Diagnostic Samples: From the Patient to the Laboratory

Prof. Dr. Walter G. Guder was Professor of Clinical Chemistry at the Ludwig-Maximilians-University of Munich and Director of the Institute of Clinical Chemistry, Bogenhausen Community Hospital Munich until January 2003. He studied medicine at Cologne, Tübingen and Munich. Walter G. Guder served as President of the German Society of Clinical Chemistry and as Chairman of the Working Group on Preanalytical Quality. Prof. Dr. Dr. Hermann Wisser was Professor of Biochemistry at the University of Stuttgart until 2002. He also served as Director of the Institute of Clinical Chemistry of the faculty of Clinical Medicine Mannheim of the University of Heidelberg. Hermann Wisser was President of the German Society of Clinical Chemistry and is honorary member in various societies of clinical chemistry. Prof. Dr. Sheshadri Narayanan is Clinical Professor of Pathology and Laboratory Medicine at the Weill Medical College of Conell University, New York City. He is a diplomat of the American Board of Clinical Chemistry and is licensed to act as Clinical Laboratory Director in all areas (chemistry, hematology, coagulation, microbiology etc.) in the States of New York and New Jersey. Dr. Bernd Zawta was Head of the Department of Scientific Customer Support and Public Relations of Roche Diagnostics GmbH. He studied chemistry at the Technical University Dresden where his doctoral thesis was on "The Chromatography of Steroid Hormones". Bernd Zawta also served as WHO consultant in Mongolia in 1985. Dr. Zawta deceased during the preparation of this new edition.

Dream and reality - An introductory case - The importance of the preanalytical phase
BIOLOGICAL INFLUENCES
Something unavoidable - Influences of age, gender, race and pregnancy
Changing habits - Influences that can vary (diet, starvation, exercise, altitude)
May I take coffee, smoke or drink before blood sampling? - Stimulants and addictive drugs as biological influence factors
What if I take herbs? - Effects of herbs on laboratory results
COLLECTION OF SPECIMEN
When to test? - Timing of sampling
Sampling during infusion therapy? - Sequence of diagnostic and therapeutic procedures
Sampling in the supine or upright position? - Effects of posture and tourniquet
What site for sampling blood? - Phlebotomy, arterial puncture and sampling from catheters
Blood from the skin - Capillary sampling
Did the lab mix up my sample? - Techniques of sample identification
A precious sample - Cerebrospinal fluid (CSF)
A sample that is nearly always available - Urine and saliva as diagnostic probes
Plasma or serum? - Differences to be considered
Take a lavender tube! - Additives and colour codes
TRANSPORT AND STORAGE
Fax me a sample - Effects of time and temperature during transport
Samples in transit - Legal standardization for mailing samples
How to keep a sample "fresh" - Storage of samples in the laboratory
PREPARATION OF SAMPLES FOR ANALYSIS
What has to be done on specimen arrival? - Specimen processing, centrifugation, distribution
Continuous or batchwise? - Preanalytical workflow and robotics
Safety aspects during the preanalytical phase - Disposal of specimens, needles, tubes and chemicals
SPECIAL ASPECTS WITH EACH ANALYTE
What is needed before blood transfusion? - Special aspects in immuno-haematology
Why a separate tube for the coagulation test? - Special aspects in haemostaseology
Blood cells are sensitive! - Special aspects in haematological analysis
Everything from a drop of blood? - Special aspects in clinical chemistry
Special tubes for hormones and proteomics? - Preanalytical factors in immunoassays
Blood cells can provide important information - Special aspects in cellular analysis
How to handle genes - Special aspects in molecular biology
When gases evaporate - Special aspects for blood gases and ionized calcium
The right time for drugs? - Special aspects in therapeutic drug monitoring (TDM)
Bacteria, fungi, parasites and viruses - Special aspects in microbiology
ENDOGENOUS AND EXOGENOUS INTERFERENCES
Can turbid samples be used? - Effects of lipaemia
A difficult case - Pitfalls with endogenous antibodies
The serum sample looks reddish - Effects of haemolysis
Does the laboratory have to know all my drugs? - Mechanisms and treatment of drug interference
Everything under control? - Quality assurance in the preanalytical phase
References
Glossary
Index