 |
 |
This is a policy based on convenience and economics rather than science! Nick Miller, London On 15 August 2018 at 10:43, LAMB, Edmund (EAST KENT HOSPITALS UNIVERSITY NHS FOUNDATION TRUST) <[log in to unmask]> wrote: > Totally agree we shouldn’t make recommendations without evidence. Surely > any laboratories offering this service and insisting on a certain tube type > will have verification data supporting their recommendations. Wouldn’t UKAS > insist on such? > > > > In east Kent we do not insist on a special tube and most of our samples > are taken into gel-SSTs. Probably about 50% of our samples yield a result > slightly below the reference range but probably of no clinical > significance. It is very rare to see high results – in fact I can’t recall > a high one. Are all of our slightly low results spuriously elevated by tube > contamination i.e. actually deficient. This seems unlikely. > > > > Insisting on a special tube type would require increased blood being taken > and would probably result in more rejected samples. > > > > > > Dr Edmund Lamb PhD FRCPath > > Clinical Director of Pathology and Consultant Clinical Scientist > (Biochemistry) > > Tel: 01227-766877 extn 7224112 > > E-mail: [log in to unmask] > > > > http://www.ekhuft.nhs.uk/patients-and-visitors/services/pathology/ > > > > [image: *] follow us on Twitter @EKHUFTPathology > > > > *From:* Clinical biochemistry discussion list [mailto:ACB-CLIN-CHEM-GEN@ > JISCMAIL.AC.UK] *On Behalf Of *MCDONALD, Tim (ROYAL DEVON AND EXETER NHS > FOUNDATION TRUST) > *Sent:* 15 August 2018 10:27 > > *To:* [log in to unmask] > *Subject:* Re: zinc analysis - are trace element free tubes required? > > > > Is anyone able to give actual data to support this? > > It seems everyone is in agreement, but what is the magnitude of the > contamination? Those labs that offer to compare a blank tube from the same > batch of the main blood tube providers, what is the range of zinc levels > seen? > > > > BW > > > > Tim > > > > *Timothy McDonald, PhD FRCPath * > > *Consultant Clinical Scientist, Royal Devon and Exeter NHS Foundation > Trust* > > *& Clinical Associate Professor (NIHR Fellow), University of Exeter > Medical School* > > > > Blood Sciences, Template A2, > > Royal Devon and Exeter Hospital > > Barrack Road, Exeter, UK, EX2 5DW > > t: Lab +44 (0)1392 402948 > > t: Medical School +44 (0)1392 408250 > > e: *[log in to unmask] <[log in to unmask]>* > > Website: www.exeterlaboratory.com > > [image: cid:image001.png@01D1ED64.AA424F80] > <http://www.exeterlaboratory.com/> > > > > *From:* Clinical biochemistry discussion list [mailto:ACB-CLIN-CHEM-GEN@ > JISCMAIL.AC.UK] *On Behalf Of *Nick Miller > *Sent:* 15 August 2018 09:21 > *To:* [log in to unmask] > *Subject:* Re: zinc analysis - are trace element free tubes required? > > > > Ignore zinc results based on plasma prepared from samples that have not > been collected in trace element free tubes! They will give the wrong > (higher) results due to contamination from the tube, the gel (if present) > and the rubber cap. The whole history of zinc measurement in clinical > chemistry, going back to Prasad in 1963, and the discovery of its > essentiality in mammalian metabolism, depends on this. Prasad, of course, > had to acid-wash his tubes and vessels. Also be very careful about how you > handle the samples for analysis. Nick Miller, London > > > > On 14 August 2018 at 20:46, Gavin Murdock <[log in to unmask]> wrote: > > Hi Mandy, > > > > It would seem to me that the main reason for using a trace element tube is > because BD actively monitor the levels of trace elements present in each > batch before release and certify that, for zinc, no more than 40 μg/L will > be present. > > A standard SST tube is not monitored for the levels of trace elements in > each batch so unless you were prepared to send an additional tube, from the > same batch as used for the patient sample, for use as a blank then it would > seem sensible to use a trace element tube to minimise pre-analytical errors. > > > > Regards, > > Gavin Murdock > > > > On Tue, 14 Aug 2018 at 16:18, PERRY, Mandy (ROYAL DEVON AND EXETER NHS > FOUNDATION TRUST) <[log in to unmask]> wrote: > > Dear mailbase > > > > For zinc analysis, some laboratories insist on trace element free tubes, > whereas other labs will accept serum from gel separator tubes. > > > > Does anyone know of any data to demonstrate the requirement for use of > trace element free tubes for zinc analysis, rather than serum gel tubes? Or > any data to that shows that serum gel tubes give accurate zinc results? > > > > I appreciate that it is widely reported that gel can cause falsely raised > zinc results, but I am struggling to find any up to date data to support, > or negate this. > > > > With many thanks > > Mandy > > > > > > *Mandy Perry, PhD FRCPath * > > *Clinical Scientist, Royal Devon and Exeter NHS Foundation Trust* > > > > ****Please note, my working days are Mon, Tue, Thurs and Fri**** > > > > Blood Sciences, Template A2, > > Royal Devon and Exeter Hospital > > Barrack Road, Exeter, UK, EX2 5DW > > t: +44 (0)1392 402948 > > e: [log in to unmask] > > Website: www.exeterlaboratory.com > > *Error! Filename not specified.* <http://www.exeterlaboratory.com/> > > > > > > > > ************************************************************ > ******************************************************** > > 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 relation to 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 other accredited > email services. > > For more information and to find out how you can switch, > https://portal.nhs.net/help/joiningnhsmail > > ------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.) 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/ > > > > ************************************************************ > ******************************************************** > > 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 relation to 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 other accredited > email services. > > For more information and to find out how you can switch, > https://portal.nhs.net/help/joiningnhsmail > > ------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 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 relation to 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 other accredited > email services. > > For more information and to find out how you can switch, > https://portal.nhs.net/help/joiningnhsmail > > ------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.) http://www.jiscmail.ac.uk/