News
Lab researcher contracts Zika virus from infected needle stick
A lab researcher at the University of Pittsburgh has contracted the Zika virus after accidentally piercing herself with an infected needle during an experiment.
The case is believed to be the United States' first Zika infection acquired in this manner as announced by university officials and the Allegheny County Health Department. The incident occurred on May 23 and the unidentified female lab researcher developed Zika infection symptoms on June 1. On June 6, the woman's fever had gone and she resumed work immediately. By June 8, the university discovered that the woman's blood sample tested positive for Zika virus. Free of fever, the researcher returned to work and is following advice to wear long sleeves and pants and wear insect repellent for three weeks after the date of the needle stick, to prevent possible mosquito exposure to the virus.
Related Article: Zika in 30 seconds: What you need to know
Direct-to-consumer clinical lab testing won't kill us -- It will make us stronger
Do direct-to-consumer blood tests pose a threat to consumers, patients and physicians? It could go either way if you believe "Direct-to-Consumer (DTC) Lab Tests, No Doctor Required," a recent, New York Times article.
Critics highlight the wide variances in the "healthy" levels of blood biomarkers. Making patients aware of their own values will certainly lead to doctor visits and occasional false alarms. However, the author argues that companies include disclaimers on their sites and advise patients to consult physicians about any concerning results.
Another complaint about DTC tests has to do with regulation. As laboratory tests are not typically regulated by FDA, and because the current regulatory regime is not monitoring the effectiveness of tests but just whether they are administered in a way that does not cause harm, lab testing can be something of a self-regulated "Wild West".
What the critical commentators do not seem to understand is that DTC lab test companies are not exactly entering a saturated market for delivering customers’ own health information to them. Indeed, more than ever before, there is both low supply and large demand for informative and actionable health data. What makes this situation so promising for the DTC companies works on three levels: the consumer, the population and the data.
Continue reading the article to see this unique perspective on DTCs.
Clinical Chemistry
Glucose Proficiency Testing (PT) criteria reset stirs standards debate
Resetting standards is a long-established means of improving quality of testing, and it can also be a way of adapting to improvements in quality that have already been realized. In the case of the College of American Pathologists’ (CAP) recent tightening of proficiency testing criteria for hospital glucose testing, both purposes are at work.
The new criteria reflect the fact that glucose meter performance has improved significantly, CAP Chemistry Resource Committee chair Gary L. Horowitz, MD, explains in the 2016 Program Update on Glucose Meter Performance. However, the change in survey criteria has brought unexpected push back from one of the leading hospital glucose meter manufacturers.
The cutoff for passing was changed from within 20% of the peer group mean to within 12.5%. Nova Biomedical believes the tightened PT criteria are not suitable for its Nova StatStrip Glucose Hospital Meter systems. Limitations of the PT materials may cause properly working StatStrip meters to falsely fail or improperly working StatStrip meters to falsely pass, in a small number of cases. In a March 2016 bulletin, the company expressed the belief that the API survey’s grading criteria are more appropriate than the CAP’s stricter grading criteria for use with artificial matrix materials.
Continuing reading the article to determine which side of the fence you sit on.
Using Biomarkers to Evaluate Traumatic Brain Injury
Traumatic brain injury (TBI) diagnosis is reliant on evaluations of clinical symptoms and advanced brain imaging. Mild TBIs rarely cause evident pathology that are easily detectable with conventional imaging but often induce damage to the blood-brain barrier (BBB), selective swelling, stretching, breakage and disconnection of white matter axons, and neuroinflammation. What laboratory assays for TBI biomarkers have clinical potential?
Cerebrospinal fluid (CSF) : serum albumin ratio is a biomarker of BBB integrity. However, in a high percentage of individuals with TBI, BBB remains intact, thus limiting the utility of the biomarker.
The concentration of tau protein in CSF correlates with the severity of the injury. However, total tau protein enzyme-linked immunosorbent assays (ELISAs) are only available in some reference laboratories.
The S100 protein is a useful tool for optimizing clinical decision rules for initial CT scans in patients with TBI and other conditions associated with neuronal damage (e.g. asphyxia, stroke). However, assessment of S100 protein with ELISA is not currently approved for clinical evaluation of patients with head trauma.
Elevated serum neuron specific enolase (NSE) levels correlate with poor outcomes in patients with severe trauma and in those who are comatose. The evaluation of this biomarker is limited by contamination with erythrocytes during sample collection and hemolysis.
Hematology
The Leukemia & Lymphoma Society and American Society of Hematology announce collaboration against deadly form of leukemia
The Leukemia & Lymphoma Society (LLS) and the American Society of Hematology (ASH) are teaming up to raise awareness and provide education about the need for new treatments for acute myeloid leukemia (AML), one of the most deadly blood cancers.
As the world's largest voluntary health organization dedicated to fighting blood cancers, LLS is leading the charge to change the paradigm of AML treatment. ASH will assist LLS in its efforts to make patients and healthcare practitioners aware of the importance and availability of AML clinical trials, a critical step in the development of new treatments. Also, ASH will support awareness of LLS's Information Resource Center, a toll-free call center staffed with master's level healthcare professionals armed with the latest information about blood cancers.
Among the support services provided by LLS's information specialists is assistance finding appropriate clinical trials. ASH will disseminate information about LLS's services through its multiple communications channels and publications, both digital and print, and during its cancer conferences. ASH President Charles Abrams, commented, "AML continues to present one of our greatest challenges, and ASH welcomes this opportunity to work with LLS to encourage greater participation in clinical trials to advance more therapies and potential cures."
Autologous stem cell transplant should be standard care for HIV-associated lymphoma
New research published online in the journal Blood, challenges the generally held belief that individuals with HIV and aggressive lymphoma are not candidates for standard treatment. Clinicians have historically been hesitant to treat HIV patients with stem cell transplant due to concerns that their immune systems would not effectively recover after intensive chemotherapy or that the procedure would cause excessive toxicities or infections post-transplant. A total of 43 patients with treatable HIV infection who had chemotherapy-sensitive relapsed/treatment-resistant non-Hodgkin (experimental group) or Hodgkin lymphoma (control group) were enrolled in this Phase II clinical trial, designed to prospectively evaluate the safety and effectiveness of autologous hematopoietic cell transplant. Researchers discovered that the experimental group had no greater likelihood of developing these complications compared to those without the virus.
After a median follow-up of 25 months, overall survival at one year and two years post-transplant was 87.3 and 82 percent, respectively. The probability of two-year progression-free survival among those with HIV was 79.8 percent. "This is an important study because we need to better understand the long-term effects of HIV infection to ensure that patients are equitably treated in a way that respects their medical regimens and the biology of their HIV infection," said Dr. Joseph Alvarnas, from the City of Hope National Medical Center.
Molecular Biology
Business Machines: IBM and University of Calgary collaborate to advance genomic health research
IBM and the University of Calgary have established a five-year collaboration to accelerate and expand genomic research into common childhood conditions such as autism, congenital diseases and many unknown causes of illness.
As part of the collaboration, IBM will augment the existing research capacity at the Cumming School of Medicine's Alberta Children's Hospital Research Institute by installing a POWER8-based computing and storage infrastructure along with advanced analytics and cognitive computing software. The initiative will support three projects including the work of Dr. Micheil Innes, a member of the Department of Medical Genetics as the Cumming School of Medicine. Dr. Innes is researching more rapid and accurate diagnosis of genetic disorders and through his work was able to help a Calgary teenager who was diagnosed with a rare form of autism.
With access to these new tools, scientists can better generate, store and analyze complex clinical, genetic and imaging data, and expect to reduce from months to days the cycle times required for investigations into how genes and environmental factors impact child health. This precision-medicine approach will lead to opportunities for better diagnostics, prevention and more personalized treatment protocols.
Research
Blood test predicts how likely you are to have a heart attack in next five years
A simple blood test could help to determine whether a patient is likely to suffer from coronary heart disease in the next five years, new research has shown.
Scientists have discovered that patients with high levels of immunoglobin G (IgG) antibody were less likely to suffer from cardiovascular disease, including stroke and heart attack, than those with lower levels, even when taking into account factors such as high blood pressure and cholesterol.
The study monitored 1,753 subjects for approximately five years, and reported that those with the highest levels of IgG were 58 per cent less likely to suffer from a heart attack, while 38 per cent were less likely to suffer from a stroke or other cardiovascular event.
Dr Ramzi Khamis of the National Heart and Lung Institute, who led the study, said that the test could help diagnose high-risk patients more efficiently and with more accuracy than can be achieved using current methods. "This test, once confirmed in other studies as well, will significantly improve cardiac risk stratification," he said. The scientist also said that although much effort is devoted to identifying high-risk patients, "better and affordable tools to predict cardiovascular risk are still needed to avoid misclassification of 'high risk' patients and resultant over- or under-treatment."
Could computers diagnose cancer? Artificial intelligence shown to spot early signs of a tumour with 92 per cent accuracy
Computers could soon be helping to diagnose cancer in patients with the help of artificial intelligence (AI) that has been trained to spot early signs of the disease.
An AI machine, developed by computer scientists at Harvard Medical School, is capable of accurately diagnosing breast cancer 92% of the time, has been developed by researchers. While it is still not quite as good as human specialists – who are correct 96% of the time – it suggests that AI could soon be used to speed up and improve cancer screening. However, the researchers indicated that the combined machine and human pathologist review increased accuracy 99.5%.
"There have been many reasons to think that digitizing images and using machine learning could help pathologists be faster, more accurate and make more accurate diagnoses for patients," said Dr Andrew Beck, a pathologist at Harvard Medical School and the Cancer Research Institute at Beth Isreael Deaconess Medical Centre. "Identifying the presence or absence of metastatic cancer in a patient's lymph nodes is a routine and critically important task for pathologists… 'Peering into the microscope to sift through millions of normal cells to identify just a few malignant cells can prove extremely laborious using conventional methods.'"
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