The role, especially in the universal screening of

The Role of
Biomedical Laboratory Testing in Detection and Management of Disease.

 

Biomedical Tests carried out in Laboratory play a massive
role in today’s healthcare and has a huge influence on the detection and
management of numerous diseases. Biomedical tests provide many healthcare professionals
with the ability to diagnose patients, pre-infection before any symptoms are
shown as well as

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aiding them during the infection. Several diagnostic
tests are used in whole population screening. Screening allows the
identification of people who may be at an increased risk of an infection or conditions
that may have an effect on their health. In the U.K. the national health
service (NHS) offer a series of screening tests to different sections of the
population. In whole population screening, biomedical tests play the role of
sieve by filtering out the population that either have a high or low risk of
having the condition that is being screened for. Those that have a higher risk
are separated and they go through further tests. Biomedical laboratory testing
help detect diseases at early stages of a person’s life before any noticeable
symptoms occur, which reduced the transmission to other beings. The economy is
saved of vast amounts of money being spent on the healthcare service due to
treatment costs as at an earlier stage treatment is more feasible, easy and
less expensive.  The specificity, sensitivity
and predictive value of the tests is why it plays such a significant role,
especially in the universal screening of pregnant woman, in the control of
infections such as hepatitis B
virus (HBV).  Screening tests help
highlight risk factors, this allows doctors to provide advice on changes to a person’s
lifestyle that will ultimately prevent them from suffering from the disease
that they may eventually get. Diagnostic tests such as mammography, full-blood
counts, echocardiography, colonoscopy, prothrombin time, bone density study,
magnetic resonance imagining, computerised tomography, electrocardiogram and prostate
specific antigen have aided treatment for multiple diseases and helped identify
the microorganism causing an infectious disease. These tests give social,
medical and economic benefits i.e. make a contribution to a patient’s safety, they
improve patient care and limit healthcare spending. “From pregnancy tests to diabetes monitors, in vitro
diagnostics are empowering patients’ with information about their health and
giving doctors the tools that they need to choose optimal treatments for the
people in their care.”

 

 

 

 

Pathology
Disciplines

 

Haematology
is a scientific discipline; a study of blood and blood forming organs. Certain infections
can cause damage to regions such as the bone marrow (where blood cells are
produced). “Haematology deals with many aspects
of diseases which affect the blood, such as anaemia, leukaemia, lymphoma and
clotting or bleeding disorders”. A test used to investigate in haematology are
Full-Blood Count tests, which is a routine blood test that provides information
on the patient’s blood cells by evaluating platelets, red blood cells and white
blood cells. Full-Blood Counts also involve samples providing information on Haemoglobin
(a protein in the structure of the red blood cells which enables it to carry to
oxygen) concentrations and Haematocrit red blood cell volume. “This can be
useful as a screening test in many different situations, e.g. a raised white
blood cell (WBC) count may indicate a response to an infection and low Haemoglobin
(Hb) may indicate the presence of anaemia.” FBCs are carried out in
adults by drawing blood from a vein (venepuncture),
usually from the back of the hand or the inside of the elbow. Peripheral blood
smear can be carried out to evaluate blood, the procedure consists of adding a
small drop of blood is placed on a slide and spread with a thin film. After a
while the blood will dry, then the slide can be placed under a microscope for
further investigation. The morphology
and appearance of all the blood elements: the white blood cells, platelets and red
blood cells can be assessed by a haematologist. Prothrombin
time, partial thromboplastin time, international normalized ratio (INR) are
also common haematology tests that aid the evaluation of bleeding and clotting disorders and to monitor
anticoagulation (anticlotting) therapies. INR is used to monitor a person under
the influence of the anticoagulant drug Warfarin. Warfarin may be prescribed
for numerous conditions including Deep Vein Thrombosis (DVT) and Atrial
Fibrillation (AF). Prothrombin time is a test of the coagulation system performed
routinely for patient’s prior surgery. In this procedure, substrate is added to
activate the clotting system in the plasma. Time taken for the primary protein
of which the blood clot is made (fibrin) is measured. A series of proteins is
required for the formation of blood clots and any deficiency will an
abnormality in the Prothrombin time.  Partial
Thromboplastin time is also another prior surgery evaluation. Second pathology
discipline is microbiology; study of infectious diseases such as bacteria, viruses, fungi and
parasites. Microbiological testing is used to ensure food is safe from microbiological
contamination. Testing in this field is “a crucial requirement
across many industries worldwide where products, processes and human health are
at risk of being negatively affected by the presence and breeding of
micro-organisms such as specific pathogens, bacteria, yeast and moulds.” “Microbiology
Testing Services.” Microbiology Testing Services, www.intertek.com/microbiology/.

The work encourages
the culturing of a particular bacterium in an incubator that is identical to
the perfect environment for the microorganism meaning the conditions are all at
optimum, then the results are examined under the microscope. The susceptibility
of the bacteria to antibiotics to help decide on treatment is also examined in
this lab. There are numerous microbiology tests
that allow microbiologist to evaluate microorganisms present in humans. Helicobacter stool antigen is an example of a
microbiological testing, it is screening test used to detect Helicobacter
pylori present in the faeces.  The
background of this organism is that it is a bacterial infection on the duodenum
and stomach lining. Acid Fast stain is an examination of the presence of
mycobacteria, monitor therapy against diagnosis of mycobacterial infection. The
waxy envelope surrounded the structure of the acid-fast bacteria. This envelope
enables it to be resistant to distaining by the acid alcohol. The stained bacteria
are resistant to decolourisation via acid alcohol due long exposure to heat
destroying the cell wall. Bacterial Antigens is an additional microbiological testing
that identifies the existence of antigens of the Streptococcus pneumoniae, Neisseria meningitides and Haemophilus influenza. The test aids the detection of bacterial antigens in CSF
which helps fast diagnosis of meningitis.  pathogenic organisms causing
meningitis, brain abscess, shunt infections subdural empyema, cerebral or
spinal epidural abscess, bacterial endocarditis with embolism can be identified
and isolated. Gram Staining tests help identify what bacteria is behind
specific infections. Gram Staining is a technique commonly used to distinguish
between gram-positive and gram-negative bacteria. The bacteria’s both vary in
function and structure. Body fluids or samples from biopsies are used to carry
out this test. This helps a patient’s prognosis. This test is related to fungus
smear and acid-fast staining.

 

  

 

Non-Biomedical
Investigations

 

X-rays and MRI Scanning’s are both forms of testing that
patients undergo that do not involve biomedical based investigation. X-Rays (a
form of medical imaging) has shown to be a massive influence in treatment and
diagnosis of multiple medical conditions. All types of medical imaging function
using ionising radiation to produce images of the person’s body. Major advancements
have occurred in medicine due to the introduction of medical imaging such as radiography,
CTs and Fluoroscopy.  X- rays aid monitoring
therapies, to keep an eye on prescribed treatment, and help diagnosis of
certain diseases such as osteoporosis. They provide the ability to examine
regions of discomfort or pain for a patient. Computerised tomography (CT Scans)
is often used to examine heart issues. Magnetic
resonance imaging (MRI) is a test that does not encourage any pain for the patient.

The use of radio waves and a magnetic field generated a fully detailed image of
the body’s internal structure and organs. MRI can detect abnormalities in the
brain, spinal cord, lungs, abdomen, chest etc. “An MRI’s ability
to highlight contrasts in soft tissue makes it useful in deciphering problems
with joints, cartilage, ligaments, and tendons.” “Magnetic
Resonance Imaging (MRI).” Edited by Steven Dowshen, KidsHealth, The Nemours
Foundation, Mar. 2014, www.kidshealth.org/en/parents/mri.html.

Electrocardiogram (ECGs) is a painless and quick test that measures the electrical
activity of the cardiac system via the usage of electrode patches stuck onto
the skin of a patient. ECGs are helpful in the diagnosis of a poor blood flow to
the heart muscles and can aid diagnosis of any heart conditions such as a heart
attack. A portable electrocardiogram known as Holter Monitor used to track the
rhythm of a patient’s heart. Stress Test involves exercise or medication to
cause an increase in a patient’s heart rate whilst carrying out various tests
and imagining, observing the hearts correspondence to the activities. It does
this by measuring the electrical signals through the heart. Holter monitor can
help diagnose conditions such as arrhythmias. Ultrasound
Scanning (USS) is another way of testing a patient to keep a monitor on their
health. USS also referred to as sonogram is a procedure that is carried out
using high frequency waves. This, like the other tests mentioned above, is harmless
to the patient and is a very rapid process. An ultrasound scan may be performed
to check for any presence of tumours as well as aiding a doctor to perform
biopsies (a small removal of human tissue for examination purposes) as it
provides an accurate location of where the tumour is. Ultrasound can detect
digestive problems such as cancers of the liver, abnormal enlargements of the
spleen, gallstones and cysts. Sigmoidoscopy screens for intestinal polyps and colorectal
cancer. Sigmoidoscopy provided doctors with the ability to view the lower inches
of the rectum and sigmoid colon. There are multiple tests to check the functioning
of a patient’s heart and multi-gated acquisition (MUGA) is
another scan that can be carried out to check whether or not the heart is
pumping blood properly.

 

 

Myocardial Infarction

 

Heart Attacks are a common life-threatening
condition in the U.K. Statistics show that in the U.K. alone” one in seven men and one in
eleven women die from coronary heart disease. CHD is responsible for nearly 70,000 deaths in the UK each year, an average of 190 people each day, or one
death around every eight minutes. Most deaths from coronary heart disease are
caused by a heart attack.” https://www.bhf.org.uk/-/media/files/…statistics/bhf-cvd-statistics—uk-factsheet.pdf.

 Myocardial Infarction also referred
as a heart attack is the condition where blood flow to the heart has decreased or
stopped. In addition to this there is damage done to the heart. This occurs due
to the result of a blockage in the coronary arteries. There are several
Biomedical and Non-Biomedical Tests carried out for the diagnosis of this
condition. Electrocardiogram (ECGs) is the first of the tests that support the
diagnosis of heart attacks. A Non-Biomedical test that helps to check if signs
and symptoms that a patient shows are an indication of a heart attack. ECGs
record the electrical impulses transported by the heart via electrode patches.

Damaged heart muscle cannot carry electrical impulses, so it allows doctors to
spot any abnormalities in the heart’s activity. Blood tests can be taken to
observe heart conditions. Damaged heart muscle can release Heart enzymes can into
your blood, this is due to the effects on an attack. Samples of a patient’s
blood can be taken to test for the presence of these enzymes. Additional
immediate tests are Medical Imagining such as chest X-Rays. High energy rays can
be passed through the patient’s body to observe if any fluids are found in the
lungs, heart size and its blood vessels. Echocardiograms involves sound waves
being aimed at the heart from a device known as a transducer, provide doctors
with video images of the heart. Through these images, conclusions can be made whether
the cardiac system is functioning correctly and if a region of the heart has
been damaged due to a myocardial infarction. Catheters are also involved in
biomedical testing, cardiac catheterisation is the procedure where “a liquid
dye is injected into the arteries of your heart through a long, thin tube
(catheter) that’s fed through an artery, usually in your leg or groin, to the
arteries in your heart. The dye makes the arteries visible on X-ray, revealing
areas of blockage.” “Heart attack.” Mayo Clinic, Mayo Foundation
for Medical Education and Research, 29 July 2017, www.mayoclinic.org/diseases-conditions/heart-attack/diagnosis-treatment/drc-20373112.  Days after a heart attack a patient may
undergo various exercises also known as stress tests which help monitor how
blood vessels and the heart respond to certain body exertions. Patient can be
made to walk on a treadmill or simply provided with medication that stimulates
the heart in a similar manner to how an exercise would. To conclude, a final example
of testing for myocardial infarction is cardiac computerised tomography or
magnetic resonance imaging which can be used to help diagnose the severe
condition.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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