Catlab Reports Bulletin
The Catlab Reports Bulletin is published monthly. Until the publication of the Catlab website, it was mailed electronically to our clients. It consists of a monograph related with laboratory topics. Each month it addresses a different area of Catlab; the topics can be more specific (concrete diagnostic techniques) or deal with more generic aspects (Quality, Management, …).
Biochemistry - CKD-EPI
Chronic kidney disease (CKD) is generally defined as a set of heterogeneous diseases that affect renal structure and function. Since 2002, it published a set of guidelines on the evaluation, classification, and stratification of the ERC. Staging classification for risk, they have used different calculations and equations. The currently recommended by the new guidelines is the equation CKD-EPI creatinine.
HEMATOLOGY - Haemoglobinopathies studies
Review of the various alterations of hemoglobin and the different methods used to detect them in Catlab. Structural haemoglobinopathies are classified by the disturbance affecting the solubility, stability, affinity for oxygen or maintenance of the reduced iron. The thalassemias are classified according to the globin chain stops synthesized, and we also have the thalassemic haemoglobinopathies, which are mutations in the globin genes that cause structural problems.
IMMUNOLOGY - Fecal calprotectin as a marker of inflammatory bowel disease
The clinical suspicion of organic bowel disease motivates a diagnostic colonoscopy that generates a high rate of false positives, because the markers are not very specific. Next january, in Catlab, we will do Fecal Calprotectin (FCP), a protein found in the cytoplasm of neutrophils and in the membrane of activated monocytes and macrophages. The FCP is reliable in discriminating patients likely to suffer inflammatory bowel disease, and to detect endoscopic inflammatory activity. It is also useful to monitor response to treatment and predict the risk of recurrence.
MOLECULAR BIOLOGY - Massive sequencing for antiretroviral resistance HIV-1
From February 2016, the massive sequencing will be used for the test of resistance to HIV-1 antiretroviral in Catlab. This method has several advantages; the resistances of the three regions (Pro, RT, INT) are determined in one integrated test; it automatically determines the subtype of HIV-1, and finally, the new test allows the detection of mutations in viral quasispecies that only represent 1% of the viral population, compared to 20% of the current test.
MICROBIOLOGY- Diagnosis of Sexually Transmitted Infections
Sexually transmitted infections (STI) are a public health problem that affects a significant number of the population. It is essential to do a reliable and early diagnosis to avoid infection, its spread and possible complications.
MICROBIOLOGY - Pick-up samples for the study of skin infections and soft tissue
This group of infections is broad and complex. Ranging from skin infections, skin appendages, subcutaneous tissue, fascia and skeletal muscle. They are very common infections of varying severity and can evolve acutely or chronically.
The collection of good quality samples for microbiological analysis, is critical in this process which will determine the microbiological diagnosis.
CYTOGENETICS - Genetic markers in the myeloproliferative syndromes classification
Myeloproliferative neoplasms (NMP) are clonal disorders of hematopoietic precursor cells, characterized by the proliferation of myeloid or more lines. Classically, the NMP were subdivided according to whether the Philadelphia chromosome (BCR / ABL1), confirming a chronic myeloid leukemia (CML), or if the patient was BCR / ABL1 negative, was detected using clinical criteria. Currently, the study of mutational status of JAK2, MPL and CALR genes, plays an important role in the classification of different subtypes of NMP.
HORMONES - Cortisol in serum. New reference ranges.
The determination of cortisol in blood is used for diagnosis and treatment of functional disorders of the adrenal gland, like Cushing's syndrome and Addison's disease. In order to improve the quality of the results obtained in our laboratory, we will proceed to replace the current reagent by a new reagent in which have been changed polyclonal antibodies by monoclonal antibodies. The new reference ranges and the date from which they are applicable shall be indicated in the reports.
IMMUNOLOGY - Anti-nuclear antibodies (ANA). A step towards standardization
Anti-nuclear antibodies (ANA) are present in the serum of patients with autoimmune diseases. In Catlab the ANA is performed with the technique of indirect immunofluorescence (IFI). The main disadvantage of the IFI, is the difficult to standardize methodology and the high degree of subjectivity. Catlab has incorporated the GSIGHT®, an analyzer that enables automated reading of the ANA. It increases sensitivity and objectivity of the technique.
URGENT CARE - Management of critical values in the Emergency Laboratories
Standard UNE-EN ISO 15189:2007 indicates clearly that the laboratory must have procedures to notify a doctor or responsible for the medical care of the patient immediately when the results of the corresponding analysis are at critical intervals.