The Second International Consensus Meeting on Orthopedic Infections was held in Philadelphia, Pennsylvania, in July 2018. More than 800 experts from all 9 subspecialties of orthopedic surgery and allied fields of infectious disease, microbiology, and epidemiology were assembled to form the International Consensus Group. The shoulder workgroup reached consensus on 27 questions related to culture techniques, inflammatory markers, and diagnostic criteria used to evaluate patients for periprosthetic shoulder infection. This document contains the group\'s recommendations and rationale for each question related to evaluating periprosthetic shoulder infection.

Testing for phosphatidylethanol (PEth) is a relatively new tool for detecting and grossly quantifying a person\'s use of alcohol in a variety of security, medical, and legal environments. The basic chemistry of PEth is explained with a particular focus on factors that make it highly suitable as a biomarker for alcohol use in such situations. This article meets the need for a literature review that synthesizes PEth laboratory findings and suggests updated guidelines for interpretation. Several ethanol biomarkers have been used for detection or monitoring alcohol use but have significant limitations. Based on this review, the authors propose three guidelines for evaluating PEth values: Light or no Consumption (<20 ng/mL), Significant Consumption (20-199 ng/mL), and Heavy Consumption (>200 ng/mL). These guidelines are important in employment and security environments, but also have applicability in such diverse activities as alcohol treatment programs, organ transplant decisions, and monitoring impaired medical professionals.

In populations with high prevalences of iron deficiency and thalassemia trait, many apparently healthy individuals have abnormal erythroid parameters, which may cause diagnostic problems in clinical practice. We studied the prevalence and causes of red cell parameter values outside their reference ranges in 394 healthy individuals of Bedouin Arab origin, who had complete blood counts (CBCs), hemoglobin (Hb) analyses and serum ferritin tests done. Their mean age ± standard deviation (SD) was 24.8 ± 4.9 years and 51.8% were females. Overall, 53.0% (209/394) had low Hb, MCV or MCH or high RDW. Anemia was present in 27.0% (55/204) of the women and 3.0% (6/190) of the men. Overall prevalence of MCV < 80.0 fL was 45.0% (176/394) and MCH < 27.0 pg was 48.0% (190/394); RDW > 14.0% was found in 21.0% (43/204) of women and 7.0% (14/190) of men. Of the women, 16.0% had iron deficiency anemia (33/204) and 65.0% had ferritin values of < 30.0 μg/L (133/204). The estimated prevalence of α-thalassemia (α-thal) trait in men was 32.0% (60/190) and that of β-thalassemia (β-thal) trait in both sexes was 3.0% (12/394). In conclusion, half of the healthy Emirati population have abnormal CBC values. For clinical purposes, they require reference standards for red cells that are derived from their own population. Screening of women for iron deficiency is justified due to a high prevalence of iron deficiency.

OBJECTIVE: Guidelines for the management of anemia and iron deficiency in chronic hemodialysis (HD) patients have been developed to standardize therapy and improve clinical outcome. The present study evaluated compliance with anemia guidelines and investigated whether differences between centers were present.
METHODS: Data on anemia management from patients in the baseline cohort of the CONTRAST study (NCT00205556) were analyzed. 598 chronic HD patients (62% male, age 63.6 ± 14.0 years) from 26 Dutch dialysis centers were included.
RESULTS: Mean hemoglobin (Hb) level was 11.9 ± 1.3 g/dl and Hb was ≥11.0 g/dl in 81% of the patients. Compliance with all anemia targets (Hb 11.0-12.0 g/dl, transferrin saturation ratio ≥20%, ferritin 100-500 ng/ml) was reached in 11.6% (95% CI 7.8-17.0) of the patients, with a wide range among centers (4-26%, adjusted for case mix, treatment-related factors and center-specific characteristics).
CONCLUSIONS: Compliance with anemia targets in stable HD patients was poor and showed a wide variation between treatment facilities.

In December 2009, the American Society for Veterinary Clinical Pathology (ASVCP) Quality Assurance and Laboratory Standards committee published the updated and peer-reviewed ASVCP Quality Assurance Guidelines on the Society\'s website. These guidelines are intended for use by veterinary diagnostic laboratories and veterinary research laboratories that are not covered by the US Food and Drug Administration Good Laboratory Practice standards (Code of Federal Regulations Title 21, Chapter 58). The guidelines have been divided into 3 reports: (1) general analytical factors for veterinary laboratory performance and comparisons; (2) hematology, hemostasis, and crossmatching; and (3) clinical chemistry, cytology, and urinalysis. This particular report is one of 3 reports and provides recommendations for control of preanalytical and analytical factors related to hematology for mammalian and nonmammalian species, hemostasis testing, and crossmatching and is adapted from sections 1.1 and 2.3 (mammalian hematology), 1.2 and 2.4 (nonmammalian hematology), 1.5 and 2.7 (hemostasis testing), and 1.6 and 2.8 (crossmatching) of the complete guidelines. These guidelines are not intended to be all-inclusive; rather, they provide minimal guidelines for quality assurance and quality control for veterinary laboratory testing and a basis for laboratories to assess their current practices, determine areas for improvement, and guide continuing professional development and education efforts.

A review of the Quality Management Program-Laboratory Services (QMP-LS) hemoglobin fraction quantitation/hemoglobinopathy investigation surveys revealed recurrent errors in diagnosis of carrier genotypes for serious hemoglobinopathies. To address these concerns, QMP-LS developed guidelines for laboratory investigation of hemoglobinopathy syndromes. The guidelines are based on current practice in the province of Ontario, expert opinion in the field, and a review of recent literature. They include an overview of the clinical significance of the hemoglobinopathies, the indications for a hemoglobinopathy investigation, key components of a thorough laboratory hemoglobinopathy investigation, interpretation of investigation results, diagnosis of rare hemoglobin variants, and indications for DNA investigation of hemoglobinopathies. The guidelines present various tables and figures outlining mean cell volume reference intervals, recommended hemoglobinopathy investigative techniques, recommendations for further investigation of abnormal findings, and algorithms for interpretation of the various laboratory hemoglobinopathy investigative techniques. The guidelines are intended for use in the processing of specimens when a clinical or laboratory physician has ordered a hemoglobinopathy investigation (hemoglobin electrophoresis).

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