JALM Talk Podcast

Keeping Up with Fentanyl: Failure to Do So Is Not an Option

The rapid rise in the prevalence of fentanyl and fentanyl analogs has contributed significantly to an increase in overdose death rates in North America.  Laboratories, healthcare providers, and government agencies struggle to effectively detect and reduce negative outcomes associated with fentanyl use in the absence of accurate data on prevalence and use.  “Keeping Up with Fentanyl: Failure to Do So Is Not an Option” was published in the July 2018 issue of The Journal of Applied Laboratory...

Automated Laboratories: When Technology Needs a Human Touch

Laboratory automation holds the promise of enhanced workflows, improved efficiency, and decreased turnaround time while mitigating an environment of rising costs, constrained resources, and staffing shortages.  Many publications tout improved outcomes from laboratory automation but realizing these results may not come easily. Automated Laboratories: When Technology Needs a Human Touch was published in the May 2018 issue of the Journal of Applied Laboratory Medicine.  This work reflects on ...

Thrombophilia: Women-Specific Reference Ranges Can Prevent Misdiagnosis in Women

“Thrombophilia: Women-Specific Reference Ranges Can Prevent Misdiagnosis in Women” was published in the March 2018 issue of The Journal of Applied Laboratory Medicine.  This work presents the establishment and impact of female-specific reference intervals for a variety of coagulation markers during pregnancy.

High-Throughput LC-MS/MS Method for Determination of the Alcohol Use Biomarker Phosphatidylethanol in Clinical Samples by Use of a Simple Automated Extraction Procedure—Preanalytical and Analytical Conditions

A high throughput LC-MS/MS method for the determination of phosphatidylethanol (PEth) in clinical samples using a simple automated extraction procedure was published in the May 2018 issue of The Journal of Applied Laboratory Medicine.  This work describes an improved automated approach to analysis of the alcohol marker phosphatidylethanol that uses liquid chromatography mass spectrometry instead of conventional HPLC.

Genotype–Phenotype Correlations of G6PDt Variants Throughout an Activity Distribution

“Genotype–Phenotype Correlations of Glucose-6-Phosphate–Deficient Variants Throughout an Activity Distribution” was published in the May 2018 issue of The Journal of Applied Laboratory Medicine.  This work examines G6PD mutations across a range of enzyme activities and seeks to establish enzyme activity cutoffs that could be implemented to rule out G6PD deficiency.

Expanding the Utility of High-Sensitivity Dried Blood Spot Immunoassay Testing with Single Molecule Counting

Recently, a method was described that combines the sensitivity of single-molecule counting with the convenience of dried spot collection.  The study evaluates three conventional protein analytes routinely measured in the clinical lab: Troponin I, Prostate Specific Antigen (PSA), and C-reaction protein.  The authors detailed the assay method that incorporates spot-scanning to account for dried blood spot variability followed by analysis with single-molecule counting.  “Expanding the Utility o...

A Paradigm Shift: Considerations in Prenatal Cell-Free DNA Screening

Cell-free DNA analysis, also called non-invasive prenatal screening and IPS, has emerged as an alternative to the conventional analysis of maternal serum markers.  Modern molecular techniques have now achieved sensitivity for the direct detection and analysis of placental DNA fragments that circulate in the maternal bloodstream and serve as a proxy for fetal aneuploidy. This technology is transforming the field of prenatal screening and has significant implications for laboratories, patients...

Medical Cannabis and Pain Management

Reflections of Two Pain Medicine Clinicians in the Era of the Opioid Crisis

The rise in opioid prescribing and subsequent growth of opioid abuse has led to increased oversight and challenges for clinicians who prescribe opioids to their patients.  Recommendations and guidance documents vary when recommending approaches to monitor patients receiving controlled substances. In this podcast, we will explore drug testing for pain management from the prescriber’s perspective.  A Laboratory Reflection “Reflections of Two Pain Medicine Clinicians in the Era of the Opioid Cr...

Pharmacogenetics of Opioid Use and Implications for Pain Management

Opioids are frequently prescribed for pain management but there is large inter-individual variation in opioid-induced pain relief. These compounds are metabolized by enzymes leading to active and inactive metabolites, and there are differences in the quantity or presence of these metabolites between individuals. This complicates the interpretation by clinicians of urine drug tests that are often administered to patients prescribed opioids. Further, although opioid addiction is a worldwide ...

Executive Summary: American Association of Clinical Chemistry Laboratory Medicine Practice Guideline—Using Clinical Laboratory Tests to Monitor Drug Therapy in Pain Management Patients

Laboratory Medicine Practice Guidelines, published by the American Association for Clinical Chemistry, recommend best practices for clinical laboratories in a number of different areas of patient testing.  These guidelines are formed via a systematic review of published literature and the consensus of experts in the field with the goal of optimizing patient care.  Recently, a review of the pain management literature was undertaken in order to produce laboratory practice guidelines in this su...

Therapeutic Monoclonal Antibodies in the Clinical Laboratory

Biological Variation of Donor-Derived Cell-Free DNA in Renal Transplant Recipients: Clinical Implications

Donor-derived cell-free DNA measurement in the circulating blood of transplant recipients is thought to have utility for clinical monitoring of tissue injury and therefore transplant rejection in heart, lung, liver, and kidney transplants, as increased levels of this biomarker are seen during acute rejection. However, the normal concentration of donor-derived cell-free DNA in successful kidney transplant patients has not been determined. An article titled “Biological Variation of Donor-Der...

The Importance of Verifying Reference Intervals for Calculated Results

A Technical Tips article titled “The Importance of Verifying Reference Intervals for Calculated Results” published in the November 2017 issue of JALM, discusses the common ways in which laboratories establish reference intervals for calculated results. Further, it contains recommendations as to the best practice for verifying these reference intervals in the patient population that they serve. The first author of this article is Dr. Rajeevan Selvaratnam, clinical chemist in the Department of...

Transforming Laboratory Utilization Review into Laboratory Stewardship: Guidelines by the PLUGS National Committee for Laboratory Stewardship

Jane Dickerson and Mike Astion

Sandwich Immunoassay for Bioactive Plasma Adrenomedullin

Andrea Sparwasser

Automated Sample Preparation Enables LC-MS/MS as a Routine Diagnostic Analysis for Serum Testosterone

Judith Stone

The Era for High-Sensitivity Cardiac Troponin Has Begun in the US (Finally)

Alan Wu

Serum Free Light Chain (FLC) Analysis: A Guiding Light in Monoclonal Gammopathy Management

Ellen Jenner

Creation of a Universal Sample Bank for Determining the 99th Percentile for Cardiac Troponin Assays

Alan Wu

Comparison of the Alere i and BD Veritor Assays for the Rapid Detection of Influenza A and B Viruses

Gregory Berry

Effect of Preanalytical Factors on the Stability of Maternal Serum Biomarkers and Calculated Risk for Trisomy 21, Trisomy 18, and Open Neural Tube Defect

Robert Schmidt

Sickle Cell Trait in the Blood Supply

Joesph Wiencek

Quality Monitoring Approach for Optimizing Antinuclear Antibody Screening Cutoffs and Testing Work Flow

Danyel Tacker

Myocardial Ischemia on Exercise Stress Echocardiography Testing Is Not Associated with Changes in Troponin T Concentrations

Point-of-Care vs Central Lab "Discrepancies"

Are Heart Failure Management Recommendations and Guidelines Followed in Laboratory Medicine in Europe and North America?

To Delta Check or Not to Delta Check? That Is the Question

The Importance of Effective Communication

Defying Gravity

Persistently Elevated Human Chorionic Gonadotropin in a Menopausal Woman

Lipoprotein Biomarkers and Risk of Cardiovascular Disease

Moving Latin American Laboratories Forward by Giving Back

α-Glutathione S-Transferase: A New Biomarker for Liver Injury?

Utility of Antinuclear Antibody Screening by Various Methods in a Clinical Laboratory Patient Cohort

The Food and Drug Administration: Overseeing, Overarching, Overreaching

Analytical and Clinical Evaluation of the NOWDiagnostics ADEXUSDx Human Chorionic Gonadotropin Test Using Whole Blood