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July 2013

From the President’s Desk: Inclusion woven into our fabric, 7/13

President

July 2013—The CAP Residents Forum, a voice for pathology residents and an effective agent of change, will celebrate its 25th anniversary at CAP ’13. Forty-two residents attended the first CAP Residents Forum in October 1988. Last year, 218 delegates from 116 training programs came to the meeting, a remarkable fivefold increase. A related statistic is even more remarkable: More than 90 percent of pathology residents in the United States and Canada are CAP junior members.

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Test utilization: a united front against waste

July 2013—When it comes to laboratory test orders, the connection between bloodletting and financially draining an institution is more than metaphorical. But a wide range of techniques can help stem test overutilization, clinical laboratory experts have found; you don’t have to drive a stake through a vampire’s heart to stanch the flow.

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Q & A, 7/13

July 2013—Can you clarify the difference between the terms “optimization,” “validation,” and “verification” as used in immunohistochemistry? These three terms relate to the processes that the laboratory must undertake before new diagnostic, prognostic, or predictive immunohistochemistry markers are used for clinical and/or pathologic decisionmaking.

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Put it On the Board, 7/13

July 2013—The FDA approved Abbott’s hepatitis C virus genotyping test for use in the United States. The RealTime HCV Genotype II test differentiates genotypes 1, 1a, 1b, 2, 3, 4, and 5 and is run on the automated m2000 platform. Gavin Cloherty, PhD, Abbott Molecular’s director of scientific affairs, told CAP TODAY the test has a 99.5 percent accuracy relative to sequencing and a greater than 99 percent discrimination of HCV genotype 1 subtype 1a versus 1b. Time to result for 22 samples and two controls, he said, is 5.25 hours, with 30 minutes hands-on time.

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Expressions follow SCOTUS gene ruling

July 2013—The U.S. Supreme Court last month handed down a landmark decision on a narrow issue with broad implications for molecular medicine: Can genes be patented? In ruling that as products of nature, genes did not meet the criteria for patent eligibility, the Court brought its collective wisdom to bear on an issue that has troubled physicians, ethicists, and patients for nearly 20 years and hindered innovators in academia and industry.

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Next-gen arrives for next (prenatal) generation

July 2013—In his 25-year practice career, Texas obstetrician James Maher, MD, has performed several thousand amniocenteses, using a long needle to draw amniotic fluid from the uterus of higher-risk pregnant women to rule out certain fetal chromosomal abnormalities—trisomy 21, or Down syndrome, in particular. Even in good hands, the procedure can lead to complications, says Dr. Maher, who supervises residents at Texas Tech University.

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Heart failure high-wire act

July 2013—After weeks of bewilderment, W. Frank Peacock, MD, finally solved the mystery of one of his so-called frequent fliers in the Emergency Department. At the time, Dr. Peacock was vice chair, Emergency Medicine, at the Cleveland Clinic. Every Monday morning, week after week, a local pastor would show up with symptoms of possible heart failure.

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AMP v. Myriad Genetics: the end of the beginning

July 2013—The most remarkable fact about the June 13 decision of the Supreme Court in Association for Molecular Pathology v. Myriad Genetics, ___ U.S. ___ (2013), is that both sides are proclaiming victory. The physicians and geneticists who challenged efforts to enforce patents on the BRCA1 and BRCA2 genes are elated that the Court has squarely held that “a naturally occurring DNA segment is a product of nature and not patent eligible merely because it has been isolated.”

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