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2014 Issues

32 analyzers in focus, from menu to special features

December 2014—Two new analyzers and a new workcell automation solution are in this year’s product guide to hematology analyzers. Sysmex’s newest offering is its XN-1000 R Automated Hematology Analyzer, an entry-level XN system for laboratories that run fewer than 100 CBCs per day.

Anemia: classification challenge and clinical questions

December 2014—Anemia is in the eye of the classifier. While that’s not as elegant as the “beauty-beholder” saying, it’s much more important. To be able to effectively treat and diagnose anemia, “You have to know what is causing the decrease in red cells,” said Sherrie Perkins, MD, PhD, speaking at an AACC workshop this year. There are plenty of definitions to choose from, said Dr. Perkins, of the University of Utah/ARUP Laboratories, Salt Lake City. At the most basic level, she noted, anemia is a pathologic condition marked by a reduced capacity of blood to transport and deliver adequate oxygen to tissues. In short, anemia is a manifestation of disease, not a disease itself.

Amid Ebola preparation, an EV-D68 outbreak

December 2014—In addition to preparing for Ebola patients, many clinical laboratories and hospitals in recent months faced outbreaks of respiratory illness caused by enterovirus D68 among children. “EV-D68 infections may be associated with severe acute respiratory illness, viral pneumonia, and severe reactive airway disease,” says Susan Novak, PhD, D(ABMM), director of microbiology at Kaiser Permanente Regional Reference Laboratories in Southern California. Focal limb weakness has also been reported as possibly related to EV-D68, she adds.

Study: elevated vancomycin MICs no cause for concern

December 2014—Elevated vancomycin minimum inhibitory concentrations do not increase the risk of death in patients with Staphylococcus aureus bacteremia, according to the findings of a comprehensive meta-analysis published in the Oct. 9 issue of JAMA. Despite widespread speculation about rising vancomycin resistance, or “MIC creep,” the authors find little evidence to challenge the current CLSI susceptibility breakpoint of ≤ 2 µg/mL for vancomycin.

From the President’s Desk: Are we there yet?, 12/14

December 2014—At this time of year, when we are inclined to reminisce, I often recall holiday travel with small children. I mention this to explain my headline—an existential question also relevant to our work at the CAP. When those around the table begin to debate a point (say, for example, during a CAP Board of Governors meeting), I sometimes recall voices. I suspect that’s true for many of us.

Massive transfusion: a question of timing, detail, a golden ratio

December 2014—Here it was, the kind of massive postpartum hemorrhage case for which the team at Duke University Medical Center had spent months preparing. The multidisciplinary group had agreed on which laboratory tests would be done in such a case, determined which blood products would be delivered, and decided which members of the OB team would be sent racing to retrieve the potentially life-saving package.

Biorepository book helps programs follow guidelines

December 2014—Securing financial support and setting up a quality management program are two of the biggest challenges to creating a successful biospecimen repository, says Nilsa C. Ramirez, MD, director of the Biopathology Center of the Research Institute at Nationwide Children’s Hospital in Columbus, Ohio.

Standardization of biospecimen collection using biospecimen kits

December 2014—A widespread concern in the collection of biospecimens is the degree of variation in the collection procedures. Standardization of biospecimen collection kits is an effective way to ensure greater consistency in biospecimen collection. These kits often contain all the materials necessary to properly collect, preserve, and ship biospecimens to the biorepository.

From tumor board, an integrated diagnostic report

December 2014—The handling of molecular information bears a certain resemblance to Wall Street’s bundling of mortgages in recent years. You can slice ’em, dice ’em, and repackage them in all sorts of ways. In medicine, however, this is being done—one would hope—without the ensuing meltdown. The goal is to shape personalized medicine, using the results of next-generation sequencing and other technologies to evaluate genetic information ranging from single gene to whole exome or whole genome, with proteomics possibly not too far behind.

Molecular Pathology Selected Abstracts, 12/14

December 2014—Overcoming limitations in the sequencing of whole viral genomes: The identification and analysis of pathogenic viruses, especially the Ebola virus, has recently received significant attention. The sequencing of newly identified viral genomes has presented historical challenges as existing technology fails to capture the 3’ and 5’ terminal ends of the viral genome.