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SENDING TESTS TO OTHER LABS
MDS Metro has been expanding its test menu to meet the needs of our patients and physicians, and we are now prepared to perform most tests that were previously sent to other facilities. Effective immediately, requests we receive for tests that are offered "in house" at MDS Metro will be tested in our facilities. We will continue to forward specimens to other facilities for tests not performed at MDS Metro. If you have any questions regarding this matter, please contact either: Dr. Michael Kelly (604) 412-4435, or Dr. Michael McNeely (604) 878-0929 or (250) 881-3109.
NEW MSP/BCMA PROTOCOL FOR DRUGS OF ABUSE TESTING
Effective March 13th, MDS Metro will implement a preliminary MSC Protocol for detection of drugs of abuse in urine as related to the Methadone Maintenance Programme. This protocol applies for ongoing monitoring purposes utilizing screening assays and where confirmatory follow-up testing is required. A protocol for assessment of acceptance to a programme will be introduced at a later date.
Two types of drug tests are covered by the protocol:
- Screening Assays for Methadone Maintenance Programmes
For patients enrolled in a programme, individual drug assays should be specifically requested. A request for a ‘drug screen’ will be interpreted as a request for methadone, opiates, benzodiazepines and cocaine only.
- Confirmatory Assays and Specific Analytes
Testing in this category should only be requested where medically necessary and where the presence of the drug would have a significant impact on the management of the patient. It should be noted that screening assays only detect the parent methadone, and requests for methadone metabolite should be ordered only when the result will affect clinical management decisions.
Confirmatory and specific analyte testing will be available only after consultation with or approval by a laboratory physician. Specimens will be retained in the laboratory for two weeks to allow for such requests.
Questions or comments may be directed to:
Dr. David Aitken (604) 412-4412
Dr. Margaret Kelly (604) 412-4426
Dr. Michael McNeely (250) 881-3109
SEMEN ANALYSIS CHANGE IN SPERM MORPHOLOGY CLASSIFICATION
On Monday, March 13, 2000, MDS Metro Laboratory Services will change the classification scheme used for reporting the sperm morphology part of the complete semen analysis examination. The new classification of sperm morphology will follow the latest recommendations of the World Health Organization (WHO) published in 1999. (1) The recommendations are that "strict" criteria (2) be used for determining morphological abnormalities of individual sperm. The use of strict morphological criteria are felt to be better at predicting in vitro fertility potential than other morphological classification schemes. (3) It is assumed strict criteria are also more predictive of in vivo fertility potential. The use of the strict sperm morphology classification scheme is also likely to be more reproducible than previous classification criteria. (4)
As a result in change of morphology classification of sperm there will be a significant change in the lower limit of the reference range for percentage "normal" sperm to 14%. In other words up to 86% of sperm can be abnormal yet the patient falls within the reference range for normality. This reference limit is based on in vitro fertility potential which has been shown to progressively decrease when normal sperm morphology percentages fall below 14% (1), (3).
Questions and comments may be directed to:
Dr. Suseela Reddy (604) 412-4483
Dr. Monika Hudoba (604) 412-4523
References:
- WHO Laboratory Manual for the examination of human semen and sperm-cervical mucus interactions. World Health organization, 1999, Cambridge Univ. Press.
- Menkveld R, Stander FSH, Kotze TJ, Kruger TF, van Zyl JA (1990). The Evaluation of Morphological Characteristics of Human Spermatozoa According to Strict Criteria. Hum. Reprod. 5, 586-592.
- Oehninger S, Kruger T (1995). Clinical Significance of Sperm Morphology Assessment. Hum Reprod. 10, 1037-1038.
- WHO Laboratory Manual for the examination of human semen and sperm-cervical mucus interactions. World health Organization. 1992. Cambridge Univ. Press.
HELICOBACTER PYLORI
The CMAJ of February 8 (162:371-372) presents an article entitled "The urea breath test for Helicobacter pylori infection: taking the wind out of the sails of endoscopy". The essence of the article is that the UBT has the potential for eliminating a number of endoscopies in the diagnosis of peptic ulcer disease. The Canadian Helicobacter pylori Consensus Conference document also recommends the UBT as the first line diagnostic test for the detection of H. pylori infection. We wish to advise you that MDS Metro has this test available. To avoid false negative results, patients must fast for 4 hours with no smoking, no antimicrobials for 2 weeks, no treatment for H.pylori for 6 weeks, proton pump inhibitor free for 2 weeks, and no over-the-counter meds for stomach discomfort for 2 weeks.
The arrangements can be made through any MDS Metro Patient Service Center. As the test is not currently covered by MSP there is a private payment of $95 required. We have applied for MSP billing but have no indication when this will become available.
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