Events during September 2023

The UK has the 4th highest prevalence rate of alcohol consumption in pregnancy in the world. Fetal Alcohol Spectrum Disorder (FASD) is the most common non-genetic learning disability in the UK with a prevalence rate of at least 5%, more than autism and ADHD combined. A high-profile public health campaign combined with effective antenatal and pre-conception care is urgently required.

Accurate and early identification of women at risk from alcohol consumption during pregnancy allows education and support to be targeted at those most in need. Self-report has limited sensitivity but is commonplace due to its acceptability and affordability. Biomarkers have the potential to provide an objective and reliable antenatal alcohol screening solution.

To explore the utility of blood biomarkers, we conducted a systematic review comparing the diagnostic accuracy of blood analysis and maternal self-report in detecting at antenatal alcohol exposure. We discovered that none of the biomarkers identified had both high sensitivity and specificity when compared to self-report. There was some evidence that a combination of biomarkers, or combining biomarkers with self-report, increases accuracy. Blood biomarkers examined were of limited use in screening for low and moderate alcohol consumption in pregnancy when compared to self-report. However, certain biomarkers, such as carbohydrate deficient transferrin (CDT) and phosphatidylethanol (PEth) may complement self-report and help improve the accuracy of diagnosis.

We applied these findings to practice with two studies comparing the prevalence of alcohol consumption in the first trimester of pregnancy using self-report and blood biomarker analysis. The booking bloods were from women under the care of Northumbria Healthcare NHS Foundation Trust (NHCT) and North Tees and Hartlepool NHS Foundation Trust (NTHFT).

Six-hundred routine blood samples were anonymously analysed from each location for the presence of Carbohydrate Deficient Transferrin (CDT), a validated marker of chronic alcohol exposure (normalising 2–3 weeks from abstinence) and Gamma-glutamyltransferase (GGT), a liver enzyme elevated for up to 8 weeks after alcohol exposure. At NHCT, CDT analysis revealed a prevalence rate of 1.4% and GGT a prevalence rate of 3.5% in the first trimester of pregnancy. Although those with elevated CDT generally had high levels of GGT, only one person was positive for CDT and GGT. The NTHFT data revealed a CDT prevalence rate of 1.7% (95% CI: 0.7–2.9) and GGT prevalence rate of 4.2% (95% CI: 2.6–5.9). No overlapping cases were identified, or a significant correlation was demonstrated between CDT or GGT. Although CDT and GGT analysis are not sensitive to low levels of alcohol, prevalence rates were similar in both areas, suggesting similar patterns of sustained alcohol use in pregnancy across the region.

We also took a full year's sample of data from the antenatal visits of women at NHCT, which documented the women's self-reported alcohol consumption. The percentage of women who reported alcohol intake in the first trimester was 0.8%, approximately half the rate of those identified by CDT. This compared to 74.1% of women who reported consuming alcohol before pregnancy, indicating the limited value of self-report in clinical practice.

As the climate health crisis continues to escalate, governments and key NHS leaders are recognising the need for change. There is growing sector awareness of the impact of the lab on the environment and it is now time for laboratory medicine to consider the role POCT can play in achieving NHS net zero carbon targets. Centres for Sustainable Healthcare propose four principles for sustainable healthcare: prevention, patient self-care, lean service delivery and low carbon alternatives.

This presentation considers the role GIRFT and POCT can have, in supporting these principles of sustainable healthcare and promoting greener diagnostic pathways.

This presentation will cover a case study completed as part of the IBMS Specialist Diploma in Immunology in 2022. It will be of interest to anyone considering completing the Higher Specialist Diploma in Immunology, or anyone who would like to learn more about the case study element. It will also be of interest to anyone who would like to learn more about the protocols used for reading and reporting methods including immunophenotyping by flow cytometry, serum protein electrophoresis and immunotyping, serum free light chains and Bence Jones protein analysis at Greater Manchester Immunology Service (GMIS).

The case is one of an elderly gentleman with who, like roughly a third of new myeloma cases in the UK, presented through A&E. The presentation will cover pre-analysis, analysis and post-analysis, considering how the tests performed in the Immunology laboratory assist in the differential diagnosis and where they fit in with the other tests ordered, both tests within and outside of the Immunology discipline. The presentation will cover the methods performed at GMIS and some of the reporting protocols, as well as discussing some of the relevant associated guidelines.

In the US, the death rate from drug overdoses more than tripled between 1999 and 2017, this was driven by increase use of opioids. This opioid epidemic had three phases: the first was dominated by prescription opioids such as oxycodone, the second by heroin, and the third by cheaper but more potent synthetic opioids such as fentanyl.

Despite a few outbreaks of synthetic opioids (such as fentanyl analogues) causing death is particular geographic areas, the UK has not faced the same epidemic as the US. However, over the past 2-3 years the UK has seen an increase in the detection of 2-benzyl benzimidazole (‘nitazene’) type opioids. These are found mixed with heroin or purchased online, typically sold as oxycodone. This talk will give a brief overview of novel opioids, discuss the potential for harm and highlight the analytical strategies to develop validated assays to detect and measure both novel opioids and other novel psychoactive substances.

This presentation will examine a specific case study submitted as part of the 'Advanced Specialist Diploma in Breast Pathology'. The case in question was a mastectomy sample for the treatment of diffuse multifocal invasive ductal carcinoma.

Within the presentation I intend to highlight the importance of pre-analysis and emphasise its correlation with macroscopic examination and block sampling. I will also highlight the importance of post analysis and the understanding of how the role of the Advanced Practitioner can directly impact patient treatment.

Perspectives on the Borderline Endocervical Cell Classification

Pandemics Present

Transfusion outside the NHS – jobs for Biomedical Scientists

I wish to offer a practical guide to working with the Human Tissue Authority.



I will provide examples of what to do and how to do it when issues arise



I will take you through the paperwork involved

I will describe how best to approach HTA reportable incidents

I will take you through how to prepare for the HTA inspection

This will be a very hands on guide and strongly welcome participation from the audience.

Scleroderma