Events in 2023
CONGRESS 2023 - Future: Preparedness planning & what might come next
28/09/2023
Future: Preparedness planning & what might come next
CONGRESS 2023 - A dual positive PLA2r and GBM patient
28/09/2023
This cases study focusses on a paient that showed dual positivity for Anti-GBM and Anti-PLA2r antibodies. It will look at how testing was requested, the methods used for the investigations and how the results lead to the conclusions drawn.
It will also look at testing algorithms in the Immunology laboratory, related to these investigations and how these could be improved.
It will also look at testing algorithms in the Immunology laboratory, related to these investigations and how these could be improved.
CONGRESS 2023 - Stented adenocarcinoma in a young female
28/09/2023
Emergency presentation of adenocarcinoma in a young female.
This case study was carried out as part of the Advanced Specialist Diploma in Histological Dissection of Lower GI Pathology. The patient was a 34-year-old female who presented at A&E with sudden onset of abdominal pain and constipation. A CT scan showed multiple colonic polyps and a likely descending colon tumour. The differential diagnosis of the tumour was of an inflammatory process, in view of her young age and negative family history of colorectal cancer. Endoscopic biopsies confirmed the diagnosis of a well to moderately differentiated mucinous adenocarcinoma. A stent was placed to relieve obstructive symptoms and a genetic questionnaire was completed. The patient subsequently underwent a subtotal colectomy in view of the large number of polyps. Histology of the resection specimen showed a circumferential mucinous adenocarcinoma multiple lymph node metastases and lymphovascular invasion, TNM 8 pT3 N2b R0 V0 L1 Pn0.
Routine Mismatch Repair (MMR) immunohistochemistry detected a loss of MSH2 and MSH6, indicating possible Lynch syndrome. Further molecular testing including Microsatellite Instability (MSI) showed that Lynch syndrome was not present, and no genetic explanation could be found as to why the patient developed bowel cancer at a young age. Detection of a KRAS mutation in the tumour cells suggests that treatment with anti-EGFR therapies such as Cetuximab may not be effective in this patient. After discussion of the histology at MDT, the patient was referred to oncology for adjuvant chemotherapy which consisted of 6 months Oxaliplatin and 5-Fluorouracil. The patient completed the course in 2019 and was referred to the surgical team for follow up with CT scans, endoscopy and CEA monitoring.
In summary, this case demonstrates the essential role of appropriate sampling and molecular testing of colonic cancer resection specimens in guiding decisions about the patient’s subsequent treatment.
This case study was carried out as part of the Advanced Specialist Diploma in Histological Dissection of Lower GI Pathology. The patient was a 34-year-old female who presented at A&E with sudden onset of abdominal pain and constipation. A CT scan showed multiple colonic polyps and a likely descending colon tumour. The differential diagnosis of the tumour was of an inflammatory process, in view of her young age and negative family history of colorectal cancer. Endoscopic biopsies confirmed the diagnosis of a well to moderately differentiated mucinous adenocarcinoma. A stent was placed to relieve obstructive symptoms and a genetic questionnaire was completed. The patient subsequently underwent a subtotal colectomy in view of the large number of polyps. Histology of the resection specimen showed a circumferential mucinous adenocarcinoma multiple lymph node metastases and lymphovascular invasion, TNM 8 pT3 N2b R0 V0 L1 Pn0.
Routine Mismatch Repair (MMR) immunohistochemistry detected a loss of MSH2 and MSH6, indicating possible Lynch syndrome. Further molecular testing including Microsatellite Instability (MSI) showed that Lynch syndrome was not present, and no genetic explanation could be found as to why the patient developed bowel cancer at a young age. Detection of a KRAS mutation in the tumour cells suggests that treatment with anti-EGFR therapies such as Cetuximab may not be effective in this patient. After discussion of the histology at MDT, the patient was referred to oncology for adjuvant chemotherapy which consisted of 6 months Oxaliplatin and 5-Fluorouracil. The patient completed the course in 2019 and was referred to the surgical team for follow up with CT scans, endoscopy and CEA monitoring.
In summary, this case demonstrates the essential role of appropriate sampling and molecular testing of colonic cancer resection specimens in guiding decisions about the patient’s subsequent treatment.
CONGRESS 2023 - Androgens and Sports: Conventional urine and modern dried blood sample testing methodologies
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 - Learnings from Parasitology EQAs: a discussion with UK NEQAS Parasitology
28/09/2023
Global travel and migration trends have meant a huge increase in the numbers of people exposed to tropical parasitic diseases. Thus, there is an increasing need for robust, reproducible and reliable screening as well as diagnostic techniques. These existing and emerging technologies all currently co-exist; each with their own specific and general pitfalls and limitations.
Thus, the need for fit-for-purpose qualitative EQAs or Proficiency Testing schemes for these parasite diagnostics remains pivotal and very timely. My talk at this congress will present findings and recommendations from Parasitology EQA schemes offered by UK NEQAS and will highlight the importance of quality management in the field.
Thus, the need for fit-for-purpose qualitative EQAs or Proficiency Testing schemes for these parasite diagnostics remains pivotal and very timely. My talk at this congress will present findings and recommendations from Parasitology EQA schemes offered by UK NEQAS and will highlight the importance of quality management in the field.
CONGRESS 2023 - Implementation of the Patient Safety Incident Response Framework (PSIRF): an NHS trust perspective
28/09/2023
The presentation gives an overview of the NHS Patient Safety Incident Response Framework, it’s principles and requirements. There is also a brief summary of the Systems Engineering Initiative for Patient Safety (SEIPS) and how this is different to previous models of investigation. The presentation then focusses on how PSIRF has been implemented at Northumbria Healthcare, an acute and community provider in the North East of England, with a focus on the phased implementation approach used by the PSIRF leads. The speaker will also cover the challenges in the implementation to date and the successes experienced so far.
CONGRESS 2023 - EUCAST – striving towards a complete system
28/09/2023
EUCAST – striving towards a complete system
CONGRESS 2023 - Shiga toxin-producing Escherichia coli O26 (STEC O26)
28/09/2023
Shiga toxin-producing Escherichia coli (STEC) O157:H7 has been the most clinically significant STEC serotype in the UK for over four decades. However, over the last 10 years we have observed a decrease in STEC O157:H7 and an increase in non-O157 STEC serotypes, such as O26:H11. Little is known about the microbiology and epidemiology of non-O157 STEC. This presentation describes the virulence, clinical outcomes and epidemiology of non-O157 STEC, focusing on the most commonly detected serotype, STEC O26:H11.