28 January 2016 (Thursday) - Haematuria

An interesting article -  the American College of Physicians have released new clinical guidelines on Hematuria

http://www.medscape.com/viewarticle/857888

For me the most telling point is that the lab’s role in diagnosis is limited to dipsticks. I suppose one gets so insular and blinkered that one comes to think that medicine can’t cope without high-tech huge analysers…..

21 January 2016 (Thursday) - IBMS Newsletter

The IBMS e-newsleter arrived today.

https://www.ibms.org/go/nm/issues,55

 I’m usually rather negative about these. And at the risk of appearing cynical today’s  didn’t grip me. More and more the IBMS newsletters are about the “I” part of “IBMS” and less about the “BMS”, which is a shame…

11 January 2016 (Monday) - Tripanosomiasis

http://www.bloodjournal.org/content/127/1/167

Here’s an interesting article: A 49-year-old woman presented immediately on return from a 2-week visit to Tanzania with

·  Malaise

·  Fatigue

·  Arthralgia

·  high fever (39°C).

Physical examination revealed signs of an arthropod bite on the neck.  

Hepatosplenomegaly and lymphadenopathy were absent. Blood analysis showed

·  leukopenia (2.3 × 109/L)

·  thrombocytopenia (55 × 109/L)

·  low prothrombin index expressed as a percentage (66%)

·  increased lactate dehydrogenase (622 IU/L; normal, 250-450 IU/L), aspartate aminotransferase: 159 IU/L; normal, 5-40 IU/L

·  alanine aminotransferase: 207 IU/L; normal, 5-40 IU/L.

·  Cerebrospinal analysis and an abdominal computed tomography scan were normal.

The peripheral blood film was diagnostic for trypanosome infection, showing the presence of extracellular flagellated parasites

  

I found this particularly relevant as I’d missed these in a recent NEQAS survey…

9 January 2016 (Saturday) - Free e-book

This morning’s haul of emails brought in a freebie at http://site.iugaza.edu.ps/akhudair/files/Atlas-of-Clinical-Hematology-6th-Edition.pdf

 Atlas of Clinical Hematology - Free eBook

From the reviews of the sixth edition: "With over 1000 illustrations the 6th revised edition covers the whole spectrum of haematology. The quality of the illustrations and the clarity of the accompanying texts make the Atlas a valuable companion to the haematology and oncology professions."

This atlas has integrated the 2001 WHO classification and made use of figures and descriptions to document recently described types of leukemia and lymphoma. The latter include leukemias of dendritic cells, rare lymphomas and persistent polyclonal B lymphocytosis, which takes a special place in the classification.

It covers all the microscopic methods in haematology that form the basis of diagnosis as well as the results of modern immunologic, cytogenetic and molecular-genetic investigation. Special emphasis is placed on the cytogenetic and molecular-genetic characterization of biological entities that might form the basis for innovative therapies.

Normal results and pathological findings are compared, and the various findings made during therapy are depicted.

All in all the Atlas of Clinical Hematology represents a complete and helpful reference work which should be present in every hematologic and oncologic department as well as in clinical laboratories for online diagnostics and scientific research… or so it claims.

Well, something for nothing can’t be bad…

!

8 January 2016 (Friday) - Leukaemia and Sunlight

http://health.ucsd.edu/news/releases/Pages/2016-01-06-leukemia-rates-higher-further-away-from-equator.aspx

Here’s some food for thought. Epidemiologists at University of California, San Diego School of Medicine report that persons residing at higher latitudes, with lower sunlight/ultraviolet B (UVB) exposure and greater prevalence of vitamin D deficiency, are at least two times at greater risk of developing leukemia than equatorial populations.

The UC San Diego study analyzed age-adjusted incidence rates of leukemia in 172 countries from GLOBOCAN, an international agency for research on cancer that is part of the World Health Organization, comparing that information with cloud cover data from the International Satellite Cloud Climatology Project. The study follows similar investigations of other cancers, including breast, colon, pancreas, bladder and multiple myeloma. In each study, they found that reduced UVB radiation exposure and lower vitamin D levels were associated with higher risks of cancer.

Leukemia rates were highest in countries relatively closer to the poles, such as Australia, New Zealand, Chile, Ireland, Canada and the United States. They were lowest in countries closer to the equator, such as Bolivia, Samoa, Madagascar and Nigeria.

How about that !!

7 January 2016 (Thursday) - BBTS Newsletter

http://britishbloodtransfusionsociety.org.uk/AHU-3Y3KP-68IPX6YGC7/cr.aspx

The BBTS e-newsletter came today. At the risk of appearing cynical it seemed to say a lot without saying much at all. It started off with a review of what had happened in the BBTS in 2016. It went on to talk about plans for 2016, but in the vaguest terms, and ended with talk about a bursary for junior staff to go to the BBTS annual conference for free.

I would like to have seen a bit more detail in this newsletter,,,

3 January 2016 (Sunday) - Sunday Blood Cell Challenge

http://clinical-laboratory.blogspot.co.uk/2016/01/sunday-blood-cell-challenge.html

“Case:  36 years old male from Turkey, Alanya have been in fever for two weeks. He has headache and nausea as well. CRP is slightly elevated and basic blood count parameters are within the reference limits. Peripheral blood smear was taken and the findings are in the image below.

What are the findings and what is your suggestion for diagnosis?”

The eye is immediately taken to the two white cells. At first sight they look to be a normal neutrophil and a normal eosinophil. Hoever closer scrutiny reveals malarial parasites; looks like P falciparum to me…