Q " # T # S $ Quality Assurance in Hemostasis AACC understands that your job demands results as quickly as possible and your time for career enrichment is limited. o t into this strained schedule is holding three Quick Take webinars in ugust. ll webinars take place at lunch time T. ecordings of missed sessions will be provided. You get all three webinars for the price of one and . T credits. pert eorge ritsma author of ress Quick Guide to Hematology Testing, understands the importance of valid coagulation testing. ritsma will present three webinars discussing Q and Q issues that relate specically to hemostasis. Over the course of three webinars, to be held August 7, 14, and 21, learn X ow to develop a rilldwards curve to establish the partial thromboplastin time TT unfractionated heparin therapeutic range X ow to determine TT sensitivity to factor and deciency X Specimen management for coagulation and platelet aggregometry X How to employ local calibration for prothrombin time/international normalied ratio T/ monitoring of warfarin therapy EXPERT: George Fritsma, MS, MLS ssociate rofessor and consultant to the epartment of !aboratory edicine "niversity of labama at irmingham proprietor of The ritsma actor your nteractive Hemostasis esource www.fritsmafactor.com and coeditor of Hematology, Clinical Principles and Applications lsevier ress REGISTER TODAY! www.aacc.org/QuickTakes14 Available Now from AACC Press! Principles of Forensic Toxicology, 4th Edition Edited by Barry Levine 2013, 550 pages, softcover ISBN 9781594251580 Product # 8288 Price only $99; AACC Member $79 This fourth edition of the classic, best-selling textbook—ideal for the classroom and the reference shelf—includes a new section on “special topics” in forensic toxicology and updated chapters on drug testing, methods validation, alcohol, GHB, and metals. Since the publication of the ﬁrst edition in 1999, Principles of Forensic Toxicologyy has been used extensively for teaching students taking a one-semester course in forensic toxicology. It has also proven to be an invaluable reference for laboratorians. The ﬁrst section provides an introduction to postmortem forensic toxicology, human performance forensic toxicology, forensic drug testing, and pharmacokinetics and pharmacodynamics. Additions to this section of the fourth edition include chapters on pain management and performanceenhanced drug testing. HOW TO ORDER ONLINE: http://www.aacc.org and click on the AACC Store link CALL: The second section is devoted to analytical principles, including both theory and applications. Methodologies covered include specimen preparation, spectrophotometry, chromatography, immunoassay, mass spectrometry, and methods validation. (800) 892-1400 or (202) 857-0717 FAX: (202) 887-5093 The third section covers commonly encountered analytes, including alcohol, benzodiazepines, GHB, miscellaneous central nervous system depressants,opioids,cocaine,cannabis,amphetamines/sympathomimetic amines, hallucinogens, anticonvulsants, antiarrhythmics, antidepressants, antihistamines, neuroleptics, nonnarcotic analgesics, carbon monoxide/ cyanide, inhalants, and metals. The newly added fourth section includes chapters on in vitro stability of drugs, postmortem redistribution, postmortem chemistry, pharmacogenomics, hair, and meconium. www.aacc.org MAIL: AACC Customer Service 1850 K Street NW, Suite 625 Washington, DC 20006 Available Now from AACC Press! Quick Guide to Immunoassay Interference By Pradip Datta, Adetoun A. Ejilemele, and John R. Petersen 2013, 75 pages, spiral binding ISBN 9781594251566 Product # 8289 Price only $22; AACC Member $18 The Quick Guide to Immunoassay Interference is a valuable resource for medical laboratory scientists and directors, physicians, and other clinical support personnel to identify how laboratory immunoassay results may be affected by different types of interference. The Guide’s pocket size provides immediate access about what to watch for and how to correct such aberrant results, which are now ever dependent on clinical laboratory results, and maintain the integrity of patient care. Starting from the basics of both immunoassays and assay interference, the Guide presents various sources of assay interference: cross-reactivity, prozone effects, heterophilic antibodies, endogenous serum components, system components, and analyte heterogeneity. The Guide also includes the various sources of preanalytical interference and is intended to be used as a reference for the diagnostics and pharmaceutical industries with regard to choosing an assay design to minimize interferences and to product support specialists so they can respond to reports of erroneous results from their customers. The Guide can be used to assist physicians, pharmacists, pathologists, physician assistants, and medical fellows, residents, and students in understanding not only how to detect erroneous immunoassay results before making clinical decisions based on them but how such interference can be resolved and correct results may be obtained. The information contained in this Quick Guide also clariﬁes laboratory assay utilization to help predict, diagnose, and monitor therapy for clinical conditions and disease. www.aacc.org HOW TO ORDER ONLINE: http://www.aacc.org and click on the AACC Store link CALL: (800) 892-1400 or (202) 857-0717 FAX: (202) 887-5093 MAIL: AACC Customer Service 1850 K Street NW, Suite 625 Washington, DC 20006 Get informed on the principles and applications of good statistical QC practices with a new online certiﬁcate program from Practical Approaches to Quality Control in the Clinical Laboratory IN SEVEN COURSES, LEARN HOW TO: X apply the appropriate statistical QC practices to monitor the performance of your test procedures X select proper materials and establish reliable target and control values X implement suitable QC rules to assess your test performance X use the appropriate frequency to measure QC samples X respond to a QC rules failure X establish protocols to review QC data X interpret proﬁciency testing results for procedure improvement Each on-demand course can be accessed online from any computer. The program features lectures with an esteemed faculty, published material and quizzes, plus interactive discussion boards where you can address questions to the faculty or your peers. 10 CE credits are offered for the successful completion of this program. Learn more about this program’s content and faculty at www.aacc.org/PracticalQC Enhance your entire laboratory with a special offer: Enroll four or more learners into this program and get the discounted rate for AACC members. Call AACC Customer Service for details at 800-892-1400 or (202) 857-0717. Clinical Chemistry Trainee Council Sign up with our 30-second, 1-step registration at traineecouncil.org Also available in Chinese, Spanish and Portuguese Clinical Chemistry Trainee Council traineecouncil.org Content includes – t Clinical Case Studies t Webcasts and Courses t Question Bank t Pearls of Laboratory Medicine t Q&A t Podcasts and CouncilChat Download the Clinical Chemistry app via and Clin Chem 2014 CLINICAL CHEMISTRY WEBINAR SERIES Cardiac Disease N ewly released guidelines are changing the lab’s role in the management of patients at risk of having a cardiac event. Researchers continue to discover new markers or novel ways to use existing assays to identify cardiovascular events earlier. Early diagnosis of both conditions allows clinicians to intervene and prevent further damage, leading to better patient outcomes. AACC keeps laboratorians on the cusp of these new developments with three exclusive webinars featuring lectures, question-and-answer sessions, and research selections with experts from the Clinical Chemistry journal. WEBI N A RS INC LUDE: JULY 8 The Drive to Deﬁne “Normal”: The 99th Percentile Value of Cardiac Troponin Fred Apple, PhD, Medical Director of Clinical Laboratories, Clinical Chemistry, POC Testing and Clinical And Forensic Toxicology Laboratories at Hennepin County Medical Center, and Professor of Laboratory Medicine and Pathology, University of Minnesota School of Medicine, Minneapolis, MN SEPTEMBER 2 Stroke Biomarkers: Current Status, Future Promise Robert Christenson, PhD, Professor of Pathology and of Medical and Research Technology at the University of Maryland School of Medicine, and Director of the Clinical Chemistry, Toxicology, and Core Laboratories and Point of Care Services at the University of Maryland Medical Center, Baltimore, MD SEPTEMBER 9 CVD Risk Prediction: The Evolving Role of Laboratory Testing Paul Ridker, MD, MPH, Director, Center for Cardiovascular Disease Prevention at Brigham and Women’s Hospital and Eugene Braunwald Professor of Medicine at Harvard Medical School, Boston, MA Learn from leading experts and stay informed – without PURCHASE ALL 3 WEBINARS AND SAVE 15% travel expenses or time away from the ofﬁce. For more MEMBER PRICE: $455 information, individual webinar prices and to register, visit NON-MEMBER PRICE: $575 www.aacc.org/cardiac14. Available Now from AACC Press! Quick Guide to Molecular Diagnostics By D. Hunter Best, Elaine Lyon, Kristina A. Roberts, and Alex Valsamakis 2013, 234 pages, spiral binding ISBN 9781594251597 Product # 7297 Price only $24; AACC Member $20 HOW TO ORDER The Quick Guide to Molecular Diagnostics is intended for physicians, residents/fellows, allied medical health professionals, nonmedical professionals, and students who wish to better understand the complex ﬁeld of molecular diagnostics. The Guide is intended to be a quick, informative reference for individuals who order molecular tests in the ﬁelds of genetics, oncology, and infectious disease. For each of these ﬁelds, information about common molecular diagnostic tests is provided to assist in ordering and results interpretation. Molecular laboratory techniques are also discussed to help readers better understand their advantages and limitations. The pocket size of this text offers immediate access when and where tests are ordered. Our experience suggests that this Guide will be a useful reference for individuals in many different ﬁelds. ONLINE: http://www.aacc.org and click on the AACC Store link CALL: (800) 892-1400 or (202) 857-0717 FAX: (202) 887-5093 MAIL: AACC Customer Service 1850 K Street NW, Suite 625 Washington, DC 20006 www.aacc.org Clinical Chemistry 2015 Special Issue Call for Papers Molecular Diagnostics A Revolution in Progress SUBMIT NOW Clinical Chemistry is pleased to announce a special upcoming theme issue on Molecular Diagnostics edited by Drs. Rossa W.K. Chiu, Frank R. Cockerill, Y.M. Dennis Lo, and Carl T. Wittwer titled “Molecular Diagnostics: A Revolution in Progress.” Clinical Chemistry, published by the American Association for Clinical Chemistry, is the most highly cited forum for peer-reviewed, original research in the fields of clinical chemistry and laboratory medicine. The purpose of this issue is to highlight recent advances in molecular diagnostics that focus on either: (1) clinical applications that use molecular diagnostics to reach novel conclusions about disease and/or therapy; or (2) new technologies that improve high-volume needs, test turnaround time, comprehensive analysis, or ease of use. Clinical Chemistryy invites authors to submit original articles related to molecular diagnostics for potential publication in this special issue. In general, manuscripts must be quantitative rather than descriptive. Article selection will be based on the overall quality and potential impact of the manuscript. Potential topics of interest include: r r r r r r r r New technologies that further advance the utility of molecular diagnostics Significant applications of molecular diagnostics that improve patient care Sample-to-answer platforms that can be used at the point of impact Informatics advances to analyze genomes, exomes, transcriptomes, epigenomes, or microbiomes Generic technologies that depend less on proprietary instruments and reagents Novel massively parallel sequencing approaches Methods and applications of cell-free nucleic acid analysis Guidelines for using specific molecular diagnostic techniques Be a part of this exciting issue! Submissions must be received through our online submission system at submit.clinchem.org. We welcome submissions after June 2014, but cannot guarantee the inclusion of late submissions for the Special Issue. Your cover letter should express your interest in submitting your paper for consideration for the Molecular Diagnostics theme issue. Journal guidelines for submission apply as described in the Information for Authors on the submission website. American Association for Clinical Chemistry aacc.org presents: Patient Safety Essentials for Laboratory Professionals Certiﬁcate Program New online certiﬁcate program from AACC, with strategies and tools to implement patient safety measures. An extensive program with a laboratory focus, taught by experts. Faculty with experience furthering improvements for patient safety in their labs and communities. Highlights work culture elements that positively impact safety initiatives, risk management and quality improvement tools, error detection methods, and addressing personnel issues. For information on content, special pricing for AACC members, and registration, please visit www.aacc.org/cert_prog October be er 9-10 0 2014 St. Louis, MO MASS SPECTROMETRY IN THE CLINICAL LAB: Best Practices and Current Applications Join AACC for an information-packed conference focusing on current applications of mass spectrometry-based testing in the clinical lab. —the value Our expert faculty will be on hand to show users—and potential users—the of mass spec tools in managing patient health, in addition to examining some of the applications already used in the clinical lab, including pain management, t, pediatric testing, sex hormones, immunosuppressants, and vitamin D analysis. Meet us in St. Louis this October to gain expertise and learn how to implement ement o orr optimize mass spectrometry resources. REGISTER TODAY! www.aacc.org/MassSpec14 DIVISION DIRECTOR OF CLINICAL CHEMISTRY HENRY FORD HEALTH SYSTEM The Department of Pathology at the Henry Ford Hospital (HFH) and Medical Group invites applications for a full-time clinical scientist as the director of the division of Clinical Chemistry Laboratories. The position entails responsibilities in directing the provision of clinical chemistry and immunochemistry testing throughout the Pathology product-line of the Henry Ford Health System as well as the teaching of residents, fellows and medical technology students. The candidate must hold a PhD degree, and be certified by the American Board of Clinical Chemistry. The successful candidate will have a strong post-graduate background of at least three years in clinical and laboratory chemistry and immunochemistry in a university or large hospital/health system setting. In addition, the candidate should have a record progressively increasing managerial responsibility in the laboratory. The latter entails substantive activities in evaluation and implementation of testing and related quality assurance activities, in accordance with federal, state and local regulatory requirements. HFH is an 811 bed, tertiary care facility in Detroit, MI, and the Pathology Department is the 12th largest hospital based laboratory in the country. The chemistry and other laboratories provide services to a level 1 trauma center, solid organ/stem cell transplant and comprehensive oncology programs, and 160 bed ICUs dedicated to surgical, medical, neurologic, neonatal and oncologic critical care. The HFH Pathology Department also serves as a core reference laboratory and as the source of expertise and oversight for the technical, regulatory and interpretive aspects of chemistry and other clinical laboratory testing in the Health System. This includes 3 other acute care hospitals, 1 psychiatric hospital and a network of 30 System “outpatient clinics in Southeast Michigan. HFH serves as one of the area’s predominant health care teaching institutions. As part of this, HFH Pathology directly supports a training program of 16 pathology residents in anatomic and clinical pathology, as well as internships for Medical Technology students from the two major training programs in the State. Lastly, educational support in laboratory science is provided to other HFH medical specialty's residency and fellowship programs. The Pathology product-line is an ISO 15189 accredited system of laboratories overseen by a pathologist vice-president and chair. Physicians and Clinical Scientists are members of the Henry Ford Medical Group, one of the nation’s largest and oldest group practices composed of over 1,200 physicians in 40 specialties. Medical school academic appointments are available with several primary affiliates including Wayne State University School of Medicine. Interested applicants should submit curriculum vitae, a statement describing previous accomplishments and future direction and the names of three references to: John L. Carey, MD Vice Chairman, Pathology and Laboratory Medicine Henry Ford Hospital and Medical Group 2799 W. Grand Blvd. Detroit, MI 48202-2689 (313) 916-1533 firstname.lastname@example.org Clinical Chemistry Reprints Advertising Representatives Cunningham Associates National Accounts Manager: JIM PATTIS Email: email@example.com ContactCadmusReprints fordigitalorprintcopies TOLLFREE Production Manager: KATHY TAMALONIS Email: firstname.lastname@example.org ADVERTISING CORRESPONDENCE: 18664875625 OREMAIL email@example.com Authorsmayalsoorderreprintsoftheir arclesbycontacng CadmusReprintsat 18664875625 ADVERTISER 180 Old Tappan Road Old Tappan, NJ 07675 Phone (201) 767-4170 Fax (201) 767-8065 PAGE NO. AbSciex Cover 4 BioVendor Cover 3 Henry Ford Health System 16A Available Now from AACC Press! Quick Guide to Clinical Chemistry, 2nd Edition By Janelle M. Chiasera, Robert W. Hardy, and John A. Smith 2013, 150 pages, spiral binding ISBN 9781594251443 Product # 7293 Price only $24; AACC Member $20 The Quick Guide to Clinical Chemistry, Second Edition, is a pocket-sized reference intended for physicians, nurses, physician assistants, nurse practitioners, medical technologists, pharmacists, and residents and students in those professions. This Guide focuses on the selection and use of chemistry laboratory tests for diagnosing and managing emergent conditions such as poisonings, acute abdominal pain, sepsis, and acute myocardial infarction. The Guide’s small size allows it to be used in situations when quick decisions must be made regarding the ordering and interpretation of chemistry tests. The emergent clinical conditions and the associated laboratory tests are described together for quick reference. HOW TO ORDER ONLINE: http://www.aacc.org and click on the AACC Store link CALL: (800) 892-1400 or (202) 857-0717 FAX: Although this Guide reviews several clinical conditions, it is not intended to be a comprehensive guide to all clinical laboratory tests, nor is it intended to dictate what constitutes reasonable, appropriate, or best care in a given situation. Comprehensive references for such information currently exist. Instead, it should be seen as it is clearly named, a “Quick Guide” to clinical chemistry. www.aacc.org (202) 887-5093 MAIL: AACC Customer Service 1850 K Street NW, Suite 625 Washington, DC 20006 NOW AVAILLABLE FROM Editedby:UttamGarg,PhD;LaurieD.Smith,MD,PhD;andBryceA.Heese,MD Laaborattory to y tessting ngg pla l ys ys an integral all p part in thee diagn gnos no is and treatmeent off in nhe h ri rited metaabolicc diseas seeasseess. With the hee iintroductio ion off expan io nde ded d neewb bor o n screenin ng for inherite teed m tabbolic diseas me di ases es, increasiing numberrs es rs ooff lab a or oratoryy peers rson o ne on n l an nd he h althcare prrov o id ders ar aree in nvo v lved in in nit itia iall aan ia nd foll nd lllow ow-up coonf nfirm mato ma tory lab aborratorry te tessting.. Beca causse in nhe h rited d metaaboli boolic d diise seases ess are sti t ll rare an and d infr freq fr e uently encount eq n ered nt erred e , fe few w gu uid des e to th thee se sele lect le ct ction an nd inte terp er retaation n ooff laboratoryy testts aree av avai a laabl ble, which h can make k ccho ke hoos ho osin os ingg the appr prop pr opriiat op atee di diag aggno n st stic i test chaall llengi g ng. Writtte ten by ten b practicingg clinical and nd labboratory exxperts, rts, Laabo rt b ratory Diagn nosiss of Inhe herriited he ted Metabolicc Di te Dise seas a ess is intended to prroovi vide de inf nfo mation about the labo nfor bora bo r toory ry test seleect ction, samplee co c llection, processing an nd d handling, g aan nd results interp pre reta et ti tioon in pat paatients with suspec ec ected inherited metabbo in bolic lic di li dise seeases. Alth th hou ough g deta tailed metho ta et od description et n is bey e on nd th he scope of thiis book, in inte ntereest sted ed labbor oraatoria at ia ian ns wil illl fi f nd informati t on to identify ti fy neece cessaaryy reso reesour our urce ces to sett up a partic i ullar ic a met etho hod. ho d. Illustrative metaabo b lic pa path thw hways an nd ch hrooma mato togr to ogram gram gr amss fo for a numbber of inhe heriteed metabolic diiso sord rder ers arre proovided. The er bookk alsoo p prrovides the h bas a ic inform mation n on clinical preseen entation, genetiics and pathogenesis, tr treaatmen nt, aand nd pro r gn g osiis is ooff seele l cted inherited meetabolic et c dis i eases. Softcoverr Copyrightt: 2012 Pages: 25 52 pages ISBN: 978 81594251405 TrimSize: 7 x 10 Product ID D: 7291 Price: $61 1.00 Member Price: P $49.00 Contents 1. Introduction to th he Labo Laboora ratory ryy Diagnossis of In Inhe h ri he r te ted Metabolic Diseasses Uttam Garg, Laurie i D ie D. Smith Sm h, andd B Bry ryce A. He ry Heesse 2. Amino Acid Disorders Zhen Zhao, Van Leung-Pineda, and Den ennis J. Dietzen 3. Organic g Acid Disorders Stanley F. Lo, Jessica A. Scott-Schwoerer, and William J. Rhead 4. The Urea Cycle Disorders and Hyperammonemias Laurie D. Smith and Uttam Garg 5. Disorders of the Carnitine Cycle and Mitochondrial Fatty Acid Oxidation Patricia M. Jones and Michael J. Bennett 6. Disorders of Carbohydrate Metabolism Angela Ferguson, Laurie D. Smith, and Uttam Garg 7. Lysosomal Storage Disorders: Mucopolysaccharidoses and Mucolipidoses Andrea M. Atherton, Laurie D. Smith, Bryce A. Heese, and Uttam Garg 8. 9. Peroxisomal Disorders Laurie D. Smith and Uttam Garg 10. Disorders of Purine and Pyrimidine Meetabolism 11. Laboratory Diagnosis of Serotonin and Catecholamine Disorders Keith Hyland y and Lauren A. Hyland y 12. Creatine Deficiency Syndromes V. Reid Sutton, William E. O’Brien, and Qin Sun 13. The Congenital Disorders of Glycosylation Miao He, Dietrich Matern, Kimiyo M. Raymond, and Lynne Wolfe 14. Lactic Acidemia and Mitochondrial Disorders Devin Oglesbee and Bryce A. Heese 15. Newborn Screening Uttam Garg, Bryce A. Heese, and Laurie D. Smith 16. Other Inherited Metabolic Diseases Uttam Garg and Laurie D. Smith 17. Index Lysosomal Storage Disorders: Sphingolipidoses and Lysosomal Transport Disorders Andrea M. Atherton, Laurie D. Smith, Bryce A. Heese, and Uttam Garg Order Online: www.aacc.org and click on the AACC store link or Call (800) 892-1400 / (202) 887-5093 Available Now from AACC Press! Quick Guide to Hematology Testing, 2nd Edition By Vishnu Reddy, Marisa B. Marques, and George A. Fritsma 2013, 180 pages, spiral binding ISBN 9781594251559 Product # 8290 Price only $24; AACC Member $20 The Quick Guide to Hematology Testingg is a speedy reference for anyone who orders, performs, or interprets hematology laboratory tests, including complete blood counts, bone marrow aspirate and biopsies, ﬂow cytometry, cytogenetics, and molecular diagnosis. Clear understanding of the signiﬁcance of hematology laboratory results is critical, and awareness of the effect of confounding factors leads to clinically sound interpretations. The Guide’s pocket size provides immediate access at the time and place that tests are ordered, performed, and interpreted. The text discusses benign and malignant conditions of the three cell lineages, including anemias, leukemias, and thrombocytopenia, emphasizing their diagnosis, treatment, and laboratory-based treatment monitoring. Disease descriptions and assays are adjacent so that all conditions may be correlated. The extensively updated second edition has new sections and expands on newly described phenotypes and genotypes of hematologic disorders and new methods, providing a current list of cell markers and mutations. Although the Guidee reviews clinical conditions, treatment, and laboratory assays, it should not be used alone to make ﬁnal diagnoses. Many current references are provided for further reading. The authors’ local experience helps make the Guidee a valuable resource for physicians, physician assistants, nurse practitioners, nurses, pharmacists, and medical laboratory scientists. www.aacc.org HOW TO ORDER ONLINE: http://www.aacc.org and click on the AACC Store link CALL: (800) 892-1400 or (202) 857-0717 FAX: (202) 887-5093 MAIL: AACC Customer Service 1850 K Street NW, Suite 625 Washington, DC 20006 Register Today! Critical and Point-of-Care Testing: Real World and Emerging Applications for Improved Clinical Outcomes CPOCT 25th International Symposium SE P TE MBER 17-20, 2014 PA R A D ISE POINT CONF EREN CE C EN TER SA N D IEGO, CA The 25th International Symposium examines how technological advances in point-of-care testing and healthcare delivery trends are changing the face of clinical diagnostics and the quality of patient care. Learn from content experts and peers as they explore the practical and promising applications of point-of-care testing for clinical decision making. Sessions include: • • • • • Point-of-Care and Molecular Diagnostics Point-of-Care and Infectious Disease Point-of-Care Testing for Assessment of Coagulation Point-of-Care Testing for Emergency Preparedness and Resource Limited Countries Practical Applications of Point-of-Care Testing: Data Driven Solutions for Improved Outcomes The meeting promises a stimulating mix of scientiﬁc presentations, interaction with POCT experts from around the world, introduction to new technologies from leading companies in the ﬁeld, and time to talk with colleagues in the warm, relaxed environment of Paradise Point Conference Center in San Diego, CA, USA. REGISTER TODAY: WWW.AACC.ORG/CPOCT14 Sponsored by the AACC CPOCT Division in cooperation with CSCC and EFLM, and under the auspices of IFCC. The conference is supported by educational grants from Accriva Diagnostics, Alere, Instrumentation Laboratory, Medica Corporation, Nova Biomedical Corporation, Radiometer, Roche, and Siemens Healthcare Diagnostics. Available Now from AACC Press! Quick Guide to Endocrinology By William E. Winter, Lindsay A. L. Bazydlo, and Neil S. Harris 2013, 189 pages, spiral binding ISBN 9781594251573 Product # 7298 Price only $28; AACC Member $23 HOW TO ORDER The Quick Guide to Endocrinology addresses the clinical presentation, pathophysiology, and laboratory testing required for diagnosing common endocrinologic problems seen by the laboratorian and clinician on a regular basis. The Guide focuses on disturbances involving the anterior and posterior lobes of the pituitary gland, the thyroid gland, the adrenal glands, the parathyroid glands, the ovaries, and the testes. A future Quick Guide will address issues relevant to diabetes mellitus. Understanding the basic biochemistry and physiology of endocrine systems is critically important when the laboratorian serves as a consultant to the clinician. This Guide can help assist graduate students, medical students, medical technologists, and laboratory supervisors, as well as MDs and PhDs, in comprehending basic endocrinology. Endocrine disorders are common and affect all aspects of medicine involving psychiatrists to neurosurgeons, and the information found in this Quick Guide will help prepare the laboratorian to act as a consultant to all of these practitioners. www.aacc.org ONLINE: http://www.aacc.org and click on the AACC Store link CALL: (800) 892-1400 or (202) 857-0717 FAX: (202) 887-5093 MAIL: AACC Customer Service 1850 K Street NW, Suite 625 Washington, DC 20006 Lab Tests Online has given a public face to laboratory medicine… …and continues to help patients engage in more productive discussions with their doctors. AACC thanks those companies and associations that supported the site in 2013. Our Sponsors Ortho Clinical Diagnostics Roche Diagnostics Siemens Healthcare Diagnostics Abbott Diagnostics Spectra Laboratories Professional Co-op Bio-Rad Laboratories Fujirebio Diagnostics Hycor Biomedical ITC Nexus Dx PAML CompuGroup Medical Randox Sysmex Our Partners ASCLS ASM CLMA ASH AMP ASCP CAP CSMLS CSCC CLSI NACB Joint Commission APHL AABB AAB AAFP-PT Show your support for laboratory medicine and patient engagement. Contact firstname.lastname@example.org to become a Sponsor. http://labtestsonline.org BioMedical Specimen Bank Provides various types of biological samples along with corresponding panels of data including analycal parameters, anthropometric variables and clinical informaon for the diagnosc industry, assay manufacturers and researchers. &ŽƌŵŽƌĞŝŶĨŽƌŵĂƟŽŶƉůĞĂƐĞŐŽƚŽ www.biomedicalspecimenbank.com A ƐƐĂǇĞǀĞůŽƉŵĞŶƚĂŶĚsĂůŝĚĂƟŽŶWĂŶĞůƐ A1 Serum A2 Urine A1a Normal Healthy Individuals (sera from 48-230 men and 48-230 women – healthy donors) lthyy blood b ĂƚĂƉƌŽǀŝĚĞĚ͗ Basic anthropometric data (race, sex, sexx, age, a height, weight, BMI), basic biochemistry, blood count A2a Normal Healthy Individuals (urine from 48-230 men and 48-230 women – healthy blood donors) ĂƚĂƉƌŽǀŝĚĞĚ͗Basic anthropometric data (race, sex, age, height, weight, BMI), basic biochemistry B ϭď DĂƚƌŝǆīĞĐƚWĂŶĞů od donors, do (12 healthy individuals, 6 men and 6 women, blood presented rin plasma) pl as serum, EDTA plasma, citrate plasma and heparin ĂƚĂƉƌŽǀŝĚĞĚ͗ Basic anthropometric data (race, sex, sexx, age, a height, weight, BMI), basic biochemistry Ϯď &ƌĞĞǌĞͲdŚĂǁWĂŶĞů (8 healthy individuals, 4 men and 4 women, blood donors, urine WŚǇƐŝŽůŽŐŝĐĂůWĂŶĞůƐ ƵŶƚŚĂǁĞĚƵƉƚŽƚŚĂǁĞĚĂŶĚĨƌŽǌĞŶϭϭƟŵĞƐͿ ĂƚĂƉƌŽǀŝĚĞĚ͗Basic anthropometric data (race, sex, age, height, weight, BMI), basic biochemistry ϭĐ &ƌĞĞǌĞͲdŚĂǁWĂŶĞů ϮĐ dĞŵƉĞƌĂƚƵƌĞ^ƚĂďŝůŝƚǇWĂŶĞůĂƚƌŽŽŵƚĞŵƉĞƌĂƚƵƌĞ ϭŽĚǇDĂƐƐ/ŶĚĞǆWĂŶĞů ϰ^ƵƉŝŶĞͬhƉƌŝŐŚƚWĂŶĞů (8 healthy individuals, 4 men and 4 women, blood sera (8 healthy individuals, 4 men and 4 women, blood donors, urine stored d donors, don &ŽƌŵŽƌĞŝŶĨŽƌŵĂƟŽŶƉůĞĂƐĞŐŽƚŽ (96 individuals,ĂƚƌŽŽŵƚĞŵƉĞƌĂƚƵƌĞĨŽƌϬƚŽϮϰŚŽƵƌƐ͕ƌĞƐƉĞĐƟǀĞůǇͿ 4 individuals from each BMI (BMI 17-40)) 17 7-4 ƵŶƚŚĂǁĞĚƵƉƚŽƚŚĂǁĞĚĂŶĚĨƌŽǌĞŶϭϭƟŵĞƐͿ ĂƚĂƉƌŽǀŝĚĞĚ͗ĂƚĂƉƌŽǀŝĚĞĚ͗ Age, sex, weight, height, BMI, waist st ccircumference, irc (race,www.biomedicalspecimenbank.com ĂƚĂƉƌŽǀŝĚĞĚ͗ Basic anthropometric data (race, sex, Basic anthropometric data sex, age, height, sexx, age, a height, ϱWŽƐƚƉƌĂŶĚŝĂůWĂŶĞů ǁĂŝƐƚͲƚŽͲŚŝƉƌĂƟŽ͕ďĂƐŝĐďŝŽĐŚĞŵŝƐƚƌǇ͕ďůŽŽĚĐŽƵŶƚ weight, BMI), basic biochemistry weight, BMI), basic biochemistry ƚ ĂƚĂWƌŽǀŝĚĞĚŽŶZĞƋƵĞƐƚĂƚĞǆƚƌĂŚĂƌŐĞ͗>ĞƉƟŶ͕^ŽůƵďůĞ>ĞƉƟŶ ͕^Ž ŽůƵ ϲ^ƚĂƌǀĂƟŽŶWĂŶĞů ZĞĐĞƉƚŽƌ͕ZĞƐŝƐŝƟŶ͕sĂƐƉŝŶ͕ŚĞŵĞƌŝŶ͕KŵĞŶƟŶ͕Ͳ&W͕ZWͲϰ͕/>ϲ͕ Ͳ& ϭĚ dĞŵƉĞƌĂƚƵƌĞ^ƚĂďŝůŝƚǇWĂŶĞůĂƚƌŽŽŵƚĞŵƉĞƌĂƚƵƌĞ ϮĚ dĞŵƉĞƌĂƚƵƌĞ^ƚĂďŝůŝƚǇWĂŶĞůĂƚϯϳΣ ŵƉĞ ĞƌĂ ZW͕W/͕ĞƚĐ͘ (8 healthy individuals, 4 men and 4 women, blood sera stored (8 healthy individuals, 4 men and 4 women, blood donors, urine stored d donors, don ŶǇĂĚĚŝƟŽŶĂůƉĂƌĂŵĞƚĞƌĐĂŶďĞĂĚĚĞĚĂƐĐƵƐƚŽŵĂŶĂůǇƐŝƐͬ ŵĂŶĂ ϳǆĞƌĐŝƐĞWĂŶĞů ĂƚƌŽŽŵƚĞŵƉĞƌĂƚƵƌĞĨŽƌϬƚŽϮϰŚŽƵƌƐ͕ƌĞƐƉĞĐƟǀĞůǇͿ ĂƚϯϳΣĨŽƌϬƚŽϮϰŚŽƵƌƐ͕ƌĞƐƉĞĐƟǀĞůǇͿ ĞůǇͿ ŵĞĂƐƵƌĞŵĞŶƚ͘WůĞĂƐĞŝŶƋƵŝƌĞǁŝƚŚƌĞŐĂƌĚƚŽĂǀĂŝůĂďŝůŝƚǇĂŶĚƉƌŝĐĞ͘ Ăďŝŝdata ůŝƚ (race, sex, age, height, ĂƚĂƉƌŽǀŝĚĞĚ͗ Basic anthropometric data (race, sex, ĂƚĂƉƌŽǀŝĚĞĚ͗ Basic anthropometric sexx, age, a height, weight, BMI), basic biochemistry weight, BMI), basic biochemistry ϴtĞĞŬŽĨWƌĞŐŶĂŶĐǇWĂŶĞů ϮŐĞWĂŶĞů Our expanding porolio of panels covers both physiological and pathological condions. Samples are stored at -150°C, supplied on dry ice as 0.105 ml serum, urine or other body uid, assorted in 96 microplate-format boxes. For more informaon please go to www.biomedicalspecimenbank.com. www.biomedicalspecimenbank.com C ŝƐĞĂƐĞ^ƚĂƚĞ;WĂƚŚŽůŽŐŝĐĂůͿWĂŶĞůƐ ϭĞ dĞŵƉĞƌĂƚƵƌĞ^ƚĂďŝůŝƚǇWĂŶĞůĂƚϯϳΣ ϮĞ fem ma of one age) (384 individuals of agedĞŵƉĞƌĂƚƵƌĞ^ƚĂďŝůŝƚǇWĂŶĞůĂƚϰΣ 1-90 years, 2 males and 2 females ϵƐƚƌƵƐͬDĞŶƐƚƌƵĂůǇĐůĞWĂŶĞů (8 healthy individuals, 4 men and 4 women, blood sera stored (8Age, healthy individuals, 4 men and 4icwomen, blood donors, d donors, don b io ĂƚĂƉƌŽǀŝĚĞĚ͗ sex, weight, height, BMI, basic biochemistry, blood urine stored ĂƚϯϳΣĨŽƌϬƚŽϮϰŚŽƵƌƐ͕ƌĞƐƉĞĐƟǀĞůǇͿ ĂƚƌŽŽŵƚĞŵƉĞƌĂƚƵƌĞĨŽƌϬƚŽϮϰĚĂǇƐ͕ƌĞƐƉĞĐƟǀĞůǇͿ count ϭϬEĞǁďŽƌŶWĂŶĞů age, ϭŶĞƌŐǇŵĞƚĂďŽůŝƐŵͬDĞƚĂďŽůŝĐ^ǇŶĚƌŽŵĞͬ ĂƚĂƉƌŽǀŝĚĞĚ͗ Basic anthropometric data (race, sex, ĂƚĂƉƌŽǀŝĚĞĚ͗ Basic anthropometric data (race, sex, height, sexx, age, a height, ŵĂŶĂ ŶǇĂĚĚŝƟŽŶĂůƉĂƌĂŵĞƚĞƌĐĂŶďĞĂĚĚĞĚĂƐĐƵƐƚŽŵĂŶĂůǇƐŝƐͬ weight, BMI), basic biochemistry weight, BMI), basic biochemistry Ăďŝŝůŝƚ ŵĞĂƐƵƌĞŵĞŶƚ͘WůĞĂƐĞŝŶƋƵŝƌĞǁŝƚŚƌĞŐĂƌĚƚŽĂǀĂŝůĂďŝůŝƚǇĂŶĚƉƌŝĐĞ͘ Obesity ϭϭƐƐĂǇĞĚ^ĞƌĂWĂŶĞů ϭĨ dĞŵƉĞƌĂƚƵƌĞ^ƚĂďŝůŝƚǇWĂŶĞůĂƚϰΣ ϭĂ KďĞƐŝƚǇWĂŶĞů ϯ^ĞŵŝŶĂůWůĂƐŵĂ ϯ^ĞǆWĂŶĞů (8 healthy individuals, 4 men and 4 women, blood sera stored d donors, don (48 normal healthy males and 48 normal healthy females, age(96-480 and BMIobese individials) fem ma ĂƚƌŽŽŵƚĞŵƉĞƌĂƚƵƌĞĨŽƌϬƚŽϮϰĚĂǇƐ͕ƌĞƐƉĞĐƟǀĞůǇͿ ůǇͿ ĂƚĂƉƌŽǀŝĚĞĚ͗Age, sex, weight, height, BMI, waist circumference, matched) ϰĞƌĞďƌŽƐƉŝŶĂů&ůƵŝĚ ĂƚĂƉƌŽǀŝĚĞĚ͗ Basic anthropometric data (race, sex, sexx, age, a height, ǁĂŝƐƚͲƚŽͲŚŝƉƌĂƟŽ͕ďĂƐŝĐďŝŽĐŚĞŵŝƐƚƌǇ͕ďůŽŽĚĐŽƵŶƚ ĂƚĂƉƌŽǀŝĚĞĚ͗Age, sex, weight, height, BMI, basic biochemistry, blood ic b io weight, BMI), basic biochemistry ĂƚĂƉƌŽǀŝĚĞĚŽŶƌĞƋƵĞƐƚĂƚĞǆƚƌĂĐŚĂƌŐĞ͗>ĞƉƟŶ͕^ŽůƵďůĞ>ĞƉƟŶ count ϱ^ǇŶŽǀŝĂůŇƵŝĚ ŵĂŶĂ ZĞĐĞƉƚŽƌ͕ĚŝƉŽŶĞĐƟŶ͕ZĞƐŝƐƟŶ͕sĂƐƉŝŶ͕ŚĞŵĞƌŝŶ͕KŵĞŶƟŶ͕Ͳ&W͕ ŶǇĂĚĚŝƟŽŶĂůƉĂƌĂŵĞƚĞƌĐĂŶďĞĂĚĚĞĚĂƐĐƵƐƚŽŵĂŶĂůǇƐŝƐͬ ϭŐ ŝƌĐĂĚŝĂŶWĂŶĞů ZWͲϰ͕/>ϲ͕ZW͕W/͕ĞƚĐ͘ ŵĞĂƐƵƌĞŵĞŶƚ͘WůĞĂƐĞŝŶƋƵŝƌĞǁŝƚŚƌĞŐĂƌĚƚŽĂǀĂŝůĂďŝůŝƚǇĂŶĚƉƌŝĐĞ͘ Ăďŝůŝƚ ďŝŝůŝ (8 healthy individuals, 4 men and 4 women, blood sera taken d donors, don ŶǇĂĚĚŝƟŽŶĂůƉĂƌĂŵĞƚĞƌĐĂŶďĞĂĚĚĞĚĂƐĐƵƐƚŽŵĂŶĂůǇƐŝƐͬ A6 Saliva every hour within 24 hours) ŵĞĂƐƵƌĞŵĞŶƚ͘WůĞĂƐĞŝŶƋƵŝƌĞǁŝƚŚƌĞŐĂƌĚƚŽĂǀĂŝůĂďŝůŝƚǇĂŶĚƉƌŝĐĞ͘ ĂƚĂƉƌŽǀŝĚĞĚ͗ Basic anthropometric data (race, sex, sexx, age, a height, ϭď DĞƚĂďŽůŝĐ^ǇŶĚƌŽŵĞWĂŶĞů weight, BMI), basic biochemistry ;ϵϲͲϰϴϬŝŶĚŝǀŝĚƵĂůƐǁŚŽŵĞĞƚƚŚĞĚĞĮŶŝƟŽŶĐƌŝƚĞƌŝĂŽĨDĞƚĂďŽůŝĐ ^ǇŶĚƌŽŵĞͿ A1h ,ĞŵŽůǇƟĐͬ>ŝƉĞŵŝĐͬ/ĐƚĞƌŝĐ^ĞƌƵŵWĂŶĞů ĞŶƚƌĂůŽďĞƐŝƚǇ;ĚĞĮŶĞĚĂƐǁĂŝƐƚĐŝƌĐƵŵĨĞƌĞŶĐĞǁŝƚŚĞƚŚŶŝĐŝƚǇͲƐƉĞĐŝĮĐ (3 x 32 individuals) values) and any two of the following: ĂƚĂƉƌŽǀŝĚĞĚ͗ Basic anthropometric data (race, sex, sexx, age, a height, ͻZĂŝƐĞĚƚƌŝŐůǇĐĞƌŝĚĞƐ͗хϭϱϬŵŐͬĚů;ϭ͘ϳŵŵŽůͬůͿ͕ŽƌƐƉĞĐŝĮĐƚƌĞĂƚŵĞŶƚ weight, BMI), basic biochemistry for this lipid abnormality ͻZĞĚƵĐĞĚ,>ĐŚŽůĞƐƚĞƌŽů͗фϰϬŵŐͬĚů;ϭ͘ϬϯŵŵŽůͬůͿŝŶŵĂůĞƐ͕ фϱϬŵŐͬĚů;ϭ͘ϮϵŵŵŽůͬůͿŝŶĨĞŵĂůĞƐ͕ŽƌƐƉĞĐŝĮĐƚƌĞĂƚŵĞŶƚĨŽƌƚŚŝƐ lipid abnormality ͻZĂŝƐĞĚďůŽŽĚƉƌĞƐƐƵƌĞ;WͿ͗ƐǇƐƚŽůŝĐWхϭϯϬŽƌĚŝĂƐƚŽůŝĐW > 85 mm Hg, or treatment of previously diagnosed hypertension ͻZĂŝƐĞĚĨĂƐƟŶŐƉůĂƐŵĂŐůƵĐŽƐĞ;&W'Ϳ͗хϭϬϬŵŐͬĚů;ϱ͘ϲŵŵŽůͬůͿ͕ or previously diagnosed type 2 diabetes ͻ/Ĩ&W'ŝƐхϱ͘ϲŵŵŽůͬůŽƌϭϬϬŵŐͬĚů͕ĂŶŽƌĂůŐůƵĐŽƐĞƚŽůĞƌĂŶĐĞƚĞƐƚŝƐ ƐƚƌŽŶŐůǇƌĞĐŽŵŵĞŶĚĞĚ͕ďƵƚŝƐŶŽƚŶĞĐĞƐƐĂƌǇƚŽĚĞĮŶĞƉƌĞƐĞŶĐĞŽĨƚŚĞ syndrome ͻ/ĨD/ŝƐхϯϬŬŐͬŵϸ͕ĐĞŶƚƌĂůŽďĞƐŝƚǇĐĂŶďĞĂƐƐƵŵĞĚĂŶĚǁĂŝƐƚ circumference does not need to be measured ĂƚĂƉƌŽǀŝĚĞĚ͗ Age, sex, weight, height, BMI, waist circumference, ǁĂŝƐƚͲƚŽͲŚŝƉƌĂƟŽ͕ďĂƐŝĐďŝŽĐŚĞŵŝƐƚƌǇŝŶĐůƵĚŝŶŐĂůůD^ͲƌĞůĂƚĞĚ ƉĂƌĂŵĞƚĞƌƐ͕ďůŽŽĚƉƌĞƐƐƵƌĞĂƚƐĞƌƵŵĐŽůůĞĐƟŽŶ͕ďůŽŽĚƉƌĞƐƐƵƌĞ ŵŽŶŝƚŽƌŝŶŐĚĂƚĂͬ,ŽůƚĞƌ;ǁŚĞŶĂǀĂŝůĂďůĞͿ͕ŝŶĨŽƌŵĂƟŽŶĂďŽƵƚ ĐŽŵŽƌďŝĚŝƟĞƐĂŶĚĐŽƌƌĞƐƉŽŶĚŝŶŐƚŚĞƌĂƉŝĞƐ͕ďůŽŽĚĐŽƵŶƚ ĂƚĂƉƌŽǀŝĚĞĚŽŶƌĞƋƵĞƐƚĂƚĞǆƚƌĂĐŚĂƌŐĞ͗>ĞƉƟŶ͕^ŽůƵďůĞ>ĞƉƟŶ ZĞĐĞƉƚŽƌ͕ĚŝƉŽŶĞĐƟŶ͕ZĞƐŝƐƟŶ͕sĂƐƉŝŶ͕ŚĞŵĞƌŝŶ͕KŵĞŶƟŶ͕Ͳ&W͕ ZWͲϰ͕/>ϲ͕ZW͕W/͕/ŶƐƵůŝŶ͕ͲWĞƉƟĚĞ͕,KDͲ/ŶĚĞǆ͕,ďϭ͕ZĞŶŝŶ͕ ůĚŽƐƚĞƌŽŶĞ͕ƉŽůŝƉŽƉƌŽƚĞŝŶƐ͕ĞƚĐ͘ ŶǇĂĚĚŝƟŽŶĂůƉĂƌĂŵĞƚĞƌĐĂŶďĞĂĚĚĞĚĂƐĐƵƐƚŽŵĂŶĂůǇƐŝƐͬ ŵĞĂƐƵƌĞŵĞŶƚ͘WůĞĂƐĞŝŶƋƵŝƌĞǁŝƚŚƌĞŐĂƌĚƚŽĂǀĂŝůĂďŝůŝƚǇĂŶĚƉƌŝĐĞ͘ ϭĚ tĞŝŐŚƚ>ŽƐƐWĂŶĞů ;ϰϴͲϵϲƉĂƟĞŶƚƐƵŶĚĞƌŐŽŝŶŐ^ůĞĞǀĞ'ĂƐƚƌĞĐƚŽŵǇďĞĨŽƌĞĂŶĚŽŶĞǁĞĞŬ͕ ŽŶĞŵŽŶƚŚ͕ƐŝǆŵŽŶƚŚƐĂŶĚĂǇĞĂƌƚŚĞƌĞĂŌĞƌ͕ƌĞƐƉĞĐƟǀĞůǇͿ ϮŝĂďĞƚĞƐ Η ͘ ͘ ͘ Ă Ŷ Ě ŵ Ă ŶǇ ŵ Ž ƌ Ğ ƚŽ ĐŽ ŵĞ͊Η ϯĂƌĚŝŽǀĂƐĐƵůĂƌŝƐĞĂƐĞ ϭĐ DĞŶƚĂůŶŽƌĞǆǇ;ŶŽƌĞǆŝĂEĞƌǀŽƐĂͿ (48 normal healthy males and 48 normal healthy females, age and BMI matched) ĂƚĂƉƌŽǀŝĚĞĚ͗ Age, sex, weight, height, BMI, basic biochemistry, ďůŽŽĚĐŽƵŶƚ͕ŝŶĨŽƌŵĂƟŽŶĂďŽƵƚĞĂĐŚƉĂƟĞŶƚ͚ƐĐůŝŶŝĐĂůŚŝƐƚŽƌǇŝŶĐůƵĚŝŶŐ ƚŚĞƌĂƉŝĞƐ͕ŝŶĨŽƌŵĂƟŽŶĂďŽƵƚĐŽŵŽƌďŝĚŝƟĞƐĂŶĚĐŽƌƌĞƐƉŽŶĚŝŶŐ ƚŚĞƌĂƉŝĞƐ͕ŝŶĨŽƌŵĂƟŽŶĂďŽƵƚĞĂĐŚƉĂƟĞŶƚ͚ƐŵĞŶƐƚƌƵĂůĐǇĐůĞ͘ ĂƚĂƉƌŽǀŝĚĞĚŽŶƌĞƋƵĞƐƚĂƚĞǆƚƌĂĐŚĂƌŐĞ͗>ĞƉƟŶ͕^ŽůƵďůĞ>ĞƉƟŶ ZĞĐĞƉƚŽƌ͕ĚŝƉŽŶĞĐƟŶ͕ZĞƐŝƐƟŶ͕sĂƐƉŝŶ͕ŚĞŵĞƌŝŶ͕KŵĞŶƟŶ͕Ͳ&W͕ ZWͲϰ͕/>ϲ͕ZW͕W/͕ĞƚĐ͕͘,ŽƌŵŽŶĞWƌŽĮůĞ;>,͕&^&͕WƌŽůĂĐƟŶ͕ŽƌƟƐŽů͕ ŶĚƌŽƐƚĞŶĚŝŽů͕,^͕ĞƚĐ͘ ŶǇĂĚĚŝƟŽŶĂůƉĂƌĂŵĞƚĞƌĐĂŶďĞĂĚĚĞĚĂƐĐƵƐƚŽŵĂŶĂůǇƐŝƐͬ ŵĞĂƐƵƌĞŵĞŶƚ͘WůĞĂƐĞŝŶƋƵŝƌĞǁŝƚŚƌĞŐĂƌĚƚŽĂǀĂŝůĂďŝůŝƚǇĂŶĚƉƌŝĐĞ͘ ϰZĞŶĂůŝƐĞĂƐĞ ϱ'ĂƐƚƌŽĞŶƚĞƌŽůŽŐǇ ϲEĞƵƌŽůŽŐǇ ϳWƵůŵŽŶĂƌǇͬZĞƐƉŝƌĂƚŽƌǇŝƐĞĂƐĞ ϴ,ĞƉĂƚŽůŽŐǇ ϵĂŶĐĞƌͬKŶĐŽůŽŐǇ ϭϬ^ĞƉƐŝƐ ϭϭdƌĂƵŵĂ ϭϮ/ŵŵƵŶĞZĞƐƉŽŶƐĞ ϭϯƵƚŽŝŵŵƵŶŝƚǇ ϭϰ/ŶĨĞĐƟŽƵƐŝƐĞĂƐĞƐ ϭϱZĞƉƌŽĚƵĐƟŽŶ ϭϲKƐƚĞŽƉŽƌŽƐŝƐ Η ͘ ͘ ͘ Ă Ŷ Ě ŵ Ă ŶǇ ŵ Ž ƌ Ğ ƚŽ ĐŽ ŵ Ğ ͊ Η PUSHING THE LIMITS IN CLINICAL RESEARCH Everything depends on having a partner you can trust RELY ON AB 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