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ACBNewsACBNewsThe Association for Clinical Biochemistry • Issue 510 • 20th October 2005

Sudoko

Special for

ACB News

Another

Pathology

Review

Announced for

England

Phoning

Results to

GPs - Could

Do Better

Sudoko

Special for

ACB News

Another

Pathology

Review

Announced for

England

Phoning

Results to

GPs - Could

Do Better

October 2005 • ACB News Issue 510 • 3

About ACB NewsThe monthly magazine for Clinical Science

The Editor is responsible for the finalcontent. Views expressed are not necessarily those of the ACB. EditorDr Jonathan BergDepartment of Clinical BiochemistryCity HospitalDudley RoadBirmingham B18 7QHTel: 07973-379050/0121-507-5353Fax: 0121-765-4224Email: [email protected]

Associate EditorsMiss Sophie BarnesDepartment of Chemical PathologySt Thomas’ HospitalLondon SE1 7EHEmail: [email protected]

Mrs Louise TilbrookDepartment of Clinical BiochemistryBroomfield HospitalChelmsfordEssex CM1 5ETEmail: [email protected]

Mr Ian HanningDepartment of Clinical BiochemistryHull Royal InfirmaryAnlaby RoadHull HU3 2JZEmail: [email protected]

Situations Vacant AdvertisingPlease contact the ACB Office:Tel: 0207-403-8001 Fax: 0207-403-8006Email: [email protected]

Display Advertising & InsertsPRC AssociatesThe Annexe, Fitznells ManorChessington RoadEwell VillageSurrey KT17 1TFTel: 0208-786-7376 Fax: 0208-786-7262Email: [email protected]

ACB Administrative OfficeAssociation for Clinical Biochemistry130-132 Tooley StreetLondon SE1 2TUTel: 0207-403-8001 Fax: 0207-403-8006Email: [email protected]

ACB ChairmanMiss Janet SmithDepartment of Clinical BiochemistryUniversity Hospital Birmingham NHS TrustBirmingham B29 6JDTel: 0121-627-8449 Fax: 0121-414-0078Email: [email protected]

ACB Home Pagehttp://www.ACB.org.uk

Printed by Piggott Black Bear, CambridgeISSN 1461 0337© Association for Clinical Biochemistry 2005

ACBNewsNumber 510 • October 2005

General News 4

Disposable Laboratory Tips 11

MRCPath Short Questions 12

Council Matters 16

Current Topics Speaking Out 18

Corporate News 20

ACB News Crossword 22

Letters 23

Situations Vacant 24

Front cover: Corporate Members representatives Mervyn Nicholas and Carla Deakin with MEP Catharine Stihler who opened EuroMedLab

4 • ACB News Issue 510 • October 2005

General News General News General News General News General News

ModernisingPathology: Building a Service Responsiveto Patients,September 2005

This new Department ofHealth document waspublished on 9th Septemberby the Modernising PathologyTeam.

The document considerswhat has been achieved inPathology modernisation so farand announces what isprotrayed as a radicalindependent review ofpathology. Norman Warner,Minister of State for NHSDelivery states in the forewordto the document that thereview of services in Englandwill “determine the feasibilityof and benefits from wide-scale servicereconfiguration andmodernisation” and anouncesthat this review is to be led byLord Carter of Coles.

The NHS website describesthe document as doing thefollowing:

• Setting out how togetherthe Department of Healthwith the NHS can re-energise the modernisation programme

• Showing how the NHS canbuild a new service shapedaround the patient andtake forward the newtechnology and news waysof working agendas.

The document also announcesa project with the NationalPrimary Care DevelopmentTeam to gain a betterunderstanding of clinical andorganisational practice relatingto pathology and to identifythe key pathology issues inprimary care.

Review of PathologyServicesWe are told that the review isaiming to maintain andaccelerate the pace of changewithin NHS Pathology andsuggest that end-points will be:

• Reconfiguring services ona wider scale

• Procure new pathologyservices closer to patients

• Support and integrateemerging scientific technologies

• Look at staff skill mixrequired for a high qualityservice

• Increase links withprimary care to improveturn-round times andreduce innapropriaterequests for patholgy tests.

The terms of reference of thereview are: “To adviseministers, in the context ofcurrent resource constraints,on the timeliness, reliability,capacity and efficiency ofcurrent pathology services inEngland, benchmarked againstinternational standards and thefeasibility of and efficiencybenefits arising from

wide-scale servicereconfiguration, innovationand modernisation andinvolvement of theindependent sector”.

The review will consist ofLord Carter of Coles with twohelpers who will, we are told,bring specialist technical andcommercial knowledge ofaspects of pathology to thetable. This small review panelwill report to Ministers bySpring 2006 and their workwill inlcude evidence from:

• Reviewing the literature• Holding meetings and

workshops with keyplayers

• Visiting a range ofpathology services

In Annex A of the document is a consideration of themodernising pathologyprocess and here the ACB’s very ownwww.labtestsonline.org.uk issingled out for praise as anexample of innovation.

The document is alreadyleading to a lot of speculationwith an early article in PrivateEye (see Eye, No. 1142, 30thSeptember) suggesting thatprivatisation is knocking onthe door of NHS pathologybehind the scenes. Certainlyright through the documentone is given the clearimpression of a determinationby someone to stir the pot andget some some real action onPathology in England! ■

Pathology Services Reviewed Again . . .



Yet again Professor Vincent Marks has come up with awinner with his new book “Panic Nation” having to bereprinted after selling out only a few weeks after publication. We asked Lisa Proctor, an R&D Manager ata busy NHS Trust to review the book for ACB News:

Panic Nation is the brainchild of Stanley Fieldmanand Vincent Marks, and has been compiled in anattempt to dispel myths about food and health thatmany of us, including myself take as absolute fact. Thebook has been co-written by a group of experts in avariety of fields and is split into three main sections.The tone is a mixture of Raj Persuad meets JeremyPaxman as the author explains the madness behind our

risk adverse nation, and the daftness that results fromthe constant search to avoid any kind of risk.

Two sections of the book - The food we eat, andHealth Risks? gives hope to all the overweight, junkfood eating, boozing fraternity and may somewhatdampen the enthusiasm of the green army. Afterspending the last fortnight desperately trying to swapmy 6-8 cups of coffee in order to keep up with the girlin the desk opposite who serenely downs her 2 litres ofwater each day, I was thrilled to find that this “fact” wasalmost certainly promoted by the bottled waterindustry. According to Stanley Feldman most of thefluid that I actually need will be provided by the foodthat I consume and just several cups of fluid a day.

Drinking More Water . . .I will be sorry to see my organic vegetables go though -I smugly snoot round the supermarket with them in mytrolley - but after reading the section on pesticides andorganic foods I'm not sure that they are all they arecracked up to be - for twice the price and half the size.I can't even console myself that my fortnightly stints ofGinseng and my twice-weekly jogging sessions aregoing to do me any good. David Bender gives aworrying account of the quality and toxicity of manyroutinely popped vitamins and health supplements.

Overall the book effectively casts doubt on the socalled facts about the food we eat and health risks. It’sfunny though, even given the perfectly plausiblecounter arguments asserted in this book, it is difficultto shake off the “facts” as we know them - I still feelthat I need to drink more water.

Panic Nation. Stanley Feldman & Vincent Marks ISBN 1-84454-122-3 John Blake Publishing Ltd ■

Marks Looks to the Nation

Lisa Proctor, R&D Manager, with the new Vincent Marks book

Members’ HandbookACB members should have received their copy of theMembers Handbook with the July ACB News distribu-tion. The current contact details of members who mayhave moved since publication of the printed volume canbe found on the ACB Members area of the website - andyou can also check and amend all of your own detailsthere.

Various changes to previous versions of the printedHandbook have been implemented. One new feature tohighlight is the 18-month year planner which containsdetails of events of training courses, other meetings as

well as ACB council, standing committee and regionalmeetings known at the time of going to press.

As a service to members of the ACB who attend suchmeetings, or others who need to refer to committeemembers to alert their representatives of itemsdiscussed or to be discussed at such meetings, you mayobtain the current up-to-date list of meetings andevents from the ACB Members area of the website. A new tab button will give you access to thisinformation for printing or inserting in the Handbookbound version of the planner. ■

Association of Clinical Biochemists(Wales Region)Autumn Scientific Meeting The Imperial Hotel, Llandudno7th-9th November 2005

Monday 7th November 15.00 Registration at The Imperial Hotel 19.00 Evening Buffet at the Imperial Hotel

Tuesday 8th November09.15-09.30 Introduction and Welcome09.30-10.15 A Rheumatologist’s View of Autoimmunity

Professor Peter Maddison (Bangor)10.15-11.00 Laboratory Investigation of Complement Disorders

Professor Paul Morgan (Cardiff)11.00-11.30 Coffee and Exhibition11.30-12.15 Anaphylaxis

Dr Graham Wild (Sheffield) 12.1513.00 Possible Developments in Clinical and Laboratory Diagnostic

Immunology Over the Next 10 YearsDr Paul Williams (Cardiff)

13.00-14.15 Lunch and Exhibition14.15-14.45 An overview of Pharmacogenomics

Mr Mike Hallworth (Shrewsbury)14.45-15.15 Establishing and Maintaining a Service for Thiopurine Methyltransferase

Dr Jonathan Berg (Birmingham)15.15-15.45 Prescribing Azathioprine - An Example of Applied Pharmacogenomics

Dr Andy Macfarlane (Bangor) 15.45-16.15 Tea and Exhibition16.15-17.15 Bayer Members Award19.30 for 20.00 Conference Dinner - followed by music and dancing

Wednesday 9th November 09.30-10.15 Renal NSF - Clinical Aspects

Dr Mahdi Jibani (Bangor) 10.15-11.00 Renal NSF - Laboratory Aspects

Dr Tony Avades (Cardiff) 11.00-11.30 Coffee and exhibition 11.30-13.00 Debate on Modernisation: This House Believes that Modernisation Through

Networking is the Only Way to Provide Effective NHS Pathology Services for the 21st CenturyMr Mike Hallworth (Shrewsbury) and Dr Emyr Benbow (Manchester)

13.00-14.00 Light lunch14.00-15.30 All Wales Clinical Biochemistry Audit Group

The approximate cost of the full meeting will be £265.00 to include accommodation. Day rates will be available. If you require any further information please contact:Eileen Smith on Tel: 01248-384 259. Email: [email protected]




October 1st 2005 marked the biennial renewal anniversary date for Health Professions Council (HPC)registration for all Clinical Scientists. Every clinicalscientist member on the register should have receivedrenewal notices from them by now with a request forcompletion of renewal information as well as paymentfor the next two years (which may well be through anexisting direct debit so will be simply a notification thatthe money will be taken shortly). You must return thisdocument to HPC to remain registered to work.

If you think you are registered and have not receiveda communication from them you should urgently contact them to determine what has happened - theymay have lost contact with you due to your relocation

or database errors. The GPO has been known to evenmislay some correctly addressed letters. HPC will onlycontact you at the registered address on their databaseand if you have moved and not notified them, thencontact could be lost and you will be struck off the register. The onus is with you to ensure renewal iscarried out at this time and that all details on the HPCdatabase for you for both contact and any direct debitbank details are correct and current. For your sake takea few moments out to check this is done. The nextrenewal anniversary will be in October 2007 but ensureyou notify them of any contact or bank detail changesin the interim. ■

Focus 2006 - Brighton15th - 18th May 2006

Brighton Hilton Metropole

We are very pleased to be circulating the invitation toparticipate for next year’s annual scientific meeting andexhibition. Important dates for your diary include:

Deadline for abstracts: 13th January 2006Early booking (reduced fees): 24th March 2006

Please check the front page of the website(www.ACB.org.uk) for further details of the meeting.Please note that the old Focus website (www.focus-acb.org) does not have details of nextyear’s meeting but is still there for posterity. ■

ACB News Sudoko SpecialFor you ardent Sudoku fans, Rugosa, our crosswordcompiler,thought you might like a go at this. Rugosawrites:

“The guy who wrote the programme I use for crosswords has justprovided an upgrade for Sudoku puzzles of varying levels of difficulty.The idea is that in a nine by nine grid, each row, each column andeach of the three by three smaller grids have to contain all of the ninesymbols. These are usually the numbers 1 to 9, but they can be lettersor anything else. Some are filled in as a starter.

I have just spent a quiet Sunday devising a hardish one based onletters. The twist in the tail is that towards the end there is no logicalway of deciding which of two ways to go . . . but the clue is in theletters!”

Coffee time just gets better and better! ■

HPC Registration Renewal - 2005



CPD4IT Conference‘Turning Order Communications into Intelligent Request Management’Monday, 5th December 2005Thackray Medical Museum, Leeds

09.30 Order Comms – ‘Is the Tail Wagging the Dog?’Rick Jones, Senior Lecturer, University of Leeds

10.00 Lab Requesting – What do GPs Want?Stephen Pill, GP; Joint National Lead for Laboratory Messaging

10.30 Tea11.00 A Novel Approach to Presenting Pathology Data to Influence the Order Requesting Process

John O’Connor, Consultant Clinical Scientist, Royal Devon & Exeter Hospital11.30 Pathology Messaging – an Update from CfH

Sally Stanley, Project Manager, Pathology Messaging, CfHJeremy Thorpe - Director of Business Requirements, CfH

12.00 Discussion followed by Lunch13.15 Terminology – Order Comms and NPfIT

David Robinson, Clinical Terminology Director, Accenture13.45 Case Study – Implementation of Order Comms

Royal Shrewsbury Hospital (in association with Indigo4) 14.15 Afternoon Tea14.45 Case Study – Implementation of Order Comms

Aintree Hospitals (in association with Olympus) tbc15.15 Case Study – Implementation of Order Comms

Royal Liverpool Hospital (in association with Anglia Health Care) tbc

Conference fee: £97, includes lunch, refreshments and parkingFor further information and Registration please contact: Diane Young on

Tel: 0113-206-4107. Email: [email protected] Website: www.cpd4it.org.uk

Advertisement

ACB West Midlands Scientific Meeting

Recent Guidelines andRecommendations: Impact onLaboratory ServicesLodge Room, Austin Court, City Centre Canalside (located between the ICC and the NIA), BirminghamWednesday 30th November 200510.30-16.00

10.30 Registration and Coffee10.50 Welcome and Introduction

Prof R Gama, Chairman, West Midlands ACB

Morning SessionRandox Sponsored Grade A Trainee Biochemist Research PresentationsChairman: Dr W A Bartlett11.00 Childhood Asthma: The Hidden Message in Parental DNA

Dr Hazel Hutton11.20 Novel Method for the Measurement of Erythrocyte TG and 6-MMP Nucleotides

Mr Pervaz Mohammed11.40 Pseudohyperkalaemia in Diabetic Patients with Renal Failure:

Potential for Diagnostic Confusion Dr Lynette Shakespeare

12.15 Lunch

Afternoon SessionRecent Guidelines and Recommendations: Impact on Laboratory ServicesChairman: Mr N R Anderson13.30 Investigation of Chronic Diarrhoea: British Society of Gastroenterology Guidelines

Dr Ian Holbrook, York14.05 Pleural Fluid Analysis: British Thoraic Society Guidelines

Dr Anne Tarn, Croydon14.40 Reporting Abnormal Out-of-Hours Test Results to Primary Care:

Royal College of Pathologists RecommendationsDr Trevor Gray, Sheffield

15.15 Use of Surplus Biological fluid samples – Implications for Routine Laboratory Practice, Clinical Audit and Research: Human Tissue Act 2004 Prof Peter Furness, Leicester

15.50 Concluding RemarksDr Jonathan Middle, WMACB Meetings Organiser

Travel: Cheap airlines fly into Birmingham International Airport from Ireland and UK regional air-ports. Book a late flight home and enjoy Christmas Shopping at the BullRing shopping centre!

For full information and on-line registration go to:

http://www.ukneqas.org.uk/special/acbwmmeet.htm

Tips Disposable Laboratory Tips Disposable Laboratory Tips


MRCPath Short Questions MRCPath Short Questions MRCPath Short


Deacon’s ChallengeNo. 55 AnswerThe upper limit of the reference range for mercury excretion in urine in occupationally exposed workersis given as: 10 µg Hg/g creatinine.

Express this as nmol Hg/mmol creatinine.

(Atomic weight mercury 200.6, molecular weight creatinine 113.1).

MRCPath, May 2005

The general expression relating weights in mass units to SI units is:

Weight (mol) = Weight (g) Atomic or Molecular weight

It is simplest to consider concentrations of mercury and creatinine in turn.

Mercury is expressed as µg and we wish to convert it to nmol. Division ofmercury in µg by its atomic weight (200.6) will give mercury in µmol. Since there are 1000 nmol in each µmol, this value must be multiplied by 1000.

Therefore for mercury:

Mercury (nmol) = Mercury (µg) x 1000200.6

Creatinine is expressed as g/L and we wish to convert it to mmol. Division ofcreatinine in g by its molecular weight (113.1) will give creatinine in mol. Since there are 1000 mmol in each mol, this value must be multiplied by 1000.

Therefore for creatinine:

Creatinine (mmol) = Creatinine (g) x 1000113.1

Questions MRCPath Short Questions MRCPath Short Questions


Question 56Calculate the loading dose of digoxin (bioavailability 0.75, salt factor = 1) required toachieve an initial plasma concentration of 1.5 µg/L in a 60 kg man (assume volume ofdistribution = 7 L/Kg):

a) If the patient has never taken digoxinb) If the patient is currently on digoxin with a plasma concentration of 0.5 µg/L

These two expressions are combined in order to convert themercury:creatinine ratio from µg/g to nmol/mmol:

Mercury:creatinine (nmol/mmol) = Mercury (µg) x 1000 x 113.1Creatinine (g) x 1000 x 200.6

Note that since creatinine appears in the denominator its molecular weightappears in the numerator (since mercury concentration is divided bycreatinine concentration). The 1000s cancel and substituting the mercurycreatinine ratio in µg/g gives:

Mercury:creatinine (nmol/mmol) =

10 x 113.1 = 5.6 nmol/mmol (2 sig figs)200.6

SOMETIMES YOU NEED TO INTERRUPT THE ROUTINE FOR URGENT TESTSWITHOUT SLOWING THE SYSTEM

THE WAITING IS ALMOST OVER

OncologyCardiac

Anaemia

CLINICAL CHEMISTRY � IMMUNOCHEMISTRY � BLOOD GROUPING � AUTOMATION � MICROSCOPY �

Thyroid

Fertility

ENDOSCOPY � DIGITAL IMAGING � PATIENT SAFETY & E - DIAGNOSIS

4.00 PM. WAITING

Council Matters Council Matters Council Matters Council Matters


Association AwardsThere is always lively discussion at Council about the nominations forHonorary Membership, Emeritus Membership and Fellows of theAssociation. It has become obvious that many ACB Members makehuge, valuable contributions to the Association at Regional level, butare not elected to receive one of the above awards. A proposal hasbeen made that Regional Awards would be one way to officiallyrecognise the efforts of such Members (see page 51 of the newMembers’ Handbook). The new National Members on Council havebeen asked to look at this and report back to Council. What do youthink? Should the ACB establish another award system, or are thereenough awards already? Views please, to Regional Members ofCouncil, the Association Chair, Janet Smith or ACB News.

Ongoing Developments

The AGM at Glasgow voted through a number of motions, notably thename of the Association (you are now a Member of the Associationfor Clinical Biochemistry) and the establishment of a Code ofConduct which forms part of the requirements for the ACB to becomea licensing body for State Registration. Part of the Code of Conductrequires there to be a disciplinary procedure for misdemeanours. As previously reported in ACB News, a small group ofeminent members has been convened to formulate the guidelines interms of misdemeanors, and to recommend to ACB Council theseguidelines, the framework of the procedures and the appropriate punishment(s). Membership of the group is Prof C P Price (Chair of the group), Dr G H Beastall, Dr G McCreanor, Mr A F Pennyand Dr M J Toop.

CongratulationsCouncil congratulates Dr Graham Beastall on the FESCC-Roche Award.This is a prestigious international award and was described by JanetSmith as “a great achievement”. Congratulations and thanks also tothe EuroMedLab Organising Committee for an excellent meeting inGlasgow.

Trainee Clinical BiochemistsAs the great cartoonist, Gary Larsen, often said in his cartoons:“Trouble Brewing”. Northgate, the company that organises the applications for Grade A Trainee Clinical Biochemists, has beenheavily criticised by Council for their handling and processing of therecent round of applications. Janet Smith has sent a strongly wordedletter to Prof Sue Hill, the Chief Scientific Officer. The WDCs (whofund the posts) have been involved and Dr Cassidy, the Regional

Awards and More . . .Reported by Steve Goodall, ACB Assistant Secretary

A report of theACB Council

Meeting held on7th July 2005

Council Matters Council Matters Council Matters Council Matters


Tutors and the ACB Education Committee are “up in arms”. It ishoped, nay expected, that Northgate’s new application software workscorrectly next time.

Sex DiscriminationIt has been noted that very few males are applying for ClinicalBiochemistry training posts. Why is this? Please tell ACB News if youknow. The Trainees’ Committee has been asked to look into thereasons and report back to Council.

Clinical Practice SectionThis group, under the Chairmanship of Dr Mike Toop, is helping tomake the ACB more user-friendly to our Medical Members. There arestill vacancies for some Regional Representatives. Dr Toop will shortlybe writing an article for ACB News.

FocusFocus 2006 will be held in Brighton. For Focus 2007 there was achoice of Manchester or Harrogate. On this occasion the red roseswon, and Manchester will be the venue. ■

Quotes from Pathology Review Press Releases . . .“The independent review panel is key to this modernisation, to look at the scope for furtherdeveloping and improving pathology services so that it can deliver a fast, convenient service forthe 21st century, focused on patients’ needs. Speeding up diagnosis is critical to hitting our 18week target for treatment. A tremendous amount of work has been done in the 18 months sincethe launch of Modernising Pathology Services but it is essential that we accelerate this progress tomake the most of this essential service."

Lord Norman Warner, Health Minister

“I am delighted to have been appointed to this important role. I look forwardto working with the other members of the panel and all stakeholders toexplore where the service could benefit from reconfiguration and identifyinnovative and practical suggestions about how further improvements couldbe made.”

Lord Carter of Coles, Chair of the Independent Review Panel

“This is an exciting and challenging time for pathology services. We are already makinggood progress with the modernisation programme and the review will stimulate newapproaches to how Government, the pathology community and the private sector canwork together to develop further a quality and responsive service that improves patientcare and experience.”

Dr Ian Barnes, National Clinical Lead for Pathology

Current Topics Speaking Out Current Topics Speaking Out Current


Some things are just not acceptable in the modern NHS. Theincreasing problems faced by many laboratories in phoningabnormal results to general practice is certainly one of them. The

situation has been made worse in many laboratories due to dramaticincreases in workload from primary care. You would think that modernelectronic links would help us out, but still most of us have a duty to phoneabnormal results based on parameters laid down in our “TelephoneResults” standard operating procedure. Let us consider a not uncommonscenario:

Over to the Deputising ServicePhoning results to GP surgeries can be traumatic even during the day whenthe answer phone often kicks in with, “The surgery is closed . . .”. So wewait until it is open and then try our luck at getting through along with therest of the world. If only we had the time and inclination we would at leastget the direct non-public telephone number for our surgeries onto ourlaboratory computer telephone directory.

Out of hours of course we interact with the GP deputising service. Theymay have off road cars to drive relief doctors around town but getting a setof abnormal U&E results through to someone who will take action can beproblematic. When junior laboratory staff try phoning results to thedeputising service they are often put off and so the Head of Department oranother laboratory heavyweight is enlisted to add some clout. However, weare certainly in part to blame. How many of us have bothered to make

Urgent Results toGPs . . . Room forImprovementBy Dr Jonathan Berg, City Hospital, Birmingham

Case StudyOn Friday night at 5.50 pm, when you would like to pack up andgo home you are confronted with results on Mrs Smith of:

Urea 29.6 mmol/LPotassium 6.4 mmol/LSodium 132 mmol/LCreatinine 357 µmol/L

The clinical details on the GP request form states “Diabetic annualcheck-up”. So . . . what do you do?

Topics Current Topics Speaking Out Current Topics Speaking Out


contact with our local deputising service and local PCTs toproduce a joint policy on transmitting abnormal out of hoursresults for primary care. Such an initiative would surely bewelcomed by the PCTs. Now that really would be joined upthinking!

Helpful Advice is at HandThe Royal College of Pathologists Professional Standards Unitpublished a very helpful guide in June 2005 entitled “Out-of-hours reporting of markedly abnormal laboratorytest results to primary care”. (If you put the title into Googleyou will go straight to the PDF). This is useful guidancewhen updating your telephone results operating procedureprior to that upcoming CPA inspection. The disciplinespecific lists of action limits make for interesting reading andtakes a somewhat wide approach. Our results on Mrs Smithwould not have been phoned using the suggested phonecriteria which have action limits of: Potassium >6.5 mmol/L,Creatinine >500 umol/L and Urea >30 mmol/L! ■

• Further information: Readers may also remember thatthe Annals published a very useful survey on the subjectof critical alert limits in the UK under the umbrella ofthe ACB National Audit Group. The reference is: Tilman Jand Barth J H. A survey of laboratory “critical (alert)limits” in the UK. Annals Clin Biochem 2003; 40:181-4

GP deputising services have an increasing profile. We need to ensurewe work positively with them as more of our work derives fromprimary care

Current Matters Speaking OutIf you would like to contribute an article

in this series please contact the Editor. If you would like to comment on the above feel free

to email your views or a letter to ACB News

Corporate News Corporate News Corporate News Corporate News


ACB News meets some Corporate Members withnews to tell at the IBMS exhibition in Birmingham

DPC have taken on the UK distributorship for Primus glycated haemoglobin and haemoglobin variantanalysis instrumentation. The Primus ultra2 HPLC system offers definitive technology for the determinationof HbA1c and Hb variants. The PDQ HPLC system offers the same definitive separation technology for thedetermination of HbA1c in a near patient environment. Both the ultra2 and PDQ produce HbA1c resultscertified as traceable to the DCCT/NGSP reference method.

The ultra2 and PDQ instruments combine the speed and precision of high performance liquidchromatography with the accuracy and specificity provided by phenyl boronate affinity separation. Bothinstruments generate results in just two minutes. HbA1c and haemoglobin variant analysis can be performedon the ultra2.

Glycated haemoglobin on the ultra2 provides on-line sample preparation for over 250 primary tubesamples using proven interference-free phenyl boronate affinity HPLC technology. The automated samplehandling allows for on board sample bar code reading reducing user intervention. The menu driven, userfriendly software and simple system maintenance ensures ease of use and minimal technician intervention.

The ultra2 also provides the ability to run in three different modes; quick scan, high resolution and reflexmodes. The Quick Scan provides reportable percentage for both haemoglobin A2 and F and an Hb variantqualitative screen in 4 minutes. Abnormal profiles may then be automatically reflexed to a high resolutionprogram which provides comprehensive identification and quantitation of Hb variants in 10.5 minutes.Alternatively all samples may be analysed initially in high resolution mode.

The PDQ systems offer the same definitive boronate affinity technology for the determination of HbA1c asthe ultra2 and produces interference free results in 2 minutes and is ideally suited to low or medium volumetesting. Its ease of use and minimal maintenance makes it suitable for use in satellite laboratories or diabeticclinics near patient testing situations.

The PDQ Plus is provided with an autosampler which provides for primary tube sampling and on-line barcode reading. For further information please contact Diagnostic Products Corporation on Tel: 01286-871 872. ■

DPC Move into HbA1C Market

John Hayes and Helen Waterman with the Primus HbA1c workstation

Corporate News Corporate News Corporate News Corporate News


The proven Tosoh immunoassaytechnology has been incorporatedinto a small benchtop anlayser, theAIA-360. This machine is able toundertake the full range of 10minute assays offered by Tosohincluding tests increasinglyrequested by A&E such as TroponinI and HCG. The machine is sonamed because it runs at up to 36 samples per hour. The firstmachines are now being placed in UK laboratories. Further details from Tosoh on Tel: 01527-592-901. ■Gill Dawson, Cliff Sweeney, Ben Starkey and David Eyres with their new baby

Tosoh Proudly Present the AIA-360

Vitech Go Horizontal forOsmolality

The tried and tested Advancemicro-Osmometer from VitechScientific has launched a newversion of their tried and testedfreesing point depression methodfor osmolality. The machinefeatures a newly designedentrance port with the samplepipette now being appliedhorizontally rather than vertically.This change helps to improvelong-term reliability of theinstrument. Further details fromTel: 01403-710-479. ■

Peter Hooper and Rick Zampa with the newosmometer

ACB News Crossword ACB News Crossword ACB News Crossword


ACB News CrosswordKeep sane at coffee time with the ACB News Crossword. Always relating to thescience and practice of Clinical Chemistry, you will never cease to be astoundedby the convoluted mind of the ACB News Crossword compiler.

Prizes for your department: The first five correct solutions to appear on the ACBNews fax machine (Fax: 0121-765-4224) will receive a copy of the new editionof Clinical Chemistry by William Marshall and Stephen Bangert. Please stateclearly the name and address of the Department that is entering the competition.

Remember that ACB News appears first as a PDF on www.ACB.org.uk aroundthe 7th of each month.

Crossword set by RugosaAcross 1 So treacly eggnog disturbed normal liver function? (8,7)9/27 Connatural misconception causes biochemical

disturbance (6,5)10 Sharp eared with disturbed balance (8)11 Clarifies view of DFS store rearrangement (8)14 Alpine mummy delivered before invention of the

refrigerator (6)17 Girl near car, upset about Cale initially, identifies

syndrome (7-6)20 How best treatment was found before Bradford Hill

and Cochrane? (5, 3, 5)23 Dreads becoming unhappier (6)25 Respected alien seemed confused (8)28 Combining iron, strontium and nickel with nitric oxide

can result in serious fires (8)29 Keen beginner arrives first before speed combat (6)30 Non-possessive description of muscle symptoms caused by

1 9/27 (7,8)Down 2 Perhaps kindle 9/27 sex relationship, for example (6)3 Part of church in which visitors’ voices echo irreverently (5)4 Dressy-sounding bearers of 9/27s (5)5 Approaches bearing corn (5)6 Teaching Eskimo race to integrate (7)7 Island in mainland America (5)8 Bizarre description of muscle lengthening movement (9)12 Stormy Loire bay (5)13 Claw in cash from temperamental one-armed bandit (5)15 British statesman’s commission? (5)16 Metal spout aims badly (9)17 Rough cider was upset (5)18 Grasses about editor’s failure to feature disastrous riot (5)19 Discordantly eager to achieve harmony (5)21 Gland then removed from decomposed Neanderthal (7)22 Disordered musculature not usual in this part of the body (6)24 Gloomy doctor, good listener (5)25 Lessens pain in heart disease sufferers (5)26 Insignificantly small sort of coin (5)27 See 9 Across

Answers to Last Month’s CrosswordAcross: 1/10/15 Annals of Clinical Biochemistry, 4 Scores, 9 Want,12 Rare, 13 Tabernacle, 18 Compartments, 21 Advertiser, 22 Urea, 24/25 Clin Chim Acta, 26 Tussle, 27 Clin Chem

Down: 1 Anaerobe, 2 Newsroom, 3 Lent, 5 Conundrums, 6 Rococo, 7 Solver, 8 Fleet Street, 11 Haemophilia, 14 Thiouracil, 16 Encroach,17 Escapism, 19 Lancet, 20 Avoids, 23 Scan

Lucky Winners . . .Paul Walker, WakefieldK Raja, King’s College, LondonSarah Mapplebeck, Royal Free, LondonJoan Zilva, Putney

Letters Letters Letters Letters Letters Letters Letters Letters


LettersReaders speak out

?

Another Approach to

Doubling Time

Deacon is to be commended on his absolutelycorrect and rigorous solution for the problem ofestimating doubling time (August ACB News, page10). I am suggesting a slightly different approach -with simplified procedure of course - whichcomplements Deacon’s solution, by giving an easiersolving procedure and goes straight to the doublingtime solution.

In any problem such as this it is obvious that theratio of initial to final concentration after a timeperiod is a function of the number of doublingperiods occurring during the experimental period.Thus the equation:

Concentration Ratio = 2x applies - where x is the number of doubling periods over theexperimental time

This is easily solved as:Log10CR = xlog102x = log10CR/log102

In this case CR = 3.09log10CR/log102 = 1.627

We therefore know that 11 days is 1.627 doublingperiods. So that (as Deacon says) the doublingperiod is 11/1.67 = 6.76 days.

Again the lazy man’s way perhaps, but I think thisapproach can be more intuitively obvious thanstarting at the standard first order rate equation. Italso recognises that any ‘rate period’ can beemployed and that the doubling time has no specialstatus beyond a pleasant and satisfying aspect for us -the method would work exactly the same for a‘decadal’ period. The approach may not, however,please the Examiners as much as Deacon’s way.

Peter ShakespeareLaing LaboratorySalisbury District HospitalSalisbury SP2 8BJ

Home Computing Without

Compromise

As a former IT business systems manager for theworld’s largest construction management company,with 26,000 PC users, I was often asked to rescueunsecured home PCs. I read with interest the GeneralNews item about a recent infection of the ACB Newscomputer (August ACB News, Page 6). Your readersmight find some of the following useful.

Anti-spyware software is no substitute for afirewall, anti-virus software and a regularly updatedoperating system, and none of these is an alternativeto weekly data back up. Microsoft Anti-Spywaresoftware is only compatible with Windows XP. Foralmost any Windows system, the following are freefor personal use and perform in combination to thesame standards of protection as well knowncommercial alternates: ZoneAlarm (firewallsoftware)http://www.zonelabs.com; AVG freeedition (anti-virus software)http://www.avguk.com;Ad-Aware SE Personal (anti-adware software)http://www.lavasoft.de; SpyBot S&D (anti-spywaresoftware)http://www.spybot.info

Multiple firewalls or multiple anti-virus softwaresare not productive, but I advocate running andupdating both Ad-Aware and Spybot on alternateweeks for overlapping protection.Be advised thatdownloading any of these non-Microsoft tools to NHSsystems without seeking approval will almost certainlyviolate NHS software licensing agreements, and thatsome free (and subscription!) security tools andsecurity sites are loaded with adware, spyware or worse.The importance of keeping your operating system andsecurity software updated, and using browser defaultsecurity settings, cannot be over-emphasised. Theaverage unprotected PC is compromised within 20minutes of first connecting to the Internet.

Colin LoveOlympus Diagnostics SystemsGreat Western Industrial ParkDean Way, SouthallMiddlesex UB2 4SB

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To advertise your vacancy contact:ACB Administrative Office, 130-132 Tooley Street, London SE1 2TU

Tel: 0207-403-8001 Fax: 0207-403-8006 Email: [email protected]

Deadline: 26th of the month prior to the month of publication

Training Posts: When applying for such posts you should ensure that appropriate supervision and training support will be available to enable youto proceed towards state registration and the MRCPath examinations. For advice, contact your Regional Tutor.

The editor reserves the right to amend or reject advertisements deemed unacceptable to the Association. Advertising rates are available on request

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ACB News - Association for Clinical Biochemistry and … · 2014-03-14 · Sudoko Special for ACB...

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