Laboratory medicine

Laboratory medicine

Thursday, May 12, 2016

CLINITEK Atlas Automated Urine Chemistry Analyzer : Benefits

CLINITEK Atlas Automated Urine Chemistry Analyzer (Rack):

The CLINITEK Atlas® Automated Urine Chemistry Analyzer (with rack) is a fully automated, benchtop instrument designed for high-volume urine testing, using Siemens' proven technology in dry-pad urine chemistry analysis.

  • Unique, continuous reagent roll for simplified loading and reduced interruptions
  • Modular design for compatibility with laboratory automation systems
  • Built-in liquid level sensing for simplified sample preparation

True Calibration of All Analytes Provides Confidence in Results
Liquid ready-to use calibration material ensures accuracy
Minimizes lot variability

Easy to Learn and Operate
Menu driven
Simple keypad operation

Built-in Liquid Level Sensing Simplifies Sample Preparation
Adjusts automatically to sample volume
Pour any volume ≥ 2 mL without need for special steps or tubes
Reduces time to prepare samples for testing

Adaptable to Laboratory Automation Systems
Modular design facilitates track readiness

The Rack Sample Handler Offers
Flexibility to accommodate a wide range of testing volumes. Load up to 200 samples at once
Maximum productivity and fewer interruptions, with walkaway time of up to 53 minutes
Easy transfer of sediment analyzer with racks that are compatible with the Sysmex UF-100™ Automated Urine Cell Analyzer

Fig. CLINITEK Atlas Automated Urine Chemistry Analyzer
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Blood gas analyzer: RapidLab 1200 systems- Features and benefits

Overview of RAPIDLab 1200 systems :
Designed to maximize turnaround time, RAPIDLab®1200 Systems have the capacity to enhance blood gas testing efficiency in the clinical laboratory by combining testing speed and reliability with low maintenance. RAPIDLab 1200 systems are our proven solution for high-volume critical care testing sites.

Leverage the benefits of RAPIDLab 1200 Systems:
  • Comprehensive test menu addresses a variety of critical care testing needs
  • Intuitive operation and minimal maintenance help increase productivity without increasing staff.
  • Industry-proven accuracy and reliability through long-life Ready Sensor® electrode technology
  • Biosafe automatic sampling system with clot detection and clearance
  • Effortless onboard Automatic Quality Control (AQC) for enhanced quality assurance and regulatory compliance
Features and benefits:

Designed to meet the challenges of the busy clinical lab or various hospital settings, RAPIDLab® 1200 Systems address all your critical care testing needs:

  • Extensive test menu includes full CO-oximetry and neonatal total bilirubin
  • Ready Sensor® electrode technology for industry-proven reliability
  • Cost-effective, cartridge-based system
  • Simplified operation with biosafe sampling
  • Automatic quality control and documentation
  • Seamless integration with your LIS/HIS
  • Dedicated technical support and on-site service

Fig. RAPIDLab 1200 system
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Tuesday, May 10, 2016

A day in the life of Staphylococcus aureus: winning essays from Nepal

Nepal’s World Antibiotic Awareness Week essay competition

“When we were assigned the theme of ‘a world without antibiotics’ for the essay competition, the first thing I thought was that a world without antibiotics would be sad and gloomy,” Pranjal Rokaya, fourth year medical student at the Patan Academy of Health Sciences, told CDDEP analyst Molly Miller-Petrie. “But I didn’t want to write a sad story—I wanted to write something happy and satirical, while still getting a strong message across. So I decided to be a happy Staphylococcus bacteria who is overjoyed by the results of irresponsible antibiotic use.”  The diary of his happy Staph took home the first place award at Patan. 

Read the full story below:

"A Staph’s Diary"By Pranjal Rokaya
First place, Patan Academy of Health Sciences
Good morning, my name is S. aureus. Full name: Staphylococcus aureus. I am a bacterium that is currently living on your skin, in your nose, in your genitalia, in your mouth and even in the heart of some of you. You might hate me and call me ugly names like “germ” and “bug,” but remember that I still love you. You provide me with food, shelter, a place to regenerate myself, and even a place to excrete my waste products. I would not be in this world if you were not here. I love you, human beings.
There are 7 billion humans and you see them everywhere. For every human being, there are billions of us bacteria. But you can't see us - at least not with your naked eye. You humans are very arrogant. You think you control this world with your science and technology. But do you really think you're the master? You have only been in this world for about 5,000 years. That's just a blip in the radar of the timeline of the universe. But we have survived harsh ice ages and volcanic meteors. We saw the dinosaurs’ rise and fall. We saw oceans fade and mountains rise. You know who will survive if there is a nuclear holocaust? That's right, us. Don’t hate us just because you ain’t us.
We are not bad beings. Mostly we like to live peacefully in your body. We just take some nutrients from your body to survive. We have a family or colony to feed just like you do. Sometimes you can't produce enough of those bad guys called immune cells. In such cases, we like to migrate deeper into your body because there is more food available inside than in your skin or nose. After we finish our feeding frenzy, we secrete waste into your body, which sadly makes you very hot. When you get a fever, it's difficult for us to survive because we have limited tolerance for high temperatures. You even try to throw us out of your body with repeated coughing, urination and diarrhea. But usually we win and enjoy your body until you die. Everything was going fine, until this poison, this crazy evil thing called antibiotics, came along.
Ah! Let's talk about antibiotics. One day, my friend had a wonderful opportunity to go into the blood of a soldier who had a gunshot wound. She was enjoying all the proteins (yummy) when suddenly this penicillin came and started destroying her cell wall. Needless to say, she did not survive as we only have one cell. As if penicillin wasn't enough, you humans started producing more villains like cephalosporins, aminoglycosides and fluoroquinolones. For more than 50 years, we suffered serious calamities at the hands of antibiotics. Initially, they would just destroy our cell wall. Later, they started tearing our DNA apart, destroying our protein and shredding our nucleus. You almost defeated us. But then you humans grew more arrogant and less thoughtful.
In your vicious killing spree, you forgot that we can fight back. You started using antibiotics even when we were not really harming you. You forgot that you have your own immune cells to fight us and started bombarding us with same medicine again and again. When tiny viruses tickled your nose and made you sneeze, you used penicillin to fight them. Haha! Are you kidding me? Those tiny viruses don't even have a cell wall. Because of your injudicious use, we found out how your drugs work. We started producing B-lactamase. We developed mechanisms to throw your drugs out of our cells. We even found ways to inactivate those poisons. Slowly, we are becoming resistant and we love it.
Today, most of your antibiotics still work. But we are slowly catching up. There will be a day when none of your poisons will harm us. None will destroy our colonies. Imagine a world without antibiotics. That will be the day we will cry in joy, "Free at last!”
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Monday, May 9, 2016

Thyroid stimulation hormone (TSH) test: indication and interpretation

When to order this TSH test ?

The thyroid-stimulating hormone (TSH) test is often the test of choice for evaluating thyroid function and/or symptoms of a thyroid disorder, including hyperthyroidism or hypothyroidism.
TSH is produced by the pituitary gland, a tiny organ located below the brain and behind the sinus cavities. It is part of the body's feedback system to maintain stable amounts of the thyroid hormones thyroxine (T4) and triiodothyronine (T3) in the blood and to help control the rate at which the body uses energy.
A TSH test is frequently ordered along with or preceding a free T4 test. Other thyroid tests that may be ordered include a free T3 test and thyroid antibodies (if autoimmune-related thyroid disease is suspected). Sometimes TSH, free T4 and free T3 are ordered together as a thyroid panel.

What does the test result mean?

A high TSH result may mean that:
  • The person tested has an underactive thyroid gland that is not responding adequately to the stimulation of TSH due to some type of acute or chronic thyroid dysfunction
  • A person with hypothyroidism or who has had their thyroid gland removed is receiving too little thyroid hormone replacement medication and the dose may need to be adjusted
  • A person with hyperthyroidism is receiving too much anti-thyroid medication and the dose needs adjusting
  • There is a problem with the pituitary gland, such as a tumor producing unregulated levels of TSH
A low TSH result may indicate:
  • An overactive thyroid gland (hyperthyroidism)
  • Excessive amounts of thyroid hormone medication in those who are being treated for an underactive (or removed) thyroid gland
  • Insufficient anti-thyroid medication in a person being treated for hyperthyroidism; however, it may take a while for TSH production to resume after successful anti-thyroid treatment. This is why the American Thyroid Association recommends monitoring this treatment with tests for thyroid hormones (T4 and T3) as well as TSH levels.
  • Damage to the pituitary gland that prevents it from producing adequate amounts of TSH
Whether high or low, an abnormal TSH indicates an excess or deficiency in the amount of thyroid hormone available to the body, but it does not indicate the reason why. An abnormal TSH test result is usually followed by additional testing to investigate the cause of the increase or decrease.
The following table summarizes some examples of typical test results and their potential meaning.
HighNormalNormalMild (subclinical) hypothyroidism
HighLowLow or normalHypothyroidism
LowNormalNormalMild (subclinical) hyperthyroidism
LowHigh or normalHigh or normalHyperthyroidism
LowLow or normalLow or normalNon-thyroidal illness; pituitary (secondary) hypothyroidism
NormalHighHighThyroid hormone resistance syndrome (a mutation in the thyroid hormone receptor decreases thyroid hormone function)
Thyroid gland
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free T4 (FT4) test : indication and interpretation

When to order free T4 test ?

Free thyroxine (free T4) tests are used to help evaluate thyroid function and diagnose thyroid diseases, including hyperthyroidism and hypothyroidism, usually after discovering that the thyroid stimulating hormone (TSH) level is abnormal.
T4 and another hormone called triiodothyronine (T3) are produced by the thyroid gland. They help control the rate at which the body uses energy and are regulated by a feedback system. TSH stimulates the production and release of T4 (primarily) and T3 from the thyroid gland.
Most of the T4 and T3 circulates in the blood bound to protein, while a small percentage is free (not bound). Blood tests can measure total T4, free T4, total T3, or free T3. The total T4 test has been used for many years, but it can be affected by the amount of protein available in the blood to bind to the hormone. Free T4 is not affected by protein levels and is the active form of thyroxine. The free T4 test is thought by many to be a more accurate reflection of thyroid hormone function and, in most cases, its use has replaced that of the total T4 test.

What does the test result mean?

In general, high free T4 results may indicate an overactive thyroid gland (hyperthyroidism), and low free T4 results may indicate an underactive thyroid gland (hypothyroidism). The test results alone are not diagnostic but will prompt the health practitioner to perform additional testing to investigate the cause of the excess or deficiency.
Both decreased and increased free T4 results are associated with a variety of temporary and chronic thyroid conditions. Low free T4 results in conjunction with a low TSH level or high free T4 results along with a high TSH may indicate a pituitary gland condition.
HighNormalNormalMild (subclinical) hypothyroidism
HighLowLow or normalHypothyroidism
LowNormalNormalMild (subclinical) hyperthyroidism
LowHigh or normalHigh or normalHyperthyroidism
LowLow or normalLow or normalNon-thyroidal illness; rare pituitary (secondary) hypothyroidism
NormalHighHighThyroid hormone resistance syndrome (a mutation in the thyroid hormone receptor decreases thyroid hormone function)
  A woman does a thyroid neck check in the mirror.
          Picture credit:

free T3 test (FT3): indication and interpretation

When to order free T3 test ?

A free T3 or total T3 test may be ordered when someone has an abnormal TSH test result. It may be ordered as part of the investigative workup when a person has symptoms suggesting hyperthyroidism, especially if the free T4 level is not elevated.

Signs and symptoms may include:

  • Increased heart rate
  • Anxiety
  • Weight loss
  • Difficulty sleeping
  • Tremors in the hands
  • Weakness
  • Diarrhea (sometimes)
  • Light sensitivity, visual disturbances
  • The eyes may be affected: puffiness around the eyes, dryness, irritation, and, in some cases, bulging of the eyes.
Free or total T3 may sometimes be ordered at intervals to monitor a known thyroid condition and to help monitor the effectiveness of treatment for hyperthyroidism.

What does the test result mean?

Increased or decreased thyroid hormone results indicate that there is an imbalance between the body's requirements and supply, but they do not tell the health practitioner specifically what is causing the excess or deficiency.
The following table summarizes some examples of typical test results and their potential meaning.
HighNormalNormalMild (subclinical) hypothyroidism
HighLowLow or normalHypothyroidism
LowNormalNormalMild (subclinical) hyperthyroidism
LowHigh or normalHigh or normalHyperthyroidism
LowLow or normalLow or normalNon-thyroidal illness; rare pituitary (secondary) hypothyroidism
NormalHighHighThyroid hormone resistance syndrome (a mutation in the thyroid hormone receptor decreases thyroid hormone function)
If someone is being treated with anti-thyroid medication for hyperthyroidism and the free or total T3 (or more frequently, the free T4 or TSH) is normal, then it is likely that the medication is effective in treating the condition. If the free or total T3 or free T4 is elevated, then the medication is not effective in treating the condition and the person may be experiencing symptoms associated with hyperthyroidism.
Picture credit: Fashion Magazine 

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