Allergy and diseases caused or complicated by allergy, such as asthma, or diseases with symptoms which mimic allergy, are among the most widespread and costly health problems in the world.

Lenco Diagnostic Laboratories, Inv. provides allergy testing that is safe, simple, and accurate with groundbreaking technology with the latest generation of automated allergy diagnostic systems.

Detection of immunoglobulin E (IgE) antibodies and determination of specific allergens allow for better outcomes and increased quality of life for allergy patients. To be reliable, the testing system used to detect allergy must be standardized. Phadia allergy test systems, along with all their components, are standardized against World Health Organization reference preparations for reproducible, reliable results. Phadia, a global leader in allergy diagnostics research and development since 1974, offers advanced automated instrumentation to process the ImmunoCAP® technology-based test kits for allergy, and inflammation markers for asthma and anaphylaxis. The ImmunoCAP® instrument provides innovative software and hardware solutions that meet laboratory automation and throughput requirements.

ImmunoCAP® Specific IgE assays are the first to be FDA cleared for the quantitative measurement of specific IgE. The most significant features of ImmunoCAP technology are extensive quality control measures, excellent allergen and reagent source materials, and calibration to WHO reference preparations. In addition, the structural design of ImmunoCAP® allows for automation and thorough elimination of unbound nonspecific material in the reaction complex, resulting in highly reproducible, accurate, and quantitative results.

Lenco Labs is proud to add the ImmunoCAP® Specific IgE assays to our already extensive test menu. As always, we strive to render the upmost in patient care, and we feel that working with companies like Phadia enable us to achieve that goal.

Lenco Diagnostic Laboratory, Inc. would like to take this time to thank you for choosing us as your clinical reference laboratory. The purpose of this letter is to enable us to process your patient's specimens in the most timely and accurate manner possible.

We have been receiving a number of specimens at the laboratory that do not have the proper amount of blood for the quantity of allergen tests ordered. We require 2ml serum from a spun barrier tube for any group of up to 6 allergens, 0.5 ml for each additional allergen. Also, please do not exceed 32 tests per form. If you require additional testing for allergens for a particular patient, please use another requisition for these tests.

If you need to receive the Allergen Test Requisition forms, please contact our Client Service Department at 718-232-1515, Ext 1. This updated Allergen Test Requisition was designed with our clients in mind. This requisition contains the most common allergens requested by our physician clients. We have also attached a flyer listing some of our standard Allergen Profiles for your use. Of course, we will also custom design a test panel for you containing any particular tests that you desire.

Lenco Diagnostic Laboratory, Inc. is pleased to announce the following panel has been added for your convenience.

• Sexually Transmitted Disease (STD) Panel #3125
  • RPR
  • Herpes Simplex Virus (HSV) I & II
  • HIV I & II
  • GC/CHLAM
  • Hep A Antibody
  • Hep B Surface Antigen
  • Hep B Surface Antibody
  • Hep B Core Antibody
  • Hep C Antibody
  • Specimen Requirements: 2 SST, 1 Urine

This panel was created in response to commonly requested tests. As always, we can custom design test panels to suit your requirements.

Lenco Diagnostic Laboratory, Inc. would like to take this time to thank you for choosing us as your clinical reference laboratory. The purpose of this letter is to enable us to process your patient's specimens in the most timely and accurate manner possible.

Expired Tubes, Containers, and other Clinical Supplies with expiration dates

Lenco Diagnostic Laboratory Inc. is committed to the highest quality of clinical laboratory testing available. To accomplish this, it is imperative that all specimens submitted to the laboratory for testing is sent in the proper, unexpired container for the test ordered. If a specimen is sent in either an incorrect container, or one that has an expired date, the requested testing will not be performed. This ensures that the most accurate test results for your patients will be generated.

In conjunction with New York State law, we will gladly provide you with any approved collection devices and containers at no charge. For a complete list of approved supplies, please contact our Client Service department at the number above.

PROTOCOL: Turn-around time for the histology specimens.

PROCEDURE:

1. Specimens received after 5:00 pm will be accessioned in Novo Path system the next day.
2. Grossing and overnight processing in Sacura VIP-300 Tissue Processor of the specimens will be done the same day as the accessioning of the specimens.
3. Histology slides will be available for diagnosis the day after accessioning.

The following exceptions are:

1. Fatty specimens - That require extra formalin fixation prior to processing [Except Friday]
2. Bones and nails - That require at least overnight decalcification to soften them.

*** NOTE: The following is the standard turn-around-time for histology specimens. Please keep in mind that this is a guideline, individual result times may vary. Typical turn-around-time is 4-5 business days, not including weekends and holidays.

Histology specimens must be accompanied by a completed requisition. Requisitions must be completely filled out in order to process the specimen. The following are of particular importance:

• Specimen number
• Number of pieces
• Type of tissue
• Date of processing and date of final diagnosis
• Comment
• Signature

Lenco Diagnostic Laboratory, Inc. is pleased to announce the following assays are now performed in-house. This significantly improves efficiency and turnaround time.

• Test 1740: Free Testosterone – 1 ml serum
  • Reference Range for: Free Testosterone
    Male age 1 – 9 0 - 0.6
    Male age 10 -18 0.6 – 159
    Male age 19 up 47 – 244
    Female age 1 -9 0 – 0.6
    Female age 10 – 18 1 – 5
    Female age 19 up 0.6 – 6.8

• Test 1735: Sex Hormone Binding Globulin (SHBG) – 1 ml serum
  • Reference Range for: SHBG
    Male age 1 – 3 42 - 156
    Male age 4 - 6 39 - 146
    Male age 7 - 9 38 - 114
    Male age 10 - 12 32 - 93
    Male age 13 - 15 13 - 63
    Male age 16 -18 11 – 54
    Male age 19 up 13 - 71
    Female age 1 - 3 51 - 158
    Female age 4 - 6 48 - 142
    Female age 7 - 9 31 - 103
    Female age 10 - 12 20 - 100
    Female age 13 - 15 17 - 77
    Female age 16 - 18 9 - 75
    Female age 19 up 18 - 114

• Test 1745: Prostatic Acid Phosphatase (PAP) – 1 ml serum
  • Reference Range for: PAP

This panel was created in response to commonly requested tests. As always, we can custom design test panels to suit your requirements.

Common Specimen Collection/Handling Errors

• Improper labeling. Unlabeled or mislabeled specimens will not be tested
• Incomplete or missing requisition form.
• Failure to provide sufficient quantity of specimen for testing (QNS).
• Using the wrong container or tube type.
• Collecting the specimen at the wrong time (e.g. peak drug level collected just prior to dosing).
• Failure to adequately tighten specimen container lids, resulting in leakage and/or specimen contamination.
• Hemolysis, caused by:
  • using needles smaller than 20- or 21-gauge
  • leaving wet alcohol on the skin during venipuncture
  • removing the needle from the vein prior to complete filling of the tube, resulting in cell damage due to a rush of air into the tube
  • filling the tube too slowly, often due to improper (too shallow) entry into the vein
• Clotting of anticoagulant tubes caused by improper/inadequate mixing.
• Failure to store samples properly for delivery to laboratory.

Proper Tube Order When Collecting Blood

To ensure the most accurate test results, vacutainer tubes should be filled in the following order:

1. Blood Culture/Sterile Tubes
2. Blue (Coagulation Tube- Sodium Citrate)
3. Red or Yellow (Serum Tube with or without Clot Activator, with or without Gel)
4. Green (Heparin Tube) Light Green (Heparin Tube with Gel Separator)
5. Lavender/Purple or Pink (EDTA)
6. Grey (Fluoride Tube)

Centrifuge Procedures

Please follow these instructions when using the Barrier Tube or the SST tube with Clot Activator in order to obtain the most accurate test results:

1. Collect blood specimen using the usual venipuncture technique. Fill tube completely.
2. Gently invert barrier tube five times to mix clot activator with blood.
3. Allow blood to clot for 30 minutes.
4. Centrifuge at High Speed for 15 minutes.
5. Remove from centrifuge. Barrier will have formed, separating cells from serum. All of the separation gel should have moved from the bottom of the tube to form a barrier layer.
6. The sample is now ready to be transported to the laboratory. Do not remove stopper.

VAP Cholesterol Test - A comprehensive lipoprotein analysis to improve patient diagnosis and treatment. The VAP cholesterol test provides a more comprehensive coronary heart disease (CHD) Risk assessment than the conventional lipoprotein profile. The VAP cholesterol test measures all primary and secondary by the NCEP ATP III* guidelines. Direct measurements are provided for total cholesterol, LDL, HDL, VLDL, and cholesterol subclasses.

In a single test profile additional lipoprotein information is provided to assist physicians to develop patient-specific treatment initiatives. Lipoprotein response to treatment can vary; the additional information provided by the VAP cholesterol test, when medically indicated, can be helpful in selecting the most appropriate therapy, including choice of drugs and the intensity of risk-reduction therapy.

*The VAP cholesterol test includes all serum lipids that define the targets of therapy recommended by ATP III:

• LDL cholesterol-Primary Target
• HDL cholesterol
• Total VLDL cholesterol
• Triglycerides
• Lipoprotein (a) cholesterol
• Remnant lipoproteins
• Intermediate-density lipoprotein (IDL) cholesterol
• VLDL3 (small dense) cholesterol
• VLDL 1+2 (large buoyant) cholesterol
• LDL particle density pattern (small dense vs large buoyant)
• HDL Subfractions: HDL2 (large buoyant, more protective) and HDL3 (small dense, less protective) and reports the total cholesterol/HDL cholesterol ratio.