Catlab Reports Bulletin
The Catlab Reports Bulletin is published monthly. Until the publication of the Catlab website, it was mailed electronically to our clients. It consists of a monograph related with laboratory topics. Each month it addresses a different area of Catlab; the topics can be more specific (concrete diagnostic techniques) or deal with more generic aspects (Quality, Management, …).
BIOCHEMISTRY - Possible interference by Biotin in some Laboratory tests
Biotin is a water-soluble vitamin that participates in cell proliferation, embryonic development, and in immunological and metabolic functions. It is commonly found in many foods, but also in some vitamin supplements. In 2017, the FDA warned about possible interference in some laboratory tests, due to the high presence of biotin. Catlab, following international recommendations, has been substituting some reagents to avoid possible interference with biotin.
GENETICS - Pharmacogenetic study of the variants of the DPYD Gene in cancer patients
Fluoropyrimidines are anticancer compounds that act as antimetabolites in chemotherapies of different tumors. Its administration has to be controlled very well, since an excess of metabolites can trigger toxicity. The elimination of these metabolites is mainly controlled by the activity of the DPD enzyme. The DPYD gene encodes the DPD enzyme. It is a highly polymorphic gene, and the detection of the variants allows to predict the enzymatic activity before starting the treatment, thus preventing the adverse effects of DPD deficiency. Thus, based on the variants found, a calculation is made of the patient's ability to metabolize fluoropyrimidines. With this, we can categorize the patients according to the metabolization capacity, and the standard drug dose can be corrected and personalized.
INMUNOLOGÍA -
Immune response and COVID-19
The clinical presentations of COVID-19 range from asymptomatic forms to a syndrome with cytokine release, respiratory failure, and death. People over 60 years old and those with comorbidities, are more susceptible to developing a deficient immune response, unable to eliminate the virus, and responsible for cytokine release syndrome.
However, other host factors, some still unknown, and some likely genetic in nature, appear to confer susceptibility to complications.
MICROBIOLOGY - Response of the Microbiology area against SARS-CoV-2(COVID19)
The reference technique for performing the microbiological diagnosis of SARS-CoV-2 is real-time PCR, which allows the detection of various virus genes with a sensitivity greater than 98%. At Catlab, various organizational changes were made to deal with the situation, and offer a SARS-CoV-2 diagnostic service 24 hours a day and 7 days a week.
IMMUNOLOGY - Diagnostic utility of the Kappa Index in Multiple Sclerosis
Today there are still no optimal biomarkers to identify all those affected by Multiple Sclerosis (MS). Numerous studies show that the quantitative analysis of kappa free chains can be of great help in predicting Isolated Neurological Syndrome, which is usually the first clinical outbreak that leads to the diagnosis of MS. In our laboratory, in addition to the kappa light chains in CSF and serum, we also have the determination of the Kappa Index.
QUALITY - Flexible scope accreditation
The UNE-EN ISO 15189: 2013 is an international standard that specifies the requirements regarding the competence and quality of clinical laboratories. The scope of each accreditation provides information on the activities in which the laboratory has demonstrated competence. A flexible scope allows new tests to be incorporated or modifications to be made at any time, for methods and analyzers that are already accredited. Catlab, one of the Laboratories with the highest percentage of accredited activity, has a flexible scope for most of its magnitudes.
MICROBIOLOGY - Valuation of the screening of Urine cultures in Primary
The diagnosis of urinary tract infections (UTI) is based on three factors: the patient's symptoms, the examination of the urine forms and the urine culture. In 2016, to qualitatively optimize the microbiological diagnosis of UTI, a screening of the urine with culture requested is started. The result of this screening is a clear decrease in negative urine cultures, an increase in positive ones, and a tendency to reduce contaminated urine cultures.
HEMATOLOGY - Diagnosis of von Willebrand disease
Von Willebrand disease is the most common inherited bleeding disorder (1 case per 10,000 inhabitants) and is characterized by defective platelet adhesion and aggregation, with mucosal associated bleeding and after surgery and trauma. The diagnosis is based on a personal or family history of bleeding, and abnormal laboratory tests of von Willebrand Factor, Factor VIII or both. In Catlab the basic coagulation tests are performed, and the first level tests for the diagnosis of von Willebrand disease; FVIII, FvW:Ag, FvW:RCo.
GENETICS - Study of rearrangements in microsatellite instability of tumor DNA
The mismatch repair system (MMR) repairs small sequence errors, produced in DNA replication. Certain tumor subtypes present as a trigger mechanism a defect in the MMR genes, which gives them a biological behavior and a different prognosis to other tumors of the same tissues. This defect manifests itself at the molecular level as an instability in the size of gene regions called microsatellites. In Catlab, the analysis of five microsatellite regions is performed, using PCR and capillary electrophoresis on paraffin samples of tumor tissue, as a marker of MMR system deficiency.
BIOCHEMISTRY - Fecal occult blood updates
Colorectal cancer ranks second in cancer incidence and mortality in developed countries. Recently in Catlab a series of changes have been made to update the technique and improve clinical interpretation. The analyzer and the collection container have been changed. The unit of the expressed results, and the cut-off point has been changed too.