June 30, 2016
Coagulation test: D-Dimer result comment revision:
The D-Dimer test result comment has been revised to reflect manufacturer’s disclaimer regarding specificity and sensitivity claims. No changes have been made to reference range or interpretation.
New Comment: In excluding deep vein thrombosis (DVT) and pulmonary (PE): In a non-high clinical probability population, using a cutoff of 0.5 mg/L FEU, a normal (<0.5 mg/L FEU) result excludes deep vein thrombosis (DVT) and pulmonary (PE) effectively. (Negative predictive value is 96-100% and 97.5-100% respectively). In detecting DVT and PE: using a cutoff of 0.5 mg/L FEU, the sensitivity is 96-100% and 93.3-100% respectively and the specificity is 34.5% and 39.6% respectively.
June 20, 2016
Device Correction Notification:
Siemens Healthcare Diagnostics has announced that N-Acetylcysteine (NAC) and Metamizole (Dipyrone) interfere with some reagents used on Parkview Health Laboratories instruments, causing falsely depressed results.
N-Acetylcysteine (NAC) interferes with Triglycerides reagent.
Metamizole interfere with Triglycerides, HDL and Uric Acid reagents.
Venipuncture should occur prior to N-Acetylcycteine (NAC) or Metamizole administration to due to the potential for falsely depressed results.
Please direct questions to Richard Brown, Chemistry Specialist, at 266-1521, or Dr Steven Wang, Clinical Pathologist, at 266-1640.
June 1, 2016
Cryptococcal Antigen Assay
Beginning June 16th Cryptococcal Antigen Assay will be done by lateral flow methodology which will allow the Microbiology Department to run this test on all shifts.
This test may be run on CSF (Epic: Cryptococcal Antigen Screen Spinal Fluid) or serum (Cryptococcal Antigen Screen Serum) and will replace the current latex agglutination method (Epic: Cryptococcal Antigen Screen).
May 31, 2016
New In-House Molecular Tests for GI Pathogens and Meningitis/Encephalitis
The Microbiology Department is now running two new molecular panels:
Epic Name: Gastrointestinal Pathogen Panel by BioFire PCR
Specimen: Stool placed in Cary Blair Vial (green top stool vial—HEMM #91915) within two hours. No endoscopy stool aspirates or rectal swabs.
TAT: Within 24 hours after receipt in the Microbiology Lab
Enteric Pathogens detected by PCR:
Bacteria: Campylobacter (C. jejuni/C. coli/C. upsaliensis), Clostridium difficile toxin A/B, Plesiomonas shigelloides, Salmonella, Vibrio (V. parahaemolyticus/V.vulnificus/V. cholerae), Yersinia enterocolitica, Diarrheagenic E. coli (Enteroaggregative E. coli (EAEC), Enteropathogenic E. coli (EPEC), Enterotoxigenic (ETEC) heat-labile (lt) and heat-stable (st) Enterotoxins , Shiga-like toxin-producing E. coli (STEC) including E. coli O157, Shigella/Enteroinvasive E. coli (EIEC).
Viruses: Adenovirus F 40/41, Astrovirus, Norovirus GI/GII, Rotavirus A, Sapovirus (Genogroups I, II, IV and V).
Parasites: Cryptosporidium, Cyclospora cayetanensis, Entamoeba histolytica, Giardia lamblia
Epic Name: Meningitis Encephalitis Pathogen Panel by BioFire PCR
Specimen: CSF from tap (no shunt fluid)
TAT: Within 4 hours after receipt in the Microbiology Lab
Meningitis/Encephalitis Pathogens detected by PCR:
Bacteria: Escherichia coli, Haemophilus influenzae, Listeria monocytogenes, Neisseria meningitidis, Streptococcus agalactiae, Streptococcus pneumoniae
Viruses: Cytomegalovirus (CMV), Enterovirus, Herpes simplex virus 1 (HSV 1), Herpes simplex virus 2 (HSV 2), Human herpes virus 6 (HHV 6), Parechovirus, Varicella-zoster virus (VZV)
Fungi: Cryptococcus neoformans/gattii
May 23, 2016
Parkview Health Laboratories presently reflexes a Group A Strep Culture on all negative Rapid Strep A results. Beginning May 31st we will begin reflexing cultures on only those patients less than eighteen years of age.
May 19, 2016
For those patients eighteen and older, a Group A Strep Culture (Soft Code: CXGRA) or Throat Culture (Soft Code: CXTHR) may be ordered separately if desired.
On June 1, 2016, PRMC Chemistry will begin Procalcitonin (PCT) testing. The specimen requirement will be 1 ml plasma from Lithium Heparin (Mint Green top PST) tube. Testing will be performed Monday-Sunday on all shifts.
The reference ranges are:
PCT <=0.5 ng/ml = Low risk for progression to severe systemic infection(severe sepsis/septic shock.
CAUTION: PCT levels below 0.5 ng/ml do not exclude infection, because localized infections (without systemic signs) may be associated with such low levels. If PCT is measured very early after a bacterial challenge (usually <6 hours), these values may still be low. In this case, PCT should be re-assessed 6-24 hours later.
PCT >0.5 to <=2 ng/ml= Moderate risk for progression to severe systemic infection (severe sepsis/septic shock).
The patient should be closely monitored both clinically and by re-assessing PCT within 6-24 hours.
PCT >2 ng/ml = High risk for progression to severe systemic infection (severe sepsis/septic shock).
For questions, contact Janet Benoit, Laboratory Technical Manager, at 266-1505, Richard Brown, Laboratory Chemistry Specialist, at 266-1521, or Dr. Steven Wang, Laboratory Pathologist, at 266-1640.
May 6, 2016
Changes effective 5-17-16, Prothrombin time reference range 9.4-11.6 seconds, APTT reference range 23.8-33.8 seconds, INR upper reportable range >8.9. If you have any questions please contact Dr. Cindy Nie at 266-1641.
On May 17, 2016, the CK and reflex CKMB will be removed from the Cardiac Stat Panel (test code CARDC). The CK or the CKMB (which includes CK & CKMB) can be ordered as needed. For questions, contact Janet Benoit, Laboratory Technical Manager, at 266-1505, Richard Brown, Laboratory Chemistry Specialist, at 266-1521, or Dr Steven Wang, Laboratory Pathologist, at 266-1640.