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Lung guideline goals: more tests, treatment

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.

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, in September 2017, they suspected they were in for a record flu season, says Sherry Childress, BSMT(ASCP), technical chief, molecular diagnostics and immunology.

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.

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.

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].”

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.”

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. It’s intended to be “kept close by and referenced frequently,” says Dr. Pritt, professor of laboratory medicine and pathology, director of the clinical parasitology laboratory, and co-director of the vector-borne disease laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minn. Here is more of what Dr. Pritt told us about the new atlas.

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.

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.

New HPV guideline for head, neck cancers

February 2018—Like a pair of one-size-fits-all jeans, testing all head and neck carcinomas for human papillomavirus may have seemed like a good idea at one time. In many cases, in fact, HPV testing is just what treating clinicians and patients need. On the other hand, not every head and neck case requires it. Now, a newly published CAP guideline should help physicians figure out the right fit in multiple settings.