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MLO Labline
    www.mlo-online.com February 2011     
Programmable Temperature controlled FISH Processing System

The StatSpin Thermobrite® automates the denaturation and hybridization steps in slide-based fluorescent in situ hybridization (F)ISH assays and reduces hands-on time while ensuring precision and +/- 1° accuracy.
Learn more: http://www.statspin.com/products_us/Thermobrite.php

NEW! CMS to scrap lab signature requirement
The Centers for Medicare and Medicaid Services (CMS) is expected to rescind its recent rule requiring a physician’s signature on requisitions for laboratory tests reimbursed under the Medicare clinical laboratory fee schedule. Visit here to learn more.

Are you determined to begin your bachelor’s degree in 2011?
If you’ve decided to go back to school in 2011, UC’s online bachelor’s degree in Clinical Laboratory Science is the ideal program to help you achieve your goal. With no required campus visits, our NAACLS accredited degree is designed for working CLT/MLTs like you who want to become a MLS/CLS/MT.
Download your free brochure today!

NEW! Syphilis test wrong in nearly one-fifth of cases
A Centers for Disease Control and Prevention (CDC) study indicates hundreds of people may have been misdiagnosed with syphilis. The CDC says a study of five U.S. labs from 2006 to 2010 shows about 18% of the positive results from reverse sequence screening were actually negative. Read the CDC report here.

More ways to improve efficiency
At Beckman Coulter, we understand the challenges of the lab and want to be your trusted partner. Learn how our customers' labs run better because we're working together. Visit http://beckmancoultermore.com/

NEW! Blood signatures diagnose respiratory infections
Coughing and wheezing patients could someday benefit from quicker, more accurate diagnosis, and treatment for respiratory infections with a simple blood test, according to scientists. A research team from Duke University Medical Center and the Duke Institute for Genome Sciences and Policy in Durham, NC, looked at the blood of individuals who had been exposed to rhinovirus, respiratory syncytial virus, or influenza. The team found each viral infection stimulated the body to produce a specific set of immune molecules that could be detected in the blood. Recording the distinct blood signatures for each virus in a database and matching them against blood samples from other ill patients pinpointed the cause of disease with more than 95% accuracy.

NEW! E coli may lead to cardiovascular or kidney disease
People who drink Escherichia coli-contaminated water and develop gastroenteritis increase their long-term risk of developing high blood pressure, heart disease, or kidney problems, according to a study published in the Nov. 17 issue of British Medical Journal. Researchers reviewed data compiled after an outbreak of gastroenteritis in May 2000 that was caused by E coli O157:H7 and Campylobacter in a municipal water system. Study participants were assessed annually. Of 1,977 adults, 1,067 (54%) experienced gastroenteritis. Compared with those who were not sick or only mildly sick during the outbreak, those who suffered acute gastroenteritis were 2.1 times more likely to later have a cardiovascular event, such as a heart attack or stroke; 1.3 times more likely to develop high blood pressure; and 3.4 times more likely to develop renal impairment.

NEW! Insurance company to study genetic testing
Aetna is funding a national study on the use, costs, and benefits of genetic tests for cancer risks. To be conducted by researchers from the University of South Florida in Tampa and Georgetown University in Washington, DC, the two-year study will explore patterns of how and for what groups of women the available genetic tests for BRCA1 and BRCA2 mutations are being used in community healthcare settings and whether significant disparities exist in the use of these tests among women of different socioeconomic, racial, and ethnic groups. The study also will examine the use of risk-reduction and screening services by patients following testing.

NEW! NOVIUS Lab named best in KLAS
KLAS has named Siemens NOVIUS Lab the recipient of its 2010 “Best in KLAS” award for laboratory information systems (LIS) for large hospitals (more than 200 beds). The annual award, the third for NOVIUS Lab in as many years, is given to a vendor or product that scores the highest in its industry segment and provides the broadest operational and clinical impact to healthcare organizations.

NEW! APIC calls for mandatory flu shots for healthcare workers
Responding to the low rates of influenza immunization among healthcare personnel nationwide, the Association for Professionals in Infection Control and Epidemiology (APIC) recommends mandatory influenza immunization as a condition of employment within healthcare facilities. In citing its stronger position, APIC acknowledged that the current policy of voluntary vaccination has not been effective and that healthcare personnel have not achieved acceptable vaccination rates. The recommendations are published in APIC’s position paper, “Influenza Vaccination Should Be a Condition of Employment for Healthcare Personnel, Unless Medically Contraindicated.”

NEW! Live and recorded conferences
Check out the latest learning tools offered by Dark Daily including “Resident education: Finding Your Perfect Pathology Job: How to Use Pathology 2.0 and Social Networking to Advance Your Career,” and “DarkDaily Audio Conference: Managed-Care Contracting: How to Ensure the New Healthcare Reforms Won’t Lower Your Lab’s Health Plan Reimbursements.” Go to www.darkdaily.com.

NEW! TearLab teams with COLA
COLA and TearLab have partnered to help make the TearLab Osmolarity System available in the U.S. at the point-of-care. In order to help make the test available through eye-care practitioners that do not currently operate with Moderate Complexity CLIA certifications, the company has partnered with COLA to provide doctors with a package of education, consulting, and accreditation services designed to allow them to meet CLIA standards and quality as a laboratory director for Moderate Complexity testing in their field.

February is International Prenatal Infection Prevention Month
According to the U.S. Centers for Disease Control and Prevention (CDC), Group B strep (GBS) is one of the most common life-threatening infections, and is still one of the leading causes of blood infection and meningitis in newborns. A more rapid laboratory test for pregnant women to detect GBS is being studied by researchers at the University of Texas Health Science Center at Houston (UTHealth) to cut down on the indiscriminate use of antibiotics in women whose GBS status is not immediately known when they arrive at the hospital to give birth. Initial results of the UTHealth study show that a new test by NanoLogix identifies GBS faster than the conventional methods. Read more here.

MLO online-only feature
Keeping up with allergy testing

Allergy-testing methods include blood tests, skin patch tests, skin injection, and the skin prick/scratch test. A survey of over 1,000 U.S. mothers indicated that while most moms (75%) know of the skin prick/scratch test, only one-third to one-half of mothers are familiar with the alternative options. Of these alternatives, blood tests (in vitro) measure the concentration of allergen-specific IgE (sIgE) in the circulation. Third-generation blood-allergy testing is now available, and physicians are using this convenient and accurate diagnostic tool as a complement to traditional skin-based testing options. Read more here.

Readers often remark that they love to “clip” various items from the print pages of MLO. And because MLO covers a myriad of laboratory-related topics, we share a continuing Labline feature: Hot Clips. Click on the highlighted words to discover various MLO archival properties concerning infectious diseases.

HIV infection and the advanced disease, acquired immunodeficiency syndrome (AIDS), remain leading causes of illness and death in the United States. In her February 2010 article, “HIV infection and nephropathy,” Shu-Ling L. Fan, PhD, D(ABCC), F(ACB), details the pathogenesis and states of infection, diagnosis, and HIV-associated nephropathy. As part of that cover story section, Cara Weibrod, PhD, writes about “The melting pot: new immigration guidelines affect TB testing.” She points out that surveillance and control of tuberculosis in foreign-born U.S. residents is still a major issue, as the United States remains the prime destination for immigrants worldwide.

In May 2010, “A year of H1N1 statistics” offered MLO readers the latest information on flu, and in July 2010, Karen Lynn put together another infectious-disease article on “Pandemic preparation: Lessons learned from H1N1.” She interviewed Susan M. Poutanen, MD, MPH, F(RCPC), microbiologist/infectious-disease consultant at the University Health Network and Mount Sinai Hospital, and assistant professor in the departments of Laboratory Medicine and Pathobiology (Microbiology) and Medicine (Infectious Diseases) at the University of Toronto, Ontario, Canada, who offered important suggestions to aid in preparing for a pandemic. Dr. Poutanen was part of the team working on the first SARS outbreak in Canada during the 2002-2003 season, and wrote about that experience in February 2007: “Do your biohazard, bioterror, and emergency planning NOW” (www.mlo-online/articles/0207/0207education.pdf).

In October 2010, “Tracking infectious disease” found Karen Lynn interviewing Jeffery K. Taubenberger, MD, PhD, chief, Viral Pathogenesis and Evolution Section, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health (NIH), Bethesda, MD. His group at NIH was, at that time, exclusively studying influenza viruses to include pandemic influenza virus strains, including the 1918 influenza, the 1957, 1968, and the 2009 influenza viruses, human seasonal influenza viruses, and influenza viruses from birds (avian influenza), swine, and horses.

Back in July 2008, Louise Townsend’s article on “Polls reveal MRSA controls” recounted results from APIC’s MRSA Prevalence Study, and was followed by a sampling of infectious-disease products. “Staffing and surveillance technology are the greatest enablers to maintaining an effective infection-prevention-and-control effort for MRSA and other multidrug-resistant organisms,” said APIC’s 2008 President.

Readers may want to scan MLO’s archives for more information on infectious diseases because any tips published might help your laboratory improve its performance when testing for any one of a number of infectious diseases

If there is a subject you would like to see in “HOT CLIPS,” just visit the CONTACT US section of our website, and let us know!

Common errors found in waived laboratories
COLA has published a white paper entitled “Federal Government Questions Quality in Waived Testing” and has called for increased education for Certificate of Waiver site personnel to ensure quality testing. COLA says evidence continues to mount that “significant quality problems exist in the largely unregulated labs relying on these tests … with the potential to contribute to errors and even patient harm.” Problems cited at the more than 125,000 waived-testing sites in the U.S. include:

  • more than 20% do not routinely check product inserts or instructions for changes to the information;
  • more than 20% do not perform Quality Control testing as specified by manufacturers’ instructions; and
  • nearly half do not document the name, lot number, and expiration dates for tests performed.
For a copy of the COLA white paper on waived testing, go to www.cola.org/waived.html.

Post-event conferences added to Executive War College
Executive War College, May 3-4, New Orleans, has added optional post-event day conferences for Thursday, May 5.

  • LEAN for Lab Leaders - achieving mastery with concepts implementation and outcomes;
  • Mergers and Acquisitions of Pathology and Clinical Laboratories - the complete laboratory mergers and acquisitions resource for lab buyers, sellers, investors and financiers;
  • “Best Practices” in Hospital Laboratory Outreach - secrets to optimizing growth in specimen volume revenue, profits and service; and
  • Identify, Cultivate, and Develop Your Lab's Untapped Top Management Talent - techniques to turbocharge every manager’s performance in your lab.
Learn more at www.executivewarcollege.com.

Genetic testing for Lynch Syndrome cost effective
Widespread genetic testing for Lynch Syndrome appears to be a cost-effective strategy for identifying those at risk for colorectal and endometrial cancer, according to a report in Cancer Prevention Research. Researchers used a mathematical model that showed when risk, based on family history, was assessed starting at ages 25, 30, or 35, followed by genetic testing for those who had risk exceeding 5%, colorectal cancers could be reduced by 12.4% and endometrial cancers by 8.8% . The average cost-effectiveness ratio, a measure of expenditure-per-life-year gained by the new strategy would be $26,000, a value below the often-quoted benchmark of $50,000.

Study suggests screening for MRSA in the nose
A new study finds that people with high levels of methicillin-resistant Staphylococcus aureus (MRSA) bacteria in the nose are more likely to have other areas of the body colonized by MRSA. Researchers at Rhode Island Hospital found that MRSA was more likely to be found in the nose than under the arms, the groin, or the perineum. They also determined that people with high levels of MRSA in the nose were more likely to have MRSA in the other three locations. The study was released Jan. 5 in the online version of the Journal of Clinical Microbiology.

New LDT for subtyping breast cancer
ARUP Laboratories offers a new laboratory developed test designed to classify breast cancer into clinically significant molecular subtypes that are important for the management of the disease. The new test is a RT-qPCR assay that measures the expression of 50 classifier genes and five control genes to identify the intrinsic subtypes known as Luminal A, Luminal B, HER2-enriched and Basal-like. Along with a categorical classification of breast cancer subtype, it also provides quantitative values for proliferation, luminal gene expression, ESR1, PGR and ERBB2. The test is listed in ARUP Laboratories' Laboratory Test Directory (LTD) as the PAM50 Breast Cancer Intrinsic Classifier.

Got a management problem?
Send us your most puzzling problems on management, from dealing with budget cuts to cranky employees or bosses. Contact our Management Q&A editor, Anne Pontius, at manqa@mlo-online.com.

LifeScan glucose meter update
The recent announcement regarding LifeScan’s decision to leave the hospital glucose-testing market does not impact TELCOR customers using the Quick-Linc/QML system or interface to the laboratory information system. TELCOR is a point-of-care middleware vendor with connections to all of the glucose-testing vendors (e.g., Abbott, Hemocue, LifeScan, Nova, Roche) and will work with LifeScan customers to make a smooth transition to a new glucose-testing provider.

“Take Center Stage” in Lab Week video contest
ASCP is holding an online video contest designed to encourage laboratory teams to “Take Center Stage” and showcase the important role they play every day. Lab teams are invited to submit short, original videos (up to four minutes long) that demonstrate the ways they go above and beyond their day-to-day responsibilities to achieve extraordinary goals or to provide outstanding levels of customer service. Videos will be posted online, and voting will take place at the ASCP Facebook page (www.facebook.com/ASCP.Chicago) from March 5-11. Visitors to the Facebook page will be able to vote by clicking “like” for as many videos as they wish (only one “like” per video). Video entries can be submitted through March 1 at www.labweekvideo.com. Learn more at www.ascp.org/labweek.

Enter CLMA’s Lab Week contest
In preparation for National Medical Laboratory Professionals Week (NMLPW), April 24-30, share your ideas and get the chance to win prizes from CLMA. Share your celebration ideas on the NMLPW Forum and check out National Medical Laboratory Professionals Week on the CLMA website for contest details.

COLA honors Hoverman with Excellence in Medicine Award
Isabel Hoverman, MD, M(ACP), the 2011 Chair of The Joint Commission’s Board of Commissioners, is the 2010 recipient of COLA’s Perry A. Lambird Memorial Excellence in Medicine Award, which is bestowed annually on a healthcare-industry professional who exemplifies the values and ideals of Dr. Lambird, a COLA founder and leader who was dedicated to improving the quality of laboratory testing. A board-certified internist in private practice in Austin, TX, Hoverman is a member of the Board of Regents of the American College of Physicians and is currently on the Board of Directors and treasurer of the American College of Physicians Foundation. She also is a member of the State Review Program Committee of the Texas Medical Foundation, the Quality Improvement Organization for Texas.

Psyche’s AP system ranked top in KLAS
Psyche Systems’ WindoPath anatomic-pathology (AP) information system ranked No. 1 among all AP-software solutions surveyed, according to the 2010 Top 20 Best in KLAS Awards: Software and Professional Services report published in December 2010. WindoPath’s rating was 86.5 in Anatomic Pathology.

iPhone app tests for hematology competency

Learn the basics of cell morphology with CellaVision’s new iPhone application CellAtlas — an educational tool to assist in the recognition and classification of blood cells. The application contains mini-lectures by experts in hematology and offers access to high-resolution classified cell images with written descriptions. The application includes CellQuiz, a game to test cell-morphology skills by matching cell class to the right cell image. The CellAtlas application is available on iTunes.

Got a testing problem?
Send us your most vexing problems on test methods, validation, reporting procedures, ornery instruments, and other technical questions. Contact our TIPS editor, Brad Karon, MD, PhD, at tips@mlo-online.com.

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ASCP-CAP-ASCO to help Tanzania hospital diagnose diseases
Three U.S.-based healthcare non-profits — the American Society for Clinical Pathology (ASCP), College of American Pathologists (CAP), and American Society of Clinical Oncology (ASCO) — have joined forces to provide financial and expertise support for the provision of telepathology equipment to a hospital in Karatu, Tanzania, built by the Foundation for African Medicine and Education, or FAME. Fewer than 10 pathologists serve 42.5 million people in Tanzania, which limits the ability of doctors there to properly diagnose their patients’ diseases. Medical care of all types is in short supply with one doctor per 25,000 persons in Tanzania. The incidence of cancer, especially cervical and breast cancer, has escalated, with approximately 35,000 new cases per year, and is one of the highest rates in Africa. The equipment allowing U.S. pathologists to help diagnose diseases correctly and at an earlier stage will be used to support an African cancer-support site at the hospital in Karatu.

Chikungunya virus heads to Australia
The mosquito-borne disease Chikungunya has been diagnosed in travelers entering Australia from countries where the disease is prevalent such as Africa, Indian Ocean island nations, the Indian subcontinent, and South-East Asia, according to The Cairns Post. While locally acquired Chikungunya has not yet been detected in Australia, mosquitoes capable of transmitting the virus — Asian tiger mosquitoes — do occur in the Torres Strait and Papua New Guinea. A Griffith University virologist says Australia’s closeness to countries where the disease was endemic means it is highly likely the disease will spread to Australia.

Dominican Republic reports first cholera death
The Ministry of Health of the Dominican Republic on Jan. 23 confirmed the first death of cholera in the country and explained that the man was from Haiti but had lived for years in the Dominican town of Higuey. In early January, the Dominican Republic had recorded 152 cases of cholera, a disease that came to this country from neighboring Haiti, which has killed nearly 4,000 people. Since the first outbreak of the epidemic in Haiti, 194,000 people have officially been infected by cholera in that country. Dominican Republic and Haiti share the island of Hispaniola, separated by a 376-km porous border. The Dominican authorities have increased immigration controls in recent months to prevent the spread of the epidemic in their country.

New MRSA strain in Isle of Man
Isle of Man health officials said they have discovered a new strain of the MRSA bacterium, called MRSA USA 300, on the island. The strain mostly affects young, fit and healthy people, is transmitted in sports centers, gyms, and pools, and can cause serious infection, the department of health says.

Got a legal issue?
Robert E. Mazer, along with his legal team from Ober|Kaler, addresses a variety of topics that concern clinical labs each month in "Liability and the lab."


Donations build AACC scholarship fund
With a generous donation from Gopal Savjani to AACC’s Van Slyke Foundation, AACC created the Past-Presidents’ Scholarship program, funding post-doctoral trainees in laboratory medicine since 1996. Laura Bender, University of North Carolina at Chapel Hill, is the 2010 recipient the scholarship. Learn more about the awards, recipients, and how to apply or donate at

BD sponsors educational workshops
The BD INFORM Education Series features a variety of speakers who present topics on infectious diseases. In addition, the workshops offer hands-on experience working with the latest technologies for blood culture, identification and antibiotic susceptibility testing (ID/AST), and healthcare-associated infection (HAI) testing. Upcoming workshops take place in West Conshohocken, PA; Davie, FL; Ontario, Canada; Seattle, WA; and Indianapolis, IN. Learn more at www.bd.com/ds/learningCenter/events/index.asp.

APIC offers HAI training in Texas
The Association for Professionals in Infection Control and Epidemiology (APIC) has been selected by the Texas Department of State Health Services (DSHS) to provide free training courses for Texas healthcare professionals on the use of the National Healthcare Safety Network (NHSN). DSHS awarded APIC with a grant to provide trainings in 15 different locations across the state from December 2010 to April 2011. The NHSN is the Centers for Disease Control and Prevention’s (CDC) online HAI-surveillance system. New requirements from the Centers for Medicare and Medicaid Services, as well as Texas state regulations, have increased HAI reporting requirements for healthcare facilities. APIC’s courses will educate healthcare professionals on the proper entry and tracking of HAIs in NHSN in order to fully comply with new requirements. For more information on the NHSN training courses, visit www.apic.org/TexasNHSN.


The 2011 MLO Media Handbook is now online at www.mlo-online.com.

“The cloning of humans is on most of the lists of things to worry about from Science, Along with behaviour control, genetic engineering, transplanted heads, Computer poetry, and the unrestrained growth of plastic flowers. ”
—Lewis Thomas (1913-1993)

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