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The difficulties in establishing and delivering reliable clinical hematology and laboratory services in resource-limited settings are well recognized. However, much can be achieved by better use of existing resources through a concerted quality improvement approach. The recommendations of this article are based in part upon work in the thalassemias, inherited disorders of hemoglobin that are widely prevalent in Asia, which may serve as a model that is applicable to other common, chronic disorders in resource-poor settings. Available resources are highlighted and recommendations made regarding approaches to improving services. Over the last few years, a number of low and middle-income countries, obtaining support from appropriate governmental sources, have identified and overcome difficulties and significantly improved clinical services for patients with thalassemia.

Objective We compared hemoglobin results from manually mixed blood gas (BG) Portex syringes (Smiths Medical) and automatically mixed safePICO BG syringes (Radiometer Medical) measured on the ABL90 FLEX blood gas analyzer at the Point of Care with a laboratory hematology analyzer (XN-series, Sysmex) to determine whether automatic mixing improved the accuracy and precision of hemoglobin measurement relative to the standardized method. Methods Ninety-nine lithium heparin tubes and EDTA tubes were collected simultaneously from selected patients at five participating institutions. The lithium heparin tubes were then split between the Portex ABG syringe and the safePICO aspirator. The Portex syringe was mixed manually according to routine procedures, while the safePICO syringe was mixed automatically on the ABL90 FLEX using the automatic mixing ball. The two syringes were mixed and run on the ABL90 FLEX analyzer by the same lab personnel. Total hemoglobin results obtained from the EDTA tubes on the Sysmex XN hematology analyzer were used as the reference values. Results Manual mixing demonstrated a larger scatter of hemoglobin values (R2 ​= ​0.515 and Mean diff.: -0.9 ​g/dL) while automatic mixing at the point of care yielded a significantly better correlation (R2 ​= ​0.986 and Mean diff.: -0.2 ​g/dL) when compared to a reference hematology analyzer. Conclusion Using the safePICO syringe with automatic mixing at the point of care results in a significantly better correlation of hemoglobin with the standardized method., Highlights • Variation in manual mixing techniques for syringes can lead to false results. • Automatic mixing ensures sample homogeneity. • Automatic mixing improved accuracy and precision of hemoglobin measurements.

Outsourcing or sending out of patients' samples to other laboratories for hematologic investigations is a common practice these days. Preanalytic variables that alter cellular parameters and levels of analytes in transit and on storage can significantly and adversely affect interpretation of test results in hematology. Awareness of these changes is necessary to avoid misinterpretation of results that in turn could influence medical management decisions.

The authors of this article formulate a strategy to guide residents and faculty in laboratory hematology. The authors build upon the recommendations of the Academy of Clinical Laboratory Physicians and Scientists (ACLPS) published earlier as well as draw from their own experiences, in discussing principles that should be considered when implementing a program that effectively trains residents to be competent pathologists in the various settings that they may encounter once they complete training.

The majority of clinical applications of flow cytometry begin with various approaches to remove red blood cells (RBCs) from the clinical sample. However, multiparameter cytometry has and will continue to contribute much to the understanding of the pathophysiology and diagnostic accuracy in the clinical evaluation of human diseases affecting erythroid cells. This review summarizes the diagnostic advances relating to erythroid cells in the areas of immunohematology, laboratory hematology, and infectious disease with particular emphasis on medical evaluation of the anemic patient and fetomaternal hemorrhage. Semin Hematol 38:148-159.

S.V. Semochkin, S.S. Kulikova, D.V. Litvinov, E.V. Inyushkina, N.V. Myakova, K.L. Kondratchkik, L.V. Baydun, D.M. Konovalov, D.A. Peregudov, E.V. Samochatova. Federal Scientific Clinical Center of Pediatric Hematology Oncology and Immunol, Adolescent and Young Adult Hematology, Moscow, Russian Federation; Federal Scientific Clinical Center of Pediatric Hematology Oncology and Immunol, Pediatric Hematology, Moscow, Russian Federation; Federal Scientific Clinical Center of Pediatric Hematology Oncology and Immunol, Laboratory Hematology, Moscow, Russian Federation; Federal Scientific Clinical Center of Pediatric Hematology Oncology and Immunol, Pathology, Moscow, Russian Federation

Twenty-nine tests in laboratory hematology, blood chemistry, and urinalysis are presented; some, such as the red and white counts, hemoglobin, urinalysis, etc., are used routinely, but others are less frequently employed. No new concepts are offered, but an attempt has been made to present, in a condensed, practical form, laboratory tests that are specifically useful for dentists in office and hospital practice.

The fourth edition of Prof George Cartwright's monograph of aboratory methodology maintains the tradition of excellence and timeliness of its forebearers. Comprehensiveness, clarity of organization, and syntactic simplicity have been the hallmarks of all editions. I treasured my copy of the first rendition (1954); it provided an uncluttered pathway through the proliferating foliage of laboratory hematology. Other texts of similar persuasion assumed too much biochemical background or too little bench experience; most clinicians found them either incomprehensible or tedious. I suspect that is why this book was written.