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Latest News

  • Turning off Hard Copy Reports

    Turning off Hard Copy Reports

    Item Author Craig Webster

    As you will be aware, laboratory reports are sent to your Practice both by electronic transfer and in hard copy form. The Directorate has received several requests to cease printing and sending hard copy reports as they have limited value with the current electronic systems in place. Unfortunately, until recently, it has not been possible to prevent the printing of hard copy reports to individual locations. We are pleased to inform you that technical advancements now make this possible.

  • TB Genomics Service Pilot Project

    Item Author Clare Overton Lewis

    PHE Birmingham are launching our TB Genomics Service pilot project next month.

    Background

    • In the last 10-months we have participated in an eight-centre international collaboration study on TB Whole Genome Sequencing (WGS) led by Oxford which has used DNA extracted from MGIT. 
    • The Oxford led project is a feasibility study on the use of WGS in TB diagnosis, resistance profiling and epidemiological mapping of outbreaks. During this Feasibility study, working with our colleagues at Oxford, DNA extraction and MiSeq sequencing methodologies have been established at Heartlands. Raw sequence data has been shared with Oxford through a cloud setup and analysis reports (on mycobacterial species identity, drug resistance predictions and strain typing) received within 48 hours of the raw data being uploaded.
  • Representative fragment of Pancreatic Adenocarcinoma stained with CA19-9: http://archive.biomedcentral.com/1742-6413/4/13/figure/F4?highres=y

    Notification of changes to CA19-9

    Item Author Craig Webster

    On Wednesday 11th June the method for the CA19-9 assay at HEFT will change from the Siemens Immulite assay to the Roche assay. Our comparisons have shown that the results are comparable in most cases; however, there were some samples which did show a poor correlation.  We are therefore going to dual report results for a period to allow transition of serially monitored patients to the new CA199 assay.

    Further more detailed information is available on request. If you have any queries or comments please contact Craig Webster (Clinical Lead for Blood Sciences) by email or ext 42930.

Introduction

Written by Craig Webster on .

This handbook encompasses all disciplines of Laboratory Medicine at Birmingham Heartlands, Solihull and Good Hope Hospitals. It has been designed to provide the busy general practitioner and hospital doctor more readily available information regarding our services. 

Search

You can search or browse our test directory here. This database includes details on all our tests and recommended profiles for the investigation of common presenting complaints.

INTERFERON GAMMA RELEASE ASSAYS (IGRA) FOR LATENT TB TESTING.

Written by Stephen Rimmer on .

The QuantiFERON-TB Gold In Tube and the T-SPOT are two in-vitro tests for measuring cell-mediated immune responses to peptide antigens from mycobacteria. These antigens, ESAT-6, CFP-10 and TB7.7 (p4) (which is used only in QFT-G) are absent from all BCG strains and from most non tubercular mycobacterial strains (NTMs) with the exception of M. kansasii, M. szulgai and M. marinum. Individuals infected with M. tuberculosis complex organisms (M. tuberculosis, M. bovis, M. africanum, M. microti, M. canetti) have mononuclear cells in their blood that recognise these mycobacterial antigens. This recognition process leads to the stimulation and secretion of IFN-γfrom sensitized T-cells. The detection and quantification of IFN-γ, measured by enzyme-linked immunoassay (Quantiferon) or enzyme-linked immunospot (T-SPOT), forms the basis of these tests – detectable as early as two weeks after infection with M. tuberculosis.

Both tests are intended for use in conjunction with risk assessment, radiography, and other medical and diagnostic evaluations.  QuantiFERON Gold-IT is the laboratory recommended method for routine screening of patients with a normal lymphocyte count.   T spots are recommended in specific circumstances (see below). 

 

 

Sensitivity

 

Specificity

 

Suggested use

 

 

QFT

 

 

84

 

 

99

·         Routine TB contact screening

·         Healthcare worker screening

·         Patients with normal lymphocyte count

·         Immigrants from high incidence areas (WHO >40/100,000/yr)

 

 

T spot

 

 

89

 

 

86

·         T lymphopenia patients (malignancy, infection)

·         Immunosuppressed (iatrogenic/immunodeficiency)

·         Neonates /paediatrics and small volume  samples (<3mls).

From: Diel et al. Chest 2010; 137(4):952-968.

IGRA results should be considered in conjunction with other epidemiologic, historic, physical, and diagnostic findings. Results cannot be correlated to stage or degree of infection, level of immune responsiveness, or likelihood for progression to active disease.  

The Hospital Trust TB service will be notified of all positive and borderline results.  

For test specific information click on the links below

Tspot test Information:

http://www.heftpathology.com/index.php?option=com_zoo&task=item&item_id=594&Itemid=627

Quantiferon IGRA test Information; 

 

http://www.heftpathology.com/index.php?option=com_zoo&task=item&item_id=1115&Itemid=627