September 2011
syzygy
Urine collection update
SNP have recently changed 24-hour urine bottles (without preservative). The new bottles replace the previously supplied
orange bottles. Along with recent advances in testing, this change provides the opportunity for an update for urinary
collections. The default urine collection type is random, except for the following tests:
Urine Test
SpecimenContainer
5-Hydroxyindoleacetic Acid 24-hour urine (5-HIAA)
Acid 24-hour urine bottle
Albumin
Specimen jar (yellow top)
First morning void preferred. Random acceptable if patient experiences difficulty
in collection.
Item 03869
Specimen jar
(yellow top)
24-hour urine
Overnight urinary albumin Albumin (overnight)
24-hour urine bottle
Aldosterone
24-hour urine
Plain 24-hour urine bottle
Catecholamines (CATS) 24-hour urine
Acid 24-hour urine bottle
Chlamydia, N gonorrhoeae Collect first portion of the urine. Do not
and T vaginalis
urinate for 2 hours prior to collection.
Refrigerate immediately after collection.
Specimen jar (yellow top)
Cortisol (free) 24-hour urine preferred. Random urine can be used if specifically
requested.
Plain 24-hour urine bottle
Creatinine clearance 24-hour urine
Plain 24-hour urine bottle
Deoxypyridinoline (DPD)
First morning void is the preferred
specimen. Protect from light in brown
paper bag or aluminium foil. 24-hour urine
can be used if specifically requested.
Specimen jar (yellow top)
M/C/S
Mid-stream collection. Refrigerate
immediately after collection
Specimen jar (yellow top)
Patient collection instructions
To assist patients with preparation, collection and storage of specimens for these tests
we have test collection notes available.
These can be downloaded Patient Services at snp.com.au;
ordered from Doctor Stores or by contacting your
Medical Liaison Manager 1300 SNPATH (1300 767284)
Note: The 24-hour bottles include instructions on the labels.
Item 98090 Urine Collection STIs
Item 11770 Urine Collection M/C/S
Item 00006 Urine Collection 5-HIAA
Item 08140
Plain 24-hour
urine bottle
Item 12370
Acid 24-hour
urine bottle
Item 61480
Overnight urinary
albumin 24-hour
urine bottle
Critical results
Why we need your after-hours
contact details
Each week we see patients whose
pathology results indicate that they are
critically ill and in need of urgent medical
attention. Our first priority is to contact
you as their referring doctor, to report
these potentially life-threatening results
so that appropriate medical care can be
administered. During normal business
hours this is straight forward, however,
after hours, unless we have a current
after-hours telephone number or mobile
phone number to contact you, we may
have to make drastic clinical decisions
to help the patient, sometimes having
to resort to calling the police to find the
patient when we have not been able to
contact either their doctor or the patient.
Clinic after-hours contact:.........................................
OR
We ask your assistance and request
that you please provide an after-hours
telephone for either your clinic or
your personal number and your mobile
number. Record these numbers in the
space under the address block (left) and
fax this side of Syzygy to:
F: (07) 3876 9312
Doctor's personal after-hours contact:
.......................................................................................
and
Doctor's mobile: ............................................................
Please be assured that we are only
recording your after-hours contact
details for the purpose of critical result
notification. Our critical results protocol
is available from snp.com.au.
NEW
Haemolysis Index (HI)
From September 2011, Sullivan
Nicolaides Pathology will routinely
report a Haemolysis Index (HI) on the
E/LFT profile. The HI is a measurement
of the free haemoglobin concentration
in a sample. An elevated index is
typically due to in-vitro haemolysis, but
can occasionally be due to haemolysis
in-vivo.
Most samples will have an HI of
<100 mg/L (< 0.1 g/L), but a heavily
haemolysed sample may have a value of
> 1600 mg/L (> 1.6 g/L). Haemolysis
can cause artefactual elevations of
potassium, phosphate, AST and LD.
The laboratory currently utilises the
HI to decide whether to delete these
analytes from the report. SNP will use
the HI to correct the serum potassium
for the amount of in-vitro haemolysis.
This collection will reduce the number
of re-collections required because of
spurious hyperkalaemia. By the same
token, severe hypokalaemia in the
setting of severe in-vitro haemolysis
will not go unrecognised.
For further information
Robert Flatman, Assistant Manager
Biochemistry
T: (07) 3377 8526
E: [email protected]
Fax to: (07) 3876 9312
Medicare rebate now available for CGH Microarray testing
For patients with intellectual disability, developmental
delay, autism spectrum disorder or multiple
congenital anomalies, conventional cytogenetic
testing (karyotyping) has previously been the
diagnostic investigation of choice for the detection of
chromosomal imbalance. However, excluding trisomy
21 (Down syndrome), the detection rate of karyotyping
in these patients is only 3–5%.
patients with developmental delay, microarrays have
a detection rate of 15–20%, more than double the
detection rate of conventional karyotyping.
By comparison, studies have shown that microarray
comparative genomic hybridisation (array CGH) detects
a clinically significant genomic imbalance in up to 10%
of patients with normal karyotype results. In unselected
For more information about array CGH,
including specimen collection, cost and
turn-around-time...
Microarray testing is now recommended internationally
as the first-tier test in patients with intellectual disability/
developmental delay. This has been recognised in
Australia, with the introduction of a Medicare Benefits
Schedule item specifically for microarray testing.
download your copy of the new Doctor Bulletin at
snp.com.au>doctor services>publications>doctor bulletins
About the author
Dr James Harraway FRCPA
Dr James Harraway completed his medical training in Christchurch, New Zealand. In 2005,
James was awarded a Nuffield Medical Fellowship to undertake a DPhil at Oxford University,
examining the molecular pathogenesis of Cockayne Syndrome. In 2008, he became the first
pathologist from New Zealand to obtain a FRCPA in genetic pathology.
Dr Harraway is available for consultation.
T: (07) 3377 8396
E: [email protected]
Comments and Feedback? Contact us at [email protected]
Syzygy – now on 100% recycled paper
Sullivan Nicolaides Pathology recognises our corporate responsibility to respect and improve
the environment in which we work and live. As part of our commitment to continually improve
environmental performance and prevent pollution, Syzygy is now printed on 100% recycled paper.
haemolysed
not haemolysed
Collection centre updates
Regional – now open
• Arundel
• Ballina Central
• Banora Point
• Benowa
• Bundaberg
• Cairns
• Helensvale (Westfield)
• Manoora
• Maryborough
• Mermaid Beach – Nobbys
• Nimbin
• Sawtell
• Toowoomba
Visit www.snp.com.au
for location and collection centre
opening times
SULLIVAN NICOLAIDES PATHOLOGY PTY LTD • ABN 38 078 202 196
134 WHITMORE STREET • TARINGA • QLD 4068 • AUSTRALIA
TEL (07) 3377 8666 • FAX (07) 3870 0549
MAIL ADDRESS • P O BOX 344 • INDOOROOPILLY • QLD 4066 • AUSTRALIA
Doctor Service Centre 1300 SNPATH (1300 767 284)