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ACB-CLIN-CHEM-GEN  April 2013

ACB-CLIN-CHEM-GEN April 2013

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Subject:

NAT2 genotyping

From:

Ben Jones <[log in to unmask]>

Reply-To:

Ben Jones <[log in to unmask]>

Date:

Wed, 24 Apr 2013 19:07:28 +0100

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (1227 lines)

Does anyone know of any lab offering NAT2 genotyping to determine if a patient is a fast or slow acetylator for isoniazid? 

Thanks
Ben
Charing Cross Hospital


On 24 Apr 2013, at 00:02, ACB-CLIN-CHEM-GEN automatic digest system <[log in to unmask]> wrote:

> There are 19 messages totaling 4167 lines in this issue.
> 
> Topics of the day:
> 
>  1. Procalcitonin for guiding antibiotic therapy on ITU (3)
>  2. automated urine pH testing (3)
>  3. West Midlands ACB meeting 24/05/2013
>  4. Hub and spoke and IT
>  5. Hepcidin
>  6. IQC for drugs of abuse
>  7. Aldolase (4)
>  8. IQC for haemolysis index (2)
>  9. CA153 stability in whole blood
> 10. bilirubin in whole blood
> 11. Tranexamic acid
> 
> ------ACB discussion List Information--------
> This is an open discussion list for the academic and clinical community working in clinical biochemistry.
> Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
> ACB Web Site
> http://www.acb.org.uk
> Green Laboratories Work
> http://www.laboratorymedicine.nhs.uk
> List Archives
> http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
> List Instructions (How to leave etc.)
> http://www.jiscmail.ac.uk/
> 
> ----------------------------------------------------------------------
> 
> Date:    Tue, 23 Apr 2013 07:50:55 +0000
> From:    Paul Collinson <[log in to unmask]>
> Subject: Re: Procalcitonin for guiding antibiotic therapy on ITU
> 
> There was one RCT that showed use of procalcitonoin produced worse outcomes
> 
> ________________________________
> Professor Paul Collinson
> 
> T: +44 (0)208 725 5934 sec (0)208 725 5923
> 
> Consultant Chemical Pathologist and Professor of Cardiovascular Biomarkers
> 
> F: +44 (0)208 725 5868
> 
> Clinical Blood Sciences
> 
> E: [log in to unmask]<mailto:[log in to unmask]>
> 
> St. George's Healthcare NHS Trust
> 
> W: www.stgeorges.nhs.uk<http://www.stgeorges.nhs.uk/>
> 
> ________________________________
> P Save Paper - Do you really need to print this e-mail?
> ________________________________
> From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Tuddenham Emma (CROYDON HEALTH SERVICES NHS TRUST)
> Sent: 11 April 2013 12:06
> To: [log in to unmask]
> Subject: Procalcitonin for guiding antibiotic therapy on ITU
> 
> Dear collective brain,
> 
> We have been asked by our ITU team to consider introducing procalcitonin to promote earlier discontinuation of antibiotics in their patients. As far as I can make out from the literature, there doesn't seem to be a significant advantage in using PCT (rather than/as well as CRP) for diagnosis of sepsis on ITU but the evidence for earlier cessation of antibiotic therapy is a bit more convincing.
> 
> I would be interested to know if anyone has introduced PCT for this purpose, and if so on what frequency of sampling (e.g. daily, 2-3 times per week)? Has anyone costed up how much this has saved their hospital in reduced antibiotic prescriptions?
> 
> Many thanks!
> Emma
> 
> Emma Tuddenham (nee Connell)
> Pre-registration Clinical Scientist
> Croydon University Hospital
> 530 London Road
> Thornton Heath
> Surrey
> CR7 7YE
> Tel: 0208 401 3548
> Fax: 0208 401 3189
> 
> 
> 
> 
> 
> ********************************************************************************************************************
> 
> This message may contain confidential information. If you are not the intended recipient please inform the
> sender that you have received the message in error before deleting it.
> Please do not disclose, copy or distribute information in this e-mail or take any action in reliance on its contents:
> to do so is strictly prohibited and may be unlawful.
> 
> Thank you for your co-operation.
> 
> NHSmail is the secure email and directory service available for all NHS staff in England and Scotland
> NHSmail is approved for exchanging patient data and other sensitive information with NHSmail and GSi recipients
> NHSmail provides an email address for your career in the NHS and can be accessed anywhere
> 
> ********************************************************************************************************************
> ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/
> ________________________________
> 
> Disclaimer:
> 
> This e-mail and any files transmitted with it are confidential. If you are not the intended recipient, any reading, printing, storage, disclosure, copying or any other action taken in respect of this e-mail is prohibited and may be unlawful. If you are not the intended recipient, please notify the sender immediately by using the reply function and then permanently delete what you have received.
> 
> Incoming and outgoing e-mail messages are routinely monitored for compliance with the Department of Health's policy on the use of electronic communications. For more information on the Department of Health's e-mail policy click here http://www.doh.gov.uk/emaildisclaimer.htm
> 
> ------ACB discussion List Information--------
> This is an open discussion list for the academic and clinical community working in clinical biochemistry.
> Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
> ACB Web Site
> http://www.acb.org.uk
> Green Laboratories Work
> http://www.laboratorymedicine.nhs.uk
> List Archives
> http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
> List Instructions (How to leave etc.)
> http://www.jiscmail.ac.uk/
> 
> ------------------------------
> 
> Date:    Tue, 23 Apr 2013 01:05:08 -0700
> From:    Mohammad Al-Jubouri <[log in to unmask]>
> Subject: Re: Procalcitonin for guiding antibiotic therapy on ITU
> 
> On the other hand there is one RCT that showed procalcitonin could reduce antibiotic exposure in non-surgical ICU patients with no apparent adverse outcomes:
> 
> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2809%2961879-1/abstract
> 
> 
> So take your pick.
> 
>  Mohammad
> 
> Dr. M A Al-Jubouri, MB ChB, MSc, FRCP Edin, FRCPath
> Consultant Chemical Pathologist
> 
> 
> ________________________________
> From: Paul Collinson <[log in to unmask]>
> To: [log in to unmask] 
> Sent: Tuesday, April 23, 2013 8:50 AM
> Subject: Re: Procalcitonin for guiding antibiotic therapy on ITU
> 
> 
> 
> 
> There was one RCT that showed use of procalcitonoin produced worse outcomes
>  
> 
> ________________________________
> 
> Professor Paul Collinson T: +44 (0)208 725 5934 sec (0)208 725 5923 
> Consultant Chemical Pathologist and Professor of Cardiovascular Biomarkers  F: +44 (0)208 725 5868 
> Clinical Blood Sciences E: [log in to unmask] 
> St. George'sHealthcare NHSTrust W: www.stgeorges.nhs.uk 
> 
> ________________________________
> 
> PSave Paper - Do you really need to print this e-mail? 
> 
> ________________________________
> 
> From:Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Tuddenham Emma (CROYDON HEALTH SERVICES NHS TRUST)
> Sent: 11 April 2013 12:06
> To: [log in to unmask]
> Subject: Procalcitonin for guiding antibiotic therapy on ITU
>  
> Dear collective brain,
>  
> We have been asked by our ITU team to consider introducing procalcitonin to promote earlier discontinuation of antibiotics in their patients. As far as I can make out from the literature, there doesn't seem to be a significant advantage in using PCT (rather than/as well as CRP) for diagnosis of sepsis on ITU but the evidence for earlier cessation of antibiotic therapy is a bit more convincing. 
>  
> I would be interested to know if anyone has introduced PCT for this purpose, and if so on what frequency of sampling (e.g. daily, 2-3 times per week)? Has anyone costed up how much this has saved their hospital in reduced antibiotic prescriptions?
>  
> Many thanks!
> Emma
>  
> Emma Tuddenham (nee Connell)
> Pre-registration Clinical Scientist
> CroydonUniversity Hospital
> 530 London Road
> ThorntonHeath
> Surrey
> CR7 7YE
> Tel: 0208 401 3548
> Fax: 0208 401 3189
>   
>  
> 
> ********************************************************************************************************************
> 
> This message may contain confidential information. If you are not the intended recipient please inform the
> sender that you have received the message in error before deleting it.
> Please do not disclose, copy or distribute information in this e-mail or take any action in reliance on its contents:
> to do so is strictly prohibited and may be unlawful.
> 
> Thank you for your co-operation.
> 
> NHSmail is the secure email and directory service available for all NHS staff in England and Scotland
> NHSmail is approved for exchanging patient data and other sensitive information with NHSmail and GSi recipients
> NHSmail provides an email address for your career in the NHS and can be accessed anywhere
> 
> ********************************************************************************************************************
> ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ 
> ________________________________
> 
> Disclaimer:
> 
> This e-mail and any files transmitted with it are confidential. If you are not the intended recipient, any reading, printing, storage, disclosure, copying or any other action taken in respect of this e-mail is prohibited and may be unlawful. If you are not
> the intended recipient, please notify the sender immediately by using the reply function and then permanently delete what you have received.
> 
> Incoming and outgoing e-mail messages are routinely monitored for compliance with the Department of Health's policy on the use of electronic communications. For more information on the Department of Health's e-mail policy click here http://www.doh.gov.uk/emaildisclaimer.htm
> 
> ------ACB discussion List Information--------
> This is an open discussion list for the academic and clinical community working in clinical biochemistry.
> Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
> ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/
> 
> ------ACB discussion List Information--------
> This is an open discussion list for the academic and clinical community working in clinical biochemistry.
> Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
> ACB Web Site
> http://www.acb.org.uk
> Green Laboratories Work
> http://www.laboratorymedicine.nhs.uk
> List Archives
> http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
> List Instructions (How to leave etc.)
> 
> ------------------------------
> 
> Date:    Tue, 23 Apr 2013 08:38:05 +0000
> From:    Jonathan Kay <[log in to unmask]>
> Subject: Re: Procalcitonin for guiding antibiotic therapy on ITU
> 
> The problem with studies showing "reduce" or "increase" is that they depend as much on the comparator group as the intervention group.
> 
> Begin forwarded message:
> 
> From: Jonathan Kay <[log in to unmask]<mailto:[log in to unmask]>>
> Subject: Re: Procalcitonin for guiding antibiotic therapy on ITU
> Date: 11 April 2013 14:22:11 CEST
> To: <[log in to unmask]<mailto:[log in to unmask]>>
> Reply-To: Jonathan Kay <[log in to unmask]<mailto:[log in to unmask]>>
> 
> When I've discussed this with microbiologists in Oxford they tell me that our local usage of antibiotics is already better optimised than in the "as is " process in publications from the USA, so the demonstrated improvements aren't available to us. We don't use the assay.
> 
> 
> Jonathan
> 
> 
> On 23 Apr 2013, at 10:05, Mohammad Al-Jubouri <[log in to unmask]<mailto:[log in to unmask]>> wrote:
> 
> On the other hand there is one RCT that showed procalcitonin could reduce antibiotic exposure in non-surgical ICU patients with no apparent adverse outcomes:
> 
> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2809%2961879-1/abstract
> 
> So take your pick.
> 
> Mohammad
> 
> Dr. M A Al-Jubouri, MB ChB, MSc, FRCP Edin, FRCPath
> Consultant Chemical Pathologist
> ________________________________
> From: Paul Collinson <[log in to unmask]<mailto:[log in to unmask]>>
> To: [log in to unmask]<mailto:[log in to unmask]>
> Sent: Tuesday, April 23, 2013 8:50 AM
> Subject: Re: Procalcitonin for guiding antibiotic therapy on ITU
> 
> There was one RCT that showed use of procalcitonoin produced worse outcomes
> 
> ________________________________
> Professor Paul Collinson
> 
> T: +44 (0)208 725 5934 sec (0)208 725 5923
> 
> Consultant Chemical Pathologist and Professor of Cardiovascular Biomarkers
> 
> F: +44 (0)208 725 5868
> 
> Clinical Blood Sciences
> 
> E: [log in to unmask]<mailto:[log in to unmask]>
> 
> St. George's Healthcare NHS Trust
> 
> W: www.stgeorges.nhs.uk<http://www.stgeorges.nhs.uk/>
> 
> ________________________________
> P Save Paper - Do you really need to print this e-mail?
> ________________________________
> From: Clinical biochemistry discussion list [mailto:[log in to unmask]<mailto:[log in to unmask]>] On Behalf Of Tuddenham Emma (CROYDON HEALTH SERVICES NHS TRUST)
> Sent: 11 April 2013 12:06
> To: [log in to unmask]<mailto:[log in to unmask]>
> Subject: Procalcitonin for guiding antibiotic therapy on ITU
> 
> Dear collective brain,
> 
> We have been asked by our ITU team to consider introducing procalcitonin to promote earlier discontinuation of antibiotics in their patients. As far as I can make out from the literature, there doesn't seem to be a significant advantage in using PCT (rather than/as well as CRP) for diagnosis of sepsis on ITU but the evidence for earlier cessation of antibiotic therapy is a bit more convincing.
> 
> I would be interested to know if anyone has introduced PCT for this purpose, and if so on what frequency of sampling (e.g. daily, 2-3 times per week)? Has anyone costed up how much this has saved their hospital in reduced antibiotic prescriptions?
> 
> Many thanks!
> Emma
> 
> Emma Tuddenham (nee Connell)
> Pre-registration Clinical Scientist
> Croydon University Hospital
> 530 London Road
> Thornton Heath
> Surrey
> CR7 7YE
> Tel: 0208 401 3548
> Fax: 0208 401 3189
> 
> 
> 
> 
> ********************************************************************************************************************
> 
> This message may contain confidential information. If you are not the intended recipient please inform the
> sender that you have received the message in error before deleting it.
> Please do not disclose, copy or distribute information in this e-mail or take any action in reliance on its contents:
> to do so is strictly prohibited and may be unlawful.
> 
> Thank you for your co-operation.
> 
> NHSmail is the secure email and directory service available for all NHS staff in England and Scotland
> NHSmail is approved for exchanging patient data and other sensitive information with NHSmail and GSi recipients
> NHSmail provides an email address for your career in the NHS and can be accessed anywhere
> 
> ********************************************************************************************************************
> ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk<http://www.acb.org.uk/> Green Laboratories Work http://www.laboratorymedicine.nhs.uk<http://www.laboratorymedicine.nhs.uk/> List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/
> ________________________________
> 
> Disclaimer:
> 
> This e-mail and any files transmitted with it are confidential. If you are not the intended recipient, any reading, printing, storage, disclosure, copying or any other action taken in respect of this e-mail is prohibited and may be unlawful. If you are not the intended recipient, please notify the sender immediately by using the reply function and then permanently delete what you have received.
> 
> Incoming and outgoing e-mail messages are routinely monitored for compliance with the Department of Health's policy on the use of electronic communications. For more information on the Department of Health's e-mail policy click here http://www.doh.gov.uk/emaildisclaimer.htm
> ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk<http://www.acb.org.uk/> Green Laboratories Work http://www.laboratorymedicine.nhs.uk<http://www.laboratorymedicine.nhs.uk/> List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/
> 
> 
> ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk<http://www.acb.org.uk/> Green Laboratories Work http://www.laboratorymedicine.nhs.uk<http://www.laboratorymedicine.nhs.uk/> List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/
> 
> 
> ------ACB discussion List Information--------
> This is an open discussion list for the academic and clinical community working in clinical biochemistry.
> Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
> ACB Web Site
> http://www.acb.org.uk
> Green Laboratories Work
> http://www.laboratorymedicine.nhs.uk
> List Archives
> http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
> List Instructions (How to leave etc.)
> http://www.jiscmail.ac.uk/
> 
> ------------------------------
> 
> Date:    Tue, 23 Apr 2013 09:42:46 +0100
> From:    Dan Turnock <[log in to unmask]>
> Subject: automated urine pH testing
> 
> Dear Mailbase, 
> 
> Does anybody know of an automated assay to measure urine pH that could be used for urine sample integrity testing? 
> 
> We use Beckman AU main chemistry analysers 
> 
> Thanks 
> 
> Dan Turnock 
> 
> ------ACB discussion List Information--------
> This is an open discussion list for the academic and clinical community working in clinical biochemistry.
> Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
> ACB Web Site
> http://www.acb.org.uk
> Green Laboratories Work
> http://www.laboratorymedicine.nhs.uk
> List Archives
> http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
> List Instructions (How to leave etc.)
> http://www.jiscmail.ac.uk/
> 
> ------------------------------
> 
> Date:    Tue, 23 Apr 2013 08:56:38 +0000
> From:    Kamaljit Chatha <[log in to unmask]>
> Subject: West Midlands ACB meeting 24/05/2013
> 
> 
> Hi,
> 
> 
> 
> 
> 
> 
> The ACB West Midlands region are holding a meeting on Friday 24th May at the Queen Elizabeth Hospital, Education Centre, Lecture Theatre 2, Birmingham
> 
> The meeting is to honour the contribution that Dr Penny Clark has made to Biochemistry and Endocrinology.
> 
> 9.30 - 10.00 Registration and refreshments
> 
> 10.00-10.45 Trainees
> 
> 10.45-11.30 “What on earth do we do about subclinical thyroid dysfunction – the Birmingham contribution?” Professor Jayne Franklyn.
> 
> 11.30-12.15 TBA Dr Neil Gittoes
> 
> 12.15-13.00 TBA Dr David Halsall 
> 
> 13.00-14.00 Lunch and AGM
> 
> 14.00-14.45 TBA Dr Timothy Macdonald
> 
> 14.45-15.15 Tea
> 
> 15.15-16.00 TBA Dr Nadia El-Farhan
> 
> 16.00-16.30 Closing remarks. Dr Penny Clark.
> 
> 
> The costs for registration is £25 for clinical scientist/BMS trainees or ACB/RCPath retired members, £35 for ACB members or RCPath Fellows, £45 for all others.  Please register through the website http://www.acbwm.org.uk/
> 
> 
> For any further infomation, please contact Kam Chatha by email – [log in to unmask]
> 
> I look forward to seeing you there.
> 
> Regards
> 
> Kam Chatha
> ACBWM Meetings Secretary 		 	   		  
> ------ACB discussion List Information--------
> This is an open discussion list for the academic and clinical community working in clinical biochemistry.
> Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
> ACB Web Site
> http://www.acb.org.uk
> Green Laboratories Work
> http://www.laboratorymedicine.nhs.uk
> List Archives
> http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
> List Instructions (How to leave etc.)
> http://www.jiscmail.ac.uk/
> 
> ------------------------------
> 
> Date:    Tue, 23 Apr 2013 10:01:29 +0100
> From:    Richard Evers <[log in to unmask]>
> Subject: Re: automated urine pH testing
> 
> Microgenics (through Thermo Fisher) do an automated urine pH testing kit.
> It is used in many toxicology labs for sample integrity testing, and we 
> have never had problems with it.
> Olympus used to have an OEM relationship with Microgenics, and you may be 
> able to get the reagent directly from Beckman if they are your normal 
> supplier. 
> 
> Thermo part number 100054 for 500mL
> 
> Richard 
> ______________________________________________________________ 
> Richard Evers 
> Toxicology Manager 
> Laboratory Services 
> Synergy Health Laboratory Services
> Gavenny Court, Brecon Road, Abergavenny, Monmouthshire, Wales, NP7 7RX
> T: +441873 856688 
> M: +447850 311399 
> F: +441873 858982 
> E: [log in to unmask] 
> 
> 
> 
> 
> 
> 
> Queries to: [log in to unmask]
> 
> This email is for the intended recipient only and may contain proprietary Information. If misdirected please notify us immediately, as you must not use, disclose or rely on it. We may monitor all incoming and outgoing messages. We take all reasonable steps to avoid sending viruses but we do not accept liability for any virus sent unknowingly.
> 
> Synergy Health Laboratory Services
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> Brecon Road
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> Monmouthshire
> NP7 7RX
> 
> Telephone +44 (0) 1873 856688
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> 
> ------ACB discussion List Information--------
> This is an open discussion list for the academic and clinical community working in clinical biochemistry.
> Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
> ACB Web Site
> http://www.acb.org.uk
> Green Laboratories Work
> http://www.laboratorymedicine.nhs.uk
> List Archives
> http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
> List Instructions (How to leave etc.)
> http://www.jiscmail.ac.uk/
> 
> ------------------------------
> 
> Date:    Tue, 23 Apr 2013 09:07:33 +0000
> From:    "COLLINS MICHAEL (RM1) Norfolk and Norwich University Hospital"
>         <[log in to unmask]>
> Subject: Re: automated urine pH testing
> 
> In the days of Technicon AutoAnalysers this was done using phenolphthalein 
> 
> Mike Collins
> BMS3
> Biochemistry Automation
> Norfolk & Norwich University Hospital
> England
> [log in to unmask]
> http://www.nnuh.nhs.uk/
>  
> 
> -----Original Message-----
> From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Dan Turnock
> Sent: 23 April 2013 09:43
> To: [log in to unmask]
> Subject: automated urine pH testing
> 
> Dear Mailbase, 
> 
> Does anybody know of an automated assay to measure urine pH that could be used for urine sample integrity testing? 
> 
> We use Beckman AU main chemistry analysers 
> 
> Thanks 
> 
> Dan Turnock 
> 
> ------ACB discussion List Information--------
> This is an open discussion list for the academic and clinical community working in clinical biochemistry.
> Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
> ACB Web Site
> http://www.acb.org.uk
> Green Laboratories Work
> http://www.laboratorymedicine.nhs.uk
> List Archives
> http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
> List Instructions (How to leave etc.)
> http://www.jiscmail.ac.uk/
> This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom
> they are addressed.
> If you have received this email in error please notify the originator of the message. This footer also confirms that this
> email message has been scanned for the presence of computer viruses but this should not be relied upon as a guarantee that the contents are virus free.
> 
> Any views expressed in this message are those of the individual sender, except where the sender specifies and with authority,
> states them to be the views of the Norfolk and Norwich University Hospitals NHS Foundation Trust. The information contained in this e-mail may be subject to public disclosure 
> under the Freedom of Information Act 2000. Unless the information is legally exempt from disclosure, the confidentiality of this e-mail and your reply cannot be guaranteed
> 
> 
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> Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
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> ------------------------------
> 
> Date:    Tue, 23 Apr 2013 12:11:18 +0100
> From:    "Richard Jones [Pathology]" <[log in to unmask]>
> Subject: Re: Hub and spoke and IT
> 
> I think this challenge is being faced in many parts of the UK. The question has changed recently as the maturity of clinical systems increases. Hence the clinical record is becoming the key focus with patient-centric data models emerging.
> 
> This means that the role of the LIMS and Middleware are changing as clinical functionality increases -e.g. intelligent order comms driven off logic with access to results, diagnosis, drugs intended procedures. This means that a layered architecture can be used which allows pathology to scale its systems for its business needs which are often regional and feed data into clinical systems which might have a more local footprint.
> 
> The persistent challenge is to deal with the boundaries. Trusts which choose monolithic LIMS/EPRs potentially lock themselves off from service communities.   Those that look wider may include more service users but the boundary just gets bigger.
> 
> Never a dull day in Pathology IT!
> 
> Rick
> 
> 
> ________________________________
> From: Clinical biochemistry discussion list [[log in to unmask]] On Behalf Of David James [[log in to unmask]]
> Sent: 03 December 2012 09:38
> To: [log in to unmask]; Richard Jones [Pathology]
> Subject: Re: Hub and spoke and IT
> 
> We have had single LIMS [LabCentre] across 2 centres [using different PAS systems] for 10 yrs. Single result database with order comms for path and radiology
> 
> dj
> 
> From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Mainwaring-Burton Richard (SOUTH LONDON HEALTHCARE NHS TRUST)
> Sent: 03 December 2012 09:33
> To: [log in to unmask]
> Subject: Re: Hub and spoke and IT
> 
> 
> ---
> 
> This message was sent from an email address external to NHSmail but gives the appearance of being from an NHSmail (@nhs.net) address. The recipient should verify the sender and content before acting upon information contained within.
> 
> 
> 
> The identified sender is [log in to unmask]<mailto:[log in to unmask]>
> 
> ---
> 
> It may be more relevant that clouds are not transparent and tend to cut out light, and are undoubtedly implicated in lightning strikes ! There must also be a message in the fact that pilots refer to flying ‘blind’ !
> 
> Having just been through the trauma of merging 3 trusts to a single LIMS, by far the biggest problems have been introduced as a consequence of merged (or non-merged) PAS systems. If there is no way of cross-indexing patient ID which is not spine certified, the system will be unsafe and will upset clinicians big time, since continuity of records is crucial.  It is all very well to accept NHS number as a key field, but that is not practical in many cases where NHS number is not known, or not certified or not used at all in many requests. This applies not only to merged trust data, but significantly to GP requests which will be difficult to marry up to hospital data.
> 
> Good luck with the instrument landings
> 
> with best wishes
> Richard
> Richard Mainwaring-Burton
> Consultant Biochemist
> South London Healthcare Trust
> Queen Elizabeth Hospital, Woolwich
> Princess Royal Hospital, Farnborough
> Queen Mary's Hospital, Sidcup
> 020-8836-5724
> mob: 07831-739876
> 
> From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Tarn Anne (RJ6) MHC-TR Consultant
> Sent: 03 December 2012 08:35
> To: [log in to unmask]<mailto:[log in to unmask]>
> Subject: Hub and spoke and IT
> 
> Dear Mailbase
> I would be grateful for some reassurance from networks already operating a hub and spoke arrangement about how it really works in practice and especially for some feedback about the IT required to support this way of working.  We are working towards this in SWL and although the intention is to have a single LIMS this looks more and more unlikely, at least in the short term.  The solution being proposed is a data warehouse and ‘clouds’.  My experience of clouds is that they dump wet stuff.
> 
> There is no firm commitment that results will transfer across from the spoke to the hub LIMS nor vice versa and the only complete patient record will be the warehouse and the clinical system (although again no visibility of whether the GP clinical record will interact with the hospital clinical record).  For Clinical Blood Sciences especially, where limited urgent tests will be done in the spoke with the rest in the hub, and sample splitting, not to mention the potential problem of having a single lab number, can anyone in a similar situation tell me whether this will work?  I appreciate that you may prefer to phone and will try to collate any responses for the mailbase.
> 
> With many thanks
> Anne
> 
> 
> 
> ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/
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> Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
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> ------------------------------
> 
> Date:    Tue, 23 Apr 2013 14:13:25 +0100
> From:    "Gail Curtis (BCUHB - Chemical Pathology)" <[log in to unmask]>
> Subject: Hepcidin
> 
> Dear Colleagues
> 
> In response to my enquiry regarding hepcidin analysis and/or genetic studies, I received the following replies:-
> 
> 
> 1.     We have sent a couple of samples for hepcidin analysis to Charing Cross, London. The contact we had was Mark Busbridge ([log in to unmask]<mailto:[log in to unmask]>) phone number 020 331 35914.
> I hope this information is of some help
> 
> 
> 2.     I'm not aware of a hepcidin assay for clinical use in the UK - but the University of Birmingham has a research-only assay (minimum of ten samples): http://www.birmingham.ac.uk/facilities/hepcidin/contact/index.aspx
> 
> Aside from that, www.hepcidinanalysis.com<http://www.hepcidinanalysis.com/> in the Netherlands offers a specific MS assay which measures hepcidin-25 (the active form) and they do accept clinical samples.
> 
> In terms of genetics, hepcidin genotyping is usually done as part of haemochromatosis genetic testing (if HFE negative) as mutations can cause juvenile haemochromatosis (type 2B):
> http://www.oxford-translational-molecular-diagnostics.org.uk/Haemochromatosis_serv.html
> 
> 
> 
> 3.     Yes, not a problem to measure hepcidin-25 for you. I still offer this as a research assay and not a diagnostic service. For the assay lithium heparin plasma is required, separated (0.5ml-1ml volume for the assay) and stored frozen (-20oC) for long-term storage. Ideally blood sample should be taken before mid-day to avoid diurnal fluctuations, a non-fasting is not required. Is the patient on parental iron therapy ? If so, would it be possible to halt therapy for a short period before sampling.
> Sample can be transported frozen to the address below.
> 
> Patricia Bignell, Clinical Scientist, based at Oxford University Hospital has a diagnostic service looking at a range of HH mutations but also TMPRSS6 gene mutations and maybe worth contacting for genetic follow-up. I'm afraid I do not have her contact details but I'm sure she must be contactable through the ACB.
> 
> Thanks
> Mark
> 
> Mark Busbridge PhD
> Senior Biomedical Scientist
> Department of Clinical Biochemistry
> 8th Floor Charing Cross Hospital
> Imperial College Healthcare NHS Trust
> Fulham Palace Road
> London W6 8RF
> 
> Tel no:  020 331 35914
> Fax no: 020 331 35195
> 
> Thanks to all who responded and particularly to Mark Busbridge at Charing Cross.
> 
> Gail
> 
> Dr Gail Curtis
> Consultant Clinical Biochemist
> Dept of Clinical Biochemistry
> Glan Clwyd Hospital
> BCUHB
> 
> Ffôn * Tel: (01745) 445293   (WHTN 1815 5293)
> 
> 
> 
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> ------------------------------
> 
> Date:    Tue, 23 Apr 2013 14:53:51 +0100
> From:    "Troup Susan (RR7) Gateshead Health" <[log in to unmask]>
> Subject: IQC for drugs of abuse
> 
> Hello,
> 
> 
> 
> We are currently using LGC IQC for our urine drugs of abuse assays on
> the LCMS, at levels 25% above and below the European Workplace cut-offs.
> We have been informed by LGC that this material is not currently
> available to order and so we need to source something similar elsewhere.
> 
> 
> 
> We currently measure:
> 
> 
> 
> Morphine
> 
> Codeine
> 
> 6MAM
> 
> DHC
> 
> Amphetamine
> 
> Methamphetamine
> 
> MDMA
> 
> MDA
> Benzoylecgonine
> 
> EDDP 
> 
> Methadone
> 
> 
> 
> 
> 
> Can anyone recommend a source of material that covers these compounds at
> appropriate levels.
> 
> 
> 
> Many thanks,
> 
> 
> 
> Susan
> 
> 
> 
> 
> 
> Susan Troup DipRCPath
> 
> Principal Biochemist
> 
> Biochemistry Department
> 
> Queen Elizabeth Hospital
> 
> Sheriff Hill
> 
> Gateshead
> 
> NE9 6SX
> 
> 
> 
> Tel: 0191 445 2287
> 
> 
> 
> 
> ------ACB discussion List Information--------
> This is an open discussion list for the academic and clinical community working in clinical biochemistry.
> Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
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> 
> ------------------------------
> 
> Date:    Tue, 23 Apr 2013 14:53:49 +0100
> From:    "[log in to unmask]" <[log in to unmask]>
> Subject: Aldolase
> 
> Hi,
> Can anyone offer an aldolase measurement.
> We have a patient with a chronically raised (4 years) CK.  Today the CK is 2396 u/l. ALT 77, AST 68. She had an M infarct 2 years ago but is now well. Started and stopped statins for FHC.  We are struggling to understand her picture.  TFTs normal, no muscle wasting........
> David
> 
> ------ACB discussion List Information--------
> This is an open discussion list for the academic and clinical community working in clinical biochemistry.
> Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
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> 
> ------------------------------
> 
> Date:    Tue, 23 Apr 2013 14:53:48 +0100
> From:    Woodrow Iain <[log in to unmask]>
> Subject: IQC for haemolysis index
> 
> Hi all,
> 
> 
> 
> I think this may have been visited before, but we have Abbott analysers
> and would like to have some handle on how the haemolysis index is
> performing. Abbott don't offer any IQC material for this. What do other
> users (Abbott or otherwise) do?
> 
> 
> 
> Thanks in anticipation
> 
> 
> 
> Iain
> 
> 
> 
> Dr Iain Woodrow,
> 
> Clinical Biochemist
> 
> Department of Clinical Biochemistry
> 
> Pinderfields General Hospital
> 
> Aberford Rd
> 
> Wakefield
> 
> WF1 4DG
> 
> 
> 
> Phone 01924 317061 or 317000
> 
> 
> 
> 
> ------ACB discussion List Information--------
> This is an open discussion list for the academic and clinical community working in clinical biochemistry.
> Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
> ACB Web Site
> http://www.acb.org.uk
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> 
> ------------------------------
> 
> Date:    Tue, 23 Apr 2013 15:32:32 +0100
> From:    "[log in to unmask]" <[log in to unmask]>
> Subject: Aldolase
> 
> Thank you for all the prompt replies.  If it's not a macro CK there'll be a lot of hats eaten.  I'll keep you all informed,
> Regards, David
> 
> ------ACB discussion List Information--------
> This is an open discussion list for the academic and clinical community working in clinical biochemistry.
> Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
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> 
> ------------------------------
> 
> Date:    Tue, 23 Apr 2013 15:33:33 +0100
> From:    Rachel Smith <[log in to unmask]>
> Subject: CA153 stability in whole blood
> 
> Thanks to those who replied to my email a while ago.  I was pointed to a good WHO paper which covers lots of analytes - but unfortunately not CA153 - and I am struggling to find anything on this.  It seems unlikely it'll be much less stable than other tumour markers, but I can't find any studies.
> 
> Does anyone have any standards they use in their lab for how long a sample for TMs (CA153 particularly) can be delayed before separation?  Or any papers anyone is aware of?
> 
> Thankyou!
> 
> Rachel Smith
> Clinical Biochemist
> _DISCLAIMER:
> This email and any files transmitted with it are confidential. If you are not the intended recipient, any reading, printing, storage, disclosure, copying or any other action taken in respect of this e-mail is prohibited and may be unlawful. If you are not the intended recipient, please notify the sender immediately by using the reply function and then permanently delete what you have received.
> 
> The information contained in this e-mail may be subject to public disclosure under the Freedom of Information Act 2000. The confidentiality of this e-mail and your reply cannot be guaranteed, unless the information is legally exempt from disclosure.
> 
> 
> ------ACB discussion List Information--------
> This is an open discussion list for the academic and clinical community working in clinical biochemistry.
> Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
> ACB Web Site
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> 
> ------------------------------
> 
> Date:    Tue, 23 Apr 2013 07:47:17 -0700
> From:    Mohammad Al-Jubouri <[log in to unmask]>
> Subject: Re: Aldolase
> 
> As all CK, ALT & AST enzymes are raised, it looks like a genuinely raised CK of skeletal muscle origin and not a macro-CK. it is a significantly raised level that can only be associated with myopathy of some sort, warrants ruling out adult onset McArdle disease and polymyositis.
> 
> Best regards
> 
> Mohammad
>  
> Dr. M A Al-Jubouri, MB ChB, MSc, FRCP Edin, FRCPath
> Consultant Chemical Pathologist
> 
> 
> ________________________________
> From: "[log in to unmask]" <[log in to unmask]>
> To: [log in to unmask] 
> Sent: Tuesday, April 23, 2013 2:53 PM
> Subject: Aldolase
> 
> 
> Hi,
> Can anyone offer an aldolase measurement.
> We have a patient with a chronically raised (4 years) CK.  Today the CK is 2396 u/l. ALT 77, AST 68. She had an M infarct 2 years ago but is now well. Started and stopped statins for FHC.  We are struggling to understand her picture.  TFTs normal, no muscle wasting........
> David
> 
> ------ACB discussion List Information--------
> This is an open discussion list for the academic and clinical community working in clinical biochemistry.
> Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
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> ------ACB discussion List Information--------
> This is an open discussion list for the academic and clinical community working in clinical biochemistry.
> Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
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> 
> ------------------------------
> 
> Date:    Tue, 23 Apr 2013 15:54:56 +0100
> From:    Rachel Smith <[log in to unmask]>
> Subject: bilirubin in whole blood
> 
> Another question:
> 
> Does anyone have a cut off of how long adult samples for bilirubin analysis can take to arrive in the lab (i.e. before being centrifuged)?  Presumably the bilirubin will be affected by the light - adult samples, certainly here, don't get protected from the light. Does anyone know of any work studying how much bilirubin levels are affected?
> 
> Thanks,
> 
> Rachel Smith
> Clinical Biochemist
> _DISCLAIMER:
> This email and any files transmitted with it are confidential. If you are not the intended recipient, any reading, printing, storage, disclosure, copying or any other action taken in respect of this e-mail is prohibited and may be unlawful. If you are not the intended recipient, please notify the sender immediately by using the reply function and then permanently delete what you have received.
> 
> The information contained in this e-mail may be subject to public disclosure under the Freedom of Information Act 2000. The confidentiality of this e-mail and your reply cannot be guaranteed, unless the information is legally exempt from disclosure.
> 
> 
> ------ACB discussion List Information--------
> This is an open discussion list for the academic and clinical community working in clinical biochemistry.
> Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
> ACB Web Site
> http://www.acb.org.uk
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> 
> ------------------------------
> 
> Date:    Tue, 23 Apr 2013 15:37:12 +0000
> From:    "Sandberg, Gary M" <[log in to unmask]>
> Subject: Re: IQC for haemolysis index
> 
> I used to make a suspension of fresh red cells in saline and freeze it in those little bullet-shaped tubes. Once thawed, the hemolysate held a stable hemolysis index for almost a week when refrigerated, no preservative. Frozen at -70C, the aliquots held a stable value for two years.
> 
>   Gary
> 
> Gary Sandberg MT(ASCP) SC
> Technical Operations Manager
> PeaceHealth Laboratories
> Bellingham, WA  USA
> 
> 
> From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Woodrow Iain
> Sent: Tuesday, April 23, 2013 6:54 AM
> To: [log in to unmask]
> Subject: IQC for haemolysis index
> 
> Hi all,
> 
> I think this may have been visited before, but we have Abbott analysers and would like to have some handle on how the haemolysis index is performing. Abbott don't offer any IQC material for this. What do other users (Abbott or otherwise) do?
> 
> Thanks in anticipation
> 
> Iain
> 
> Dr Iain Woodrow,
> Clinical Biochemist
> Department of Clinical Biochemistry
> Pinderfields General Hospital
> Aberford Rd
> Wakefield
> WF1 4DG
> 
> Phone 01924 317061 or 317000
> 
> ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/
> 
> This message is intended solely for the use of the individual and entity to whom it is addressed, and may contain information that is privileged, confidential, and exempt from disclosure under applicable state and federal laws.  If you are not the addressee, or are not authorized to receive for the intended addressee, you are hereby notified that you may not use, copy, distribute, or disclose to anyone this message or the information contained herein.  If you have received this message in error, immediately advise the sender by reply email and destroy this message.
> 
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> Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content.
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> ------------------------------
> 
> Date:    Tue, 23 Apr 2013 17:01:09 +0100
> From:    "[log in to unmask]" <[log in to unmask]>
> Subject: Aldolase
> 
> Just a follow up - the patient's troponin T is 539 ng/L (N <13).  She was quite well when seen in clinic this morning - definitely no chest pain.
> DB
> 
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> This is an open discussion list for the academic and clinical community working in clinical biochemistry.
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> 
> ------------------------------
> 
> Date:    Tue, 23 Apr 2013 22:16:42 +0100
> From:    Elizabeth Fox <[log in to unmask]>
> Subject: Tranexamic acid
> 
> Dear all, 
> 
> I've had a request for measurement of tranexamic in blood as part of a research study.  Does anyone know of a lab that offers this assay?
>  
> Thanks, 
> 
> Kind regards,
> 
> Liz
> 
> Dr Elizabeth Fox
> Clinical Scientist
> Specialist Laboratory Medicine
> Leeds Teaching Hospitals NHS Trust
> 
> ------ACB discussion List Information--------
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> ------------------------------
> 
> End of ACB-CLIN-CHEM-GEN Digest - 22 Apr 2013 to 23 Apr 2013 (#2013-94)
> ***********************************************************************

------ACB discussion List Information--------
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