Dear Colleagues,
I am very pleased to announce that CMFT now offer a service for plasma Cystatin C. I hope you will find it useful.
The service is fully quality controlled in our CPA/UKAS-accredited laboratory, with EQA from Equalis. We have set what we believe is a competitive price, £12.20 per test, to be reviewed annually. This compares favourably with the price from VIAPATH (the only other UK provider of which we're aware) which is currently £13.20. Results will be returned by either Lab2Lab, fax or 1st class post within 24h of receipt – please let us know your preference before starting to send orders. Please phone us first for clinically-urgent requests and we will endeavour to provide a quicker result.
Our full postal address is as follows:
Department of Clinical Biochemistry,
CSB3,
Clinical Sciences Centre,
Manchester Royal Infirmary,
Central Manchester NHS Foundation Trust,
Oxford Road,
Manchester,
M13 9WL
UK
Best wishes,
Chris
Dr Christopher Chaloner FRCPath
Consultant Paediatric Biochemist
Deputy Head of Service, Clinical Biochemistry
CMFT
Tel: 0161 701 2752
-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of ACB-CLIN-CHEM-GEN automatic digest system
Sent: 26 July 2014 00:11
To: [log in to unmask]
Subject: ACB-CLIN-CHEM-GEN Digest - 24 Jul 2014 to 25 Jul 2014 (#2014-146)
There are 16 messages totaling 4064 lines in this issue.
Topics of the day:
1. CKD (8)
2. cystatin C (2)
3. Uncertainty of eGFR
4. MP wants to incorporate astrology into medicine (4)
5. Alpha defensin
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Date: Fri, 25 Jul 2014 08:58:19 +0100
From: "OConnor John (ROYAL DEVON AND EXETER NHS FOUNDATION TRUST)"
<[log in to unmask]>
Subject: CKD
New NICE CKD guidance issued yesterday
http://www.nice.org.uk/guidance/cg182/resources/cg182-chronic-kidney-disease-update-classification-table
Did anyone notice this !
"Consider using eGFRcystatinC for people with CKD G3aA1 "
BW
John
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Date: Fri, 25 Jul 2014 08:12:48 +0000
From: David James <[log in to unmask]>
Subject: Re: CKD
I’ve already had one GP ask about it, and have contacted CCG to see if they want it commissioned
dj
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of OConnor John (ROYAL DEVON AND EXETER NHS FOUNDATION TRUST)
Sent: 25 July 2014 08:58
To: [log in to unmask]
Subject: CKD
---
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New NICE CKD guidance issued yesterday
http://www.nice.org.uk/guidance/cg182/resources/cg182-chronic-kidney-disease-update-classification-table
Did anyone notice this !
“Consider using eGFRcystatinC for people with CKD G3aA1 “
BW
John
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Date: Fri, 25 Jul 2014 08:13:36 +0000
From: David James <[log in to unmask]>
Subject: Re: CKD
I suppose the get out from a commissioning perspectoive is “consider” !
dj
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of OConnor John (ROYAL DEVON AND EXETER NHS FOUNDATION TRUST)
Sent: 25 July 2014 08:58
To: [log in to unmask]
Subject: CKD
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New NICE CKD guidance issued yesterday
http://www.nice.org.uk/guidance/cg182/resources/cg182-chronic-kidney-disease-update-classification-table
Did anyone notice this !
“Consider using eGFRcystatinC for people with CKD G3aA1 “
BW
John
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------------------------------
Date: Fri, 25 Jul 2014 11:19:10 +0100
From: Jonathan Middle <[log in to unmask]>
Subject: Re: CKD
Hi
I looked at the Table in the link John sent and was interested in the eGFR
values used in the stratification of CKD.
Is anyone concerned about whether the uncertainty requirements for eGFR
estimation that would enable laboratories accurately and reliably to
discriminate between values of, say, 44 & 45 mL/min/1.73m^2, can be
achieved?
These two articles may be informative!
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3689324/
http://www.ncbi.nlm.nih.gov/pubmed/24839297
Cheers
Jonathan
On Fri, Jul 25, 2014 at 8:58 AM, OConnor John (ROYAL DEVON AND EXETER NHS
FOUNDATION TRUST) <[log in to unmask]> wrote:
> New NICE CKD guidance issued yesterday
>
>
> http://www.nice.org.uk/guidance/cg182/resources/cg182-chronic-kidney-disease-update-classification-table
>
>
>
> Did anyone notice this !
>
> “Consider using eGFRcystatinC for people with CKD G3aA1 “
>
> BW
>
> John
>
>
> ********************************************************************************************************************
>
> 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.
>
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>
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> staff in England and Scotland
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------------------------------
Date: Fri, 25 Jul 2014 10:21:02 +0000
From: David James <[log in to unmask]>
Subject: Re: CKD
Just to put the cat among the pigeons – what is the uncertainty of measurement caused by the fact that it is assumed that all people of the same age and gender have the same muscle mass ☺
dj
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Jonathan Middle
Sent: 25 July 2014 11:19
To: [log in to unmask]
Subject: Re: CKD
Hi
I looked at the Table in the link John sent and was interested in the eGFR values used in the stratification of CKD.
Is anyone concerned about whether the uncertainty requirements for eGFR estimation that would enable laboratories accurately and reliably to discriminate between values of, say, 44 & 45 mL/min/1.73m^2, can be achieved?
These two articles may be informative!
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3689324/
http://www.ncbi.nlm.nih.gov/pubmed/24839297
Cheers
Jonathan
On Fri, Jul 25, 2014 at 8:58 AM, OConnor John (ROYAL DEVON AND EXETER NHS FOUNDATION TRUST) <[log in to unmask]<mailto:[log in to unmask]>> wrote:
New NICE CKD guidance issued yesterday
http://www.nice.org.uk/guidance/cg182/resources/cg182-chronic-kidney-disease-update-classification-table
Did anyone notice this !
“Consider using eGFRcystatinC for people with CKD G3aA1 “
BW
John
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------------------------------
Date: Fri, 25 Jul 2014 11:34:50 +0100
From: "OConnor John (ROYAL DEVON AND EXETER NHS FOUNDATION TRUST)"
<[log in to unmask]>
Subject: Re: CKD
Good point David
I have endless discussions with GP’s around bird like old ladies with extremely low BMI’s and muscle mass in whom the eGFR is fairly useless as an indicator of renal function.
John
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of David James
Sent: 25 July 2014 11:21
To: [log in to unmask]
Subject: Re: CKD
Just to put the cat among the pigeons – what is the uncertainty of measurement caused by the fact that it is assumed that all people of the same age and gender have the same muscle mass ☺
dj
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Jonathan Middle
Sent: 25 July 2014 11:19
To: [log in to unmask]
Subject: Re: CKD
Hi
I looked at the Table in the link John sent and was interested in the eGFR values used in the stratification of CKD.
Is anyone concerned about whether the uncertainty requirements for eGFR estimation that would enable laboratories accurately and reliably to discriminate between values of, say, 44 & 45 mL/min/1.73m^2, can be achieved?
These two articles may be informative!
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3689324/
http://www.ncbi.nlm.nih.gov/pubmed/24839297
Cheers
Jonathan
On Fri, Jul 25, 2014 at 8:58 AM, OConnor John (ROYAL DEVON AND EXETER NHS FOUNDATION TRUST) <[log in to unmask]<mailto:[log in to unmask]>> wrote:
New NICE CKD guidance issued yesterday
http://www.nice.org.uk/guidance/cg182/resources/cg182-chronic-kidney-disease-update-classification-table
Did anyone notice this !
“Consider using eGFRcystatinC for people with CKD G3aA1 “
BW
John
********************************************************************************************************************
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.
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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/
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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/
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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/
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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: Fri, 25 Jul 2014 11:38:58 +0100
From: Ian Young <[log in to unmask]>
Subject: cystatin C
There have been significant issues with standardization of cystatin C assays (which I am sure bypassed NICE completely!).
For those who may be interested in pursuing this, it is important to have some knowledge of the standardization status of the assay and the most appropriate equation to use.
The following paper is very relevant:
Generation of a new cystatin C-based estimating equation for glomerular filtration rate by use of 7 assays standardized to the international calibrator.<http://www.ncbi.nlm.nih.gov/pubmed/24829272>
Grubb A, Horio M, Hansson LO, Björk J, Nyman U, Flodin M, Larsson A, Bökenkamp A, Yasuda Y, Blufpand H, Lindström V, Zegers I, Althaus H, Blirup-Jensen S, Itoh Y, Sjöström P, Nordin G, Christensson A, Klima H, Sunde K, Hjort-Christensen P, Armbruster D, Ferrero C.
Clin Chem. 2014 Jul;60(7):974-86. doi: 10.1373/clinchem.2013.220707. Epub 2014 May 14
Best wishes
Ian
IS Young
Professor of Medicine, Queen's University Belfast
Associate Medical Director (Research and Development), Belfast Health and Social Care Trust
Centre for Public Health
1st Floor ICS B Block
Royal Victoria Hospital
Grosvenor Road
Belfast BT12 6BJ
Northern Ireland
tel: 0044 2890 632743
fax: 0044 2890 235900
email: [log in to unmask]<mailto:[log in to unmask]>
------ACB discussion List Information--------
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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: Fri, 25 Jul 2014 10:56:41 +0000
From: Jonathan Kay <[log in to unmask]>
Subject: Re: CKD
Is there any evidence yet of improved outcomes from routine reporting of eGFR? I repeatedly asked the ACB for this after their statement but I haven't seen any.
Jonathan
On 25 Jul 2014, at 11:34, OConnor John (ROYAL DEVON AND EXETER NHS FOUNDATION TRUST) <[log in to unmask]<mailto:[log in to unmask]>> wrote:
Good point David
I have endless discussions with GP’s around bird like old ladies with extremely low BMI’s and muscle mass in whom the eGFR is fairly useless as an indicator of renal function.
John
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of David James
Sent: 25 July 2014 11:21
To: [log in to unmask]<mailto:[log in to unmask]>
Subject: Re: CKD
Just to put the cat among the pigeons – what is the uncertainty of measurement caused by the fact that it is assumed that all people of the same age and gender have the same muscle mass :)
dj
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Jonathan Middle
Sent: 25 July 2014 11:19
To: [log in to unmask]<mailto:[log in to unmask]>
Subject: Re: CKD
Hi
I looked at the Table in the link John sent and was interested in the eGFR values used in the stratification of CKD.
Is anyone concerned about whether the uncertainty requirements for eGFR estimation that would enable laboratories accurately and reliably to discriminate between values of, say, 44 & 45 mL/min/1.73m^2, can be achieved?
These two articles may be informative!
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3689324/
http://www.ncbi.nlm.nih.gov/pubmed/24839297
Cheers
Jonathan
On Fri, Jul 25, 2014 at 8:58 AM, OConnor John (ROYAL DEVON AND EXETER NHS FOUNDATION TRUST) <[log in to unmask]<mailto:[log in to unmask]>> wrote:
New NICE CKD guidance issued yesterday
http://www.nice.org.uk/guidance/cg182/resources/cg182-chronic-kidney-disease-update-classification-table
Did anyone notice this !
“Consider using eGFRcystatinC for people with CKD G3aA1 “
BW
John
********************************************************************************************************************
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 Sitehttp://www.acb.org.uk<http://www.acb.org.uk/> Green Laboratories Work http://www.laboratorymedicine.nhs.uk<http://www.laboratorymedicine.nhs.uk/> List Archiveshttp://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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Date: Fri, 25 Jul 2014 11:04:15 +0000
From: Anders Kallner <[log in to unmask]>
Subject: Uncertainty of eGFR
Interestingly, the uncertainty of the "reference method" e.g. iohexol or iothalamate estimations is never included. The major sources of uncertainty there is the estimation of the distribution volume. For this usually another algorithm is applied with unknown uncertainty.
Further, the factors and exponents applied to the eGFR algorithms, whether based on Cystatin C or creatinine, are not usually considered.
Finally, the algorithms are evaluated using population data and comparing epidemiological parameters. However, take a look at the scatter plots being the basis for the regression analysis and you will find a most remarkable spread around the regression line. That is where the patients we treat will be found. Algorithms may be useful to treat populations but that is rarely our task.
Most likely, this is what David James hints at. It is never wise - or even acceptable - to move from information regarding the central tendency of a data set to individual values, whereas the opposite is the recognized, legitimate mode of operation. Consequently, the appraisal of the uncertainty in using the algorithms is most likely underestimated. However, nephrologists tend to accept an A-zone around a regression of +/- 30 %!?
Anders Kallner
Anders Kallner, MD, PhD
Assoc Professor (R)
Dept Clin Chem
Karolinska University Hospital
171 76 Stockholm
Phone +46 851774943
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Date: Fri, 25 Jul 2014 12:27:11 +0100
From: birminghamquality <[log in to unmask]>
Subject: Re: cystatin C
The UK NEQAS for eGFR estimations recently asked Labs measuring Cystatin C to return results. Over the last two months of offering this service, we had results back from only 2 Labs. Fortunately, the scheme is future-proof and will be able to assess whatever Labs are doing. At the moment they are not doing Cystatin C.
I’m sure everyone has seen my ‘essays’ on eGFR, SAUSAGES included, and that I have no particular axe to grind as to whether Enzymatic Creatinine or Cystatin C or N-Gal or whatever has the potential to give the best clinical information. I know it is not uncompensated traditional Jaffe creatinine, which is still in use. I have often questioned as to why that, for the price of a first class stamp Labs could get a ‘true’ creatinine result, the majority of Labs haven’t moved away from the stop-gap ‘Compensated’ [but still non-specific] Jaffe. The feedback from Labs is that the money just isn’t there.
Over the assay life cycle with early adopters moving through to the small minority etc etc, we see marked changes in apparent assay performance as more Lots/Batches are introduced and the users are not just the enthusiasts. The assay performance of Cystatin C needs to be scrutinised closely if it is to be rolled out.
I remain to be convinced that given their obvious financial pressures Labs are going to be queuing up to take a leap of faith into the dark (despite its recent research data) to start using an untried system notwithstanding that that is what is being instructed/recommended by NICE, by commissioners or by experts or whatever.
Regards to all
Finlay
PS Jonathan already knows that I would be one of those concerned about whether the uncertainty requirements for eGFR estimation that would enable laboratories accurately and reliably to discriminate between values of, say, 44 & 45 mL/min/1.73m^2 could be met
f
Finlay MacKenzie
NEQAS - Deputy Director and Consultant Clinical Scientist
Tel:
+44 (0) 121 414 7300
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760047300
Email:
[log in to unmask]
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[cid:image001.gif@01CFA803.C1C44F30]
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Ian Young
Sent: 25 July 2014 11:39
To: [log in to unmask]
Subject: cystatin C
There have been significant issues with standardization of cystatin C assays (which I am sure bypassed NICE completely!).
For those who may be interested in pursuing this, it is important to have some knowledge of the standardization status of the assay and the most appropriate equation to use.
The following paper is very relevant:
Generation of a new cystatin C-based estimating equation for glomerular filtration rate by use of 7 assays standardized to the international calibrator.<http://www.ncbi.nlm.nih.gov/pubmed/24829272>
Grubb A, Horio M, Hansson LO, Björk J, Nyman U, Flodin M, Larsson A, Bökenkamp A, Yasuda Y, Blufpand H, Lindström V, Zegers I, Althaus H, Blirup-Jensen S, Itoh Y, Sjöström P, Nordin G, Christensson A, Klima H, Sunde K, Hjort-Christensen P, Armbruster D, Ferrero C.
Clin Chem. 2014 Jul;60(7):974-86. doi: 10.1373/clinchem.2013.220707. Epub 2014 May 14
Best wishes
Ian
IS Young
Professor of Medicine, Queen's University Belfast
Associate Medical Director (Research and Development), Belfast Health and Social Care Trust
Centre for Public Health
1st Floor ICS B Block
Royal Victoria Hospital
Grosvenor Road
Belfast BT12 6BJ
Northern Ireland
tel: 0044 2890 632743
fax: 0044 2890 235900
email: [log in to unmask]<mailto:[log in to unmask]>
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ht
------------------------------
Date: Fri, 25 Jul 2014 11:27:46 +0000
From: Jonathan Kay <[log in to unmask]>
Subject: Re: CKD
Really interesting topic. There are many guidelines/ rule-based systems/ DSS that have decision points where the noise is high. I think the answer is:
1 Assess the systems's overall performance even knowing that individual components may be wrong. This may be against alternative systems or having no system at all.
2 Not make important decisions based on individual input values (which is really a subset of 1).
Jonathan
On 25 Jul 2014, at 11:19, Jonathan Middle <[log in to unmask]<mailto:[log in to unmask]>> wrote:
I looked at the Table in the link John sent and was interested in the eGFR values used in the stratification of CKD.
Is anyone concerned about whether the uncertainty requirements for eGFR estimation that would enable laboratories accurately and reliably to discriminate between values of, say, 44 & 45 mL/min/1.73m^2, can be achieved?
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Date: Fri, 25 Jul 2014 13:23:59 +0100
From: Jonathan Middle <[log in to unmask]>
Subject: MP wants to incorporate astrology into medicine
Just seen this:
http://www.bbc.co.uk/news/uk-politics-28464009
For once I am (almost) speechless!
Jonathan
--
AQMLM <http://www.aqmlm.org.uk> | STEMNET <http://www.stemnet.org.uk/>
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Date: Fri, 25 Jul 2014 14:09:25 +0100
From: "OConnor John (ROYAL DEVON AND EXETER NHS FOUNDATION TRUST)"
<[log in to unmask]>
Subject: Re: MP wants to incorporate astrology into medicine
Jonathan
(Tongue in cheek here)
Are we not also culpable in respect of this?
After all we still maintain tests in our catalogue with almost no predictive power for the diseases they are meant to indicate.
Also before taking the Pisces out of the equation altogether, there may just be something……….
The month of birth effect in multiple sclerosis: systematic review, meta-analysis and effect of latitude.
http://www.ncbi.nlm.nih.gov/pubmed/23152637.
Have a good weekend everyone
John
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Jonathan Middle
Sent: 25 July 2014 13:24
To: [log in to unmask]
Subject: MP wants to incorporate astrology into medicine
Just seen this:
http://www.bbc.co.uk/news/uk-politics-28464009
For once I am (almost) speechless!
Jonathan
--
AQMLM<http://www.aqmlm.org.uk> | STEMNET<http://www.stemnet.org.uk/>
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Date: Fri, 25 Jul 2014 13:24:57 +0000
From: "Coward, Steve" <[log in to unmask]>
Subject: Re: MP wants to incorporate astrology into medicine
How do we approach the uncertainty relating to the time of birth?
Regards,
Steve
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of OConnor John (ROYAL DEVON AND EXETER NHS FOUNDATION TRUST)
Sent: 25 July 2014 14:09
To: [log in to unmask]
Subject: Re: MP wants to incorporate astrology into medicine
Jonathan
(Tongue in cheek here)
Are we not also culpable in respect of this?
After all we still maintain tests in our catalogue with almost no predictive power for the diseases they are meant to indicate.
Also before taking the Pisces out of the equation altogether, there may just be something……….
The month of birth effect in multiple sclerosis: systematic review, meta-analysis and effect of latitude.
http://www.ncbi.nlm.nih.gov/pubmed/23152637.
Have a good weekend everyone
John
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Jonathan Middle
Sent: 25 July 2014 13:24
To: [log in to unmask]<mailto:[log in to unmask]>
Subject: MP wants to incorporate astrology into medicine
Just seen this:
http://www.bbc.co.uk/news/uk-politics-28464009
For once I am (almost) speechless!
Jonathan
--
AQMLM<http://www.aqmlm.org.uk> | STEMNET<http://www.stemnet.org.uk/>
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Date: Fri, 25 Jul 2014 14:30:24 +0100
From: "OConnor John (ROYAL DEVON AND EXETER NHS FOUNDATION TRUST)"
<[log in to unmask]>
Subject: Re: MP wants to incorporate astrology into medicine
Simple, use astronomy, its been done before, but you have to be famous
http://en.wikipedia.org/wiki/Star_of_Bethlehem
John
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Coward, Steve
Sent: 25 July 2014 14:25
To: [log in to unmask]
Subject: Re: MP wants to incorporate astrology into medicine
How do we approach the uncertainty relating to the time of birth?
Regards,
Steve
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of OConnor John (ROYAL DEVON AND EXETER NHS FOUNDATION TRUST)
Sent: 25 July 2014 14:09
To: [log in to unmask]
Subject: Re: MP wants to incorporate astrology into medicine
Jonathan
(Tongue in cheek here)
Are we not also culpable in respect of this?
After all we still maintain tests in our catalogue with almost no predictive power for the diseases they are meant to indicate.
Also before taking the Pisces out of the equation altogether, there may just be something……….
The month of birth effect in multiple sclerosis: systematic review, meta-analysis and effect of latitude.
http://www.ncbi.nlm.nih.gov/pubmed/23152637.
Have a good weekend everyone
John
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Jonathan Middle
Sent: 25 July 2014 13:24
To: [log in to unmask]<mailto:[log in to unmask]>
Subject: MP wants to incorporate astrology into medicine
Just seen this:
http://www.bbc.co.uk/news/uk-politics-28464009
For once I am (almost) speechless!
Jonathan
--
AQMLM<http://www.aqmlm.org.uk> | STEMNET<http://www.stemnet.org.uk/>
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Date: Fri, 25 Jul 2014 18:43:11 +0100
From: "Verrill Helen (RVW) Pathology" <[log in to unmask]>
Subject: Alpha defensin
Dear collective
I've been asked to look into the feasibility of measuring alpha defensin
for a research study. Does anyone have any knowledge of any labs
assaying this or any commercially available kits? I'm not sure yet which
of the 6 defensins I'll be looking for - just trying to prepare for a
meeting so I have some knowledge,
Thanks in advance
helen
Consultant Clinical Scientist
North Tees & Hartlepool NHSfT
01642 624455
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