10 December 2016 (Saturday) - Pipetting

 

Here’s something useful. At first sight it might seem to be teaching your granny to suck eggs, but it is very easy to get into bad ways. Going back to basics with pipettes is never a bad thing..

9 December 2016 (Friday) - Discussion Forum

One of the Facebook groups I follow was advertising a link to the MHRA’s website this morning. They’ve set up a discussion forum “as a tool to help those involved in blood component collection, processing, testing and distribution to comply with the EU Blood Directives, UK Statutory Instruments and good practice requirements. It provides the ideal opportunity for extended communication between peers and allows users to put forward their comments and get “real-life” examples of ways in which they can manage robust quality procedures that ensure compliance and which dovetail with their own business needs and resources”

Having signed up and had a look I was immediately put off by someone posting under the name of “Transfusion Guru”.

It hasd been my experience that informative websites are useful, but discussion forums are (usually) little more than on-line arguments. Hopefully this website might be a useful resource but my hopes aren’t high.

Mind you I shall give it a chance before dismissing it out of hand…

8 December 2016 (Thursday) - LabQuality

This morning’s haul of emails had something which at first sight seemed to be a plug for a commercial site, but on further reading gave food for thought.

LabQuality is an EQA provider, and the article posted gave an impartial view of what they do.

Were I still in a position to do so I might well consider taking some of their products…

7 December 2016 (Wednesday) - Beam Me Up, Spotty

As a child I used to visit my mother on a Monday evening. Not so much out of a sense of filial duty as for the fact that she had the only colour telly in the family, and Monday night was “Star Trek” night.

I was fascinated how Doctor McCoy could wave a tricorder about and diagnose all sorts of diseases and conditions. Over the years I went on to get Star Trek tattoos, founded a Star Trek fan club and I’ve come to consider my role in healthcare to be akin to Dr McCoy’s tricorder.

There is now a competition to actually make a tricorder. The winning team will “develop a Tricorder device that will accurately diagnose 13 health conditions (12 diseases and the absence of conditions) and capture five real-time health vital signs, independent of a health care worker or facility, and in a way that provides a compelling consumer experience.”

On the one hand part of me is impressed. My mobile phone is effectively Captain Kirk’s communicator. But tricorders…. The bit that worries me is the “independent of a health care worker or facility” bit. Will I finally be superceded by a tricorder?

I doubt it, but will follow progress with interest

6 December 2016 (Tuesday) - Art ?

I read an interesting article in one of the Facebook science groups I follow this morning. You can read it by clicking here

Basically Science Gallery London in conjunction with Science Gallery Melbourne have opened calls for submissions for a new international art exhibition called ‘BLOOD’.  Themes for installations include blood-borne medical conditions, genetics, blood testing and blood doping for sport. They’re interested in proposals addressing or exploring some of the following themes and topics:

• Taboo – surrounding menstruation, ritual behaviour or activities involving blood, food created from blood
• Stigma – associated with living with blood borne viruses such as HIV, or other genetic conditions affecting blood.
• Giving – donating blood to strangers, placenta donation, the connection between a mother and foetus
• Identity – blood type, associations with racial identity, mixed race, family, chimeras, human/animal hybrids, and eugenics
• Health – diseases of the blood, immunity. Blood testing and the future of blood based testing etc.
• Sport – Drugs and sport, blood doping.

I suspect it won’t actually be much relevance to my CPD activities, but I shall keep an eye out… you never know…

5 December 2016 (Monday) - BloodMed Newsletter

The latest BloodMed email arrived in my inbox this morning with some interesting news:

• Warning on future of US blood collection
• Smart patch for anticoagulants?
• Oral factor IX capsule close

Blood collection is interesting stuff; the smart patch was thought-provoking. There was also MCQs, EMQs and Case reports. Really should peruse those….

4 December 2016 (Sunday) - Mitotic Figure

An interesting picture posted on the New Medical Laboratory Scientist Facebook page:

A mitotic figure. They are not uncommon in disease states, but can be seen in seemingly healthy individuals. Mind you they are obscure; I’ve only seen a handful of the things.

30 November 2016 (Wednesday) - IBMS Newsletter

The IBMS newsletter came by email this morning. All sorts of info including:

IBMS Updates

 

IBMS retirees can claim retired membership rate
IBMS concessionary rates available
Imtiaz Ali's poster prize on platelet fraction
PHE issues National user manual template
IBMS gains new student affiliate society
ECC lectures available online
 

Links of the month

 

HIV test performed on USB stick
DIY diagnosis of illness is dangerous trend, say pharmacists
Experts raise alarm over declining effect of last-line antibiotics
UK team of health experts to tackle global disease outbreaks
Old Blood as Good as New for Transfusions, Study Finds
Two antibiotics fight bacteria differently than thought
Superfast therapy cracks multidrug-resistant tuberculosis
Engineers design a new weapon against bacteria
Tumour cells in blood samples could predict prostate cancer spread
The Road to Perfect EQA?
'War on superbugs' like E. coli announced by government
Method to detect the presence toxoplasmosis parasite

29 November 2016 (Tuesday) - Rare Anaemias

The BBTS is getting involved with some work on rare inherited anaemias such as

·         Congenital Dyserythropoietic Anaemia

·         Diamond-Blackfan Anaemia

·         Congenital Sideroblastic Anaemia

·         Red Cell Membrane disorders

·         Red Cell Enzyme disorders

·         Transfusion-dependent unexplained inherited anaemias

They are asking for input from those with vested interests. I don’t think I’d be an help top them, but I shall watch the project with interest…

29 November 2016 (Tuesday) - Transfusion News email

The Transfusion News email arrived this morning. Some interesting snippets including:

Drones Capable of Delivering Blood Products

November 22, 2016
Drones—small pilotless aircrafts—are capable of delivering packages cheaply and are not limited to passable roads or constrained by traffic. Rwanda started using drones to deliver blood products this year. Researchers in the United States recently investigated the use of drones to deliver blood products that need to be maintained at a constant temperature during transport. […] [Read More]

Mutating Haematopoietic Stem Cells May Cure Sickle Cell Diseases

November 16, 2016
Sickle cell disease and β-thalassaemia are caused by mutations in the β -globin gene. Previous studies have shown that transplants of normal β-globin genes into haematopoietic stem cells (HSC) may cure the disease; however, this process is considered inefficient. New advances recently published in Nature point towards an approach that may improve the efficiency of […] [Read More]

Laboratory Testing is Suggested Before Intravenous Immunoglobulin is Given to Neonates

November 9, 2016
Although intravenous immunoglobulin (IVIG) use is documented to treat a wide range of severe disorders in adults, IVIG use in neonates is not well-characterized. A retrospective study recently published in TRANSFUSION describe IVIG use in neonates in the NICU at one Canadian hospital. Only 37 neonates received IVIG over 11 years. [Read More]

Personally I’m intrigued with the thought of blood delivery by drone. It takes an inordinate amount of time to get blood a relatively short distance. The drones in the article didn’t seem to have that much of a carrying capacity, but I wonder just how long it will be before a day’s blood delivery can be flown in this way…

29 November 2016 (Tuesday) - Scurvy

An interesting article. I can remember when our general studies lecturer at Bromley Tech used the original scientific article about curing scurvy with citrus fruits to show science in action. At the time we all thought scurvy was one of those conditions that have long since been cured. But I have seen a couple of cases.

Apparently it is on the increase in diabetics. Diabetics seem to avoid fruit to control glucose levels…

28 November 2016 (Monday) - NHSBT Communication

The November communication to hospitals from NHS Blood and Transplant from NHSBT became available today

For Action 

1.1  Revisions to Iron in your diet patient information leaflet and educational resources

1.2 Invitation to submit an abstract for the SHOT Symposium 12 July 2017 

For Information

2.1 Choosing Wisely UK campaign launch

2.2 NICE guidance for fetal Rh D genotype

2.3 RCI will be changing the wording of reports for feto-maternal haemorrhage investigations 

For Training

3.1 Training & Education Events and Courses

Not that much of direct relevance to me… but anything learned is never wasted…

28 November 2016 (Monday) - NEQAS blood films

The results of NEQAS morphology survey 1607BF came in today.

1607 BF1

I noted

·         Eosinophilia

·         Atypical Mononuclears

·         myelocytes

·         Platelet clumps

I felt this was ?MDS/leukoerythroblastic. The correct answer was CMML which is in the classification of MDS by the WHO, so I got that right

1607 BF2

I noted

·         Atypical lymphocytosis

·         Atypical Mononuclears

·         Thromboctyopenia

I felt this was glandular fever… possibly a lymphoma.. The correct answer was in fact glandular fever; I’m pleased with that.

1604 PA1

I noted blood borne worms. I thought they were Wucheria Bancrofti. Apparently they were loa loa. I remain unconvinced, but I am no expert on blood bourme worms. How often do we see them?

1604 PA2

I didn’t see anything in this film and this was the correct answer

28 November 2016 (Monday) - HCPC Newsletter

Issue 66 of the HCPC’s “In Focus” magazine arrived in my in-box this morning. It had all sorts of interesting things including:

• ·         Focus on the Fitness to practise annual report 2016
• ·         Final call for renewals – Social workers in England and Operating department practitioners
• ·         Have you used our app?
• ·         Upcoming partner recruitment
• ·         Update on the Children and Social Work Bill
• ·         Policy update
• ·         HCPC events summary
• ·         Data protection in practice

I must admit I skimmed most of it; focussing on the Fitness to practise annual report. It is no secret I have a personal interest in this. About one in two hundred of us have a complaint made against us. And when it happens years of exemplary service are disregarded…. I find myself having great difficulty to consider Fitness to practise hearings with any degree of objectivity.

I hope none of my colleagues ever find themselves in such a hearing facing trained lawyers who delight in what they see as word games whilst journalists look on hoping for scandal and gossip…

Whilst the public need to have confidence in the health care professionals there needs to be a better way of policing those health care professionals. The current way leaves scars…

27 November 2016 (Sunday) - Videos

After a week of not actually finding much CPD I came across this:

https://www.facebook.com/MedicalVideos.us

Quite a useful little link. I shall have a look in-depth later…

21 November 2016 (Monday) - Transfusion Evidence email

The Transfusion Evidence email came in this morning Ten rather interesting links to peruse at leisure later…

Latest Evidence in Transfusion Medicine 1) Intravenous iron or placebo for anaemia in intensive care: the IRONMAN multicentre randomized blinded trial : a randomized trial of IV iron in critical  illness Inati A ; Kahale M, et al., Pediatric Blood & Cancer. 2016   2) Long-term outcomes in patients with septic shock transfused at a lower versus a higher haemoglobin threshold: the TRISS randomised, multicentre clinical trial Lakkaraja M ; Jin JC, et al. Transfusion. 2016   3) Allogeneic blood transfusion is a significant risk factor for surgical-site infection following total hip and knee arthroplasty: a meta-analysis Keir A ; Pal S, et al. Transfusion. 2016   4) Iron supplementation to treat anaemia in adult critical care patients: a systematic review and meta-analysis Zhang H ; Zhang P, et al. Postepy W Kardiologii Interwencyjnej = Advances in Interventional Cardiology. 2016;12(-3):247-53 5) A systematic review on the rotational thrombelastometry (ROTEM(R)) values for the diagnosis of coagulopathy, prediction and guidance of blood transfusion and prediction of mortality in trauma patients Kwon S ; Lew S, et al. The Journal of Surgical Research. 2016;205(-2):499-509   6) Transfusion thresholds and other strategies for guiding allogeneic red blood cell transfusion Karkouti K ; Callum J, et al. Circulation. 2016   7) Topical versus intravenous administration of tranexamic acid in primary total hip arthroplasty: a systematic review and meta-analysis of randomized controlled trials Ray I ; Bhattacharya R, et al. Journal of Obstetrics and Gynaecology of India. 2016;66((Suppl 1)):347-52   8) Effect of short-term vs. long-term blood storage on mortality after transfusion Hall DP ; Estcourt LJ, et al. The Cochrane Database of Systematic Reviews. 2016;(-9):CD011756   9) Tranexamic acid in patients undergoing coronary-artery surgery Moore C ; Bolton T., et al. Trials. 2016;17(-1):458 10) A randomized trial to evaluate the use of text messaging, letter, and telephone call reminders to improve return of blood donors with reactive serologic tests McNicol ED ; Tzortzopoulou A, et al. The Cochrane Database of Systematic Reviews. 2016;(-9):CD006883

21 November 2016 (Monday) - BloodMed email

The BloodMed email arrived this morning. Some interesting snippets:

• EBV gene link to cancer
• Transfused blood can be preserved
• Progress on acute leukemia genetics

There was also hints on includes Essay practice, MCQs, EMQs and Case reports in the Training and CPD link.

Not a bad email….

20 November 2016 (Sunday) - 1604 DM

The results of the latest digital morphology became available. The case was “A 39 year old female presents unwell at the emergency department. Hb 120g/L, WBC 6.5 x 10*9/L, Platelets 150 x 10*9/L. The analyser fails to produce a differential so a blood film is examine”

I first looked at the image some time ago and I said there was left shift with toxic granulation and some early myeloid cells.

Your Observations: Rank Morphological Feature Participants who selected this feature 1 Blast cells 63.6% 2 Promyelocytes 36.5% 3 Toxic granulation 19.8% 4 Reactive lymphocytes/Plasmacytoid lymphs/Turk cells 20.5% 5 Clumps 36.1% Considering the morphological features you have selected which of the following diagnostic categories do you think might be most likely. Acute Leukaemia Chronic Myeloproliferative disorder Actual pathological diagnosis: Bone marrow infiltration by carcinoma

The red cells showed polychromasia  and there were some stomatocyes seen. I didn’t rate those as important enough.

I don’t think I did too badly….

It seems odd that the system told me I didn’t participate but recorded my entry…