16 January 2025 (Thursday) - BTLP-TACT Exercise

Well… I decided to have a go at the BTLP-TACT as I had a few minutes. It presented me with one case – a sixty year old chap in out patients with a DVT.

 

The blood group was positive in every well and was therefore uninterpretable. A job for NHSBT I think.

The antibody screen was positive in wells 1 and 3 so I performed antibody panels. The enzyme panel was negative in every cell, and the IAT panel was positive in cells 1, 3, 4, 6, 8 and 10 corresponding with anti-s but didn’t exclude anti-Kp(a)

 

I got the thumbs-up.

15 January 2025 (Wednesday) - Mobile Phones

The nice people at Lablogatory sent out their update today. This one was posed an interesting dilemma… Interesting in that is it actually a dilemma. The chap writing the article said “one thing I’d like to solve is the issue we see in the lab regarding the use of cell phones and other personal electronic devices. What options do we have as lab leaders?…”

 

Back in the day when I was a manager I was under strict orders that they were utterly and completely banned without question. The chap who gave me that order was always walking round fiddling on his mobile.

I found myself reflecting on the attitudes to mobile devices I’ve seen from managers over the years. Many are relaxed about them. Some would rather people didn’t have them in their pockets but see them as a necessary evil and a way of keeping people sweet. And others would quite happily let staff stand round idly chatting for up to half an hour but would go hysterical at the sight of a mobile phone.

 

The fellow writing the article then went on to say “you catch more flies with honey than with vinegar”. That was always my attitude, but I’m not a manager any more.

Personally I have my phone in my pocket all the time. If I get a message, my watch shows me a synopsis. Sometimes I need to deal with the message right away; other times not. Most people seem to do this these days. I don’t see this as an issue.

Am I wrong?

14 January 2025 (Tuesday) - Westgard QC Update

The nice people at Westgard QC sent out their update today. You can read it by clicking here.  

All rather dry and heavy going, but all useful stuff and in all honesty far more relevant to measuring things than much of the CPD that comes through these days…

13 January 2025 (Monday) - BTLP-TACT Exercise

Having found a mistake in the BTLP-TACT software I was loath to try again…

It presented me with one case – a ninety-seven year-old chap with liver disease who was bleeding.

He grouped as O Rh(D) Positive with a negative antibody screen

 

They’d asked for FFP. According to https://pmc.ncbi.nlm.nih.gov/articles/PMC8362012/ this is contraindicated. But the last time I didn’t issue, I got the thumbs down. So I issued. 

I was right to do so.

 

12 January 2025 (Sunday) - Slide Saturday Challenge

The American Society of Hematology had their Slide Saturday Challenge yesterday…

”Analyze this peripheral blood smear from the #ASHImageBank and identify the structures that the arrows are pointing to. How are these structures formed and what disorders could they be indicative of?

Share your insights in the comments!”

 

For once everyone had the answer right – acanthocytes. So often pictures like this on Facebook have as many disparate answers as there are people to give them.

 

The expert opinion said “The peripheral blood smear shows red blood cells with arrows pointing to acanthocytes (also called spur cells) which are spiculated cells with irregular, pointed or clublike projections that are unevenly distributed on the cell surface. Central pallor is absent.

Acanthocytes form as a result of membrane lipid abnormalities, and can be seen in liver disease, neuroacanthocytosis, severe malnutrition, and abetalipoproteinemia.

Did you guess correctly?”

 

Personally I’d have liked a comparison with burr cells; to me a burr cell has projections more regularly all the way round the cell. I would have liked to have seen if expert opinion agreed with me.

9 January 2025 (Thursday) - BTLP-TACT

Time for another BTLP-TACT exercise… I was presented with one case – a seventy-seven year-old woman requiring group and save.

 

The control was positive and in the past that has invalidated the entire group.

The antibody screen was positive in all three cells so I performed antibody panels.

The IAT panel was positive in all cells but 4 and 8 which could possibly have been a combination of D, E, Cw, S, Lu(a), K, Fy(a). However the enzyme screen was negative, so in BTLP-TACT world this would be a combination of anti-S and anti-Fy(a).

 

I got it wrong…

The combination of anti-S and anti-Fy(a) was correct but in BTLP-TACT world apparently anti-K might have been there too. I’m sure that in the past anti-K has had to work by enzyme in their exercises.

I shall add that to their list of foibiles…

 

But apparently anti-Jk(a) could not be excluded even though panel cell four had a negative reaction despite being Jk(a) positive.

In layman’s terms, that’s bollox.

6 January 2025 (Monday) - Fritsma Factor Update

The Fritsma Factor newsletter appeared in my inbox today. As always it is a rather useful update on all matters haemostatic…