October 1, 2010by Barry P. Latner, M.D., Medical Director of Laboratory Services
Although Shakespeare did not have this question in mind when he wrote Hamlet, it is an appropriate one to consider when completing a laboratory test requisition. C-reactive protein (CRP) is one of the most sensitive acute phase proteins and appears to be a nonspecific host defense against inflammation... more...
Effective August 4, 2010 the name of the test "UA conditional" (15015) will be changing. The test will now be named UA with Microscopic (C&S if indicated). When this test is ordered, a complete urinalysis is performed which includes... more...
Outbreak Norovirus specimens are processed at California State Public Health laboratories. They are currently charging for this service. In the event of a facility or regional outbreak, State laboratories are prepared to process specimens rapidly and are able to track the progress of outbreaks throughout the State. If a Norovirus Outbreak is suspected,... more...
April 1, 2010by Barry P. Latner, M.D., Medical Director
Tuberculosis remains a contemporary disease. Since 1993, the proportion of cases in the United States has increased each year in foreign-born vs. U.S. born individuals. By 2007, the TB rate among immigrants was 9.7 times higher than in U.S.-born citizens... more...
June 30, 2009by Barry Latner, M.D., Medical Director Laboratory Services, John Muir Health
At the time of this writing, the World Health Organization (WHO) has changed the phase of pandemic alert for the novel Influenza A (H1N1) virus from Phase 5 to Phase 6. This indicates a global pandemic is underway in which there is little or no immunity in the population. While the upgrade designation is... more...
Allergy and diseases caused or complicated by allergy, such as asthma, or diseases with symptoms which mimic allergy, are among the most widespread and costly health problems in the world. John Muir Health, MuirLab will soon provide testing for allergy that is safe, simple, and accurate with groundbreaking technology with the latest generation... more...
Beginning May 1, 2009 MuirLab changed its method of high risk HPV to a newly FDA-approved molecular methodology from Hologic, Inc. While we have been very satisfied with the performance of our previous assay, market forces have eliminated that manufacturer from the HPV cytology product line more...
In our continuing commitment to provide innovative laboratory services for patients and physicians, John Muir Health and MuirLab are pleased to offer the next evolution in HIV-1 viral load testing, the COBAS® AmliPrep/Taqman HIV-1 test by Roche Diagnostics. This FDA-approved real time... more...
October 1, 2008by Barry P. Latner, M.D. Medical Director, Laboratory Services
The manufacturer of our Estradiol assay has updated its standardization to the international reference method of isotope dilution gas chromatography mass spectrometry (ID-GCMS) method from the USP reference material. As a result, there are some changes... more...
On March 31, 2008, the Microbiology Department will be moving to the new MuirLab Core Lab in Concord. In order to expedite STAT gram stains on specimens that will need to be read in the hospital, we are requesting that two swabs of the specimen be submitted to the Laboratory. One swab will be used to make the gram stain and the second... more...
May 1, 2008by Barry P. Latner, M.D., Medical Director, Laboratory Services
In 2004 the clinical laboratories of John Muir Health started reporting estimated glomerular filtration rate (eGFR) along with serum/plasma creatinine as recommended by the National Kidney Foundation. The rationale for this was to remind us that approximately 11% of the U.S. adult population has chronic kidney disease,... more...
May 1, 2008by Nader Shihabi, MD and Bernard Larner, MD
We are changing the criteria for reflex urine cultures. In the past, the only criteria for urine cultures was WBC >10 in the urine. We will now also culture urines with positive leukocyte esterase or positive nitrite. These two parameters were... more...
Effective April 1, 2008, "CBC with Auto Differential" and "CBC with Manual Differential" will be combined into a single test, "CBC with Differential". Automated or manual differential results will be reported based upon internal laboratory reflex criteria. If specific morphologic evaluation... more...
January 1, 2008by Barry P. Latner, M.D., Medical Director, Laboratory Services, John Muir Health
In September (2007) the Clinical Laboratories of John Muir Health introduced a new assay for cTnI and implemented reporting practice guidelines published in the laboratory literature and endorsed by all major cardiology organizations (including ACC and AHA). A significant guideline for cTnI was the decision-limit for myocardial injury/myocardial-cell necrosis being set at the 99th percentile of a population of normal, healthy individuals... more...
Despite recent improved access to antiretroviral treatment and care in many regions of the world, the AIDS pandemic claimed between 2.4 and 3.3 million lives in 2005, the highest number since 1981. Half a million or more than 570,000 of these deaths were children less than 15 years old... more...
The genus Legionella includes over 40 different species of fastidious Gram-negative bacilli. While these organisms represent normal environmental flora, many have been shown to cause human disease, most commonly opportunistic pneumonia in immunocompromised patients. The vast majority of such cases... more...
In an attempt to remind clinicians of the importance of the degree of protein binding in the action of phenytoin and in the interpretation of serum/plasma phenytoin concentrations, the Clinical Laboratories of John Muir Health will soon report... more...
The PLAC test is a blood test that measures the level of Lp-PLA2, an enzyme highly specific for vascular inflammation and implicated in the formation of rupture-prone plaque. The PLAC test is cleared by the FDA to aid in assessing risk of both coronary heart disease and ischemic stroke associated... more...
Enterohemorrhagic E. coli (EHEC), also known as Shiga-toxin-producing E. coli (STEC), is recognized as an important cause of human diarrhea, hemorrhagic colitis, thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS). The E. coli serotype O157:H7 has been documented as the most common... more...
Beginning September 11, 2007 the Clinical Laboratories of John Muir Health will complete the conversion of all of its chemistry and immunochemistry assays (> 70 tests) to a single new platform. This change to Beckman Coulter instrumentation is made... more...
July 1, 2007by Dr. Barry Latner, Medical Director for the Clinical Lab John Muir Health
Following the work of a task force of the Department of Medicine headed by Ross Pirkle, M.D., the Medical Executive Committee of the JMMC Walnut Creek Campus approved an updated list of "Critical Values" for laboratory tests. This list is considerably pared down... more...
Abbott Laboratories' PRISM HBsAg assay was approved this month by the Food & Drug Administration to test people who donate blood, blood components, and organs for transplant for the hepatitis B virus. The test also may be used to screen blood... more...
January 1, 2000by Barry P. Latner, M.D., Medical Director, Laboratory Services
Vitamin D has received increasing attention over the past few years. In fact, testing for Vitamin D deficiency is one of the fastest growing tests across the country, if not the fastest, with many clinical labs reporting doubling and tripling of requests year over year. Once many foods were fortified with Vitamin D and the incidence and prevalence of rickets... more...
John Muir Medical Center Laboratory Urinalysis Department announces the conversion of manual urine microscopic analysis to an automated flow cell system that counts & characterizes the separate elements in the specimen... more...
With the automation of our urine microscopic exams we have changed our critical value levels for white blood cells. Please note the following... more...
January 1, 2000by Barry P. Latner, M.D., Medical Director, Laboratory Services
New Trough reference range: 10-20 µg/mL; New Peak reference range: 30-50 µg/mL. Vancomycin is one of the most widely used antibiotics for the treatment of serious gram-positive infections involving methicillin-resistant S. aureus (MRSA), and has been in clinical use for nearly 50 years. Early in 2009 the Infectious Diseases Society of America,... more...
In an attempt to better serve your needs, erase confusion, and eliminate testing errors with regards to (pediatrics) RSV testing, please take note of the following: The STAT Respiratory Syncytial Virus (RSV) test is the RSV Direct Antigen Screen #15845. If we receive a NP swab aspirate, we perform the RSV Antigen Screen. Respiratory Syncytial Virus DFAs are not... more...
Very shortly we will be distributing new requisitions to our clients. You will notice a change in your order options for the Occult Blood and PSA test. The new Occult Blood test (EFOBT) will give you the option of ordering either an Occult Blood Screen... more...
To date, there have been approximately 226 patients diagnosed with Nephrogenic Systemic Fibrosis/Nephrogenic Fibrosing Dermopathy (NSF/NFD), possibly associated with intravenous Gadolinium MR Contrast administration. In the past 20 years,... more...
Latent TB infection (LTBI) generally results in the conversion of the TB skin test (TST) from negative to positive within two to ten weeks after exposure. Persons with a positive TST are infected, but if they have no symptoms and a negative chest x-ray, they cannot... more...
I recently had the opportunity to attend and present in a Molecular Diagnostics conference held in Ft. Lauderdale Florida. Although I typically shy away from these "technical" types of gatherings, I was quite surprised to find the majority of the presentations and discussions moving away from the scientific developments, which have dominated this area... more...
The clinical laboratory at John Muir Medical Center will be offering the Affirm™ VPIII test for Bacterial Vaginosis/Vaginitis in October of 2006. The Affirm VPIII test is a molecular probe-based system for the rapid diagnosis of the most common causative agents of bacterial vaginosis (BV) and vaginitis... more...
MuirLab is pleased to announce that we will be offering the intact PTH assay as an in-house test. PTH is one of the primary hormones for calcium metabolism and maintenance of optimal calcium ion concentrations, and works directly on bone and kidney. Therefore, measurement ... more...
Through comprehensive epidemiologic and molecular biologic studies over the last 10-15 years, it has become clear that infection with specific types of Human Papilloma Virus (HPV) is required for the development of cervical caner and its high-grade precursors... more...
January 1, 2000by Barry P. Latner, M.D., Medical Director, Laboratory Services
Fecal occult blood testing (FOBT) is used as a method to screen for colorectal cancer and to test for gastrointestinal bleeding in general. Traditionally, it has been performed using guaiac-based methods that detect the pseudoperoxidase activity of the hematin portion of hemoglobin. The guaiac-based methods are limited... more...
MuirLab is pleased to announce the introduction of quantitative Hepatitis C Virus RNA testing by polymerase chain reaction (PCR). Hepatitis C (HCV) is one of the most common—and significant—blood-borne infectious diseases in North America, and is a leading cause of chronic liver disease... more...
January 1, 2000by Barry P. Latner, M.D. Medical Director, Laboratory Services
While long considered the test of choice for the chronic management of diabetes, the American Diabetes Association with the International Expert Committee recently issued a report endorsing the use of HgbA1c level ≥6.5% as the favored test... more...
The Food & Drug Administration this month approved a new laboratory test to diagnose the H5 strain of the Avian Influenza virus (a.k.a. bird flu) in people. The test, which was developed by the Centers for Disease Control & Prevention, is called... more...
When ordering Parathyroid Hormone Intact Molecule, TOTAL CALCIUM is needed to produce a result that includes a diagnostic graph which plots parathyroid hormone concentrations against total serum calcium values. This graph is designed to aid in the diagnosis of primary hyperparathyroidism,... more...
Normal hemostasis requires a balance between procoagulant and anticoagulant systems which may be perturbed by either inherited or acquired defects. Acquired defects may be environmental or intrinsic. Inherited defects associated with bleeding disorders, such as... more...
Recently, the National Kidney Foundation published 15 clinical practice guidelines on chronic kidney disease. Their work shows that approximately 11% of the U.S. adult population have chronic kidney disease, which is defined as either kidney damage... more...
Microbes have the incredible ability to quickly respond to antibiotic pressures by developing various mechanisms of resistance. It is with increasing regularity that we read about the "super bugs" such as MRSA, VRE, and multiply resistant M. tuberculosis that are spreading throughout our communities... more...
In addition to its well-known role in infectious mononucleosis (IM), Epstein-Barr virus (EBV) is implicated in several malignancies, including Burkitt's lymphoma and nasopharyngeal carcinoma. Fortunately, increasing demand for viral testing has made sophisticated blood tests for EBV more easily available, and these tests are now being routinely performed at MuirLab... more...
Methicillin-resistant Staphylococcus aureus (MRSA) has grabbed recent national media attention and alarmed the public, but there has been little publicized about the emergence of resistance among enteric Gram negative bacilli. There is a resistance mechanism called KPC, Klebsiella pneumoniae carbapenamase, that has been... more...
Cystic fibrosisis a common autosomal recessive genetic disorder with an incidence of approximately 1:3000 births. Over 1000 mutations in the cystic fibrosis transmembrane regulator (CFTR) gene have been described. JMMC Clinical Laboratory offers a Cystic Fibrosis Mutation screening test that includes... more...
MuirLab introduces the latest addition to our test menu, N Latex Cystatin C, a new diagnostic test for the quantitative determination of Cystatin C in human serum or plasma. Cystatin C provides a practical alternative to the traditional 24-hour urine creatinine clearance... more...
This pathogen causes skin infections presented as cellulitis, impetigo, folliculitis, furunculosis, carbuncles, abcesses, and infected lacerations. The patient has no history of hospitalization, admission to a nursing home, dialysis, surgery... more...
Amikacin is a semi-synthetic aminoglycoside antibiotic used to treat different types of bacterial infections. This medication can cause serious kidney problems and nerve damage, resulting in permanent hearing loss and balance problems... more...
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