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SA Pathology Newsletter 3 Issue 3

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SA Pathology Newsletter 3 Issue 3 2015 3 s Newsletter Maternal GBS detection 3 New genetics technology 4 SA Pathology INSIde in the new RAH 5 Haemoglobinopathy 6 Vitamin B12 deficiency 8 Aspergillosis infection 10 Respiratory virus update 12 Wallaroo Mt Gambier > 54 Port Augusta > 59 YeARS > 45 YeARS YeARS Berri > 46 We’re part of YeARS your community Gawler Port Pirie > 35 Murray Bridge YeARS > 29 YeARS > 41 YeARS Victor Harbor Whyalla > 27 Port Lincoln > 50 YeARS > 47 YeARS YeARS For our patients and our population www.sapathology.sa.gov.au TFT or TSH From the When considering thyroid testing consider whether you should request inside a TFT or a TSH? A request for TFT allows us to robotics technology, which will all provide you with a fT4 test where From the Executive Director work together with the new patient the TSH is abnormal or the tests are administration system (ePAS) being performed: introduced across our SA hospitals. n for the purpose of monitoring The convergence and integration of thyroid disease in the patient; or technologies puts us under pressure n to investigate the sick euthyroid to achieve time lines and agreed syndrome if the patient is an service benchmarks, but also presents admitted patient; or opportunities to embrace change for n to investigate dementia or better patient outcomes. psychiatric illness of the patient; We now have a chance to improve on or the best diagnostic support for all South n to investigate amenorrhoea or Australians, ensuring we are there at the infertility of the patient; or right time for the right clinical reason, n you suspect your patient has a and to support healthcare professionals pituitary dysfunction or making their decisions and tasks easier, n your patient is on drugs that resulting in improved care for our interfere with thyroid hormone few businesses today are patients and the population. unaffected by technological change; metabolism or function. and this will be keenly felt in health. Far from altering our vision, these SA Pathology in particular is in the changes mean we confirm our Please include the relevant clinical process of radical change, which is both commitment to enhanced healthcare notes on your request form. daunting and exciting as significant using tomorrow’s tools, including genetic change like this occurs once every few testing and sequencing for personalised DHEA or DHEA-S generations. care, and in partnerships which will Testing DHEA or its sulphated improve delivery of quality pathology analogue DHEA-S is conducted to I consider myself privileged to be here services to clinicians. at this point in time, as we step into a assess adrenal gland function in new future as part of a wider healthcare SA Pathology is investing in the future a variety of conditions including revolution. and we will be there to take our place hirsutism in women, adrenal in the new RAH as it starts to support dysfunction and the investigation At SA Pathology we are implementing patients, clinicians and our other of adrenal tumours. DHEA-S is more a new electronic pathology laboratory hospitals across the state. stable than DHEA and can be used information system (ePLIS), and are interchangeably with DHEA for most about to implement a new track and Mr Ken Barr clinical situations. SA Pathology provides routine SA Pathology on mobile DHEA-S testing for screening which is covered under the MBS. DHEA Have you used your mobile phone or tablet to visit the screening is not covered under the SA Pathology web site lately? If you’re looking for a test in the MBS and will attract an upfront Pathology Guide or for a nearby Patient Centre you’ll find the patient fee of $28.23. site much easier to navigate following our recent upgrade for mobile devices. Visit www.sapathology.sa.gov.au next time Unless specifically noted all DHEA you need to know. screening requests will be processed as DHEA-S. ¥ SA Pathology Newsletter Photography Cover Published by SA Pathology SA Pathology Photo and Imaging Our history in regional Editorial Committee Design South Australia. Mark Fitz-Gerald, dianne Zurcher, Sue dyer design ISSN 2203 – 2339 Print Kieran Weir and Adrian Griffiths Printing ISSN 2203 – 2347 Online Contact Newstyle Printing [email protected] SA Pathology Newsletter > 3 – 2015 PAGE 2 Improved detection of maternal GBS On 6th October we replaced the current culture test for Group B Streptococcus (GBS) with a Nucleic Acid Test (NAT) which detects up to 10% more GBS infections than traditional culture. What to collect Why change? n Vaginal, rectal and combined swabs Two thirds of neonatal GBS infections penicillin/amoxycillin during labour, if are suitable. occur in mothers who tested negative GBS is detected. Susceptibility testing n Place swabs in liquid Amies and for GBS before delivery. Current is only required for patients with request GBS NAT screen. laboratory methods lack sensitivity severe and immediate IgE-mediated for GBS detection, resulting in a risk allergy such as anaphylaxis – please If additional bacteriological testing is to some infants. GBS NAT, a more indicate this on the request form. required (e.g. because of premature sensitive test, will improve detection rupture of membranes, maternal and reduce infection in newborn Further information fever) the same swab can be used but children. For further information please contact please also; the On Call Microbiologist on Sensitivity testing n request MCS and (08) 8222 3000. ¥ n include clinical information. Prevention of perinatal GBS infection involves administration of IV benzyl- Sterilising equipment safety SA Pathology’s Food and gas plasma and ozone sterilisation Environmental Laboratory offers rapid processes. We have recently upgraded biological indicators (RBI’s) to monitor our test to provide faster results, in steam units and autoclaves, providing most cases next day. evidence of the proper operation of sterilisation equipment. If you own or operate sterilisation equipment we can help provide the Self-contained RBI’s contain confidence you need to ensure its bacterial spores resistant to the safe operation. mode of sterilisation being measured. Geobacillus stearothermophilus For more information visit is the highly-resistant spore used www.sapathology.sa.gov.au/foodlab or to monitor steam, hydrogen peroxide phone the laboratory on 8222 3363. ¥ New Patient Centres North Adelaide Kensington Park Angaston Recently relocated to Specialises in paediatrics 3 – 7 Fife Street, Angaston 55 O’Connell Street 360 Magill Road, Kensington Park Monday to Friday 8:00am to 12:30pm Monday to Friday 7:30am to 4:30pm Monday, Tuesday and Thursday Saturday 8:30am to 11:30am Saturday 8:00am to 12 noon 8:30am to 12.30pm SA Pathology Patient Centre hours are Maitland Yorketown correct at time of publication. 69 Robert Street, Maitland 23 Waterloo Bay Road Monday to Friday 8:30am to 12 noon Monday to Friday 8:30am to 11:30am Please check the website Modbury Rose Park for the latest updates Modbury GP Plus 24 Kensington Road, Rose Park www.sapathology.sa.gov.au 77 Smart Road, Modbury Monday, Wednesday & Thursday Monday to Friday 8:30am to 12:30pm 8:30am to 12:30pm SA Pathology Newsletter > 3 – 2015 PAGE 3 www.sapathology.sa.gov.au > > New genetics technology> improves diagnosis > > A significant number of us will be affected by genetically determined diseases in our lives. 2 to 3% of the population will be identified at birth and, by the age of 25, up to 5.5% of the population will have developed a genetic disorder. Later in life, up to 60% of the population is affected by a condition such as cardiovascular disease or cancer in which genetics plays a role. The diagnostic challenge This unprecedented change in Whole-exome sequencing processing capacity has resulted SA Pathology has effectively applied Diagnosis of genetic disorders has, in significant advances in genetic whole-exome sequencing to severe to date, been hampered by a number pathology. All candidate genes can paediatric cases including multiple of factors leading to some families now be tested at once, significantly congenital abnormalities, complex experiencing years of delay in reducing the time to diagnosis. neurological and metabolic disorders, diagnosis, the so-called ‘diagnostic Depending on the clinical phenotype, developmental delay and intellectual odyssey’. There are literally gene analysis can be broad, disability. thousands of rare genetic disorders, eliminating the need for health each individually affecting only a professionals to prioritise a select While many rare genetic conditions small number of people. This means group of genes for testing. This is a don’t have an effective treatment or that genetics health professionals paradigm shift as, for the first time, cure, it is often possible to alleviate may see few or even no cases of genetic testing may precede early symptoms with new therapies and some conditions in their working attempts at clinical diagnosis. help people better manage their life. A second major challenge has disorders. Test results provide been the vast number of genes Diagnostic testing information on risk of recurrence potentially involved in a given in families and can help plan future condition. This often results in the Targeted testing pregnancies. But for genetically need for consecutive rounds of gene SA Pathology is also accredited for complex conditions, testing the whole prioritisation and testing, each time targeted gene panel analysis using exome is appropriate as it avoids excluding another possible cause. NGS. For conditions with few genetic the problem of prioritising individual causes, testing a subset of genes or gene targets, and repeat testing if the ‘panels’ is appropriate, as only the Next-Generation Sequencing results are negative. genes known to be associated with Advances in sequencing technology a disorder need be tested. are now transforming the way Past obstacles, new breakthroughs genetic disorders are diagnosed.
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