of tissue constructs,” Wilks said. “Therefore, a scaffold-free approach is much better suited to investigating the questions we ask.”

Researchers in Morgan’s lab at Brown have been studying scaffold-free tissue engineering for more than 15 years. The lab is focused on developing tools that allow scientists to leverage the intrinsic properties of cells to assemble 3D tissues and synthesize their own extracellular matrix, Morgan explained. The lab has developed technology that allows researchers to control the 3D shape of artificial tissue constructs, forming spheres, rings or more complex geometries, by exploiting a phenomenon they call cellular self-assembly.

However, cellular self-assembly seemed to work differently with fibroblasts, a highly contractile cell found throughout the body that plays an important role in wound healing, extracellular matrix synthesis and breakdown, and tissue homeostasis.

The tissue stiffness characteristic of progressive fibrosis, for example, is due to the abnormal behavior of fibroblasts that accumulate and alter the extracellular matrix in a way that ultimately results in loss of organ function.

When the researchers applied technology from the lab to fibroblasts, the tissue constructs broke down spontaneously.

As a Ph.D. A student in Morgan’s lab, Wilks found that altering the composition of the nutrients the cells were grown in would help stabilize the formation of the tissue constructs for days, weeks, or even months.

Additionally, Wilks recognized that by adjusting additional parameters such as mold geometry and cell count, he could form stable 3D ring-shaped tissue constructs, or patterns, that facilitated the tension that a caused the fibroblasts to orient and synthesize their own extracellular matrix. .

“That’s when I really got excited: when I saw how the fibroblasts were aligning and synthesizing this beautiful collagen-rich 3D extracellular matrix in a periodic wave pattern that looks like this you see in native connective tissues like ligaments and tendons,” says Wilks. noted. “I had never seen this before in an engineered fabric construction.”

A showdown

Wilks wondered if it was possible to quantify the stiffness and strength of tissue constructs to allow researchers to replicate normal tissue as well as tissue affected by disease.

Using a tensile testing machine called Instron, the team measured the force needed to stretch the fabric until it broke. This type of data can be used to assess mechanical properties such as tissue strength and stiffness, which can then be related to tissues in the human body. It can also be used to measure how adding a drug would change tissue strength and stiffness.

For example, Wilks said, the data can be used to test whether an anti-fibrotic drug candidate stops the stiffening of tissues that is characteristic of fibrotic diseases.

“In this paper, we develop a 3D connective tissue model that allows us to directly quantify how exposing cells in a 3D environment to different nutrients, growth factors, or drug treatments leads to changes in extracellular matrix synthesis and tissue mechanics, which is an important functional measure of tissue and used clinically to monitor disease progression,” Wilks said. “While there is still a lot of work being done, we believe this model shows promise for screening potential anti-fibrotic drugs. This would address a major unmet need as there is currently no treatment available that can completely stop or reverse fibrosis.”

The new model is one of the most advanced constructs for representing the architecture, composition and 3D mechanics of native connective tissues like ligaments and tendons, the researchers said. Animal models are expensive, ethically controversial and not always predictive of human pathophysiology, said Morgan, who directs the Brown University Center for Alternatives to Animals in Testing.

He added that this type of research is a valuable springboard for creating sophisticated models that can replace and surpass the use of animals.

Video: https://youtu.be/IeZwwAkWk-8

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