September 2013—Our clinicians are asking about testing for IgG4-related disease. What role does IgG4 immunohistochemical staining play? IgG4-related disease is a recently recognized fibroinflammatory condition that may affect a wide variety of organ systems, producing mass lesions and generally responding to immunosuppressive therapy. The pancreas, salivary/lacrimal glands, and kidney are frequently affected, but almost any tissue may be involved, including aorta, pleura, retroperitoneum, and lymph nodes.
Read More »September 2013
Newsbytes, 9/13
September 2013—Lab test data in the EMR: why what you see may not be reality: Blind faith is seldom the solution. And it’s definitely not the answer when it comes to accepting the capabilities of your hospital’s electronic medical record system.
Read More »Anatomic Pathology Selected Abstracts, 9/13
September 2013—Quantification of the Ki67 proliferative index in neuroendocrine tumors of the gastroenteropancreatic system; Clinicopathologic and immunohistochemical study of intrapulmonary SFTs; Papillary mucinous metaplasia of the endometrium as a precursor of endometrial mucinous adenocarcinoma; Expression of miRNAs and PTEN in endometrial specimens; Molecular investigation of lymph nodes in colon cancer patients using OSNA; Thymidylate synthase expression and molecular alterations in adenosquamous carcinoma of the lung; Microdensitometry of osteopontin as a prognostic biomarker in colorectal carcinoma tissue microarrays; Evaluation of pathological and molecular features in clinically aggressive dermatofibromas; Interobserver agreement in the reporting of colorectal polyp pathology by bowel cancer screening pathologists
Read More »Clinical Pathology Selected Abstracts, 9/13
September 2013—Routine coagulation testing for patients presenting to the ED with chest pain; Prospective comparison of curbside versus formal consultations; Primary prevention of cardiovascular disease with a Mediterranean diet; Quick study: a case of Gamma heavy chain disease
Read More »Cancelled lab tests—study analyzes why
September 2013—A handful, a fraction of a percent, a tiny portion. In most institutions, that’s about how many tests are cancelled after they’ve been ordered and a specimen has been sent to the laboratory. But even that small number can have significant quality implications. The authors of the Q-Probes study, ”Reasons for Test Cancellation,” looked at more than a million specimen accessions at several dozen institutions, to get a fix on why tests are being cancelled and to gain insight into how laboratories can bring that number down. As the study makes clear, there is definitely room for improvement.
Read More »Poor testing, dosing dog fetomaternal bleeds
September 2013—If Mark Brecher, MD, were compiling a greatest hits list of medical successes of the 20th century, there’s one advance he’d be sure to include: the introduction of Rh immune globulin in the late 1960s to prevent the Rh sensitization of Rh-negative mothers who deliver an Rh-positive baby.
Read More »ALK-positive NSCLC—patient’s story opens eyes
September 2013—For good or bad, Matthew Hiznay seems to be an odds beater. First, a minority of lung cancer patients have never smoked. He’s one of them, having been diagnosed with late-stage non-small-cell lung cancer in August 2011. Obviously, that’s the bad.
Read More »With molecular testing, better infection control
September 2013—Rapid and accurate molecular assays have gradually infiltrated the field of bacterial diagnosis. For several potentially lethal nosocomial pathogens—Clostridium difficile, vancomycin-resistant enterococcus, Mycobacterium tuberculosis, and methicillin-resistant Staphylococcus aureus—FDA-approved molecular assays are making a difference. Not only have they improved the accuracy of diagnosis, benefiting patients and clinicians, they have also been a boon to infection control practitioners.
Read More »For prenatal NGS labs, new accreditation requirements
September 2013—With the 2013 edition of the Laboratory Accreditation Program checklist, the College moves to a new level in its effort to ensure the highest-quality practices in clinical laboratories’ use of next-generation DNA sequencing.
Read More »AMP case report: aCGH as a diagnostic aid in a childhood Spitzoid melanoma
September 2013—CAP TODAY and the Association for Molecular Pathology have teamed up to bring molecular case reports to CAP TODAY readers. Here, this month, is the third such case. (See the February 2013 issue for the first, on multilocus sequencing for rapid identification of molds, and last month’s issue for the second, on the importance of screening for Lynch syndrome in patients with endometrial cancer.)
Read More »Letters, 9/13
We read with interest your article in the June issue, “To reduce UTIs, one lab takes a long, wide look.” We strongly agree that there is inappropriate prescribing of antibiotics for patients whose urine cultures are reported with organism identification and antibiotic susceptibilities but who do not have urinary tract infection. This is because many physicians send urine for culture inappropriately and then equate a positive result with infection; they believe that these laboratory tests are diagnostic for UTI.
Read More »A pathologist’s observations about in-office AP labs
September 2013—With the GAO reporting that self-referral of anatomic pathology and other services costs Medicare millions, and with legislation introduced Aug. 1 that would prohibit such self-referrals, physician groups are fighting back, arguing that the exemptions allow for more integrated care. Not so, says pathologist Matthew Foster, MD, who shared what he’s observed about in-office AP labs in an Aug. 8 CAP online panel discussion. He is with Pathology Consultants of Central Virginia, an independent lab that provides services to Centra Health, a nonprofit hospital system serving a community of about 350,000. He is also associate medical director of the Alan B. Pearson Regional Cancer Center in Lynchburg. Dr. Foster’s edited remarks follow.
Read More »From the President’s Desk: It’s our teammates who matter most
September 2013—Cross-country runners train for terrain and endurance. Downhill routes require biomechanical adaptations because the runners must anticipate and adjust for sudden rocks in the road or lack of traction. While there is time to plan around threats on an uphill route, threats to safety or stability in a downhill race may manifest too late for avoidance strategies. Agility matters.
Read More »MOC:PQRS incentive: what it is, how to earn it
September 2013—The Centers for Medicare and Medicaid Services has approved the American Board of Pathology for participation in the MOC:PQRS Additional Incentive Program. This approval allows ABP diplomates who are participating successfully in the PQRS incentive program to earn an additional 0.5 percent incentive payment on the total Medicare part B allowed charges for participating in MOC:PQRS in 2013.
Read More »Challenge and change in blood bank systems marketplace
September 2013—From future innovations to tighter regulations, seven users and marketers of blood bank software shared their perspectives on the blood bank systems marketplace with CAP TODAY. Here and on the following pages is what they told us. Beginning on page 20 is the 2013 guide to blood bank information systems.
Read More »Put It on the Board, 9/13
September 2013—FDA clears Vitek MS: BioMérieux has been granted FDA 510(k) de novo clearance for Vitek MS, the first clinical mass spectrometry MALDI-TOF-based system available in the U.S. for rapid identification of disease-causing bacteria and yeast. To gain FDA clearance, BioMérieux submitted data from a multi-center study consisting of 7,068 clinical isolates.
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