A Weekly Compilation of Clinical Laboratory and Related Information
from The Division of Laboratory Science and Standards
May 23, 2013
View Previous Issues - Healthcare News Archive
30 Years of HIV: Looking Back, Looking Ahead
There was no fanfare on May 20, 1983 when Science published what is undoubtedly among the most important medical papers of the 20th century. In the usual dry prose, researchers from the Institut Pasteur in Paris described a new retrovirus, which they dubbed lymphoadenopathy associated virus, or LAV. It was, they reported, a "typical type-C RNA tumor virus" with a tropism for T-lymphocytes and was similar to -- but clearly distinct from -- human T-cell leukemia viruses, which had recently been discovered. Today, we know it simply as HIV.
Whole-Genome Sequencing: Clinical Guidelines for Europe
The European Society of Human Genetics has developed recommendations for how to incorporate whole-genome sequencing into clinical diagnostics. The recommendations appear in the June issue of the European Journal of Human Genetics.
The recommendations are:
- Clinicians and researchers using the new technologies should share their experiences and establish testing guidelines at the local, national, and international levels.
- Targeted sequencing is preferred to minimize unsolicited (incidental) findings.
- The risk–benefit profile in individual cases should justify a sequencing approach to diagnosis.
- A protocol must be in place for healthcare professionals to communicate unsolicited findings.
- Guidelines for informed consent should be developed, but a patient's desire not to know should not override the practitioner's providing information when a condition is treatable or affects relatives.
- Patients should be informed if their genetic information is used in research or stored in biobanks.
- Guidelines should be established for which unsolicited findings in minors should be disclosed to parents.
- Guidelines should address recontacting patients when new research findings affect care.
- Nations should collaborate on establishing and maintaining databases of genotypic and phenotypic information on gene variants and patients.
- Primary care physicians and specialists should continue their education so that they can discuss and interpret genetic test results for patients.
- Experts in genetics and genomics should raise public awareness of genetic testing and screening.
It Came From Norway to Take On a Medical Goliath
Hospitals that the quality inspectors deem deficient can lose their accreditation and be barred from Medicare reimbursement. A nonprofit called the Joint Commission, though not on the tip of patients' tongues, is the outfit we're accustomed to seeing every three years for these quality checkups. So I was surprised to learn that the surveyors, as they like to be called, were coming instead from a Norwegian company called DNV, that's short for Det Norske Veritas, or, in English, "The Norwegian Truth." The company has been approved by the federal Centers for Medicare and Medicaid to certify hospitals since 2008. So DNV surveys its client hospitals annually, rather than every three years, which has been the Joint Commission's norm.
ISO 9001 is an internationally recognized quality system in manufacturing and service industries. Before DNV applied it to the field, ISO 9001 had never before been used in U.S. hospitals.
Lawmakers' Bills Keep Spotlight on ICD-10 Debate
Sen. Tom Coburn (R-Okla.) has introduced a Senate version of the Cutting Costly Codes Act of 2013, a bill aimed at blocking HHS from implementing the ICD-10 diagnostic and procedural codes, which it is scheduled to do on Oct. 1, 2014. Given the Obama administration's support for ICD-10, the chances that the bill will kill implementation efforts once and for all appear unlikely. But what it will most certainly do is keep alive the healthcare industry's debate on ICD-10 implementation.
Medicaid Expansion Popular in South, Poll Shows
The political leadership in the five Deep South states is solidly against Medicaid expansion, and has been so for months. Republican governors in Georgia, South Carolina, Alabama, Mississippi and Louisiana, along with their GOP-controlled legislatures, have bucked proposals to open their states’ Medicaid programs to hundreds of thousands of uninsured people, as outlined under the 2010 Affordable Care Act. But a newly released survey of adults in those five Southern states shows a different sentiment among the public. Across the region, 62.3 percent of respondents view Medicaid expansion favorably, including 61 percent in Georgia, according to the recent survey results released.
Primary care physicians should ask all adults older than 18 years about their drinking habits, according to the final recommendation statement on alcohol misuse released this week by the US Preventive Services Task Force (USPSTF). Based on recent studies, the new recommendations also state that brief behavioral counseling is effective and should be offered to any adult who screens positive for risky or hazardous drinking. The new guidelines were published online May 14 in the Annals of Internal Medicine. According to the Task Force, approximately 30% of the US population engages in risky drinking behaviors.
CDC Takes a Closer Look at Kids’ Mental Health
Somewhere between 13 and 20 percent of kids in the United States experience some sort of mental illness, according to a new report from the Centers for Disease Control and Prevention. That adds up to millions of children suffering from disorders like ADHD, depression, autism and illicit drug use.
The total annual cost of the illnesses? About $247 billion a year.
The study, published as part of the CDC’s weekly journal MMWR, is the first time that federal researchers have sought to compile estimates of how many children have specific mental disorders and describe federal efforts for monitoring the issue.
Exploring Trends in Cytology
"Cytology is a pretty good gig," Michele A. Smith, SCT(ASCP), education coordinator for cytology students at the State Laboratory of Hygiene at the University of Wisconsin at Madison said. "We're not pigeon-holed into one discipline; in fact, we're responsible for many different healthcare professionals across the care team."
"We are responsible for partnering with many types of clinicians, including radiologists, pulmonologists, general practitioners and obstetricians and gynecologists," she said. "We have the opportunity to work with many different patients in many different ways." Smith also mentioned risk management, coding and billing, anatomy, physiology, pathology, management and supervisory roles, pharmaceuticals and laboratory test development as potential job avenues for graduating cytologists. "Cytology is also an excellent way to get your feet wet in medicine, when the goal is to eventually pursue graduate school, medical school, nursing or physician assistant studies," she said.
The Outrageous Cost of a Gene Test
Only one in about 400 women carry mutations to BRCA1 or to a related gene BRCA2, though such hereditary defects are implicated in between 5 percent and 10 percent of all breast cancers. The majority of the 230,000 cases of breast cancer diagnosed annually in the United States are not related to these genes. But if you’re that one in 400 women, you’d want to know so you could make informed decisions about your health care. Unlike routine tests for diabetes or high cholesterol, however, the BRCA gene evaluation — performed by only one company in the United States, Myriad Genetics — is phenomenally expensive, with a “list price” close to $4,000 when a related genomic-rearrangement test is included in the analysis, which oncologists typically recommend. We’re paying this lofty price in large part because Myriad owns broad patents on these two BRCA genes, which it acquired in 1997 and 1998, respectively — and refuses to license the test to any other American company. (Last month, the Supreme Court heard arguments in a lawsuit challenging the appropriateness of those patents and is expected to deliver its decision by June.)
Gene-Testing Dispute Focuses on How Much a Patient Should Know
Should patients undergoing broad DNA testing for a specific ailment be told of unexpected findings that signal risk of cancer or other serious diseases, even if they don’t request the information? The question is at the core of a battle brewing among doctors and ethicists amid growing use of gene sequencing for clinical use and the plethora of information that results from such tests. Writing in the journal Science, a team of ethicists said patients should decide how much they want to know and how deeply scientists should look into their genome.
It has come to our attention that you are currently marketing the uChek Urine analyzer, which is intended for use with Siemens Multistix SG10, Siemens Multistix SG, Siemens Uristix, Bayer Diastix, and Bayer Keto-Diastix reagent strips for the qualitative and semi-quantitative determination of urine analytes including glucose, urobilinogen, pH, ketone, blood, protein, bilirubin, nitrite, leukocyte, and specific gravity. The uChek Urine analyzer appears to meet the definition of a device as that term is defined in section 201(h) of the Federal Food Drug and Cosmetic Act.
Please note that though the types of urinalysis dipsticks you reference for use with your application are cleared, they are only cleared when interpreted by direct visual reading. Since your app allows a mobile phone to analyze the dipsticks, the phone and device as a whole functions as an automated strip reader. When these dipsticks are read by an automated strip reader, the dipsticks require new clearance as part of the test system. Therefore, any company intending to promote their device for use in analyzing, reading, and/or interpreting these dipsticks need to obtain clearance for the entire urinalysis test system (i.e., the strip reader and the test strips, as used together). For an example of this type of device system, and a summary of the type of data used to support clearance of the system, see the decision summary for k111221 [PDF 424.82KB]1.
Accuracy of Blood Glucose Meters Draws Scrutiny
Blood glucose meters, which millions of diabetics rely upon to regulate their blood sugar, have become less costly and easier and less painful to use. But they haven’t become more accurate, a top Food and Drug Administration official said at a meeting of researchers analyzing studies that show wide variation in the performance of the machines used to measure blood glucose levels. Katherine Serrano, diabetes branch chief in the FDA division of chemistry and toxicology devices, said the federal government is aware of accuracy problems with meters on the market. But she said the FDA is limited in its response because some manufacturers are in Asia, and the agency must rely on the manufacturers’ own studies related to accuracy.
Anticipating the Digital Medicine Revolution, Scripps Doctor Prescribes Smartphone Apps as Frequently as Medications
Pathologists might want to borrow a page from a tech-savvy doctor who was voted the “Most Influential Physician Executive” in 2012. A cardiologist, this physician says he now prescribes mobile applications for his patients almost as frequently as he prescribes therapeutic drugs. Many clinical laboratory managers will recognize the name of Eric Topol, M.D., who is the Director of the Scripps Translational Science Institute, Professor of Genomics at the Scripps Research Institute, and Chief Academic Officer at Scripps Health, all located in La Jolla, California. Topol has a passion for wireless medical technology. Moreover, he is nationally recognized as a wireless medical technology trailblazer, as well as for his medical expertise. In fact, in one news clip, NBC News touts him as the nation’s foremost expert in the explosion of wireless medicine. Topol was also selected by GQ Magazine in 2009 as one of the nation’s 12 “Rock Stars of Science.”
Cheap, Fast, Accurate Home Colon Cancer Test Joins Growing List of Diagnostic Tests Shifting From Medical Laboratories to Homes
Steady progress is happening in consumer self-test kits as new diagnostic technology supports at-home kits that produce results with accuracy approaching 90%. For decades, the fecal occult blood test (FOBT) has been used to detect colon cancer. By the end of this year, Mode Diagnostics expects to receive clearance to sell its home version of the FOBT in European Union countries. Following clearance by the EU, the company anticipates a decision from the U.S. Food and Drug Administration within 12 to 18 months. Also, Mode Diagnostics has hired a representative in China to establish a presence in that market. “There is a huge appetite for self-diagnostics” from people who want discretion or are anxious about hereditary conditions, observed Alan Hirzel, a partner in the London office of consulting firm Bain & Company.
Labs Fail to Detect Cases of Bacterial Food Contamination
Foodborne illnesses are a continuing problem in the U.S., but labs that are supposed to detect the presence of pathogens aren’t up to snuff, according to a new report. The analysis, presented at the 113th General Meeting of the American Society for Microbiology, revealed worrisome gaps in the ability of food laboratories to detect or rule out the presence of common disease-causing bacteria such as E. coli, Salmonella, Listeria, and Campylobacter. The study involved about 40,000 food laboratory proficiency tests conducted over the last 14 years and showed that food microbiology laboratories that are supposed to identify pathogens in food submit a disturbing number of false negative and false positive results. The data was compiled by the American Proficiency Institute (API), a private institute that monitors the accuracy of bacterial testing among labs that voluntarily submit to the review.
“Rapidly identifying the pathogen responsible for an infection and testing for the presence of resistance is critical not only for diagnosis but also for deciding which antibiotics to give a patient,” said Ralph Weissleder, MD, PhD, Director of the Massachusetts General Hospital Center for Systems Biology and Professor of Radiology at Harvard Medical School in Boston. The new system is designed to reduce the emergence of treatment-resistant bacterial strains. Dr Weissleder said, “Since the NMR device can identify the drug-resistant strains in 2.5 hours, patients can be given accurate treatments on the same day, which will help reduce the emergence of these strains.” The researchers reported their results in the April 23 issue of Nature Communications and online in the May issue of Nature Nanotechnology.
New Diagnostic Test for Lymphatic Filariasis
A new diagnostic test for a worm infection that can lead to severe enlargement and deformities of the legs and genitals is far more sensitive than the currently used test, according to results of a field study in Liberia, in West Africa, where the infection is endemic. The new test found evidence of the infection - lymphatic filariasis - in many more people that the standard test had missed. The study, the first to independently evaluate the new test, was led by researchers at Washington University School of Medicine in St. Louis and funded by the Bill & Melinda Gates Foundation. The infection affects 120 million people living in 73 countries, leaving some 40 million profoundly disfigured and incapacitated. Both tests detect the presence of worms that cause lymphatic filariasis, a devastating mosquito-borne illness also known as elephantiasis.
Reflex Testing of Lung Cancer Tissue Needs to be Improved
In an ideal world, the oncologist meeting a patient newly diagnosed with nonsmall-cell lung cancer (NSCLC) will already have information on genetic mutations in the tumor, so can initiate targeted therapy (where appropriate) from the very start. For this to happen, however, there needs to be reflex (or automatic) testing of lung cancer tissue for genetic mutations and biomarkers. Findings from 2 recent surveys suggest that this is currently happening in less than half of cases. This shows a need for "greater collaboration in incorporating biomarker testing into a patient's care early on, with the goal of initiating an appropriate lung cancer treatment plan as soon as possible," said Kevin Lokay, vice president of oncology at Boehringer Ingelheim, in a statement.
Expanding Uses for Pap
Using a highly accepted and widely used Pap test for more than HPV screening may be the diagnostic equivalent of "more bang for the buck." That sort of helpful screening blast may be what researchers at Johns Hopkins Kimmel Cancer Center discovered when they used cervical fluid obtained during routine Pap tests to run a parallel test for ovarian and endometrial cancers.
Quest Acquires Concentra Lab and Toxicology Services
Quest Diagnostics (DGX), the world's leading provider of diagnostic information services, announced that it has acquired the toxicology and clinical laboratory business of medical center operator Concentra, a subsidiary of Humana Inc. (HUM). In addition, Quest Diagnostics has entered into a long-term agreement with Concentra to be its primary provider of workplace drug toxicology and clinical laboratory testing. This is Quest Diagnostics' third announcement regarding an acquisition of a laboratory business in 2013. In April, Quest Diagnostics announced plans to acquire the lab-related clinical outreach operations of Dignity Health in California and Nevada. In January, the company completed the acquisition of the clinical and anatomic-pathology outreach laboratory businesses of Massachusetts-based UMass Memorial Medical Center.
Dialysis facilities could cut bloodstream infection rates among their patients by up to half by following a set of recommendations from the U.S. Centers for Disease Control and Prevention, according to new research. The CDC suggested that adopting their protocols could save lives and reduce health care costs. "Dialysis patients often have multiple health concerns, and the last thing they need is a bloodstream infection from dialysis," CDC director Dr. Tom Frieden said in an agency news release. "These infections are preventable. CDC has simple tools that dialysis facilities can use to help ensure patients have access to the safe health care they deserve."
CDC Director Discusses Extreme Heat Awareness With Atlanta Area School Students
No one should die from a heat wave. But every year, extreme temperatures kills an average of 675 people in the United States more than hurricanes, lightning, tornadoes, earthquakes, and floods combined. Extreme heat affects everyone, but children, the elderly, the poor or homeless, people who work or exercise outdoors, and those with chronic medical conditions are most at risk. Throughout the week of May 20th CDC will feature new information and updates on the impact of heat related illness nationally; climate change and health, there will be a special focus on student athletes and health during Extreme Heat Awareness Week.
Ewwww -- Poop in Pools More Common Than You may Think, CDC Warns
Attention swimmers: More than half of the public pools tested in a new study contained bacterial evidence that someone may have pooped in the pool. Investigators from the Centers for Disease Control and Prevention worked with state and local public health departments last summer to collect samples from pool filters at 161 pools in the metro-Atlanta area. Some of the pools were public, some were in private clubs and some were in water parks. Over the winter, researchers used genetic tests to identify several types of pathogens in the filter samples. Among the 161 samples, 93 -- or 58% -- contained Escherichia coli, a bacterium that lives in the digestive tract of humans and other warm-blooded animals. The researchers treated the presence of E. coli as “a fecal indicator,” they wrote in their report. How did it get into the pools? In all likelihood, swimmers delivered some of it into the water by failing to take a thorough, soapy shower before getting into the pool. “Each person has an average of 0.14 grams of fecal material on their perianal surface that could rinse into the water,” the report notes.
Fecal Transplant: FDA Wants Regulation
Researchers who have been reporting success with the use of fecal transplant to treat resistant C. difficile are likely to need an OK from the FDA to continue that treatment. The reason the FDA is stepping into the "poop" involves the way in which the agency interprets existing regulations that cover biologic drugs. Fecal microbiota, it said, meets the definition of a biologic product and such products require an IND [Investigational New Drug approval] before they are tested in humans. FDA spokesperson Curtis Allen told MedPage Today that the FDA has not issued a new rule covering the fecal transplants, but going forward physicians will need an IND if they plan to use the treatment.
Vitamin C Kills Drug-Resistant TB in Lab Tests
Vitamin C can kill multidrug-resistant TB in the lab, scientists have found. The surprise discovery may point to a new way of tackling this increasingly hard-to-treat infection, the US study authors from Yeshiva University say in Nature Communications. An estimated 650,000 people worldwide have multidrug-resistant TB. Studies are now needed to see if a treatment that works using the same action as vitamin C would be useful as a TB drug in humans.
In the laboratory studies, vitamin C appeared to be acting as a "reducing agent" - something that triggers the production of reactive oxygen species called free radicals. These free radicals killed off the TB, even drug resistant forms that are untreatable with conventional antibiotics such as isoniazid. Lead investigator Dr William Jacobs, professor of microbiology and immunology at Albert Einstein College of Medicine at Yeshiva University, said: "We have only been able to demonstrate this in a test tube, and we don't know if it will work in humans and in animals.
Drugmakers including Bristol-Myers Squibb Co., Pfizer Inc. (PFE) and Eli Lilly & Co. (LLY) have spent billions of dollars on ineffective therapies in a so-far fruitless effort to come up with an effective treatment for dementia and Alzheimer’s. Now, in the latest of a steady drumbeat of research that suggests diet, exercise and socializing remain patients’ best hope, a study published today in the Proceedings of the National Academy of Sciences shows that vitamins B6 and B12 combined with folic acid slowed atrophy of gray matter in brain areas affected by Alzheimer’s disease.
“You don’t have any other options for these patients, so why not try giving them this cocktail of B vitamins?” says Johan Lokk, a professor and head physician in the geriatric department at Karolinska University Hospital Huddinge in Sweden, who wasn’t involved in the study.
Synthetic Influenza Virus May Cut Vaccine Delivery Time
Vaccines against pandemic influenza may reach the field faster if the virus' genetic sequence is posted immediately to the Internet and used as a template for influenza virus gene assembly and vaccine creation, according to an article published in the May 15 issue of Science Translational Medicine. Philip R. Dormitzer, MD, PhD, global head of virology and head of research in the United States for Novartis Vaccines and Diagnostics, Cambridge, Massachusetts, and colleagues developed a method that skips a time-consuming step in traditional vaccine production.
Mysterious Respiratory Illness Kills 2, Leaves 5 Others Hospitalized in Southeast Alabama
A mysterious respiratory illness has left five people hospitalized and two dead in southeast Alabama, state health officials said. Seven people have been admitted to hospitals with a fever, cough and shortness of breath in recent weeks, Alabama Department of Public Health spokeswoman Mary McIntyre said in a statement. Two of the seven have died. The Alabama Department of Public Health and the Centers for Disease Control Respiratory Laboratory are analyzing lab tests from all seven patients.
H7N9 Case Numbers Stalled, but Pandemic Potential Remains
Stay Vigilant, Initiate Treatment Early, CDC Urges
Despite the fact that since May 7, no new human cases of avian influenza A (H7N9) infection have been reported in China – the only country affected by the deadly virus to date – the CDC continues to encourage medical professionals in the United States to maintain a high level of alert and be prepared for the virus because its global pandemic potential still is unknown. The Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota, Minneapolis, reported that as of May 15, 131 lab-confirmed cases have been reported, including 36 deaths. Although the number of new H7N9 infections hasn't increased, the death toll is rising as previously confirmed patients remain hospitalized, battling complications that include acute respiratory distress syndrome and organ failure.
Swine Flu Found in Elephant Seals off California
Researchers have detected swine flu in elephant seals off the Central California coast, saying it was the first time a human pandemic strain has been found in marine mammals. However, none of the animals showed clinical signs of the illness.A University of California, Davis study found the seals contracted the H1N1 virus in 2010, as the pandemic caused by the virus was winding down in humans, the Contra Costa Times reported. The influenza virus commonly crosses species barriers, and it wasn’t the first time a marine mammal has been found to carry a human strain, UC Davis professor Tracey Goldstein told the newspaper. However, until now researchers had never found a human pandemic strain in marine mammals, Goldstein said.
The West Nile virus season last year was the deadliest since the virus emerged in the U.S. in 1999, according to the final CDC numbers. There were 286 confirmed deaths, The final tally for total laboratory-confirmed infections was 5,674, Infections were reported from all 48 contiguous states and the District of Columbia, although most (62%) came from just seven states -- California, Louisiana, Michigan, Mississippi, Oklahoma, South Dakota, and Texas. Texas was the hardest hit, accounting for one-third of all cases. The CDC alerted the public in August that West Nile virus activity was surging after years of waning, but even now the reason for the uptick remains unclear.
Navajo Confront an Increase in New H.I.V. Infections
A surge in H.I.V. infections on the Navajo reservation has doctors and public health workers increasingly alarmed that the virus that causes AIDS has resurfaced with renewed intensity in this impoverished region. A report released last month by the federal Indian Health Service found that there were 47 new diagnoses of human immunodeficiency virus on the reservation in 2012, up 20 percent from 2011. Since 1999, new H.I.V. cases among Navajo are up nearly fivefold, the report found. The tally of new cases from last year represents the highest annual number recorded among the tribe by the health agency.
Can Statins Cut the Benefits of Exercise?
An important new study suggests that statins, the cholesterol-lowering medications that are the most prescribed drugs in the world, may block some of the fitness benefits of exercise, one of the surest ways to improve health. No one is saying that people with high cholesterol or a family history of heart disease should avoid statins, which studies show can be lifesaving. But the discovery could create something of dilemma for doctors and patients, since the people who should benefit the most from exercise — those who are sedentary, overweight, at risk of heart disease or middle-aged — are also the people most likely to be put on statins, possibly undoing some of the good of their workouts.
Antibody Gets High Marks for Asthma Control
Asthma exacerbations decreased by 87% in patients treated with an investigational agent that targets the interleukin-4 (IL-4) receptor, results of a placebo-controlled phase II trial showed. Dupilumab was associated with an exacerbation rate of 6% compared with 44% in the placebo group. Measures of lung function and asthma control also improved significantly in the dupilumab arm, and treatment with the monoclonal antibody was associated with a reduction in biomarkers of Th2-driven inflammation.
Pot Luck: Could Marijuana Be Used to Treat Diabetes?
In research dubbed "remarkable" by an accompanying editorialist, US doctors describe how current users of marijuana appear to have better blood glucose control than never or former users. Existing cannabis smokers had lower levels of fasting insulin and were less likely to be insulin resistant than nonusers; this finding remained true even when patients with diabetes were excluded in this large sample from the National Health and Nutrition Survey (NHANES) between 2005 and 2010. Marijuana users also had smaller waist circumferences and higher levels of HDL cholesterol than never users, Elizabeth A. Penner, from the University of Nebraska College of Medicine, Omaha, and colleagues report in their article published online May 16 in the American Journal of Medicine.
A new, casually transmittable infection — a unique strain of bacterial meningitis — has cast a pall over the gay night life and dating scene, with men wondering whether this is AIDS, circa 1981, all over again. Seven men have died in New York City, about a third of diagnosed cases, since 2010. And in the last few months, the contagion seemed to be accelerating. It has targeted gay and bisexual men, and nobody knows exactly why. The city’s best hope to curb the outbreak is to vaccinate as many at-risk men as possible, focusing on those most in danger.
Handbags May Contain More Germs Than Average Toilet Flush
Washing your hands after using the bathroom might be a common practice to stop the spread of germs, but not many women may wash their hands after they put them in their purse. Twenty percent of handbags swabbed had levels of bacteria-related contamination which could potentially cross-contaminate other surfaces – and contained more germs than the average toilet flush, CBS New York reported. Leather handbags were the most likely to contain the most bacteria, because the spongy material is a perfect breeding ground, according to the study.
Brain to Be Model for Supercomputers
The brain’s repute took a big hit in 1997 when an IBM supercomputer defeated world chess champion Gary Kasparov in a match reported around the world. But in the second round, the brain is back. A Sandia National Laboratories-supported workshop in Albuquerque called NICE, for Neuro-Inspired Computational Elements workshop, discussed ways to use the brain’s superior ability to send electrical signals along massively parallel channels, with multiple intersections at downstream nodes, to handle rapidly changing, high-volume information.
U.S. Doctors Ramp up 'Routine' Use of EHRs, E-Prescribing: Report
U.S. physicians have shown a significant increase in accessing digital health data at double the rate of their global counterparts, according to a new report by IT consulting company Accenture. Doctors in the United States increased their "routine" use of health IT— such as e-prescribing and entering data in electronic health records (EHRs)—by 32 percent, compared with 15 percent of doctors in other countries, according to the May 9 report, titled "The Digital Doctor Is 'In,'" based on a survey conducted by Harris Interactive.
Health Records Safe Despite Tornado
An early report on Monday's tragedy in Oklahoma points to just how far this nation has come in a short time on health information exchange. The scouring winds of the massive tornado that struck Moore, Okla., a southern suburb of Oklahoma City, tore off part of the roof of Moore Medical Center a satellite of the Norman Regional Health System. But many of the essential elements of patient records for more than 2 million people have been backed up by the regional health information organization serving Oklahoma City and stored in a Cerner Corp. data warehouse “buried in the side of a large, manufactured hill in Kansas City,” Evacuating patients from the hospital in Moore was a problem, but wrangling its patients' records, won't be. Records stored by the exchange include patient demographics, visits, procedures, lab results, vital signs, histories and physicals, discharge summaries, discharge medications and radiology reports. The 7-year-old exchange has among its members 26 hospitals, 99 clinics and 2,500 users. The exchange claims 1,400 registered provider users and 2.4 million patients' records.
Lawsuit Says IRS Illegally Seized 60 Million Health Records
The suit filed in the Superior Court of San Diego by Robert Barnes, a Malibu lawyer representing a corporate client named John Doe Co, charged that IRS agents raided the company on March 11, 2011 in a tax case and seized the medical records. This seizure, the suit charged, violated privacy rules enshrined in the 1996 Health Insurance Portability and Accountability Act.
Physicians seeking medical staff privileges at a hospital should first go into a bathroom and fill a small paper cup, all for the sake of patient safety, suggests an article published online April 29 in JAMA. Requiring physicians to take a urine drug test as a condition of employment is already the norm at hospitals, but lead author Julius Pham, MD, PhD, and colleagues recommend that hospitals also screen medical staff applicants for possible impairment by substance abuse. In addition, while they are at it, hospitals might want to subject their medical staff to random drug tests and test physicians involved in any mishap — a sentinel event, in quality-control parlance — that leads to a patient's death, writes Dr. Pham
Little White and the Three Toxins
Previously unknown poisonous compounds isolated from a new species of mushroom may be responsible for the deaths of hundreds in China, but precisely how the fungus killed its victims is not clear. Over the course of 30 summers, as seasonal rains drenched the verdant highlands of Yunnan province in southwest China, here and there a villager would suddenly drop dead. The killer, which became known as Yunnan Sudden Death Syndrome, took roughly 400 lives over the course of 3 decades, but never revealed its identity. As the cases piled up, the Chinese government became increasingly anxious. Then, spurred into action by a TV documentary that aired in 2005, officials dispatched an elite investigative unit from the Chinese Center for Disease Control (CDC) and Prevention to scour the hills for clues. “Otherwise healthy people would suddenly faint, go into a coma, and die,” says Robert Fontaine, an epidemiologist at the US Centers for Disease Control and Prevention who was part of the investigative team. “So this was a major concern for the government.”
By the end of 2009, investigators had established that the majority of families that suffered SUDs had eaten T. venenata, whereas not one of the unaffected families living nearby had consumed it. In early 2012 they confirmed that T. venenata contains three toxic compounds: α-guanidinobutyric acid, known to cause seizures in rabbits, and two previously unidentified amino acids with unusual chemical configurations (Angew Chem Int Ed, 51:2368-70, 2012). No SUDs were reported from the areas of Yunnan monitored by the Chinese CDC in 2010 and 2011, so for now the case is closed—at least from a public-health perspective. “We know how to stop it, and interventions have worked,” says Fontaine. The molecular mechanisms by which the Little White took its victims remain the final mystery.
U.K. to Pilot Illumina Genetic Test for Breast, Ovarian Cancer
The U.K. is piloting a new genetic test developed by Illumina Inc. (ILMN) to help cancer patients and their doctors better identify appropriate treatments and help determine if relatives have cancer risk. Illumina’s TruSight test, to be introduced in 2014 at the Royal Marsden hospitals in London and Sutton, can analyze 97 genes that are linked to cancer within a few weeks for a few hundred dollars, the Wellcome Trust said in a statement. The pilot program will start for women with breast and ovarian cancer and may eventually be rolled out to the rest of the U.K. National Health Service and for other types of cancers, it said.
Saudi Officials Expand Labs to Track Deadly SARS-Related Virus
Saudi Arabia says it has dedicated nine additional laboratories to help investigators track a deadly new respiratory virus related to SARS that appears to be centered in the kingdom. Health Ministry announcement follows its report that two health care workers became ill this month after being exposed to patients with the virus. Experts are closely studying whether it can spread easily from person to person.
Rotavirus: India Unveils Cheap Rotavac Diarrhoea Vaccine
Scientists in India have unveiled a new low-cost vaccine against a deadly virus that kills about half a million children around the world each year. Rotavirus causes dehydration and severe diarrhoea and spreads through contaminated hands and surfaces and is rampant in Asia and Africa. India says clinical trials show the new vaccine, Rotavac, can save the lives of thousands of children annually. An Indian manufacturer said the vaccine would cost 54 rupees ($1; £0.65). International pharmaceutical companies GlaxoSmithKline and Merck produce similar vaccines but each dose costs around 1,000 rupees.
Niger Offers Cash Reward to Help Eradicate Guinea Worm
Niger is offering cash rewards to anyone reporting a case of Guinea worm as part of efforts to permanently eradicate the parasitic disease in the impoverished West African nation, the health ministry said. Though it once afflicted around 3.5 million people annually across Asia and Africa, according to the U.S.-based Carter Center, Guinea worm disease is now on the verge of being eradicated worldwide.
Anyone reporting a case of Guinea worm, confirmed as such by health authorities, would be offered a reward of 20,000 CFA francs ($39.58).
Disclaimer- The information provided in this news digest is intended only to be general summary information. It does not represent the official position of the Centers for Disease Control and Prevention and is not intended to take the place of applicable laws or regulations.
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