News
Lab testing equipment to be upgraded with Festival of Trees proceeds
Sheila McKay may not be here today if not for a blood test she had done in the winter of 2015.
Following her complete blood count, McKay was informed she had Non-Hodgkin lymphoma, lung cancer and an aneurysm in her brain. Thanks to early intervention, she now leads a healthy life free of worrying too much about those things. While McKay’s life is forever changed by the work of the hematology lab, the upgrades made possible by this year’s Festival are expected to make the experiences of future patients even more efficient and impactful.
McKay’s story is just one example of why this year’s Festival of Trees is so important for central Albertans, with proceeds going towards upgrading technology in both the hematology and microbiology labs at Red Deer Regional Hospital. "We’re privileged and very grateful to have these proceeds benefit our laboratory. It extends not only to every patient in Red Deer, but I really think throughout the zone which serves about 500,000 people," says Dr. Garnet Horne, Pathologist and Zone Clinical Department Head for Central Zone labs.
"Without the lab, health professionals can’t make the decisions they need to make. When we think about healthcare, we think about things like emergency, intensive care, all the bells and whistles and the drama," she says. "We forget about the place where the behind the scenes work is done that allows the people to make decisions about what to do in emergency and in the ICU."
Listen to Sheila tell her story
Quality
California labs commonly use outdated CRE detection practices
Many hospital laboratories in California are using outdated practices to detect carbapenem-resistant Enterobacteriaceae, or CRE, leading to false reports of susceptibility that could impact patient care and hinder the detection of outbreaks, researchers said.
According to a study published in Clinical Infectious Diseases, among 128 hospital laboratories in California that responded to a voluntary survey about their testing practices, 28% reported using outdated minimum inhibitory concentration (MIC) breakpoints for CREs.
According to James A. McKinnell, MD, infectious disease specialist at LA BioMed and assistant professor of medicine at the David Geffen School of Medicine at UCLA, and colleagues, one of the causes of carbapenem resistance among Enterobacteriaceae may be the presence of a carbapenemase enzyme that can hydrolyze the antibiotics. Most labs that did in-house testing for carbapenemase reported using the Modified Hodge Test, which McKinnell and colleagues said is associated with “significant performance issues,” including false-negative and false-positive results.
“Laboratories and clinicians need to understand the implications of not using current CLSI breakpoints, which in our study would have resulted in up to 20% of KPCs being categorized as falsely meropenem susceptible,” they wrote. “Such miscategorization could lead to administration of inappropriate antibiotics and subsequent poor patient outcomes, as well as undetected spread of CRE. Regulatory agencies need to develop a more streamlined process for [antimicrobial susceptibility test] manufacturers that allow them and clinical microbiology laboratories to rapidly adopt new breakpoints.”
Pre-Analytical
Drone Sets Record for Clinical Lab Test Delivery Distance
Clinical laboratories and anatomic pathology groups could soon be receiving blood samples and tissue specimens through the air by medical drone. The technology has been tested successfully in Europe, which Dark Daily reported in July. Now, Johns Hopkins University Medicine (JHUM) has set a record in America for the longest distance drone delivery of viable medical specimens.
In a project to demonstrate the viability of using drones to transport medical laboratory specimens, the Johns Hopkins University team flew a drone with specimens more than 161 miles across the Arizona desert. The goal is to bring autonomous medical delivery drones a step closer to transforming how specimens get transported across long distances, according to a Johns Hopkins press release.
A previous Johns Hopkins study in 2015 proved common and routine blood tests were not affected when medical laboratory specimens were transported in up to 40-minute flights on hobby-sized drones. This latest research provides evidence that unmanned aircraft may be able to successfully and quickly shuttle medical specimens even longer distances between remote hospitals and medical laboratories.
Leadership
Pathologists Use Facebook And Twitter To Share Insights About Puzzling Cases
In August, a doctor in Spain posted x-ray and microscopic pictures from a man's thigh on Twitter, asking for help. The physician was concerned that he had cancer. But the images that pathologist Jerad Gardner saw on his screen in Little Rock, Ark., reminded him of something else he had come across a few times — a benign tumor that looked like a rare form of cancer. He suggested the Spanish doctor perform a molecular DNA test. It ultimately revealed that the tumor wasn't cancerous.
No one thinks that doctors should make a diagnosis via Twitter. But there is a growing movement to use social media to share information. And Gardner, an associate professor of pathology and dermatology at the University of Arkansas for Medical Sciences, is one of the pioneers, building a community of followers and colleagues on Twitter and Facebook.
"Dr. Gardner is a leader in approaching diagnoses in new ways, embracing the latest technologies and innovations medicine has at its fingertips, " says Dr. R. Bruce Williams, president of the College of American Pathologists, an organization that advances the practice of pathology and laboratory science.
"I'm no stranger to criticisms about social media. It's been a long uphill fight to convince my colleagues that this is something we should do and I know there are still naysayers. Most of those are people who don't actually use social media so they don't really understand how it works." says Dr. Gardner.
In terms of privacy, he says that images where identifying information is left out "do not require patient permission to post on social media, either ethically or legally." An article he co-authored, published in the American Medical Association Journal of Ethics, states that images omitting a patient's identifying details on social media, just like in medical journals, don't violate privacy law.
In Gardner's view, it's a good thing if "everything on social media is public. If I do something wrong other people can call me out on it immediately." He adds that the immediacy and wide reach of social media offer benefits not found in medical journals — but with caveats.
Transfusion Medicine
A bloody mess: The story behind paid plasma in Canada
Documents obtained via the Access to Information Act—more than 850 pages of communications between Health Canada, Canadian Blood Services (CBS) and Canadian Plasma Resources (CPR) between 2009 and 2016—raise new questions about blood governance in Canada and its ties to industry. They indicate that, since 2009, CPR’s parent has been working in a partnership with then-German-owned Biotest AG, the world’s fifth biggest player in the plasma-proteins therapies market; in 2009, it told Health Canada that it planned to invest $400 million to spearhead a Canadian plasma industry. Health Canada, which describes its relationship with CBS as “arm’s length,” worked closely with the blood regulator shaping messaging that paved the way for CPR’s arrival. The documents reveal that over years Health Canada worked collaboratively with CPR itself—in one exchange a top Health Canada official asked if CPR planned to announce its Saskatoon facility before or after Health Canada’s inspection, an approval necessary for it to set up business; she later sent “Congratulations!” after the approval was granted.
Emails within Health Canada also indicate the agency wanted to phase out reliance on the five-year 1997 royal commission into the “tainted blood scandal” headed by Justice Horace Krever; long upheld as a roadmap for blood governance, it warned against compensation for blood products. In its place: a three-page 2010 document created at a “stakeholder” meeting convened by an industry lobby group. The documents also cast doubt on former Health Minister Jane Philpott’s statement in a March 2016 interview that she knew nothing of CPR’s business plans. In fact, CPR had provided the ministry with detailed business plans for years; in February 2016, a month before that interview, the minister’s office itself requested information about the number of jobs created by CPR in Saskatoon.
Read the entire article by clicking the title above for a full appreciation of the scope of paid plasma in Canada. Note: Long read
Scientists receive £100,000 funding for revolutionary artificial blood research
A RUNCORN science company has won a grant to help fund a £100,000 pioneering research project to develop artificial blood. SpheriTech says its s SpheriTech’s synthetic blood, SpheriSome® Hb, could revolutionise the treatment of trauma patients.
Dr. Don Wellings, the founder and managing director of SpheriTech, said: "The use of donated blood in transfusion therapy, while effective in restoring an adequate supply of oxygen in the body of the recipient, has several limitations. Although testing procedures exist to detect the presence of certain diseases in blood, these procedures cannot eliminate completely the risk of blood-borne disease.”
"Despite numerous attempts to come up with viable synthetic blood substitutes since the 1980s, there is still not a single synthetic blood substitute currently available for human trauma patients in the US and Europe."
SpheriTech has now invented and is developing a novel blood substitute, a Haemoglobin-based oxygen carrier (HBOC), which will be intravenously administered to deliver oxygen to the body’s tissues.
Dr Wellings says SpheriSome® Hb also has the ability to be fully excreted from the body and not accumulate in various tissues, and is non-toxic, non-immunogenic, non-antigenic and non-carcinogenic.
Molecular Genetics
MedReleaf Partners with LabCorp’s Dynacare to Offer Genetic Diagnostic Test for Cannabis Recommendations
Canadian patients are increasingly turning to medical cannabis for relief. As of June 2016, there were approximately 75,000 Canadians registered to purchase medical cannabis from a licensed producer and that grew to over 200,000 a year later. While patient demand is evident, the physician community is looking for more scientific evidence before they embrace the widespread recommendation of cannabis for use as a medicine.
There is a need to address the primary areas of concern for physicians and to bring increased certainty and clarity when prescribing. For that reason, MedReleaf Corp., a leading Canadian medical cannabis producer, is introducing a ground-breaking, patent-pending, new genetic test called ReleafDxTM. This novel test analyzes a patient’s DNA and health conditions to provide physicians with answers to two key questions: 1) what dosage should be prescribed; and 2) what cannabis product will work best for each individual.
Through extensive research, MedReleaf has translated human genetic information related to how tetrahydrocannabinol (THC) and cannabidiol (CBD) are metabolized to help predict better health outcomes for patients. ReleafDxTM analyzes biomarkers within known metabolic pathways to allow physicians to identify patients that may metabolize cannabis more slowly or quickly than normal. Knowing this information will help minimize the chance of an adverse reaction and maximize the likelihood of a positive effect.
Research
Medical University of Vienna Team Shows Roche PCR Test Suitable for Rapid Neonatal Sepsis Diagnosis | GenomeWeb
Medical University of Vienna researchers have shown that a Roche PCR test has superior sensitivity rates and can more rapidly identify pathogens in the blood of neonatal patients than traditional blood culture testing.
As a result, the researchers deemed the Roche SeptiFast Mgrade PCR test using a modified DNA extraction protocol acceptable for rapid detection of neonatal sepsis alongside conventional blood culture. The researchers published their findings last week in the journal PLOS One.
"Routinely, hospitals hold a low-birth-weight baby and start them on prophylactic antibiotic treatment while drawing cultures during the first 48 hours," Darshna Tanna, Roche's lifecycle leader for microbiology, said in an interview. "The quicker you can rule out a bacterial infection, the quicker you can get babies off empirical treatment and out of the neonatal intensive care unit."
The researchers in Vienna prospectively analyzed 212 episodes of suspected late-onset sepsis in neonatal patient samples using the SeptiFast diagnostic test with the modified DNA extraction protocol. They compared the results with those from blood culture, laboratory biomarkers, and clinical signs of sepsis.
Using a blood volume of 100 μL, the test demonstrated a sensitivity of 90.2 percent "for the diagnosis of blood-culture positive sepsis episodes; a moderately high number of positive test results in episodes without infection potentially due to contamination during blood drawing and processing; and an increased pathogen detection rate in patients with clinical sepsis," the researchers said.
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