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March 2013

Policing blood use pays off for Allina Laboratories

March 2013—A January study of almost 1,000 patients with acute gastrointestinal bleeding has found that restrictive blood transfusion strategies produce better patient outcomes. The study, “Transfusion strategies for acute upper gastrointestinal bleeding,” discovered that patients with severe acute upper GI bleeding who received blood transfusions when their hemoglobin levels fell below 7 g/dL, rather than 9 g/dL, had higher probabilities of survival at six weeks, as well as reduced rates of further bleeding and fewer adverse events (Villanueva C, et al. N Engl J Med. 2013;368:11–21).

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TB or not TB? Newer assays settle in

March 2013—Though tuberculosis is primarily diagnosed and treated in the public health system, there’s a need for greater knowledge about TB in the private sector, says Sundari Mase, MD, MPH, of the CDC’s Field Services and Evaluation Branch, Division of Tuberculosis Elimination. Among private physicians, she says, “there is little institutional knowledge about TB.” When Dr. Mase sees patients, often she’ll note diagnostic delays in recognizing TB, “delays that occur because physicians aren’t thinking about TB.”

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What happened when lab set sights on parasites

March 2013—When Bobbi S. Pritt, MD, director of clinical parasitology and virology in the Division of Clinical Microbiology at Mayo Clinic, set out to improve test utilization among the physicians for whom her laboratory performs assays, she figured that knowledge was power. Simply educate the clinicians, she thought, and surely they would begin to order the most appropriate tests for their patients.

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Put it On The Board, 3/13

March 2013—FDA clears ALK automated gene scanner; precision medicine center at Weill Cornell, NY-Presbyterian; sequence-based system cleared for HLA typing; Abbott to collaborate on companion CLL test; Cepheid, OHSU to develop oncology assays for Xpert; Clarient adopts Qiagen KRAS; test could reduce number of repeat biopsies; and Ventana, Biocare sign p63 license agreement.

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Q & A, 3/13

March 2013—Submit your pathology-related question for reply by appropriate medical consultants. CAP TODAY will make every effort to answer all relevant questions. However, those questions that are not of general interest may not receive a reply. For your question to be considered, you must include your name and address; this information will be omitted if your question is published in CAP TODAY.

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Anatomic Pathology Selected Abstracts, 3/13

March 2013—Immunohistochemical assay versus Oncotype DX qRT-PCR assay for estrogen and progesterone receptors; accuracy and precision of endometrial intraepithelial neoplasia diagnosis; histologic patterns and molecular characteristics of lung adenocarcinoma; MicroRNA expression profiling as a diagnostic tool for thyroid cancer; inflammation and preneoplastic lesions in benign prostate as risk factors for prostate cancer; and reclassification of serous ovarian carcinoma using a two-tier system.

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