Laboratory Medicine Commons^™

Current State And Needs Of Clinical Laboratories In Latin America: A Cross-Country Assessment., Alejandro R. Molinelli, Elizabeth L. Palavecino, José C. Jara-Aguirre, Kerry Cosby, Allison Targowski, Barbara Goldsmith, Rosa Sierra-Amor, Juan D. García, Alicia Algeciras-Schimnich, Eugenio H. Zabaleta, Veronica I. Luzzi, Jessica M. Colón-Franco

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

The Association for Diagnostics & Laboratory Medicine (ADLM) aims to improve health by providing education to laboratory scientists worldwide. Different regions of the world face unique challenges shaped by their national and regional contexts. However, the needs of clinical laboratories worldwide remain largely understudied. To address this gap, we conducted a comprehensive needs assessment survey among laboratory professionals in the Latin American region. The survey was distributed to over 2708 individuals across Latin American countries and yielded 148 responses. Most respondents were from urban areas (74%) and worked in private hospital laboratories (45%), with microbiology (25%) and chemistry (23%) identified …

Validation Of A Real-Time Pcr Laboratory Developed Test For The Detection Of Pneumocystis Jirovecii In Bronchoalveolar Lavage Samples, Caitlyn Moon

Honors Scholar Theses

Pneumocystis jirovecii is an opportunistic, host-obligate fungal pathogen responsible for causing P. jirovecii pneumonia (PJP) in humans. PJP is treated with trimethoprim-sulfamethoxazole (TMP-SMX), a strong broad-spectrum antibiotic that carries risk of renal and hepatotoxicity. Therefore, rapid diagnosis or exclusion of PJP is crucial to ensure PJP-positive patients receive effective treatment and PJP-negative patients avoid unnecessary antibiotics. Unlike most microorganisms, P. jirovecii cannot be cultured, presenting complications for the typical methods of diagnosing fungal pathogens. Historically, the gold standard for diagnosis was direct microscopic examination with stains such as methenamine silver and calcofluor white, but this diagnostic technique requires highly skilled …

Phenol–Chloroform Dna Extraction For Dna Amplification From Personal Items, Aditya Rahman Ernanto, Dinda Amaliyatul Khasanah, Yunita Aldirahayu, Rizki Setiyaningrum, Arya Iswara

Makara Journal of Science

This study examined the feasibility of extracting DNA from various personal items using the phenol–chloroform–isoamyl alcohol (PCIA) method. A towel, collared shirt, toothbrush, shower puff, comb, hair tie, and buccal swabs were analyzed. The quality of the DNA extraction, along with DNA concentration, purity, and suitability for multiplex PCR amplification, were evaluated. The shower puff exhibited the highest DNA concentration (68.35 ng/µL), whereas the collared shirt yielded the lowest (26.43 ng/µL). All samples exhibited good DNA purity (A260 nm/A280 nm ranging from 1.827 to 1.985), emphasizing the potential of this method for forensic analysis. Factors influencing DNA concentration included material …

Current State And Needs Of Clinical Laboratories In Latin America: A Cross-Country Assessment., Alejandro R Molinelli, Elizabeth L Palavecino, José C Jara-Aguirre, Kerry Cosby, Allison Targowski, Barbara M Goldsmith, Rosa Sierra-Amor, Juan D García, Alicia Algeciras-Schimnich, Eugenio H Zabaleta, Veronica I Luzzi, Jessica M Colón-Franco

Ambulatory and Primary Care Articles

The Association for Diagnostics & Laboratory Medicine (ADLM) aims to improve health by providing education to laboratory scientists worldwide. Different regions of the world face unique challenges shaped by their national and regional contexts. However, the needs of clinical laboratories worldwide remain largely understudied. To address this gap, we conducted a comprehensive needs assessment survey among laboratory professionals in the Latin American region. The survey was distributed to over 2708 individuals across Latin American countries and yielded 148 responses. Most respondents were from urban areas (74%) and worked in private hospital laboratories (45%), with microbiology (25%) and chemistry (23%) identified …

Clinical Performance Of A Novel Point-Of-Care High-Sensitivity Cardiac Troponin I Assay, Alan H. B. Wu, Simon A. Mahler, Stacey L. House, Saeed A. Jortani, Michael H. Creer, Kristin L. Rising, Jason J. Bischof, Chad Crystal, Gary F. Headden, Fred S. Apple, Nicholas E. Harrison, Andrew C. Meltzer, Justin T. Baca, Brian Tiffany, Mark Sochor, Grace U. Pentecostes, Katrina P. Di Tullio, Manish S. Gupta, Adam J. Singer, James L. Januzzi

Department of Emergency Medicine Faculty Papers

BACKGROUND: High-sensitivity cardiac troponin (hs-cTn) assays performed in the central laboratory have long turnaround times. This study evaluates the clinical performance of a novel bedside point-of-care (POC) hs-cTnI assay (i-STAT® hs-TnI) to aid in the diagnosis of myocardial infarction (MI).

METHODS: A prospective multisite cohort study involving emergency department (ED) patients with symptoms suggestive of acute coronary syndrome was conducted at 28 sites across the United States. Serial whole blood samples were collected at 0-1 h and >1-3 h from ED presentation. Primary outcome was MI or non-MI. Sensitivity, specificity, and negative predictive value (NPV) for MI were calculated with …

Masld-Induced Hyperammonemia With Atypical, Restricted Diffusion Pattern Suggesting Mixed Metabolic And Hypoxic-Anoxic Injury, Renu Thomas, Nhuchau Tiffany Nguyen, Daniel Bao, Jonathan Tang, Uzma Ali, Damon Cao

HCA Healthcare Journal of Medicine

Background

Hepatic encephalopathy is a common cause of altered mental status for patients with decompensated cirrhosis. Their conditions typically improve with high-dose laxatives; if not optimally treated, can develop neurologic sequelae like cerebral edema and herniation. In severe cases, despite normal systemic oxygenation, hyperammonemia may result in mixed restricted diffusion patterns that partially resemble those seen in hypoxic-anoxic brain injury.

Case Presentation

A 61-year-old woman with cirrhosis secondary to metabolic dysfunction-associated steatotic liver disease, scleroderma, and rheumatoid arthritis presented to the emergency room with altered mental status. She was admitted to the intensive care unit (ICU) and was intubated due …

Synthesis And Evaluation Of Amidoximes As Potential Pharmaceuticals Against Antimicrobial-Resistant Bacteria, Prudence Mange

Honors Theses

The rise of antimicrobial-resistant bacteria in the healthcare industry has led to devastating effects in recent years, ranging from increased risks associated with hospital treatment to longer illness duration, which may eventually lead to increased death rates (Naghavi, Mohsen et al, 2024). To combat this ongoing challenge, this project aims to synthesize amidoximes, which are organic derivatives of carboxylic acids with an oxime and an amino acid group. Amidoximes have been utilized in various clinical applications, including antituberculosis medication, hypotensives, antiarrhythmics, antibacterials, and antifungals (J. Chil et al., 2011). -- The focus of this project was to test their antibacterial …

Effectiveness Of Vitamin D3 In Facilitating The Therapeutic Progression Of Healing Diabetic Foot Ulcers, Fatemeh Nouri, Sara Aghaei, Gülüzar Özbolat, Yusuf Döğüş, Mahdi Mirhamidi, Reza Rahimi Barghani, Amin Daemi

Chulalongkorn Medical Journal

Background: Today’s, diabetes and its complications have afflicted a large population all over the world, so that it is estimated that its prevalence in all age groups will reach from 2.8% in 2000 to 4.4% in 2030. It is well known that vitamin D may cause rapid wound healing and anti-inflammatory.

Objective: Regarding the importance of the quality of life of diabetic patients and the improvement of chronic diabetic foot ulcers, this paper aims to investigate the efficacy of vitamin D3 on the healing of diabetic foot ulcers. The present research is conducted as a randomized controlled trial.

Methods: …

Incidence Of Cytogenetic Abnormalities Detected By Fish Analysis In Multiple Myeloma Cases: A Seven-Year Study From A Cytogenetic Laboratory In King Chulalongkorn Memorial Hospital, Thailand (2018–2024), Montakarn Tansatit, Nutcharee Jongpornchai, Suwannee Songchart, Kittipornpan Krajokpap, Hudadini Da-Oh

Chulalongkorn Medical Journal

Background: Multiple myeloma (MM) is a genetically heterogeneous plasma cell malignancy with cytogenetic abnormalities influencing prognosis and treatment outcomes. Fluorescence in situ hybridization (FISH) is crucial for detecting clinically significant abnormalities, including IGH translocations and deletions (e.g., del(17p)), particularly in non-dividing plasma cells. However, cost and accessibility challenges limit comprehensive testing in resource-constrained settings like Thailand. Objectives: To investigate the incidence of cytogenetic abnormalities detected by FISH in MM cases over seven years in a Thai population, highlighting regional trends and barriers to comprehensive testing. Methods: A retrospective analysis was conducted on 360 bone marrow samples from MM patients between …

Multivariate Optical Imaging Of The Oxygen-Metabolism Axis, Jesse D. Ivers

Graduate Theses and Dissertations

Metabolic reprogramming is a characteristic hallmark of multiple pathologies and promotes disease progression, survival, and severity. Current methods to investigate metabolic reprogramming, however, require reductions of dimensionality both because of instrumentation limitations and analysis tools. This work aims to define a blueprint for high dimensional study of the oxygen metabolism axis to enable more sensitive study metabolic reprogramming. We hypothesized (1) multivariate imaging of metabolic and oxygenation metrics in ex vivo tissue sections would elucidate differences in resistant and sensitive head and neck squamous cell carcinoma (HNSCC) xenografts that traditional uni-variate methods miss and (2) an engineered hyperspectral darkfield microscopy …

Audit Of The Impact Of The Pause In The National Screening Service For Breast Cancer During The Covid-19 Pandemic, Ava Coakley

International Undergraduate Journal of Health Sciences

In Ireland there is a free national screening service for breast cancer called BreastCheck. BreastCheck invites women aged fifty to sixty-nine to have screening mammograms once every two years to detect any densities in their breast mammogram which could indicate breast cancer. If densities are seen on a mammogram a breast core is sampled and sent to a histopathology laboratory where a part of the tissue is examined by a consultant pathologist using a microscope. Further tests can then be performed on this sample if it is diagnosed as breast cancer. Tests include immunohistochemistry and dual in-situ hybridisation (DISH). BreastCheck …

Ldt Fda Ruling: A Conundrum For Laboratories Across The Usa, Charma Henry

MSMLS Capstone Projects

Abstract

In the article “The Future of Laboratory Medicine Understanding the New Pressures," author Mauro Panteghini expresses that the clinical laboratory has always undergone significant changes due to technological advances and external economic pressures. “Laboratories are indeed an easy target for economic restrictions and limitations due to their technological characteristics.” (Panteghini, 2004, pg. 205) Though these words were written over 20 years ago, no more valid words have been spoken in light of the newest pressure all laboratories face with the new LDT regulation set by the FDA.

This regulation places drastic economic pressure on laboratories to pay the FDA …

Enhancing Diagnostic Reliability Through Centrifuge Validation And Staff Education: Quality Management Initiative In A Clinical Laboratory, Chris Agoki

MSMLS Capstone Projects

Abstract

This capstone project aims to enhance diagnostic reliability in a clinical laboratory by validating centrifuge performance and implementing an adult education-based training program within a quality management framework. Twenty archived, de-identified whole blood samples were analyzed to compare the performance of a new centrifuge with an existing model, focusing on plasma volume, hemolysis index, and Tacrolimus concentration.

The study demonstrated statistical and clinical equivalence between the devices, supporting the implementation of the new centrifuge. A staff training program, grounded in andragogical principles and guided by transformational leadership and Kotter’s 8-Step Change Model, was developed to integrate validation practices into …

Predictive Indicators For Graduation Upon Acceptance Into A Naacls-Approved Medical Laboratory Science Program, Warren Hovis

LSU Doctoral Dissertations

The primary purpose of this study was to determine the influence of selected academic and personal demographic characteristics on student success at a NAACLS-accredited medical laboratory science program in the southern portion of the United States.

Both academic and demographic categories were selected on students who entered the medical laboratory science program from 2014 to 2019 (pre-COVID). The sanitized, archived data set was provided by the MLS department and the registrar and student affairs office at the participating school. The extant data set contained academic and demographic variables, collected over a five-year period, of initially over 170 accepted MLS students. …

Tissue Engineering: History, Principles, Applications, Challenges, And Future Work, Alexa Cesari, Ms

Student Papers, Posters & Projects

Tissue engineering is a comprehensive and cutting-edge field that leverages principles from multiple scientific disciplines to assist in regenerative medicine. It is defined by the most basic structure of the human body, the cell. When an injury occurs, cells send signals to initiate wound healing processes. In most cases, the body is equipped to heal wounds on its own; however, there are instances where wounds are too severe and cannot undergo proper regeneration. When this occurs, alternative measures are taken to assist in wound repair. With numerous advancements made over the years, tissue engineering has become an increasingly common method …

Impact Of A Sepsis Quality Improvement Initiative On Clinical And Operational Outcomes, Christopher B. Thomas, Benjamin Wyler, Claude M. D’Antonio, Mark Laperouse, Shannon Alwood, Kristen Richard, Alyse Grantham, Roya Sheybani, Matt G. Sorrells, Wei Jien Tan, James W. Teague, Hollis O’Neal, Tonya Jagneaux

School of Medicine Faculty Publications

Background/Objectives: Sepsis is a costly and life-threatening condition caused by a dysregulated host response to infection. Lack of a reliable, timely diagnostic for sepsis leads to under- and overdiagnosis, suboptimal outcomes, and strained hospital resources. Our Lady of the Lake Regional Medical Center (OLOLRMC) implemented a sepsis learning health program to evaluate and improve outcomes through standardized ED workflows and the incorporation of a novel sepsis diagnostic test. Methods: We report the results of the first year of experience following the implementation of the learning health initiative and sepsis testing. Data from the Epic EHR were analyzed across two groups: …

Detection Of Chromosomal Mosaicism- The Importance Of Karyotyping And Fish, Allison Kalinousky, Jennifer L. Roberts, Madeeha Alikhan, John Herriges, Lei Zhang, Elena Repnikova

Research Days

This project evaluates the prevalence of chromosomal mosaicism in constitutional samples using conventional cytogenetic techniques evaluated at Children's Mercy Hospital during a 20-year period.

Diagnostic Considerations For Gastrointestinal Stromal Tumors With Altered Immunophenotype Following Imatinib Treatment: A Case Report And Literature Review, Jihuan Chen, Liz M. Yang, Jonathan Somma, Yujun Gan, Zengying Wu, Zhiyan Fu

School of Medicine Faculty Publications

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors in the gastrointestinal tract and have a high rate of recurrence and metastasis. Using an immunohistochemical (IHC) panel including KIT/CD117 and DOG1 allows for accurate diagnosis in more than 98% of cases. However, after tyrosine kinase inhibitor treatment, some cases can exhibit histologic dedifferentiation and loss of KIT/CD117 and DOG1 expression that may cause difficulty in confirming recurrent or persistent disease. We present such a case of an Imatinib treated, CD117 and DOG1 dual negative, metastatic GIST to the liver in a 55-year-old female which required molecular analysis to confirm …

Contamination To Clarity: Reducing Blood Culture Contaminations By Implementing An Initial Specimen Diversion Technique, Giovanna Tiago Bsn, Rn, Jaclyn Godfrey Msn, Rn, Judson Mary, Cj Lucia, Jacqueline Laird, John Brennan, Mason Everlith, Stacey Peace Rn, Anne M. Aquila

Posters

The aims of this initiative were:

• Target a unit with high blood culture contamination rates, with secondarily high central line utilization rates.
• Implement an evidence-based initial specimen diversion technique.
• Determine if technique had an impact on a unit’s blood culture contamination rate.
• Revisit the literature and modify as needed

Synchronous Clear Cell Renal Cell Carcinoma And Classic Hodgkin Lymphoma, Phuoc Christie-Nguyen, Ahmed A Ahmed, Nourhan Ibrahim, Jacob Armstrong, Brenda Mai

Faculty, Staff and Student Publications

Introduction: The coexistence of renal cell carcinoma and classic Hodgkin lymphoma is exceedingly rare, with only two documented cases. Here, we present the third case diagnosed in our institution.

Case presentation: A 46-year-old man presented with right flank pain, fever, mild pancytopenia, and renal mass on computed tomography scan, suggesting renal malignancy. Despite intravenous antibiotics and extensive workup for recurrent fever, his condition did not improve. A bone marrow biopsy revealed rare large EBV-positive B cells. Surprisingly, imaging only showed minimal intraabdominal lymphadenopathy in the perinephric region. Subsequent surgery confirmed clear cell renal cell carcinoma in the kidney and scattered …