Events in 2023

The analysis of free light chains in clinical laboratories to support the diagnosis and treatment monitoring of Myeloma has evolved over 6 decades. From urine analysis for Bence Jones Protein using gel electrophoresis in the 1950s to the launch of the first commercial assay for serum free light chain measurement in 2001.

This talk will describe the biochemistry of free light chains and the benefits and challenges of the different methodologies available in laboratories today. I will also describe the complexity of clinical interpretation of results, highlighting relevant national guidance, recently developed diagnostic tools for clinicians and testing advice for laboratories.

Scleroderma

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.

Increasing antimicrobial resistance observed globally in key Gram-negative bacteria and failure of the antimicrobial development pipeline to keep up has left clinicians with few remaining treatment options. This presentation will: i) highlight the current gaps in our antimicrobial armamentarium (with a focus on the World Health Organisation critical priority pathogens); ii) give an overview of new antimicrobials that have reached phase 3 clinical trials and other therapeutic approaches currently in the pipeline; and iii) share experience from the reference laboratory.

What’s new in antivirals? (Antivirals & Mabs as therapeutics)

Update on endocervical adencarcinomas

The Arenaviridae have the dubious distinction of containing among their members one of greatest proportions of hazard group 4 viruses of any recognised taxonomic family. These viruses cause persistent asymptomatic infections in their rodent reservoirs, however zoonotic spill over often results in viral haemorrhagic fever (VHF) and high mortality. Transmission to humans occurs via contact with infected rodent excreta, through contaminated food and inhalation of aerosols. Human to human transmission also occurs. In sub-Sharan West Africa, Lassa virus (LASV) has been identified as a VHF since 1969 and is endemic over much of rural Nigeria, the countries of Mano River Union, Ghana, Togo and Benin.

From a global health security perspective, it is of significant international interest since it the most commonly imported VHF into non-endemic countries. In nearly every imported circumstance, the cryptic nature of Lassa fever and related difficulties in diagnosis, places enormous demand on clinical, laboratory and public health resources of the recipient country. Given our current understanding of LASV and other evolving members of the genus, attention should be focused on other new and emerging mammarenaviruses which have similar incubation times and could result in similar human disease with a propensity to overburden public health systems.

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.

ISO15189:2012 had reached its periodic review date and there was international consensus that it needed revision. The new version was published on 6th December 2022 and there are some key changes which include an emphasis on a patient-focused approach and to promote the welfare of patients - i.e. putting the patient at the heart of the service. There is also more emphasis on a risk based approach to the Quality Management system. In addition ISO 22870 (POCT) has been incorporated into ISO 15189:2022.

This presentation will review POCT definitions, highlight key considerations for currently accredited POCT services and also for organisations considering applying for accreditation to include (or extend) POCT in their scope.

POCT is referenced implicitly throughout ISO 15189:2022 and with additional distinct requirements as an Annex A.

The presentation will discuss generic POCT services, and highlight considerations on both current POCT services and also emphasise considerations for planning new POCT services, and that overall, when compared with ISO 22870:2016, things have not changed as much as one would think. Principles are similar, and POCT could even be considered as another specialty within pathology, regardless of where it is or managed from.

The Air Ambulance covering Derbyshire, Leicestershire and Rutland first approached Blood Transfusion in February 2021 to discuss the idea of them being able to carry blood on the aircraft so they can carry out lifesaving transfusions at the roadside. In the previous months the medics on board had been documenting those patients they had attended that they thought would have benefited from being transfused at the scene of an injury.

The majority of these were road traffic accidents and stabbings where blood loss had led to severe morbidity or even mortality. After months of meetings discussing what equipment was needed (e.g. blood boxes, temperature monitoring devices, storage etc.), finances, validation procedures and trialling the process we finally started providing blood on board in February 2022.