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June 2013

Newsbytes, 6/13

June 2013—Clinical IT help desks bring service to new level; PathCentral introduces plug-and-play AP system; ONC guideline addresses transition of care under meaningful use criteria; Laboratory systems certified as electronic health record modules

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Q & A, 6/13

June 2013—Say an individual is stuck with an HIV-contaminated needle or occult infected with HIV by bodily fluid transmission and is started on preventive antiretroviral treatment to prevent permanent infection. (Treatment protocol is one-month intensive treatment.) Is there any known laboratory procedure by which a specimen could be isolated to determine by culture if the patient was indeed infected (assuming the patient is seronegative six months plus after treatment was initiated)?

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Anatomic Pathology Selected Abstracts, 6/13

June 2013—Prolonged cold ischemia time and ER immunohistochemistry in breast cancer: To aid detection of estrogen receptor expression in breast tumors, the American Society of Clinical Oncology and College of American Pathologists recommend that cold ischemia time be kept under one hour. However, data to address the upper threshold of cold ischemia time are limited.

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Clinical Pathology Selected Abstracts, 6/13

June 2013—Ehrlichiosis is a tick-borne disease that may be asymptomatic or result in fatal sepsis. Ehrlichiosis transmitted from transfusion of blood products has not been documented. A case report of a 9-year-old Georgia boy with a history of acute lymphoblastic leukemia is the first report of Ehrlichia ewingii infection transmitted by a platelet transfusion. The authors first describe the patient as presenting to the hospital with complaints of fever, fatigue, malaise, vomiting, diarrhea, and petechial rash.

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Keeping an eye on H7N9, and learning from the past

June 2013—What began as a trickle of reports in China earlier this year swelled into a flood of patients with grave flu-like symptoms. Each time, PCR assays returned the same result: unsubtypable influenza A. Amid a rising mortality rate, viral samples were sent to China’s national laboratories for sequencing analyses. On March 31, Chinese officials posted the results to an open-access database and alerted the World Health Organization to a public health emergency of international concern: The H7N9 epidemic had begun.

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How labs are taming test utilization

June 2013—It might be a legacy of the economic downturn. Perhaps it is the prospect of increased capitation under health care reform. Or it could be the stunning price tags of some new tests on the clinical laboratory test menu. Whatever the cause, health systems across the country are increasingly moving beyond education and retrospective review to more specific, targeted, prospective controls on test utilization.

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To reduce UTIs, one lab takes a long, wide look

June 2013—Lance Peterson, MD, wasn’t expecting to be surprised. But the numbers were dramatic enough to startle even him. Dr. Peterson, an epidemiologist and director of microbiology and infectious diseases research at NorthShore University HealthSystem, in Chicago’s northern suburbs, was looking at figures from the interim analysis of a study he and his colleagues were doing to review presumed urinary tract infections at the four-hospital system.

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