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December 2015

For pathologists, 8% aggregate hike in Medicare pay

December 2015—The final Medicare physician fee schedule for 2016 delivered on the Centers for Medicare and Medicaid Services’ July proposal of an overall increase in payment for pathologists and independent laboratories. The agency also fulfilled some pathologists’ fears by cutting payments for prostate biopsy services by 19 percent for the technical component and 18 percent for the global payment.

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Clinical Pathology Abstracts, 12/15

December 2015—Optimizing transfusion ratios in massive transfusion protocols: The 1:1:1 ratio of packed red blood cells to plasma to platelet use for massive transfusion emerged out of data on mortality in military personnel wounded in combat. Many studies have investigated the optimal ratio for use in massive transfusion. The literature is controversial, and studies continue to support and refute the 1:1:1 ratio.

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Anatomic Pathology Abstracts, 12/15

December 2015—Reappraisal of etiologic field effect in cancer predisposition and progression: The term field effect, which is also known as field defect, field cancerization, and field carcinogenesis, has been used to describe a field of cellular and molecular alteration that predisposes to the development of neoplasms within that territory.

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Newsbytes, 12/15

December 2015—Fellowship blends clinical informatics and pathology: Ask Rebecca Johnson, MD, and her colleague Bruce Levy, MD, about a newly approved fellowship program that allows fellows to train concurrently in clinical informatics and any other of the pathology subspecialties, and they’ll give you a similar answer: This has been in the works for a long time.

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Prostate biopsy’s role in active surveillance

December 2015—As a treatment option, a strategy of active surveillance is becoming more widely accepted for early stage prostate cancer where risk of progression is low. But the new emphasis on active surveillance brings increased anxiety among prostate cancer patients about the information they’re getting from their physicians and how to deal with it. When M. Elizabeth H. Hammond, MD, participated four years ago in an open dialogue with prostate cancer patients at a conference on active surveillance, “I was really rocked by the things I heard,” she said. “The patients were angry and frustrated by our telling them active surveillance is a good treatment option.

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Latest HbA1c debate examines race as nonglycemic factor

December 2015—In 2010, the American Diabetes Association endorsed the use of hemoglobin A1c to diagnose type 2 diabetes, and fierce arguments over the wisdom of that move have ensued ever since. A 2013 debate at the American Association for Clinical Chemistry’s annual meeting featured a spirited dialogue on the merits of using HbA1c as a diagnostic marker, compared with the traditional—and still ADA-recommended—alternatives, fasting plasma glucose and two-hour plasma glucose.

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Guide to urinalysis instrumentation

December 2015—Not everyone shares Lauren Foohey’s idea of a good time, and she knows it. “Performing urine sediment analysis under a microscope—I thought it was fun,” Foohey says with a laugh. She spent 10 years in the laboratory before ultimately becoming senior director of global marketing for point-of-care urinalysis and diabetes at Siemens Healthcare, Point of Care Diagnostics.

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A step-by-step process to 95% autoverification

December 2015—Many laboratories have yet to reap the benefits of autoverification even though there is clear evidence of its benefits. During a recent internal study at Labsco, we discovered that more than 70 percent of our customers have not yet implemented AV. Of the customers who did perform AV, the highest percentage seen was about 60 percent (primarily in hematology and coagulation).

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Multiplex PCR test for detection of enteropathogens in an infant

December 2015—Clostridium difficile is an anaerobic spore-forming, Gram-positive bacteria transmitted by the fecal-oral route. The virulence of Clostridium difficile is primarily conferred from two toxins, A and B. Disruption of the normal gut flora, typically from intake of antimicrobials, allows Clostridium difficile to proliferate, causing a broad spectrum of clinical symptoms from asymptomatic colonization to colitis, a spectrum of diarrhea severity, and a protracted course of disease.

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