Interpreting the full blood count

The full blood count (FBC) is one of the most commonly requested blood tests in medical practice and can provide a wealth of useful information about a patient’s general state of health, as well as highlighting abnormalities which indicate systemic or sinister pathologies. This article seeks to explore the different parameters of the FBC, and how these relate to some more common clinical presentations, as well as their relation to morphological findings seen on the blood film. As with most investigations, differential diagnoses suggested by any individual laboratory tests are wide and are most valuable when combined with history and examination.

Proposed Framework for Comparison of Continuous Probabilistic Genotyping Systems amongst Different Laboratories

Continuous probabilistic genotyping (PG) systems are becoming the default method for calculating likelihood ratios (LRs) for competing propositions about DNA mixtures. Calculation of the LR relies on numerical methods and simultaneous probabilistic simulations of multiple variables rather than on analytical solutions alone. Some also require modelling of individual laboratory processes that give rise to electropherogram artefacts and peak height variance. For these reasons, it has been argued that any LR produced by continuous PG is unique and cannot be compared with another. We challenge this assumption and demonstrate that there are a set of conditions defining specific DNA mixtures which can produce an aspirational LR and thereby provide a measure of reproducibility for DNA profiling systems incorporating PG. Such DNA mixtures could serve as the basis for inter-laboratory comparisons, even when different STR amplification kits are employed. We propose a procedure for an inter-laboratory comparison consistent with these conditions.

Comparative analysis of laboratory data of patients suffering from SARS-CoV-2-induced pneumonia and bacterial pneumonia

Comparative analysis of laboratory data of 46 patients suffering from pneumonia caused by SARS-CoV-2 and 12 patients - pneumonia of bacterial etiology is given. It was established that in patients with COVID-19 compared to patients with bacterial pneumonia, the level of direct bilirubin is 84% more, and thrombocrit is three times more, which can indicate intravascular hemolysis and activation of the hemostasis system. Sex differences in laboratory indicators in patients with COVID-19, which go beyond the known limits of the physiological norm, were not detected. However, in men, hematocrit, hemoglobin, and plasma creatinine values were statistically higher than in women, but the amount of C-reactive protein in women was 5 times greater. However, these laboratory measures in COVID-19 have low prognostic significance. Therefore, conventional laboratory measures do not reveal clinic-critical differences in bacterial pneumonia and pneumonia caused by SARS-CoV-2. When conducting multifactorial analysis, it turned out that the laboratory indicators of patients suffering from bacterial pneumonia are not clustered and it is impossible to form predictor models from them. While laboratory indicators of patients suffering from pneumonia caused by COVID-19 form a directed pathogenetic response of the body as a whole, which causes multi-branch associated changes in homeostasis. Unfortunately, the amount of data available to us did not allow a qualitative discriminant analysis, which, with a very large amount of data, could lead to discriminant equations that are resistant to random emissions. This would allow, according to the available key individual laboratory indicators, to identify patients suffering from COVID-19 in the early stages already in the first hours of admission to the clinic.

The results of a subjective assessment of the organization of inpatient care for newborn parents and neonatologists

Aim. To study the opinion of mothers of newborns and neonatologists about the organization of inpatient care for newborns in St. Petersburg. Methods. An anonymous survey of 2123 mothers of newborns and 172 neonatologists of St. Petersburg was conducted. The representativeness of the sample was checked by using the method of Professor A.M. Merkov, with the errors do not exceed 4 and 3%, respectively. Mathematical processing and data analysis were carried out by using the statistical software package PASW STATISTICS. Results. 28.9% of mothers were partially or completely unsatisfied with the organization of inpatient care for newborns, in most cases due to the unfriendly and inattentive attitude by the medical staff (22.4%), the unsatisfactory provision by child care products (12.8%) and poor material and technical equipment of a medical organization (12.5%). On average, the human qualities of neonatologists were rated quite high by mothers at 4.630.09 (out of 5) points, and in mid-level practitioners were significantly lower 3.910.08 points (p 0.05). In general, staying a newborn in a medical organization required financial costs for 37.3% of women, and 13.9% of respondents who received help through compulsory medical insurance paid for individual laboratory and other tests on their own. Mothers rated the organization of inpatient care for newborns on average 4.010.09 points. Compared to mothers, neonatologists rated it higher in the medical organization they work for and lower overall in St. Petersburg (M=4.110.10 points and M=3.780.12 points; p 0.05). According to the doctors, the main disadvantages of organizing inpatient care for newborns are poor material and technical equipment and problems associated with the staffing and qualifications of medical personnel. Conclusion. There is a need to improve the process of providing inpatient care to newborns.

Clinical Exome Studies Have Inconsistent Coverage

BACKGROUND Exome sequencing has become a commonly used clinical diagnostic test. Multiple studies have examined the diagnostic utility and individual laboratory performance of exome testing; however, no previous study has surveyed and compared the data quality from multiple clinical laboratories. METHODS We examined sequencing data from 36 clinical exome tests from 3 clinical laboratories. Exome data were compared in terms of overall characteristics and coverage of specific genes and nucleotide positions. The sets of genes examined included genes in Consensus Coding Sequence (CCDS) (n = 17723), a subset of genes clinically relevant to epilepsy (n = 108), and genes that are recommended for reporting of secondary findings (n = 57; excludes X-linked genes). RESULTS The average exome nucleotide coverage (≥20×) of each laboratory varied at 96.49% (CV = 3%), 96.54% (CV = 1%), and 91.68% (CV = 4%), for laboratories A, B, and C, respectively. For CCDS genes, the average number of completely covered genes varied at 12184 (CV = 29%), 11687 (CV = 13%), and 5989 (CV = 37%), for laboratories A, B, and C, respectively. With smaller subsets of genes related to epilepsy and secondary findings, the CV revealed low consistency, with a maximum CV seen in laboratory C for both epilepsy genes (CV = 60%) and secondary findings genes (CV = 71%). CONCLUSIONS Poor consistency in complete gene coverage was seen in the clinical exome laboratories surveyed. The degree of consistency varied widely between the laboratories.

758. High-Throughput Mining of Electronic Medical Records Using Generalizable Autonomous Scripts

Background The electronic medical record (EMR) has become a modern compendium of health information, from broad clinical assessments down to an individual’s heart rate. The wealth of information in these EMRs hold promise for clinical discovery and hypothesis generation. Unfortunately, as these systems have become more robust, mining them for relevant clinical information is hindered by the overall data architecture, and often requires the expertise of a clinical informatician to extract relevant data. However, as the information presented to the clinician through the digital workspace is derived from the core EMR database, the format is well structured and can be mined using text recognition and parsing scripts. Methods Here we present a program which can parse output from Epic Hyperspace®, generating a relational database of clinical information. To facilitate ease of use, our protocol capitalizes on the familiarity of Microsoft Excel® as an intermediary for storing the raw output from the EMR, with data parsing and processing scripts written in SAS V9.4 (Cary, North Carolina). Results As a proof of concept, we extracted the diagnosis codes and standard laboratories for 190 patients seen in our Congenital Cytomegalovirus Clinic at Texas Children’s Hospital in Houston, Texas. Manual extraction of these data into Microsoft Excel® took 1 hour, and the scripts to parse the data took less than 5 seconds to run. Data from these patients included: 3800 ICD-10 codes (along with their metadata) and 33,000 individual laboratory values. In total, more than 850,000 characters were extracted from the EMR using this technique. Manual review of 10 randomly selected charts, found the data in perfect concordant with the EMR, a direct reflection of the fidelity of the parsing scripts. On average, an experienced user was able to enter three ICD-10 codes each minute, and six individual laboratory values per minute. At best, this same process would have taken at least 110 hours using a conventional chart review technique. Conclusion High-throughput data mining tools have the potential to improve the feasibility of studies dependent upon information stored in the EMR. When coupled with specific content knowledge, this approach can consolidate months of data collection into a day’s task. Disclosures All authors: No reported disclosures

Laboratory Automation in Clinical Microbiology

Laboratory automation is currently the main organizational challenge for microbiologists. Automating classic workflows is a strenuous process for the laboratory personnel and a huge and long-lasting financial investment. The investments are rewarded through increases in quality and shortened time to report. However, the benefits for an individual laboratory can only be estimated after the implementation and depending on the classic workflows currently performed. The two main components of automation are hardware and workflow. This review focusses on the workflow aspects of automation and describes some of the main developments during recent years. Additionally, it tries to define some terms which are related to automation and specifies some developments which would further improve automated systems.

Use of admixture effectiveness curves for prediction of the compressive strength of concrete

This paper presents the results of individual laboratory tests conducted in the Research and Experiment Facility of the University of Science and Technology in Bydgoszcz, in particular of tests conducted on pastes of low water-binder ratios (from 0.2 to standard water demand (Mrozik 2012)). The purpose of this document is to examine the effect of the applied admixtures (plasticizer or superplasticizer) and its amount on the bulk density of a cement paste, thus on the compressive strength of concrete (as shown in the paper (Neville 2012), properties of concrete can be estimated on the basis of pastes). Conclusions concerning the suitability of specific amounts of plasticisers and superplasticizers were formulated and effectiveness curves were established on the basis thereof.

Descriptor Fingerprints and Their Application to WhiteWine Clustering and Discrimination.

This study continues the attempt to use the statistical process for a large-scale analytical data. A group of 3898 white wines, each with 11 analytical laboratory benchmarks was analyzed by a fingerprint similarity search in order to be grouped into separate clusters. A characterization of the wine’s quality in each individual cluster was carried out according to individual laboratory parameters.

Marcadores moleculares

Molecular markers are becoming essential tools in many areas of biology including bio-medicine, breeding, forensics and diversity analysis. In addition they are also being exploited to locate and isolate genes of interest. A variety of DNA based molecular marker techniques are now available. Individual techniques employ different methods used routinely in molecular biology and different kinds of markers are distinguished by their capacity to detect polymorphism at one or many loci and whether they are dominant or co-dominant markers. The choice of marker system will depend on individual laboratory facilities and the applications of interest to each researcher.