Ethical Checklists for Clinical Research Projects and laboratory medicine: two tools to evaluate compliance with bioethical principles in different settings.

OBJECTIVES: To develop two ethical checklists to evaluate (i) management of ethical concerns in research projects and (ii) awareness of ethical conduct of healthcare laboratory professionals. METHODS: Comprehensive discussion among the members of IFCC Task Force on Ethics based on pertinent literature. RESULTS: This Checklist for Clinical Research Projects should be useful to evaluate research proposals from an ethical perspective before submitting it to an IRB or its equivalent, thereby diminishing rejection rates and resulting in more time-effective projects. The checklist designed to evaluate the ethical conduct in laboratory medicine could be useful for self evaluation (internal audits) and for certification/accreditation processes performed by third parties. CONCLUSIONS: These checklists are simple but powerful tools useful to guide professionals to adhere to ethical principles in their practice, especially in developing countries where accredited ethics committees may be difficult to find.

Ethical issues in the use of leftover samples and associated personal data obtained from diagnostic laboratories.

Diagnostic laboratories are an integral part of the research ecosystem in biomedical sciences. Among other roles, laboratories are a source of clinically-characterized samples for research or diagnostic validation studies. Particularly during the COVID-19 pandemic, this process was entered by laboratories with different experience in the ethical management of human samples. The objective of this document is to present the current ethical framework regarding the use of leftover samples in clinical laboratories. Leftover samples are defined as the residue of a sample that has been obtained and used for clinical purposes, and would otherwise be discarded. Secondary use of samples typically demands institutional ethical oversight and informed consent by the participants, although the latter requirement could be exempted when the harm risks are sufficiently small. However, ongoing discussions have proposed that minimal risk is an insufficient argument to allow the use of samples without consent. In this article, we discuss both positions, to finally suggest that laboratories anticipating the secondary use of samples should consider the adoption of broad informed consent, or even the implementation of organized biobanking, in order to achieve higher standards of ethical compliance which would enhance their capacity to fulfill their role in the production of knowledge.

Conflicts of Interest and An Approach to Managing Them.

Conflicts of interest (COI) exist in every step of life, including in medicine and science. Professionals who work in different areas of Health systems, such as physicians in care patient, in pharmaceutical and biomedical devices industries, in management positions, in teaching or in research, all must apply rigid ethical principles. It is possible with these actions that COI were detected in several circumstances such as in the prescribing therapy, in production or employment of technology in services of Health system, in article publications, and in decision-making for those who have decided to occupy positions of responsibility in scientific and healthcare institutions, in industry or professional associations, among others. These actions must be consistent with the essential principles of Bioethics. At present, COI disclosure has been irreversibly installed in Medicine. A detailed description of the classification of conflicts of interest and its ethical and legal implications in the practice of health sciences such as those that appear in the practice of clinical and laboratory medicine, pharmaceutical industry and also, research and publications are included. Final considerations on the management of COI are also included.

Ética y laboratorio clínico: conceptos básicos / Ethics and the clinical laboratory: basic concepts / Ética e laboratório clínico: conceitos básicos / Reconocimiento a la trayectoria del Prof. Dr. Juan Miguel Castagnino†

Resumen Los profesionales bioquímicos, y quienes desempeñan su trabajo en el laboratorio de análisis clínicos, en el ejercicio de su deber como individuos, como profesionales y proveedores del servicio de salud, deben desarrollar sus tareas en un marco de cumplimiento de los estándares éticos, tal como ocurre en otras áreas vinculadas con la atención de la salud. Para abordar con éxito los complejos problemas suscitados en el ámbito específico de la atención sanitaria y para estudiar los factores naturales (p. ej.: aparición del coronavirus SARS-CoV-2), tecnológicos [p. ej.: inteligencia artificial (IA)] y sociales (p. ej.: desplazamientos demográficos) que pueden tener repercusiones sobre la salud humana y la biósfera en su conjunto, es necesario que los profesionales de la salud y quienes desempeñan sus funciones en ese medio, tomen conocimiento de los conceptos básicos de ética aplicados a la salud. El objetivo de este artículo es considerar los dilemas éticos que deben afrontar en el trabajo diario los profesionales del laboratorio clínico. Para ello la propuesta consistió en abordar los principios, documentos y declaraciones nacionales e internacionales sobre ética aplicados a la salud, en particular al laboratorio de análisis clínicos y, en segundo término, brindar un marco teórico basado en los principios de la Bioética Principalista, para afrontar los problemas éticos que se generan en las diferentes fases del proceso bioquímico total (preanalítica, analítica y posanalítica).

Abstract Biochemical professionals, and those who carry out their work in the clinical analysis laboratory, in performing their duties as individuals, professionals and health service providers, must carry out their tasks within a framework of compliance with ethical standards, such as it occurs in other areas related to health care. To successfully address the complex problems raised in this specific field and to study the natural (i.e.: appearance of the SARSCoV- 2 coronavirus), technological [i.e.: artificial intelligence (AI)] and social (i.e.: demographic shifts) factors that may have repercussions on human health and the biosphere as a whole, it is necessary that health professionprofeals and those who perform their duties in this environment, become aware of basic concepts on ethics applied to health. The objective of this article is to consider the ethical dilemmas that clinical laboratory professionals must face in their daily work. To this aim, we set out to address the national and international principles, documents and declarations on ethics applied to health, in particular, to the clinical analysis laboratory and secondly, to provide a theoretical framework based on the principles of Principalist Bioethics, to face the ethical problems that are generated in the different phases of the complete biochemical process (pre-analytical, analytical and post-analytical).

Resumo Os profissionais bioquímicos, e aqueles que exercem o seu trabalho no laboratório de análises clínicas, no exercício das suas funções como indivíduos, como profissionais e prestadores do serviço de saúde, devem desempenhar as suas funções num quadro de observância dos padrões éticos, tal como ocorre em outras áreas relacionadas com o atendimento da saúde. Para abordar com sucesso os problemas complexos levantados no campo específico dos cuidados da saúde e estudar os fatores naturais (por exemplo: aparecimento do coronavírus SARS-CoV-2), tecnológicos [por exemplo: inteligência artificial (IA)] e sociais (por exemplo: deslocamentos demográficos) que podem têm repercussões na saúde humana e na biosfera como um todo, é necessário que os profissionais da saúde e aqueles que exercem suas funções neste ambiente, tomem conhecimento dos conceitos basicos da ética aplicados à saúde. O objetivo deste artigo é considerar os dilemas éticos que devem ser enfrentados no trabalho diário pelos profissionais de laboratórios clínicos. Para isso, nos propusemos abordar os princípios, documentos e declarações nacionais e internacionais sobre a ética aplicados à saúde, em particular, ao laboratório de análises clínicas e, em segundo lugar, fornecer um quadro teórico baseado nos princípios da Bioética Principalista, para enfrentar os problemas éticos que são gerados nas diferentes fases do processo bioquímico total (pré-analítica, analítica e pós-analítica).

Identification of an equilibrium intermediate in the unfolding process of galectin-1, which retains its carbohydrate-binding specificity.

The unfolding process of galectin-1 (Gal-1) in the presence of a denaturing agent was examined using fluorescence and far-UV circular dichroism (CD) spectroscopy determinations, and was found to be completely reversible. The data showed that the transitions of guanidine hydrochloride (GdnHCl)-induced lectin unfolding, in the absence of ligand, were biphasic in nature, clearly showing the existence of at least one stable intermediate. On the other hand, the unfolding in the presence of disaccharide yielded data that could fit very well to a two-state model, indicating a stabilizing effect of the ligand. The folding intermediate was further characterized by size exclusion chromatography, near-UV CD and anilinonaphtalene sulfonate binding, and shown to belong to the molten globule type. Strikingly, this intermediate retained its carbohydrate-binding specificity, as evidenced by the tryptophan fluorescence changes detected upon its interaction with lactose.

Activation of oxidative burst and degranulation of porcine neutrophils by a homologous spleen galectin-1 compared to N-formyl-L-methionyl-L-leucyl-L-phenylalanine and phorbol 12-myristate 13-acetate.

Galectins are a family of animal lectins defined by their beta-galactoside-binding activities and a consensus sequence in their carbohydrate-recognizing domain (CRD). Relevant roles of galectins are described in adaptive immune response, innate immunity and modulation of the acute inflammatory response. We have extended our previous studies on a porcine spleen galectin-1 in relation to its functional roles such as polymorphonuclear neutrophils (PMNs) stimulation compared to well known PMN activators e.g. N-formyl-L-methionyl-L leucyl-L-phenylalanine (fMLP) and phorbol 12-myristate 13-acetate (PMA). Relative to activation of NADPH-oxidase fMLP and PMA are stronger than galectin-1 plus cytochalasin B (CB) when the lectin is employed at low concentrations (gal-1 1 microM, 3.6+0.8 nm O(2)(-)/min/10(7) PMN). Higher doses of galectin-1 (10 microM) plus CB produced a significant activation of NADPH-oxidase (27.9+14.8 nm O(2)(-)/min/10(7) PMN) and stimulated PMN degranulation up to 50%. We propose that local galectin-1 concentrations under physiological conditions might reach suitable levels for pig PMN stimulation, and might be a natural inducer of O(2)(-) formation or degranulation. Porcine galectins might produce enhanced responses in vivo when they stimulate neutrophils in combination with some other stimuli.

An enzyme-linked immunosorbent assay for measuring anti-sheep red blood cells antibodies in lead-exposed toads.

INTRODUCTION: Immune function assays to screen immunotoxic effects of xenobiotics has recently become of major interest. In the framework of our studies, we standardized methods to quantify the humoral response of an amphibian species (Bufo arenarum, Amphibia, Anura) exposed to sublethal lead (as acetate). METHODS: The levels of agglutinins to heterologous red blood cells (RBC) were measured in serum from adult B. arenarum. Since agglutinin titers were very low, a noncompetitive enzyme-linked immunosorbent assay (ELISA) method was carried out. As toad serum showed marked nonspecific binding, we developed a new ELISA on microtiter plates for the quantitative determination of the heterophile antibodies. The method was based on that described by Hirvonen et al. [Vox Sang. 69 (1995) 341], employing sheep red blood cells (SRBC) sensitized with amphibian antibodies that were transferred to microplates; later the measurement of bound immunoglobulins was performed. Different variables such as the amount of antigen, blocking agents, and other experimental conditions (fixing solution and commercial plates) were studied. Toads (n=22) received a weekly subcutaneous injection of 50 mg/kg lead (acetate) for 6 weeks, and the control ones (n=26) were injected with Na acetate at the same time. RESULTS: The anti-sheep RBC antibodies titers of adult toads were obtained with the improved ELISA method, being the absorbance range 0.12 to 1.58 AU (1/200 diluted serum). Titers from lead-exposed toads were also determined, being the final titers (expressed as (-)x +/-S.E.M.) higher (0.79+/-0.06 AU), than those of Day 0 (0.57+/-0.06) (P<.01). DISCUSSION: It was concluded that the ELISA technique we developed was useful for measuring the humoral immune response in this animal model and that in these preliminary studies, lead showed an immunostimulating action on the humoral immune system.

Determinación de hierro sérico: Evolución del desempeño de los laboratorios participantes del Sub-Programa PEEC-Hematología / Iron serum determination: evolution of performance of participating laboratories of the PEEC-Hematology Sub-Program / Determinação de ferro sérico: Evolução do desempenho dos laboratórios participantes do Sub-Programa PEEC-hematologia

El objetivo de este trabajo fue determinar la evolución del desempeño analítico en la determinación de hierro sérico, de los laboratorios participantes del Sub- Programa PEEC-Hematología (PEEC-H) del Programa de Evaluación Externa de Calidad Prof. Dr. Daniel Mazziotta de la Fundación Bioquímica Argentina, mediante el análisis de los resultados de ferremia en 6 encuestas (E) realizadas en los meses de julio entre los años 2010 y 2015 (E 77, 81, 85, 89, 93 y 97). Hasta el 2011 se utilizaban métodos con y sin desproteinización, siendo estos últimos los más utilizados (94%). En 2015 en la red de laboratorios se emplearon solamente métodos directos sin desproteinización, siendo los colorimétricos los más utilizados (aproximadamente 95%). El Desvío Relativo Porcentual aceptable (DRPa) fue de ±10% en todas las encuestas analizadas. El 56% de los laboratorios tuvieron un desempeño promedio aceptable en las E 77, 81 y 85, evolucionando 3 años después, a 70% en las E 89, 93 y 97. Según estas consideraciones, al presente no es necesario ajustar el DRPa para el analito hierro, ya que con este valor los laboratorios aún deben trabajar para lograr una mejoría en su desempeño.

The aim of this work was to evaluate the evolution of the analytical performance of serum iron determination by the laboratories participating in the Sub- Program PEEC-Hematology (PEEC-H) EQAS Program Prof. Dr. Daniel Mazziotta of the Argentine Biochemical Foundation. To this end, results of serum iron determinations from July 2010 to July 2015 (surveys #77, 81, 85, 89, 93 and 97) were used. Up to 2011, there were methods both with and without deproteinization, the latter being the most used (94%). In 2015, only one commercial method without deproteinization was used, with colorimetric methods employed in 95% of the cases. In all the surveys analyzed, the acceptable DRP was ±10%. In surveys 77, 81 and 85, 56% of the laboratories had an acceptable performance percentage, and it evolved to a 70% in the surveys 89, 93 and 97, three years later. According to these considerations, there is no need to adjust the acceptable DRP for the iron analyte. In this way, laboratories will continue to work in order to improve their performance.

O objetivo deste estudo foi determinar a evolução do desempenho analítico na determinação de ferro sérico, dos laboratórios participantes no Sub-Programa PEEC-Hematologia (PEEC-H) do Programa de Avaliação Externa de Qualidade Prof. Dr. Daniel Mazziotta da Fundación Bioquímica Argentina, através da análise dos resultados de ferremia em 6 pesquisas de opinião (E) realizadas nos meses de julho entre os anos 2010 a 2015 (Pesquisa No. 77, 81, 85, 89, 93 e 97). Até 2011 eram empregados métodos com e sem desproteinização, sendo os colorimétricos os mais utilizados (aproximadamente 95%). O Desvio Relativo Percentual aceitável (DRPa) foi de ±10% em todas as pesquisas analisadas. 56% dos laboratórios tiveram desempenho médio aceitável nas pesquisas 77, 81 e 85, progredindo para 70% nas pesquisas de 89,93 e 97, 3 anos mais tarde. De acordo com estas considerações, hoje não é necessário ajustar o DRPa para o analito ferro, visto que com esse valor os laboratórios ainda devem trabalhar para alcançar uma melhoria no seu desempenho.

Transition from congress abstract to full paper: the case of a national Argentinean congress in clinical laboratory.

BACKGROUND: Transition from communications (abstracts) of an Argentinean congress and their publication as full papers was analyzed. No similar report was found for clinical laboratory in Latin America. METHODS: A total of 388 communications from five congresses were identified, and searches were performed on the internet to find the publications. Pairs were established (1 communication, 1 publication), and characteristics were analyzed. RESULTS: In total, 10.8% of the communications were published. Mean time elapsed was 2+/-1.0 years (x +/- SD). A total of 62% of the publications appeared in Argentinean journals and 38% in foreign journals (5 in Spanish, 11 in English). Mean author number was 4.8+/-2.4 for communications and 5.1+/-2.3 for publications. In total, 59.5% of the publications changed the number and order of authors. Clinical Chemistry was the main topic (45.4% for communications, 38.1% for publications), followed by Microbiology (21.1%, 23.8%). Universities participated in 217 communications (55.9%) and 32 publications (76.2%), while other institutions participated in 171 communications (44.1%) and 10 publications (23.8%). CONCLUSIONS: Publication index was lower than for other congresses. Time elapsed was consistent with others. Preference for Argentinean journals may indicate a focus on local readers but also limitations in language skills. Variations in authorship arise from modifications of individual participation in the final work. More publications from all institutions are desirable. Differences of content were below those reported by others.

Algoritmos de laboratorio para el estudio del estado del hierro / Laboratory algorithms for the study of iron status / Algoritmos de laboratório para o estudo do estado do ferro

La disponibilidad adecuada de hierro (Fe) es esencial para el desarrollo humano y la salud en general. El Fe es un componente clave de las proteínas portadoras de oxígeno, tiene un papel fundamental en el metabolismo celular y es esencial para el crecimiento y diferenciación celular. La ingesta inadecuada de Fe en la dieta, las condiciones inflamatorias crónicas o agudas y numerosas patologías están asociadas con alteraciones en la homeostasis de este metal. La regulación estricta del metabolismo del Fe es necesaria pues el Fe libre es altamente tóxico y los seres humanos sólo pueden excretar pequeñas cantidades a través del sudor, la piel, el enterocito y eliminarlo por pérdidas en procesos normales y patológicos. El objetivo de este trabajo es analizar los algoritmos para la evaluación preliminar tanto de la deficiencia como de la sobrecarga de Fe, sobre la base de diferentes parámetros, algunos accesibles, de simple resolución y que pueden ser efectuados en todos los laboratorios de análisis clínicos. Entre ellos, se analizarán el hemograma con los Índices hematimétricos, Reticulocitos, Fe sérico, Capacidad Total de Fijación de Hierro (CTFH) para calcular el Índice de Saturación de Transferrina (ISTf) y también el dosaje de Ferritina (Ft), todas mediciones que integran el "estudio del estado del hierro". Asimismo, se exponen y se consideran otros marcadores de uso poco frecuente en este medio, como la Protoporfirina Eritrocitaria Libre (PEL), la Eritropoyetina (EPO), entre otras, que ayudan desde el laboratorio al diagnóstico de una anemia. En los casos de sospecha de una sobrecarga de Fe, si bien la confirmación diagnóstica se realiza por estudios genéticos, como estudio inicial se reafirma la evaluación del paciente por medio del "estudio del estado del hierro" y especialmente el dosaje de Fe sérico y del ISTf para seguimiento del tratamiento instaurado. En las últimas décadas, se han producido importantes conocimientos sobre el metabolismo del Fe que han permitido descubrir otras proteínas que intervienen en el transporte, absorción, reciclaje y balance del Fe plasmático. Entre estas, existen marcadores séricos que podrían sumarse a los algoritmos propuestos y ellos son el Receptor de Transferrina (RTf) y la Hepcidina (Hp). Como conclusión, se destaca la necesidad de medir más de un marcador del "estado del hierro" para establecer el diagnóstico de una deficiencia o de un exceso de Fe.

Adequate availability of iron (Fe) is essential for human development and overall health. Iron is a key component of the oxygen-carrying proteins, it has a fundamental role in cellular metabolism, and it is essential for cell growth and differentiation. Inadequate intake of Fe in the diet, chronic or acute inflammatory conditions and many diseases are associated with alterations in the homeostasis of this metal. Strict regulation of Fe metabolism is necessary because free Fe is highly toxic and humans can excrete only small amounts through sweat, skin, and enterocyte loss in normal and pathological processes. The objective of this work is to analyze algorithms for the preliminary assessment of both Fe deficiency and overload, based on different parameters, some simple resolution ones that can be performed in all clinical laboratories. Among them, CBC, Hematimetric Indices, Reticulocytes, serum Fe, Total Iron Binding Capacity (TIBC) will be considered to calculate Transferrin Saturation Index (TfSI) and Ferritin Dosage (Ft), all measurements being part of the "study of iron status." Other markers of less frequent use in our region will also be considered, such as Free Erythrocyte Protoporphyrin (FEP), and Erythropoietin (EPO), among others, that help, from the laboratory in the diagnosis of anemia. In cases of suspected Fe overload, although the diagnosis was confirmed by genetic studies performed as initial study, the patient assessment is reaffirmed through the "study of iron status" and especially serum Fe and TfSI dosage for monitoring treatment underway. In recent decades, important insights on Fe metabolism have yielded more knowledge on other proteins involved in the transport, absorption, recycling and plasmatic Fe balance. Among these, there are serum markers that could be added to the proposed algorithms, which are Transferrin Receptor (TfR) and Hepcidin (Hp). In conclusion, the need to measure more than one analyte of the "iron status" is highlighted in order to establish the diagnosis of Fe deficiency or excess.

A disponibilidade adequada de ferro (Fe) é essencial para o desenvolvimento humano e para a saúde em geral. O Fe é um componente fundamental das proteínas transportadoras de oxigénio, tem um papel fundamental no metabolismo celular, e é essencial para o crescimento e diferenciagäo celular. A ingestäo inadequada de Fe na dieta, as condigöes inflamatorias crónicas ou agudas e inúmeras doengas estäo associadas a alteragöes na homeostase deste metal. A regulagäo rigorosa do metabolismo do Fe é necessària porque o Fe livre é altamente tóxico e os seres humanos apenas podem excretar pequenas quantidades através do suor, pele, enterócitos e eliminà-lo por perdas em processos normais e patológicos. O objectivo deste trabalho é analisar algoritmos para a avaliagäo prévia tanto da deficiéncia quanto do excesso de Fe, com base em diferentes parámetros, alguns acessíveis, de simples resolugäo e que podem ser realizados em todos os laboratorios clínicos. Dentre eles seräo analisados o hemograma com Índices hematimétricos, Reticulócitos, Fe sérico, Capacidade Total de Fixagäo do Ferro (CTFF) para calcular o Índice de Saturagäo da Transferrina (IST) e também a dosagem de Ferritina (Ft), todas elas medigóes que integram o "estudo do estado do ferro". Também sào expostos e considerados outros marcadores de uso pouco frequente nesse meio, como a Protoporfirina Eritrocitària Livre (PEL), a Eritropoietina (EPO), dentre outros, que ajudam a partir do laboratório ao diagnóstico de uma anemia. Nos casos de suspeita de um excesso de Fe, embora o diagnóstico seja confirmado através de estudos genéticos, como estudo inicial é reafirmada a avaliagäo do paciente por meio do "estudo do estado do ferro" e especialmente a dosagem de Fe sérico e do IST para o seguimento do tratamento instaurado. Nas últimas décadas, houve importantes co-nhecimentos a respeito do metabolismo do Fe que permitiram descobrir outras proteínas envolvidas no transporte, absorgäo, reciclagem e balango do Fe plasmàtico. Dentre elas, hà marcadores séricos que poderiam se unir aos algoritmos propostos e eles säo o Receptor de Transferrina (Tf) e Hepcidina (Hp). Em conclusäo, destaca-se a necessidade de medir mais de um marcador do "estado do ferro", para estabelecer o diagnóstico de uma deficiéncia ou de um excesso de Fe.

Serum protein profile and blood cell counts in adult toads Bufo arenarum(Amphibia: Anura: Bufonidae): effects of sublethal lead acetate.

Lead is a multiple-source pollutant, well known for its toxicity, of great risk both for the environment and human health. The main target organs of lead are the hematopoietic, nervous, and renal systems; there are also reports in support of its impairment effects on the reproductive and immune systems. It is well known that most of the metal is accumulated in the blood cells and that many of the deleterious effects are related to its circulating concentrations. These adverse effects have been described not only in humans but also in a number of other vertebrates such as fish and birds. The purpose of the present work was to evaluate the effects of weekly administration of sublethal Pb (as acetate, 50 mg x kg(-1)) during 6 weeks on the profile of the serum proteins and blood cell counts of the adult South American toad, Bufo arenarum (Anura: Bufonidae). The electrophoretic patterns of serum proteins pointed out the presence of four fractions; the metal provoked a significant decrease in both total proteins and albumin fraction; among the globulin fractions, the G3 resulted augmented. These findings may be related to the impact of lead on the toads' hepatic cells and immune system. The number of total red blood cells (RBC) showed a tendency to decrease after the injections of the metal, whereas the number of white blood cells (WBC) increased significantly; the differential leukocyte counts showed a statistically significant increase in the absolute number and in the relative percentage of blast-like cells. The decrease in RBC was attributed to the negative impact of the metals on the hemoglobin synthesis. The increasing of the WBC counts may be interpreted as a consequence of the induction of proliferation of pluripotential hematopoietic cells.

Galectin-1 receptors in different cell types.

Galectins are a family of animal lectins defined by two properties: shared amino acid sequences in their carbohydrate-recognizing domain, and beta-galactoside affinity. A wide variety of biological phenomena are related to galectins, i.e., development, differentiation, morphogenesis, tumor metastasis, apoptosis, RNA splicing, and immunoregulatory function. In this review, we will focus on galectin-1 receptors, and some of the mechanisms by which this lectin affects different cell types. Several galectin-1 receptors are discussed such as CD45, CD7, CD43, CD2, CD3, CD4, CD107, CEA, actin, extracellular matrix proteins such as laminin and fibronectin, glycosaminoglycans, integrins, a beta-lactosamine glycolipid, GM1 ganglioside, polypeptide HBGp82, glycoprotein 90 K/MAC-2BP, CA125 cancer antigen, and pre-B cell receptor.

IFCC handbook on Master Program in clinical laboratory sciences.

This document summarizes the steps in development of a new IFCC Master Program and outlines some of the ways the IFCC would assist in setting up such a regional Program. This is intended to be of assistance to those who wish to embark on such an endeavour.

Effect of lead acetate on the in vitro engulfment and killing capability of toad (Bufo arenarum) neutrophils.

Lead is an element of risk for the environment and human health and has harmful effects that may exceed those of other inorganic toxicants. The immune system is one of the targets of lead. Its immunomodulatory actions depend on the level of exposure, and it has been demonstrated that environmental amounts of the metal alter immune function. Very little information is available regarding the effect of the metal on different aspects of the immune system of lower vertebrates, in particular of amphibians. The aim of this study was to investigate the effect of sublethal lead (as acetate) on the function of polymorphonuclear cells of Bufo arenarum. The results revealed that phagocytic and lytic functions of the adherent blood cells collected from sublethal lead-injected toads and incubated with suspensions of Candida pseudotropicalis were affected negatively. The decrease of the phagocytic activity was correlated with increased blood lead levels (P < 0.0001). Additional information referred to the total and differential leukocyte counts was presented; the only difference found was in the number of blast-like cells that resulted augmented in the samples of lead-injected toads. It was concluded that the evaluation of these parameters might be a reliable tool for the biological monitoring of the immune status of amphibians.