News
1 in 2 Canadians will get cancer
Almost one in every two Canadians is expected to be diagnosed with cancer in their lifetime, and one in four Canadians will die from the disease, a new report by the Canadian Cancer Society predicts. In 2017, an estimated 206,200 Canadians will be diagnosed with some form of cancer and an estimated 80,800 will succumb to their malignancy (leading cause of death). The four cancers — prostate, breast, lung and colorectal — continue to top the list of the most common malignancies.
"Currently, every year we're seeing an increase in the number of cancer cases in Canada," said the society's epidemiologist, Leah Smith. About 45% of those cases will occur in people age 70 and older, said Smith, noting that as more people move into old age, the number of cancer cases will rise. Despite the projection that cancer will cause the deaths of one in four Canadians, cancer mortality rates have been declining since their peak in 1988. Survival rates for some cancers have improved dramatically over time: overall, 60% of Canadians diagnosed and treated for cancer will survive five years or longer, said Smith.
350 years ago, a doctor performed the first human blood transfusion. A sheep was involved
A quick history lesson - In 1667, Dr. Jean-Baptiste Denys performed the first documented blood transfusion to a human. His subject, an unnamed mentally ill 15-year-old boy, had been bled to promote his health, so much that he was suffering from blood loss. Writing for Wired, Tony Long points out that the transfusion was a little different than those performed in modern hospitals. "He used a sheep’s blood," writes Long. "And, somehow, the kid survived."
The boy didn’t get better, unsurprisingly. He was lucky to have survived due to the negligible quantity of blood given (5-6 ounces). By the third transfusion, though, the inevitable happened. The outcome was a subsequent trial in which Denys was found not responsible for the death. Arsenic, a known poison, was ruled as the culprit. The French court banned transfusion all the same. "For some, the risk that science could create monsters—or worse, corrupt the entire human race with foreign blood—was simply too much to bear," writes medical historian Holly Tucker. After Denys’ experiments and some failed experiments later the same year in England, no member of the mainstream scientific community attempted to do it again until the nineteenth century.
CDC provides updates on Lyme Disease diagnostics
More than 3.4 million diagnostic tests are performed for Lyme disease each year in the United States. In a recent webinar, researchers from the Centers for Disease Control and Prevention (CDC) provided updates on Lyme disease diagnostics.
The current recommended testing strategy is serology-based and uses a standardized two-tiered testing (STTT) approach. According to CDC’s Martin Schriefer, PhD, one of the diagnostic challenges is in the lack of pathognomonic features associated with the disease, which increases the need for effective laboratory testing methods. The small number of spirochetes in a clinical sample also poses a challenge, he said, thus increasing the need for an amplification step in the testing method. Dr. Schriefer discussed using modified two-tier strategies (MTTT) to achieve these objectives. One such MTTT approach uses a 2-EIA (whole cell EIA followed by EIA for C6 antibody). This approach takes advantage of the greater diagnostic sensitivity in early Lyme disease that the C6 EIA provides, minimizes the complexity and subjective interpretation of western blotting, and maintains the specificity of STTT.
Clinical Chemistry
Key diabetes test gives higher blood sugar readings in black patients
"There has been a long debate about why African Americans have a higher hemoglobin A1C than whites [with diabetes]. Is it a biological difference or do African Americans have higher blood glucose because they don't have the same access to care or insurance?" said the study's lead author, Dr. Richard Bergensta. A recent study found that biological and socioeconomic factors appear to play a role in the difference.
The study included 104 African American and 104 Caucasian people with type 1 diabetes. The study participants were all aged 8 or older, had diabetes for at least two years and were recruited from 10 diabetes centers in the United States. The study volunteers wore a continuous glucose monitor for up to 12 weeks. The mean A1C was 9.1% for the African American group and 8.3% for the Caucasian group -- a difference that should have been 0.4%. "I think these findings may have a small influence on management." Bergenstal theorized that this may be because more glucose attaches to hemoglobin in black people, which could be due to a shorter life span for red blood cells. But, this study wasn't able to answer that question, and Bergenstal said more research is needed.
Hematology
New malaria test earns Dutch hematologist the European Inventor Award
Dutch hematologist Jan van den Boogaart was awarded the European Inventor Award by the European Patent Office in Italy for his new malaria test that can diagnose much faster and reliably than current methods. He worked with Austrian biochemist Oliver Hayden to develop the first automated blood test to diagnose the disease. The test includes an algorithm that can diagnose malaria at a rate of 120 blood tests per hour and an accuracy of 9%. Instead of trying to find the malaria parasite itself in the blood, this new test looks for the effects the infection has on the blood. "If 30 parameters in the blood vary simultaneously, including the shape and density of red blood cells and the level of hemoglobin, the diagnosis is as good as clear", Hayden said, according to NU.nl. Van den Boogaart conducted the research for Siemens, who will develop the algorithm further. "The company will ensure that the technology also becomes available on the market."
Microbiology
Enhanced test for urinary tract infections detects more bacteria than standard test
A new enhanced test, developed at Loyola University Chicago, detects significantly more bacteria than the standard test, according to a study presented at a meeting of the American Society for Microbiology in New Orleans. The new test, called enhanced quantitative urine culture (EQUC), uses a higher volume of urine compared to current standards. In addition to room air, samples are incubated in air containing a high concentration of carbon dioxide and in an anaerobic (absence of oxygen) environment. Samples are incubated for 48 hours in three growth media.
The study enrolled 150 urogynecologic patients, half of whom reported symptoms of UTIs. Urine samples from the patients were subjected to both the standard culture and the EQUC tests. In 69 of the 75 women reporting UTI symptoms, the EQUC test detected one or more bacteria species, for a total of 110 species. Using the standard culture, only 50 percent of these bacteria species were identified. The standard culture identified most of the E. coli bacteria, but only 24 percent of the non-E. coli bacteria. Loyola researchers will soon launch a clinical trial to investigate whether using the EQUC method could improve the clinical care of women with UTIs.
Antifungal therapeutic drug monitoring by liquid chromatography tandem mass spectrometry
Clinical Case: A clinician diagnosed an allogeneic hematopoietic stem cell transplant recipient with invasive aspergillosis and started treatment with intravenous voriconazole according to standard recommendations. The laboratory obtained a trough sample 5 days after treatment began and sent it to a reference laboratory for therapeutic drug monitoring (TDM). The reference lab used a threshold of >5.5 µg/mL for voriconazole toxicity. At this time, with the patient stable, the daily dosage was continued. However, 2 days later, the patient complained of visual disturbances and subsequently presented mental changes consistent with voriconazole toxicity. The result of the initial TDM sample was not yet available. The laboratory obtained a new trough sample, and the clinician adjusted the dosage based on the clinical findings. A result for the first TDM sample showing a voriconazole concentration of 6.2 µg/mL arrived 2 days after the patient presented symptoms of toxicity. The second sample showed a voriconazole concentration of 8.6 µg/mL.
Could this patient’s voriconazole toxicity have been prevented? Find out here
Molecular Genetics
Laboratory IT systems grapple with genetic testing surge
At the HIMSS Precision Medicine Summit, Patrick Mathias, associate director of laboratory medicine informatics at University of Washington, spotlighted just how complex the genetic testing boom has become for clinical technology. The genetic testing market has become similarly complex and dynamic, he said – with more than 69,100 genetic testing products on the market and as many as 10 new ones every day.
To improve the management of tests and better integrate their genetic information into workflow, Seattle Children’s Hospital – which spends more than $1,000,000 annually on genetic sendout testing – helped launch Pediatric Laboratory Utilization Guidance Services, or PLUGS, a nationwide network with more 60 other hospitals and health systems, with the aim of improving ordering, retrieval, interpretation and reimbursement for genetic tests. It also made use of lab genetic counselors to improve quality and reduce costs – they help spot and correct errors that could impact patient safety, said Mathias, leading to cost savings that in turn justify the addition of more resources. Having achieved those successes, "the challenge was how can we do that so we can scale across all health systems," said Mathias.
Research
Biosensing tattoo changes colour when your blood sugar levels change
A team of researchers at Harvard and MIT have now come up with a rather curious alternative to standard monitoring tests for diabetics. Using a specialized ink, they created a biosensing tattoo, one that will change colour depending on your blood sugar levels.
Known as DermalAbyss ink – currently still in the proof-of-concept stage and not available to the general public – it is able to track pH levels, as well as sodium and glucose concentrations within your bloodstream. Too much glucose and the ink becomes brown. Too much sodium and it becomes green (under UV light, at least). Purples and pinks indicate a changing pH level. “The DermalAbyss ink presents a novel approach to biointerfaces in which the body’s surface is rendered as an interactive display,” the team explained. At present, it’s only been tested on pig skin, which is very similar to our own. “We envision new participation between the biotech companies and skin professionals…in order to embrace the idea of human device symbiosis,” they conclude.
Check out the possibilities for biosensors as tattoos in this video!
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