March 2018—Among the many never-ending chores that humans undertake—paying bills, filing taxes, flossing—writing medical guidelines can seem like an especially perpetual task. Just ask the architects of an updated document on molecular testing for lung cancer, issued by the CAP, the International Association for the Study of Lung Cancer, and the Association for Molecular Pathology.
Read More »March 2018
Labs take stock of surprising flu season
March 2018—In a severe flu season that started early, laboratories faced unprecedented test volumes, used new testing platforms, and negotiated vendor supply shortages. When laboratory staff at Arkansas Children’s Hospital in Little Rock began seeing a rising number of requests for respiratory tests, and five positive flu results,
Read More »Puzzling out the positive shift in the final 14-day rule
March 2018—When the CMS’ new 14-day rule took effect Jan. 1, conditions for laboratories doing outpatient reference testing might have changed for the better. But for labs navigating the new billing regulations, some forecasters are predicting confused seas ahead. “We’ve been reaching out to a number of our customers who I know will be affected by this and saying ‘What’s your take?’ and together just putting our heads around what it really means. But there is still quite a bit of confusion out there,” says Kurt Matthes, vice president, reengineering and service, at revenue cycle management software provider Telcor.
Read More »Inflammatory biomarkers foreshadow CKD, study finds
March 2018—The central idea of the film Minority Report—that a “precrime” police unit can predict and prevent crimes—still mostly inhabits the realm of science fiction. Luckily, in medicine, researchers studying “predisease” can make headway on prevention by analyzing the laboratory test results from samples collected years earlier, when patients showed no clinical symptoms, that might have been able to predict disorders such as chronic kidney disease (CKD) in those patients.
Read More »From the President’s Desk: A warm welcome around the world
March 2018—I was just out of training and still getting my bearings when I learned that the new partner in our group was expected to manage CAP Laboratory Accreditation Program inspections. Today I think that is a good idea, but back then I was nervous. I had done several CAP inspections as a resident. But did I know enough to get a laboratory through one?
Read More »Why carbapenemase-producing CRE raise the bar
March 2018—When Stephen Brecher, PhD, compares MRSA to carbapenem-resistant Enterobacteriaceae, the figures of speech come fast and furious. “We are not in Kansas anymore,” he said. “The bar has been raised. I consider MRSA a picnic compared to CP-CRE [carbapenemase-producing CRE].”
Read More »Pros and cons of carbapenemase detection tests
March 2018—When it comes to diagnostic tests, everyone wants the same thing Lars Westblade, PhD, wants: A unicorn. “The diagnostic performance of a test is reflected in its sensitivity and specificity,” Dr. Westblade said. “It has to be a very good test. And then we need to think about the speed of the test.” There’s also the cost. When all these factors come together just so, “we get what’s called diagnostic perfection,” he says, or the rare event that Brandi Limbago, PhD, of the CDC calls “a diagnostic unicorn.”
Read More »For AP signout: infectious diseases pathology atlas
March 2018—New from CAP Press this month is the Atlas of Fundamental Infectious Diseases Histopathology: A Guide for Daily Practice, edited by Bobbi S. Pritt, MD, MSc, DTM&H. It covers bacterial, viral, fungal, and parasitic infections and contains more than 800 images.
Read More »Gene testing moves cardiomyopathy analysis forward
March 2018—From phenotype to genotype in the understanding and diagnosis of cardiovascular disease—that was the medical journey on which Joseph Maleszewski, MD, and Birgit Funke, PhD, took attendees at a symposium at the November 2017 meeting of the Association for Molecular Pathology.
Read More »Clinical Pathology Abstracts, 3/18
March 2018—Web platform vs. genetic counselor for releasing carrier results from exome sequencing: Genomics can be used to generate a large amount of data that may have important implications for clinical care and selection of therapeutics. However, a bottleneck exists in clinical genomics due to the large volume of results and the lack of availability of knowledgeable professionals to return them to patients in person.
Read More »Anatomic Pathology Abstracts, 3/18
March 2018—Magee equation 3 for predicting response to chemotherapy in some breast tumors: Magee equations were derived as an inexpensive, rapid alternative to the Oncotype DX commercial assay. Magee equation 3 uses immunohistochemical and FISH data for estrogen receptor (ER), progesterone receptor (PR), HER2, and Ki-67 for its calculation: 24.30812+ERIHC×(–.02177)+PRIHC×(−0.02884)+(0 for HER2 negative, 1.46495 for equivocal, 12.75525 for HER2 positive)+Ki-67×0.18649.
Read More »Molecular Pathology Abstracts, 3/18
March 2018—Nonendoscopic detection of Barrett’s esophagus using DNA methylation biomarkers: Esophageal adenocarcinoma is an aggressive disease, with a less than 20 percent five-year survival rate, and its incidence is rapidly increasing. Early detection of esophageal adenocarcinoma or its precursor lesion, Barrett’s esophagus, would enable more effective treatment strategies and a greater chance of cure.
Read More »Newsbytes, 3/18
March 2018—How hospitals use savvy and software as a phishing net: We all know we shouldn’t click on suspicious emails, but suppose you see an email from your department of human resources with an attached document about a new dress code. You open it, thinking “What new dress code?” And now you’ve infected the hospital’s computer system with a virus.
Read More »Q&A column, 3/18
March 2018—Our pathology group has an unusual case of residual squamous cell carcinoma of the lung in a lobectomy specimen after chemotherapy. The lung shows a hilar scar (1.7 cm) involving the lung parenchyma and the peribronchial adipose tissue. In the scar there is residual carcinoma (0.4 cm) that focally is involving the peribronchiolar adipose tissue around the lobar bronchus. The focus is located at 0.3 cm of the final surgical resection margin of the bronchus. Because the tumor involves peribronchiolar adipose tissue, is it considered outside the lung (extension outside the lung)? Since the tumor is in the mediastinal fat around the bronchi and had to invade the viscera pleura to invade the peribronchial adipose tissue, would the tumor stage be ypT2a? Or T3 since it is invading part of the mediastinal fat? Or should it be pT1?
Read More »Put It on the Board, 3/18
March 2018—AMP issues recommendations for clinical CYP2C19 genotyping allele selection: To promote standardized testing across laboratories, the Association for Molecular Pathology published on Feb. 27 consensus, evidence-based recommendations for designing and validating clinical CYP2C19 assays.
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