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CONGRESS 2023 - Changing and expanding roles in Cellular Pathology
27/09/2023
Changing and expanding roles in Cellular Pathology
CONGRESS 2023 - Clinical and economic evaluation of the clinical utility of UCH-L1 and GFAP in mild TBI
26/09/2023
There are 1.4 million UK ED attendances for head injury every year. Up to 2/3 of these are in adult patients. The severity of head injury associated traumatic brain injury (TBI) is assessed clinically using the Glasgow Coma Score (GCS). The majority of fatal outcomes occur in moderate TBI (GCS 9-12) or severe TBI (GCS=8), which account for only 5% of attenders.
The presence of severe TBI is usually clinically clear cut and prompt evaluation using computed tomography (CT) imaging of the brain is performed, followed by hospital admission with further detailed evaluation. This is also often the case where moderate TBI is suspected. There is clearly a need to identify patients that account for the remaining 95% of attenders, with minor or mild head injuries, who will go on to have serious intracranial lesions.
In patients with GCS 13-15, however, only 1/10 demonstrate evidence of pathology on CT scan.
The measurement of serum biomarkers of brain injury has been proposed as a method to accurately differentiate those patients with GCS 13-15 who are likely to have underlying pathology from those with GCS 13-15 with no underlying pathology.
Among the most studied biomarkers are Ubiquitin C-terminal hydroxylase-L1 (UCH-L1) and Glial Fibrillary Acidic Protein (GFAP). UCH-L1 GFAP have been shown to correlate with TBI severity and clinical outcomes. Current evidence indicates that both serum GFAP and UCH-L1 are detectable in serum in less than 1 hour following a mTBI. GFAP and UCH-L1 levels are significantly elevated in patients with TBI with intracranial lesions on computed tomography (CT) and, in patients with mTBI, can distinguish between those with a normal and an abnormal CT scan of the brain.
Patients with mild TBI are at low risk of clinically significant brain injury in the absence of raised serum GFAP and UCH-L1 and other associated risk factors. They do not require a CT head scan and may be safely discharged providing there is a safe support system of care. It is anticipated that this could reduce head CT in these patients by 40%.
Methodology and preliminary results form an ongoing clinical and economic evaluation of the FDA approved serum GFAP and UCH-L1 on the Abbott Alinity platform in patients with mTBI will be presented.
The presence of severe TBI is usually clinically clear cut and prompt evaluation using computed tomography (CT) imaging of the brain is performed, followed by hospital admission with further detailed evaluation. This is also often the case where moderate TBI is suspected. There is clearly a need to identify patients that account for the remaining 95% of attenders, with minor or mild head injuries, who will go on to have serious intracranial lesions.
In patients with GCS 13-15, however, only 1/10 demonstrate evidence of pathology on CT scan.
The measurement of serum biomarkers of brain injury has been proposed as a method to accurately differentiate those patients with GCS 13-15 who are likely to have underlying pathology from those with GCS 13-15 with no underlying pathology.
Among the most studied biomarkers are Ubiquitin C-terminal hydroxylase-L1 (UCH-L1) and Glial Fibrillary Acidic Protein (GFAP). UCH-L1 GFAP have been shown to correlate with TBI severity and clinical outcomes. Current evidence indicates that both serum GFAP and UCH-L1 are detectable in serum in less than 1 hour following a mTBI. GFAP and UCH-L1 levels are significantly elevated in patients with TBI with intracranial lesions on computed tomography (CT) and, in patients with mTBI, can distinguish between those with a normal and an abnormal CT scan of the brain.
Patients with mild TBI are at low risk of clinically significant brain injury in the absence of raised serum GFAP and UCH-L1 and other associated risk factors. They do not require a CT head scan and may be safely discharged providing there is a safe support system of care. It is anticipated that this could reduce head CT in these patients by 40%.
Methodology and preliminary results form an ongoing clinical and economic evaluation of the FDA approved serum GFAP and UCH-L1 on the Abbott Alinity platform in patients with mTBI will be presented.
CONGRESS 2023 - Clinical Andrology: A Urology Surgeon’s Perspective
26/09/2023
Clinical Andrology: A Urology Surgeon’s Perspective
CONGRESS 2023 - Colposcopy for patients with learning difficulties
28/09/2023
From earlier work that I had done in a sexual health setting, I identified that there were barriers for women with a learning disability attending for cervical screening. I was invited to talk to a group of women about cervical screening as part of an initiative called 'The Josephine Project'. Josephine is an anatomically correct cloth doll which is used for health promotion purposes - she has body parts which can be detached and has a 'space' in her head where women can put ideas on paper. Within a mock up clinic, Josephine, along with her friends (the women in the group), attended the sexual health clinic to have a cervical sample taken. This work was very successful and led to several women taking up the offer of screening.
Myself and Jilly realised that as Nurse Colposcopists this work could be translated into a secondary care setting and so Josephine was invited to the colposcopy clinic following an abnormal cervical screening result. This presentation discusses some of the barriers for the women with a learning disability and how 'Josephine' came to life to help and support some of those women.
Myself and Jilly realised that as Nurse Colposcopists this work could be translated into a secondary care setting and so Josephine was invited to the colposcopy clinic following an abnormal cervical screening result. This presentation discusses some of the barriers for the women with a learning disability and how 'Josephine' came to life to help and support some of those women.
CONGRESS 2023 - Delegates attending this presentation will learn: Which androgens are tested for in sport The problems with current sample collection techniques Comparison of conventional urine with dried blood spots.
28/09/2023
Androgens are the naturally occurring or synthetic hormones which can increase lean body mass and decrease fat mass and are the most effective and widely abused ergogenic drugs in sport. The detection methodologies for the exogenous steroids is mostly based on the gas/liquid chromatography and mass spectrometry, while detection of the exogenous administration of endogenous steroids requires more complex methodologies including the longitudinal monitoring of individual urinary steroid concentrations/ratios and isotope ratio mass spectrometry. Although, urine has always been the first choice of sample matrix to detect androgens in sports. However, blood matrix is also now paving its way towards a complementary matrix for detection of androgens in sports. Dried blood spots (DBS) analysis is the latest tool in sports drug testing. DBS testing has advantages in the collection, shipment, and storage compared to traditional urine and blood-based procedures.
The World Anti-Doping Agency (WADA) has recently introduced DBS testing as an implementation for routine doping analysis during the recent Olympic and Paralympic Games in Tokyo and Beijing. DBS samples can be obtained with relatively little training and require minimal invasion at the collection site. A variety of devices based on micro-lancet and micro-needle approaches have been applied in the DBS collection.
Most androgens in DBS are stable at room temperature, so there are no specific requirements during transport. Also, considering the small size and weight of DBS, the DBS-based technique is more cost-effective compared to urine or blood samples. However, as a microscale sample, DBS require more sensitive and accurate analytical methods. The Drug Control Centre, King’s College London (a WADA accredited lab), we are currently investigating the use of DBS testing in our systematic regular analysis as a new methodology.
This presentation will discuss the current situation, perspectives, and challenges of implementing DBS testing for detecting androgens in sports.
The World Anti-Doping Agency (WADA) has recently introduced DBS testing as an implementation for routine doping analysis during the recent Olympic and Paralympic Games in Tokyo and Beijing. DBS samples can be obtained with relatively little training and require minimal invasion at the collection site. A variety of devices based on micro-lancet and micro-needle approaches have been applied in the DBS collection.
Most androgens in DBS are stable at room temperature, so there are no specific requirements during transport. Also, considering the small size and weight of DBS, the DBS-based technique is more cost-effective compared to urine or blood samples. However, as a microscale sample, DBS require more sensitive and accurate analytical methods. The Drug Control Centre, King’s College London (a WADA accredited lab), we are currently investigating the use of DBS testing in our systematic regular analysis as a new methodology.
This presentation will discuss the current situation, perspectives, and challenges of implementing DBS testing for detecting androgens in sports.
CONGRESS 2023 - Development & Introduction of ISO 15189:2022
25/09/2023
ISO15189:2022 has undergone a major revision and was release in December 2022. David was one of the core drafting team responsible for the latest version and will discuss how the document was developed and agreed by the international community, why the changes were made and the purpose of the new standard.
Areas covered in this lecture will include the change in the format of the standard, why Point of Care testing is now part of the main assessment, if applicable and the increased empathies on risk and patient welfare.ISO15189 was revised and released in December.
Areas covered in this lecture will include the change in the format of the standard, why Point of Care testing is now part of the main assessment, if applicable and the increased empathies on risk and patient welfare.ISO15189 was revised and released in December.
CONGRESS 2023 - Digital cervical cytology: The Monklands experience
28/09/2023
Digital cervical cytology: The Monklands experience
CONGRESS 2023 - Dimorphine-assisted treatment programme
28/09/2023
Dimorphine-assisted treatment programme
CONGRESS 2023 - Ensuring fairness in training opportunities
26/09/2023
"Don’t worry, you’ll be next" – have you ever said, or heard this phrase when it comes to training opportunities?
Should you have a queue? Should you make promises? Or do you risk losing staff if you don’t?
This session will discuss considerations to ensure fairness in training opportunities, from an individual and organisational perspective. It will also look at how to ensure your opportunities and training are inclusive, and support diversity.
Should you have a queue? Should you make promises? Or do you risk losing staff if you don’t?
This session will discuss considerations to ensure fairness in training opportunities, from an individual and organisational perspective. It will also look at how to ensure your opportunities and training are inclusive, and support diversity.