Events in 2023

CONGRESS 2023 - Molar pregnancy and gestational trophoblastic disease – why the hCG assay matters

27/09/2023
In this presentation, Imran Jabbar, will delve into the crucial topic of measuring human chorionic gonadotrophin (hCG) in gestational trophoblastic disease (GTD). With a focus on trophoblastic tumours, Imran will explore the significance of hCG as a diagnostic and monitoring tool in GTD. The presentation will cover the principles behind hCG measurement techniques, including immunoassays and molecular methods.

Imran will highlight the challenges and advancements in accurately quantifying hCG levels, and discuss their clinical implications. Attendees will gain insights into the role of hCG measurement in early detection, disease monitoring, and prognostic evaluation, ultimately contributing to improved patient outcomes in GTD management.

CONGRESS 2023 - Kell Blood Group System

27/09/2023
If you're interested in blood groups, blood group serology, transfusion or just want to know "what the hell is Kell?" then this talk is for you...

This presentation on the Kell Blood group system will cover the following;

An entertaining overview of the Kell blood group system
Structure, function and molecular background of the most well-known Kell blood group system antigens
Clinical significance of antibodies to Kell blood group system antigens
The association with the Kx blood group system
Interesting facts about the lesser known Kell Blood group system antigens

CONGRESS 2023 - How do molecular diagnostic techniques make a difference to the patient pathway?

27/09/2023
This presentation will give delegates attending an:

Overview of the pre-analytical processing pathway and potential risks associated with each stage.
Historical/current/prospective optimisation of the pre-analytical pathway.
Understanding of the near-future perspectives for standardisation-will technologies such image analysis and spatial profiling affect the practice of pathology laboratories.

CONGRESS 2023 - What is new in hepatitis?

27/09/2023
Despite effective treatments and vaccines viral hepatitis remains a massive burden on global health affecting the poorest counties disproportionately. Effective treatments and diagnostics for hepatitis remain outside the reach of most people in resource-poor regions.

In contrast, UK strategies against viral hepatitis have been relatively successful, in particular the prospect of HCV elimination, which is already showing improved outcomes in liver health.

Effective strategies depend on high quality epidemiological data which is gleaned from a wide variety of sources including diagnostic laboratory reporting, sentinel surveillance programs and prospective screening of high-risk groups.

The key components preventing transmission of blood-borne viruses such as donor screening, surveillance of susceptible groups and vaccination are now further enhanced by retrospective case finding from historical data, opt-out screening in emergency departments and high intensity test-and-treat events in prisons.

Biomedical Scientists can make a valuable contribution towards viral hepatitis management by sharing local-level data, enabling practical testing solutions for marginalised groups and working closely with clinical teams.

CONGRESS 2023 - Acute obstetric coagulopathy

27/09/2023
Postpartum haemorrhage is caused by obstetric complications but may be exacerbated by haemostatic impairment. It is a common observation that placental abruption and amniotic fluid embolism are associated with a severe and early coagulopathy characterised by hypofibrinogenaemia and increased fibrinolysis.

In Cardiff, a programme of research has been undertaken investigating the early detection and replacement of fibrinogen based on viscoelastic haemostatic assays. This culminated in the development of a care bundle for postpartum haemorrhage called the Obstetric Bleeding Strategy for Wales (OBS Cymru). Introduction of the OBS Cymru intervention across Wales resulted in fewer women experiencing massive postpartum haemorrhage (defined as >2500 mL) and decreased need for blood transfusion. The intervention is being investigated further in a NIHR supported study.

At term, women have increased levels of procoagulant clotting factors and reduced anticoagulants leading to a prothrombotic state. Our study confirmed these findings and demonstrated significantly raised thrombin generation. We identified two main types of coagulopathy; a dilutional coagulopathy with coagulation factors and platelets falling progressively with bleed size. However, clinically significant reductions in clotting factors were not seen until bleeds of 3000-4000 mL had occurred due to the high starting levels. Despite this, thrombin generation did not decrease due to increased levels of factor VIII during bleeds. Similar dilution-related falls were seen with fibrinogen levels. The exception was factor XIII which falls at term and decreases further with bleed size. The clinical significance of this finding has not been investigated but could suggest a role for cryoprecipitate.

In a subgroup of women we identified an early and severe consumptive coagulopathy caused by hyperfibrinolysis with very high D-dimer and plasmin/antiplasmin complexes which we termed acute obstetric coagulopathy (AOC). In addition, women with AOC had low levels of fibrinogen and evidence of an acquired dysfibrinogenaemia demonstrated by a reduced Clauss/antigenic ratio. The coagulopathy caused depletion of factor V and factor VIII but other clotting factors and thrombin generation was preserved. An increase in activated protein C was observed but no increase in soluble thrombomodulin demonstrating similarities and differences to trauma-induced coagulopathy.

AOC occurred in about 1/1000 deliveries and was associated with a high rate of fetal and neonatal deaths. It was most commonly associated with placental abruption but occurred with all underlying causes of postpartum haemorrhage.

CONGRESS 2023 - Pathology of Head & Neck – Histology & Cytology

27/09/2023
The aim for this session is to carry on with the patient’s journey to final diagnosis. This presentation will discuss how the valuable material obtained from ROSE clinics are utilised in making a diagnosis and provide prognostic/treatment related information.

With the use of a number of examples, this presentation will illustrate how cytology impacts on patient’s management pathway, and how a standardised reporting system could be useful in unifying diagnostic pathways and performing future work on audit and quality improvement.

Finally, the strengths and limitations of head and neck cytology from the perceptive of a histo/cytopathologist will be discussed

CONGRESS 2023 - UKNEQAS CPT Diagnostic Cytopathology Cell Block Scheme

27/09/2023
Cell blocks from Diagnostic Cytopathology (DC) samples have always had value in the diagnostic process as a complement to the traditional cytology stains – Papanicolaou and Romanowsky. It has become more important to provide material for Immunocytochemistry to refine malignant diagnosis, and more recently, the use of molecular testing to aid in the choice of tailored chemotherapy regimens. If this information can be obtained from DC samples, which are less invasive than biopsy samples, the patient will benefit.

External Quality Assurance of cell block preparations has up to now been covered by the Tissue Diagnostic scheme. However, this is not entirely appropriate as cytopathology departments use a variety of cell block preparation methods and fixatives. The increase in number of cell block Haematoxylin and Eosin slides submitted to our evaluation service and the queries we receive regarding advice on best preparation methods suggested there was a need for a separate scheme for evaluation of cell blocks. A circulated survey indicated that there is a need for such a scheme. In response to this we performed 2 pilot studies which were well supported and successful, leading to the launch of the live scheme in April 2023.

This presentation covers the development of the scheme and the results of the 2 pilots. As an ongoing process the scheme will be able to garner information about ‘best methods’ and this can be passed on to laboratories experiencing problems and improve standards. UKNEQAS CPT is not just a ‘tick box’ service for UKAS, it is also an advisory service which aims to improve diagnostic practices.

CONGRESS 2023 - IIF and Artificial Intelligence

27/09/2023
IIF and Artificial Intelligence

CONGRESS 2023 - Clinical Liaison Role in Wales – an update on the journey so far

27/09/2023
Clinical Liaison Role in Wales – an update on the journey so far

CONGRESS 2023 - Your career in Clinical Biochemistry: IBMS qualifications and the role of the Advisory Panel (Wednesday)

27/09/2023
Your career in Clinical Biochemistry: IBMS qualifications and the role of the Advisory Panel