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May 2015

Pharma strives to aid companion diagnostics

May 2015—M. Elizabeth H. Hammond, MD, is no mind reader. But approach her at a conference or meeting, and she has a pretty good idea what you’re going to ask her. “I was the chair for the 2007 and 2013 ASCO-CAP HER2 guideline, and since that time, the most common question I get from individuals is, ‘How do you know the guideline is making any difference?’” says Dr. Hammond, who is a professor of pathology and adjunct professor of internal medicine at the University of Utah School of Medicine and a consulting pathologist, Intermountain Healthcare.

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MALDI in microbiology: Set to stun?

May 2015—In the business world, the term “disruptive innovation” is hot. In product launches, business plans, and job resumes, it’s become a standard part of the pitch. Like the flux capacitor in the fictional DeLorean time machine, disruptive innovations vault a field past traditional barriers and obstacles, outstripping rival technologies.

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At CAP ’15, 98 courses and a focus on daily practice

May 2015—With several dozen pathology associations worldwide, many with their own meetings, why should a pathologist opt to attend CAP ’15 in Nashville, Tenn., Oct. 4–7? Philip Cagle, MD, supplies some thoughts. “There are many pathology organizations, and each has its own niche. Whereas at the CAP meeting, there are many courses covering a broad range of areas, from things such as practice management and quality assurance to different areas of anatomic pathology and clinical pathology,” says Dr. Cagle, ...

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Letters, 5/15

May 2015—Speech recognition: I found the article on speech recognition to be well reported and interesting (“Hear me now? Another audition for speech recognition,” March 2015). We implemented speech recognition at NorthShore University HealthSystem (as your writer reported) before I retired as director of the clinical pathology division. What William Watkin, MD, said in the article about our smooth implementation was so true.

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Labs solve price, space squeeze to welcome TLA

May 2015—After several years of watching their European counterparts have all the fun, a handful of American microbiology laboratories are going live with systems touted as providing total automation of diagnostic bacteriology. The systems automate how specimens are barcoded, plated, and inoculated, then move the plates on a track to an incubator, photograph them at a preset incubation time, discard or keep the plates as appropriate, and offer up the digital images for interpretation by medical technologists viewing them on computer screens.

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Aptima HPV and Aptima genotype assays for triage of borderline squamous (ASCUS) cytology: CLEAR study

May 2015—The characterization of the HPV genome and development of techniques that have the ability to detect nucleic acids in cytologic specimens has had a major impact on patient management. The Hybrid Capture 2 High-Risk HPV DNA Test, or HC2 (Qiagen, Gaithersburg, Md.), which uses probes designed to target the entire HPV genome, was cleared by the FDA in 1996. It was soon realized that determination of clinical sensitivity and specificity was essential to fully characterize assay performance and understand and classify correlation with cervical disease.

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Cytopathology + More | Latest guidelines for pancreatobiliary cytology—a recap

May 2015—Pancreatobiliary malignancy currently accounts for about three percent of all cancer cases and six to seven percent of all cancer deaths, making it the fourth leading cause of death in the U.S. Between 2006 and 2010 the incidence rate of pancreatic cancer increased by 1.3 percent per year and the death rate increased by 0.4 percent per year.1 The incidence of pancreatic cancer has tripled since the 1920s, likely secondary to an aging population, improved disease reporting, and possibly due to increased environmental mutagens2 such as smoking.

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Cytopathology and More | Negative Pap, positive hrHPV: what we know so far

May 2015—Cervical cancer is the second most common cancer in women worldwide, and high-risk human papillomavirus (hrHPV) is considered the principal causative factor in the development of most cervical cancer and its precursor lesions. For this reason, screening algorithms that include testing for hrHPV are part of the new cervical cancer screening guidelines set forth by the American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology.

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Cytopathology and More | Inside the 2014 Bethesda System for Reporting Cervical Cytology

May 2015—The value of standardized terminology for reporting cytology and histopathologyhas been essential in our work and important for patient care. The Bethesda System for Reporting Cervical Cytology, put forward in 1988 thanks to the pioneering work of Diane Solomon, MD, and Robert Kurman, MD,1 saw unprecedented adoption around the world. The Bethesda System, or TBS, led to a number of significant downstream events ...

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Q&A column, 5/15

May 2015—Q. I am a pathologist practicing in a small community hospital. I was involved with a patient who was declared brain-dead and subsequently designated a donor of multiple organs. The organ procurement agency ordered additional testing during the two days before the organ harvest, including a CT scan of the chest. The latter revealed a solitary pulmonary nodule.

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Anatomic Pathology Selected Abstracts, 5/15

Editors: Michael Cibull, MD, professor emeritus, University of Kentucky College of Medicine, Lexington; Rouzan Karabakhtsian, MD, attending pathologist, Department of Pathology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Thomas Cibull, MD, dermatopathologist, Evanston Hospital, NorthShore University HealthSystem, Evanston, Ill.; and Rachel Stewart, DO, resident physician, Department of Pathology and Laboratory Medicine, University of Kentucky. Molecular detection of ...

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Clinical Pathology Selected Abstracts, 5/15

May 2015—Use of hemoglobin content of reticulocytes to evaluate anemia in cancer patients: Evaluating iron-deficiency anemia in patients with cancer is difficult. Malignancy is frequently associated with anemia of chronic disease. However, it is important to distinguish iron-deficiency anemia due to inadequate iron stores from anemia of chronic disease due to decreased iron availability with abundant stores. Advanced reticulocyte indices, such as the cellular hemoglobin content of reticulocytes, named CHr and RET-He, are reportable parameters on newer automated hematology analyzers.

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Molecular Pathology Selected Abstracts, 5/15

May 2015—Clinical and molecular effects of order of acquired mutations in myeloproliferative neoplasms: Cancers arise and evolve from the accumulation of somatic mutations. With the addition of each mutation, tumor subclones are selected for biologic attributes that increase growth and proliferation potential. However, the authors hypothesized that it may not only be the presence of the mutations that affects these attributes but also the order in which the mutations arise, since their interactions and resulting environment likely play a key role in the development of subsequent genetic events and the tumor’s neoplastic behavior.

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Newsbytes, 5/15

May 2015—A lab IT strategic plan: from guidance to lessons learned: For those with even the slightest bit of health care business acumen, it should come as no surprise that when health systems expand quickly through mergers and acquisitions, hospital labs often struggle to communicate and cooperate with their counterparts at far-flung sister sites. Faced with such a challenge, the lab at the rapidly growing Geisinger Health System embraced a solution.

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