Diary of the “mad” med-lab techs

Dec. 1, 2010

The best of the freebies

In their efforts “back in the day” to place their names and products before the lab-supply purchasers, new companies gave away disposable and printed brochures, monographs, and paperback and occasional hardback publications. Eventually, books were replaced by sticky notes and ballpoint pens. And while such items are still available, generally they are no longer free.

Ortho gave free or nominally priced lab materials if a lab had standing orders of blood cells and/or reagents. Every blood bank had the big cross-match rack for microscopic reading of cross-match tubes; it took years for me to find another of those “railroad track” racks. Labs that printed their own cross-match worksheets kept a couple of Ortho’s worksheets in a drawer “just in case.” The series of blood-bank and coagulation plastic-bound monographs were the earliest authorities on basic and esoteric antibody testing, and the fold-out charts made the “coagulation cascade” — why clotting started and stopped — easier to understand and then explain to students.

Abbott provided the most professional looking soft-cover publications. The large format The Morphology of Human Blood Cells in Wright Stained Smears of Peripheral Blood and Bone Marrow was completed in 1954 by Dr. L.W. Diggs and contained the finest set of colored non-photographic illustrations of blood cells. By 1984, it was already in its 4th edition and is still available from Abbott for $12. The company published an outstanding collection of colored photographs from bacterial culture tubes to fetal mice, covering most microbiology sub-categories in Schneierson’s Atlas of Diagnostic Microbiology (9th edition by 1984). Copies on Amazon range from $5 upward, worth every penny to get one just for the beauty of the plates.

Ames’ wall charts provided color pictures of urinary inclusions not otherwise available. DuPont, Technicon, and several others put out soft-cover publications related to specific organ or disease conditions; early ones dealt with diabetes testing; at the time, standard blood glucose was about the only related procedure available to most clinical labs — the glyco-hemoglobin was still considered “esoteric.”

The only free hardback distributed was the tried-and-true Difco Manual, since many labs had to make their own media, especially for unusual organisms. Manufacture of both blood and MacConkey plates was just starting as were volume sales to medium-size labs — but both bigger labs and remote labs continued making their own for years. Other than from sales and tech reps, the best place to find these gems was at national meetings: AACC, AABB, or CLMA. Most available ASCP, ASM, and CAP publications were hard copy and expensive. Now, they all are.

—Chuck Millstein, MBA, MT(ASCP), CLDir(NCA)

Gold mine in a book

I uncovered a gold mine: Manual of Commercial Methods in Clinical Microbiology: Allan L. Truant, editor, ASM Press Washington, DC. Where has this textbook been hiding? This textbook has it all. It lists peer-reviewed comparisons of every test kit and automated system available on the market and is, thus, unbiased by manufacturer or vendor prejudice.

With so many baby boomers leaving the workforce and taking with them countless years of valuable information and experience, the laboratory’s “newbies” are going to need all the help they can get. I unearthed this absolute jewel of information and personally recommend that it be included as an essential reference source for every bench tech and supervisor in clinical microbiology and immunology. I regret not listing it with my other favorites in the June 2010 “Mentoring Minute;” but I confess, I just recently discovered it.

My deeply ingrained honesty translates into the fact that I read all 481 pages — from A.F.B. Adjusting Reagents (Mycobacteria) to ZStatFlu (Rapid Systems and Instruments for the Identification of Viruses) — impressive contributions from hundreds of dedicated scientists — before writing this brief recommendation. I regret I did not have this gem with me before I retired; my decisions would have been much more informed. The only shortcoming is that there are no color plates which would have added a valuable dimension to this otherwise remarkable work.

Refer to this manual before making decisions regarding the purchase of any manual or expensive automated equipment upon which you have set your eye. Trust me, once you have made a decision, you are stuck with it for a while — for a long while if it is capital equipment. But do not rely solely on the written word. In-house validation studies are valuable and mandatory. In fact, I was actually asked by a young supervisor during a College of American Pathologists annual on-site inspection what a validation study was.

—By Colleen K. Gannon, MT(AMT) HEW,
the “Nancy Grace” for labs

Book offers truth about herbal remedies

The cover of Prescription or Poison? The Benefits and Dangers of Herbal Remedies by Amitava Dasgupta, PhD, intrigued me: “Many people believe that if it’s herbal, ‘natural,’ or for sale at a health-food store, it must be safe.” After reading this most interesting new publication from Hunter House Publishers, my mind has been changed. Did you know that

  • the ingestion of as little as 4 mL of oil of wintergreen can be fatal to a child; in the Western world, essential oils are the fourth most common agent in childhood poisoning?
  • nutmeg ingested in large amounts produces hallucinations?
  • patients on Warfarin therapy should consult with their physicians before initiating daily intakes of fish-oil supplement?
  • if you have any liver problems or hepatitis, you should not take noni juice?

  • licorice is effective in protecting the liver from hepatitis A- and hep B-induced damage; it can stop the replication of the hep C virus and may eventually kill the virus?
  • ginger is more effective in preventing motion-sickness than dimenhydrinate (e.g., brand names Dramamine, Gravol)?
  • Chapter 12 — likely the most pertinent to MLO’s readership — is “How Herbal Remedies May Affect Laboratory Test Results,” but the carefully wrought chapter-by-chapter Notes, the Further Reading page, and the Glossary are equally valuable. Dasgupta addresses an alphabetical plethora of herbs, from astragalus to garlic to sage, and covers vitamins A, B, C, D, E, and K.

    Dasgupta is a professor of pathology and laboratory medicine at the University of Texas-Houston Medical School and a past contributor to MLO in the area of drugs of abuse and, most recently, herbal toxicity. Anyone interested in learning 1) the dangers of combining alternative remedies with common medications, and 2) the proper use of alternative medicines would be wise to put Prescription or Poison? in a handy spot for frequent reference.

    —By Carren Bersch, Editor, MLO

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