Issue 81  November 9th 2018

Woman says Memorial Hospital made her work with colleague who used racial slur

A former Memorial Hospital employee says the hospital did not follow their own discrimination policy when she reported a white coworker for using a racial slur in 2017. Ja’Lisa Turner, who is black, filed a lawsuit Sept. 14. It states Turner was employed by Memorial Hospital as a laboratory associate from August 2013 to March 2018. On June 10, 2017, Turner was working with a medical technologist in the lab when she asked her coworker to pass her some specimens. The lawsuit states the coworker replied to Turner’s request by saying, “What am I, your (racial slur)?”

Turner’s suit states she was emotionally traumatized and could not complete that shift. Because it was a weekend, she reported the behavior to management four days later and was told it would be investigated. Memorial Hospital officials declined to comment on the pending lawsuit.

When Turner met with management again six days after reporting the racial slur, the suit states she was told the investigation was complete and that appropriate action had been taken. Turner says she was not told what that “appropriate action” was. After that meeting, Turner says she was forced to work with the coworker she’d reported on more than 40 occasions. Turner’s suit states working with this person created a hostile work environment that interfered with her ability to do her job.

Memorial Hospital has a “No Discrimination, No Harassment” policy that was issued in June 2014, the lawsuit states. The policy says that all forms of discrimination based on race are prohibited. It further provides that the hospital “will not tolerate or condone any action by ... co-workers ... which constitutes illegal harassment or discrimination.” Memorial Hospital officials told the BND it could not provide a copy of the written policy because of a pending legal matter.

Influenza vaccines may protect against lab-confirmed influenza-linked hospitalization during pregnancy

A group of international investigators conducted a retrospective test negative design study to analyze the effectiveness of influenza vaccination against laboratory-confirmed influenza-associated hospitalization during pregnancy, using data from the Pregnancy Influenza Vaccine Effectiveness Network (PREVENT). The outcomes measured included acute respiratory or febrile illness (ARFI) and the confirmed presence of influenza viruses in real-time reverse transcription polymerase chain reaction.

A total of 19,450 ARFI hospitalizations were reported, 6% of which had real-time reverse transcription polymerase chain reaction influenza virus testing. The analytic sample used included 1030 hospitalizations. Results suggested that 79% of ARFI hospitalizations occurred in women younger than 35 years; 65% of ARFI incidents occurred in women in their third trimester, and 66% had no high-risk medical conditions. The researchers also noted that 58% of ARFI hospitalizations with polymerase chain reaction testing were positive for influenza virus: 13% of influenza-positive and 22% of influenza-negative women had been vaccinated, which correlates to an unadjusted influenza vaccine effectiveness of 48% (40% adjusted) against influenza-associated hospitalization during pregnancy.

"In addition to the ample data on the safety of inactivated influenza vaccination during pregnancy, mounting evidence that influenza vaccination reduces the risk of mild to moderately severe [laboratory-confirmed influenza] disease during pregnancy, and evidence that maternal vaccination offers secondary protection to infants during the first months of life, our finding of 40% [influenza vaccine effectiveness] in preventing [laboratory-confirmed influenza] hospitalization during pregnancy further strengthens the rationale for influenza vaccination programs for pregnant women," the investigators concluded.

After mass shootings blood donations can go unused

After mass shootings like the one at a Pittsburgh synagogue just last weekend that left 11 dead and six wounded, Americans often rush to donate blood to help the victims. New research suggests that some of that blood could end up going to waste. "There is an emotional desire after these events to immediately donate blood, but that's not always necessary and it's not always the best immediate response. The best thing you can do is donate blood year around," said first study author Dr. M. James Lozada. He's an assistant professor of anesthesiology at Vanderbilt University Medical Center in Tennessee.

Lozada, who started the study while at Northwestern's School of Medicine in Chicago, explained that a typical blood donation takes two days to process, but most blood transfusions for shooting victims occur within the first 24 hours of the tragedy. The study examined the deadliest mass shooting in U.S. history, which occurred in Las Vegas on Oct. 1, 2017. There were 58 deaths, 869 wounded people, and 220 hospital admissions, including at least 68 critical care admissions.

A public call for blood donations was announced during a news conference and widely reported by the media. In the three days after the shooting, the American Red Cross saw a 53 percent spike in blood donations nationwide. The Las Vegas blood bank, United Blood Services, reported 791 blood donations immediately after the mass shooting. Of those donations, 137 (17 percent) went unused and were later discarded, compared to an average of 26 wasted donations per month at the blood bank. The findings, which were published in The Journal of Trauma and Acute Care Surgery, showed that a call for immediate blood donation was unnecessary in Las Vegas and probably in other mass shootings, the authors said.

Yale Cancer Center investigators show recommended, but underused, treatment for rare blood cancer saves lives

US and European guidelines on treating polycythemia vera (PV), a potentially deadly blood cancer, call for two treatments for patients with high-risk disease: therapeutic phlebotomy and cytoreductive therapy with a drug called hydroxyurea (HU). HU is the most commonly used option, but evidence for HU treatment is limited and both treatments are underused. Now, researchers at Yale Cancer Center (YCC) have documented reduced risk of death and incidence of blood clots in patients receiving those therapies.

The study, published in Blood Advances, represents a “real-world” look at the outcomes of high-risk PV patients. Among 820 patients, those treated with phlebotomy had a 35% reduction in death and a 48% reduction in the risk of developing blood clots (thrombosis). For the second treatment, HU, researchers found that every 10% increase in the proportion of days patients used the drug led to an 8% lower risk of death and thrombosis.

“Our study highlights the value of adhering to PV treatment guidelines,” said the study’s lead investigator, Nikolai A. Podoltsev, MD, PhD, a hematology expert at YCC and assistant professor of medicine (hematology) at Yale School of Medicine. “Use of the two recommended treatments saves lives.” But the analysis also suggests that many patients are not receiving the recommended treatments. In the study, about 39% of patients were undertreated, with more than 16% of patients receiving neither treatment, and 23% receiving only phlebotomy.

AACC calls for greater federal oversight of medical testing at physician offices, pharmacies to safeguard patient safety

With more and more medical tests being performed outside the traditional clinical laboratory, AACC released a position statement today emphasizing the need to ensure consistent high-quality testing at non-traditional facilities such as physician offices and pharmacies. The statement urges Congress to direct the Department of Health and Human Services (HHS) to study testing at non-traditional sites and to recommend steps to ensure patients get consistently reliable results to facilitate effective treatment.

The last few decades have seen a dramatic rise in the use of waived tests, which are tests that regulators consider easy to perform with a low risk of error. Since 1993, the number of facilities outside of the traditional clinical lab that perform only waived testing has also grown more than 170% and these facilities now represent 71% of all clinical laboratory testing sites. Past studies have found that about one-third of waived testing sites either don't have or don't follow test instructions, in addition to other significant, widespread deficiencies.

Raising the standard of testing at waived sites is critical to ensuring the safety of the many patients who rely on them. To accomplish this, AACC calls on Congress to direct HHS to perform a comprehensive assessment of all types of waived testing sites in order to develop a path to improvement for these facilities. In addition, because individuals who perform waived tests oftentimes do not have formal training in laboratory medicine, AACC encourages waived testing sites to hire qualified clinical laboratory professionals as consultants to supervise and train personnel onsite.

For new HPV DNA test, study finds there may be little benefit in screening women aged 55 with a negative test

A single negative human papillomavirus (HPV) DNA test – a newly introduced test which can detect cases of 14 high risk HPV strains to a high degree of accuracy – at the age of 55 suggests that women will be at low risk of cervical cancer, and there is little benefit of continued screening with this type of test. However, for the more commonly used, and cheaper, cytology screening (also called pap or smear test), regular screening up to age 75 may still prevent some cancers, even though the benefits decline with age. The findings come from a new modelling study, published in The Lancet Oncology journal.

The research team used a mathematical model to estimate the lifetime risk of cervical cancer in older women who had not been vaccinated. They developed, calibrated and validated their model using Canadian health data, including cervical cancer incidence rates from Statistics Canada and HPV prevalence from the screening program in British Columbia (data from over 200,000 women). Based on Canadian data, they assumed that 42% of women who live until age 100 years will have a total hysterectomy.

The model predicted that without screening or vaccination, 1 in 45 women would be diagnosed with cervical cancer in their lifetime. Perfect adherence to cytology screening every 3 years between the ages of 25 and 69 reduced the lifetime risk of cervical cancer to 1 in 532 women. For unvaccinated women with typical adherence to cytology screening, stopping screening at age 55 years was associated with a lifetime risk of cervical cancer of 1 in 138, compared to 1 in 160 when screening was stopped at age 70 years. Although increasing the age at which women stopped cytology screening from 55 years to 75 years led to incremental decreases in cancer risk later in life, the findings suggest that a substantial part of the reduction in risk is due to screening before age 55 years.

Hospital lab techs by day, Mary Lou Vendivil and Jenn Strauman have turned their shared love of baking into a successful sideline, Scientific Sweets

On the second Monday in June, Jenn Strauman was checking her phone while on a break from her job as a medical laboratory technologist at Health Sciences Centre when she spotted an email carrying the subject line, "Cookies!"

Her initial thought was, "Great, another order." After all, as the co-founder of Scientific Sweets, a home-based biz specializing in intricately decorated confections, the majority of the communiques she and her business partner Mary Lou Vendivil, also a lab tech at HSC, receive revolve around cookies.

Except this particular inquiry was more than their standard, everyday cookie request. After coming across their Instagram page, which boasts eye-catching shots of superhero cookies, dinosaur cookies, even cookies that appear to be slices of pepperoni pizza, a person claiming to be an associate of TV reality star Khloe Kardashian wanted to place an order for a party scheduled for the following Sunday in Los Angeles to toast the California homecoming of Kardashian’s two-month-old daughter True.

"Our first thought was this has to be a joke," says Strauman, seated next to Vendivil in a Taylor Avenue coffee shop. "But after reading it out loud to our co-workers, everybody agreed it sounded totally legit."