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Latest TB testing guide set forth by ATS, CDC, IDSA

March 2017—Testing for latent Mycobacterium tuberculosis infection and active tuberculosis disease remained relatively unchanged for many years. Screening for latent infection depended on an initial positive tuberculin skin test, and evidence for active TB required a positive culture for M. tuberculosis complex. New tests altered this picture in the past five years. For diagnosis of latent infection, interferon-gamma release assays have taken a major role. And nucleic acid amplification testing is becoming a mainstay for establishing a diagnosis of TB.

Liver injury patterns: pitfalls and pointers

March 2017—Keep eyes wide open to everything and describe everything because there might be a number of different factors playing into a patient’s disease. That was the reminder Robert M. Najarian, MD, opened with last fall in his CAP16 presentation on common patterns of liver injury.

Dashboard eases performance analysis and prep

March 2017—Crystal Sands, MBA, MT(ASCP)SM, manager of quality, regulatory, and safety at NorDx Laboratories in Scarborough, Me., has a new favorite product, and she’s not shy about saying so. “Oh my gosh, I’ll be playing with it for a long time,” she says. “Every time I use it, I find different ways to slice and dice.”

In cancer sequencing, a new lingua franca

February 2017—NGS has taken its NBS, or next big step: a newly published joint consensus guideline on how to interpret and report sequence variants in cancer. With these 20 pages of best practices for making next-generation sequencing a regular part of cancer diagnostics, the field is moving, essentially, from frontier town to gated community.

Guidelines reset horizons of molecular testing in NSCLC

February 2017—It doesn’t happen often. But from time to time, says Gene Finley, MD, director of medical oncology at Allegheny Health Network in western Pennsylvania, a patient who is at death’s door will make such a dramatic recovery with therapy that clinicians refer to it as a “Lazarus effect.”

One bug or prix fixe? Respiratory pathogen testers weigh in

February 2017—With the number of rapid, accurate molecular assays for respiratory pathogens growing, microbiology laboratories have more options than ever. They include, among others, Meridian Bioscience’s Illumigene assays for group A Streptococcus and pertussis and its newest assay, Mycoplasma Direct, as well as Alere’s assays for influenza A/B, respiratory syncytial virus, and Streptococcus on its i molecular platform. No longer are laboratories limited to inaccurate rapid antigen tests, weeks-long culture, or multi-pathogen panels.

OIG warns against selective free labeling services

February 2017—A laboratory’s proposal to provide free labeling services to some of its dialysis center clients poses more than a minimal risk of fraud and abuse, according to an advisory opinion from the Office of Inspector General of the U.S. Department of Health and Human Services.

AMP v Myriad: driving or disrupting innovation?

February 2017—The Association for Molecular Pathology belongs to a small and exclusive club of plaintiffs on the winning side of a unanimous U.S. Supreme Court decision. Such a ruling was issued in 2013 in the case of AMP v Myriad Genetics, a suit sponsored by the American Civil Liberties Union with the AMP as lead plaintiff.

In AP systems marketplace, software comes and grows

February 2017—Software for anatomic pathology has evolved mightily since 1987, the year that CAP TODAY set sail on its maiden voyage as a monthly publication. During that year, HL7 was founded and the Co-Path system, then the flagship product of Collaborative Medical Systems, made a terrific splash on the small exhibit floor at the Palmer House Hotel in Chicago.

An unusual BRAF mutation in a patient with melanoma

February 2017—An activating BRAF mutation is found in 40 to 60 percent of melanoma patients. BRAF (B-Raf proto-oncogene) encodes a protein-kinase that activates the MAP kinase/ERK signaling pathway, a pathway that regulates cell differentiation, growth, and survival. Another protein, NRAS, normally activates BRAF. A mutated BRAF, however, can act independently of NRAS and skew cell activity toward growth and survival and away from differentiation.