viernes, 16 de mayo de 2014



Healthcare News

A Weekly Compilation of Clinical Laboratory and Related Information 
from The Division Of Laboratory Programs, Standards And Services


May 15, 2014


View Previous Issues - Healthcare News Archive


Findings Confirm What Pathologists Have Known for Years: Significant Numbers of Primary Care Doctors Are Uncertain About the Correct Clinical Laboratory Test to Order

National survey of 1,769 family practice and internal medicine specialists determines that they are struggling to stay current with changing guidelines for ordering and interpreting medical laboratory tests. These are two conclusions resulting from a survey published in the March-April edition of the Journal of the American Board of Family Medicine (JABFM). It is important that clinical laboratory administrators and pathologists understand the survey findings for two important reasons. First, as reimbursement moves away from fee-for-service to other forms—such as bundled payment and per-patient-per month—laboratory managers will need to deal with the problem of unnecessary utilization of medical laboratory tests. Second, the findings of this survey suggest an opportunity for pathologists and lab administrators to improve the utilization of lab test resources by streamlining systems and opening or improving communication channels with the doctors.
Sources of Confusion Range from Test Names to Costs 
As to what causes their uncertainty, primary-care doctors responded as follows:
  • Absence of information about patient costs (53%)
  • Insurance restrictions (40%)
  • Different names for the same test (20%)
Missing lab test results and confusing report formats were other challenges perceived by the doctors. This suggests an opportunity for clinical laboratories to improve and enhance lab test reporting procedures to help physicians get optimal value from test results. In addition, clinical laboratories should improve their electronic test ordering capabilities by adding features that show physicians medical laboratory test costs and patient insurance deductibles before physicians order tests. The study’s purpose was to reveal challenges and solutions primary-care doctors perceive in ordering and interpreting clinical laboratory tests. Titled” Primary Care Physicians’ Challenges in Ordering Clinical Laboratory Tests and Interpreting Results,” this national survey was completed in 2011. This data is from a study that was sponsored by the Clinical Laboratory Integration into Healthcare Collaborative (CLIHCTM) program from the CDC’s Division of Laboratory Programs, Standards, and Services.


AACC Calls FDA’s Proposed Method to Improve Glucose Meters a ‘Burden’

The American Association for Clinical Chemistry has responded to the FDA’s recent draft proposal to reclassify usage guidelines for prescription blood glucose meters, saying that the changes would limit opportunities to monitor blood glucose in critical care scenarios. The organization supports the FDA’s initiative to enhance patient care but recommends improving clinical protocols in critical care rather than increasing regulatory requirements for the equipment.


Protein "Clue" Will Allow Doctors to Diagnose Pneumonia "Within Minutes," Saving Children’s Lives

Should a breathless child with fever be treated with antibiotics in case they have pneumonia? This is the question emergency doctors ask themselves many times a day, and currently it takes over 24 hours to get a definitive answer. Pneumonia remains the leading cause of death in children globally. Being able to tell whether a child has severe pneumonia caused by bacteria which must be treated quickly with antibiotics is critical. A paper published in leading journal Clinical Infectious Diseases by Dr Climent Casals-Pascual, a researcher at the University of Oxford's Wellcome Trust Centre for Human Genetics, has revealed that a protein "clue" detected in the blood can be used to diagnose pneumonia caused by bacteria in minutes


Depression is Detectable in the Blood

While blood tests for mental illnesses have until recently been regarded as impossible, a recent study clearly indicates that, in principle, depression can in fact be diagnosed in this way and this could become reality in the not too distant future. Researchers at the MedUni Vienna have now used functional magnetic resonance imaging of the brain and pharmacological investigations to demonstrate that there is a close relationship between the speed of the serotonin uptake in blood platelets and the function of a depression network in the brain. "This is the first study that has been able to predict the activity of a major depression network in the brain using a blood test. 


Researchers Make Luminescent Nanocrystals Glow at Different Rates for Rapid DiseaseDetection

Researchers from Macquarie University in Sydney, Australia and Purdue University are researching so-called “t-Dots,” luminescent nanocrystals, as marker tags for use in medical screening and other applications. Their latest work, published in Nature Communications, has focused on offering a new variable in optical detection of luminescent nanoparticles: time. The team tested the technology in detecting pathogen DNA strands and have reported that “tunable luminescence lifetimes have considerable potential in high-throughput analytical sciences,” according to the study abstract.


Electronic Nose 'Sniffs Out' Prostate Cancer

A new "electronic nose" is capable of detecting prostate cancer from a urine sample with nearly 80% accuracy, according to a proof-of-concept pilot study published in the Journal of Urology. The device, ChemPro 100 eNose (Environics Inc), is still relatively early in development, but experts say it has potential to add to current diagnostic methods, which include screening for prostate-specific antigen (PSA). The device was put to the test with samples from 50 patients with biopsy-confirmed prostate cancer and 15 patients with benign prostatic hyperplasia (BPH). It detected cancer with a sensitivity of 78%, specificity of 67%, and area under the curve of 0.77.


MIT Scholar Fights Malaria With Magnets

Invention holds promise for quick, accurate diagnosis of the fatal disease, even in the most challenging situations Even though malaria kills more than 600,000 people every year, it’s often difficult to tell who has got it. For a proper test, you need skilled health care workers and sensitive chemicals. Both are often difficult to obtain in hard-hit regions like sub-Saharan Africa. Now John Lewandowski, a graduate student in mechanical engineering at the Massachusetts Institute of Technology, thinks he has the answer. He helped invent a battery-powered machine that uses magnets and lasers to identify malaria-infected blood, and cofounded a company, Disease Diagnostic Group (DDG), to develop it. The small device, called the Rapid Assessment of Malaria (RAM), is portable and easy to use in the field; testers do not need specialized medical training. Each test can be done in about one minute, and cheaply — for about 25 cents. Importantly, it can also detect malarial infections in people who do not yet show symptoms of the disease.


Mayo Clinic Launches 50-gene Cancer Panel Test

Mayo Clinic announces the launch of CANCP, a new gene panel cancer test to help tailor chemotherapy to the individual patient based on the unique genomic signature of the patient’s tumour. CANCP, an abbreviation for Solid Tumour Targeted Cancer Gene Panel by Next-Generation Sequencing, scans specific regions in 50 genes known to affect tumour growth and response to chemotherapy.


FDA Clears BD Max Enteric Bacterial Panel

The panel is a qualitative test that detects DNA from Campylobacter spp. (jejuni and coli), Salmonella spp., Shigella spp. / Enteroinvasive E. coli (EIEC) as well as stx 1 and stx 2 genes in stool specimens. According to BD, these pathogens are responsible for up to 95 percent of bacteria-causing gastroenteritis and account for millions of deaths annually. The panel runs on the BD Max System, which automates sample preparation, extraction, amplification, and detection on a single system.


Double-coded Tubes Ensure Traceable Tissue Storage

Micronic’s externally threaded 3.00-mL tube provides a fully traceable storage solution for tissue samples. With a unique 2-D data matrix code laser encrypted on the bottom, and large human-readable code on the sidewall, the 3.00-mL tissue tubes provide easy and unambiguous identification and storage of donor and transplant samples. For highly accurate and reliable results, the tissue tubes are produced from medical-grade polypropylene. To ensure high sample integrity, even down to vapor phase liquid nitrogen temperatures, the tissue tube includes a “single turn” TPE/polypropylene screw cap that stays securely in place even during repeated freeze/thaw cycles. 


Many People With Gluten Sensitivity Haven’t Had Proper Tests

People who believe they are sensitive to gluten have often not been adequately tested to rule out celiac disease, reports a new study. Jessica R. Biesiekierski told Reuters Health that people with trouble digesting gluten who are not tested for celiac disease may not get proper treatment, which could lead to health problems down the line. She led the new study at Eastern Health Clinical School at Monash University and Alfred Hospital in Melbourne, Victoria, Australia.


Recycled Blood is Better Than Donated Blood for Transfusions, Hopkins Study Finds

We recycle a lot of things — paper, plastic, metal, blood.
Yes, blood. During some surgeries, operating room personnel try to capture as much blood as possible and return the red blood cells to your system, instead of, or in addition to, donated blood from a blood bank. They find that patients have better outcomes when transfused with their own blood. A Johns Hopkins University study, published in the June issue of the journal Anesthesia and Analgesia, explains one reason for that. As banked blood sits on shelves for as long as 42 days, the membranes of red blood cells become less able to change shape and squeeze through the smallest capillaries to deliver critical oxygen to tissues.


Researchers 3-D Print Liver-Like Device to Detoxify Blood

Researchers at UC San Diego have developed a 3-D-printed device that can detoxify blood in much the same manner as the liver, using nanoparticles to lure and trap toxins that damage cells. The “biomimetic 3D detoxifier” is specifically designed to remove “pore-forming toxins” that can pierce the membrane of healthy cells. These are often the result of venomous animal bites or stings, or an antibiotic-resistant bacterial infection such as Methicillin-resistant Staphylococcus aureus (more commonly known as a staph infection).


A Central Receptor for Blood Coagulation Decoded; Potential for New Drugs to Treat Stroke and Heart Attacks

An international team of researchers in cooperation with the University of Bonn has taken two "snapshots" of a receptor which are of critical importance for blood coagulation. The scientists now hope to be able to develop novel drugs using these results. These include tailor-made blood-thinning substances for heart attack and stroke patients whose effects are reversible and better controllable than those of current therapies. The researchers are presenting their results in the renowned journal Nature.


Optical Traps on Chip Manipulate Many Molecules at Once

Optical trapping, a technique for studying single molecules, is traditionally delicate, requiring special equipment and a soundproof room, with data collected one molecule at a time. Cornell physicists have shrunk the technology of an optical trap, which uses light to suspend and manipulate molecules like DNA and proteins, onto a single chip. And instead of just one molecule at a time, the new device can potentially trap hundreds of molecules at once, reducing month-long experiments to days. “We love single-molecule experiments because the data are beautiful and clear, and we learn so much by manipulating and perturbing molecules and watching how things change,” said Michelle Wang, professor of physics, who led the study published online in Nature Nanotechnology April 28. In their paper, they also described transporting molecules over a relatively long distance using the waveguides. This ability lets the new optical trap integrate with existing fluorescence labeling techniques for tagging molecules of interest


Scientists Add Letters to DNA’s Alphabet, Raising Hope and Fear

Scientists reported that they had taken a significant step toward altering the fundamental alphabet of life — creating an organism with an expanded artificial genetic code in its DNA. The accomplishment might eventually lead to organisms that can make medicines or industrial products that cells with only the natural genetic code cannot. The scientists behind the work at the Scripps Research Institute have already formed a company to try to use the technique to develop new antibiotics, vaccines and other products, though a lot more work needs to be done before this is practical. The work also gives some support to the concept that life can exist elsewhere in the universe using genetics different from those on Earth.


Soy Sauce Molecule May Unlock Drug Therapy for HIV

Virologists at the University of Missouri have discovered that a potent molecule found in soy sauce has the potential to serve as a next generation treatment to stop HIV from spreading in the body. HIV patients undergoing treatment with anti-AIDS medications often develop resistance to first-line drug therapy regimens such as Tenofovir. The researchers’ work suggests that the molecules may help in the development of compounds that can be 70 times stronger than Tenofovir. “EFdA, the molecule we are studying, is less likely to cause resistance in HIV patients because it is more readily activated and is less quickly broken down by the body as similar existing drugs,” said Stefan Sarafianos, associate professor of molecular microbiology and immunology in the University of Missouri School of Medicine, and a virologist at the Bond Life Sciences Center at MU.


Patient’s Cells Deployed to Attack Aggressive Cancer

Doctors have taken an important step toward a long-sought goal: harnessing a person’s own immune system to fight cancer. An article published in the journal Science describes the treatment of a 43-year-old woman with an advanced and deadly type of cancer that had spread from her bile duct to her liver and lungs, despite chemotherapy. Researchers at the National Cancer Institute sequenced the genome of her cancer and identified cells from her immune system that attacked a specific mutation in the malignant cells. Then they grew those immune cells in the laboratory and infused billions of them back into her bloodstream. The tumors began “melting away,” said Dr. Steven A. Rosenberg, the senior author of the article and chief of the surgery branch at the cancer institute. The woman is not cured: Her tumors are shrinking, but not gone. And an experiment on one patient cannot determine whether a new treatment works.


Rare Byproduct of Marine Bacteria Kills Cancer Cells by Snipping Their DNA

Yale University researchers have determined how a scarce molecule produced by marine bacteria can kill cancer cells, paving the way for the development of new, low-dose chemotherapies. The molecule, lomaiviticin A, was previously shown to be lethal to cultured human cancer cells, but the mechanism of its operation remained unsolved for well over a decade. In a series of experiments, Yale scientists Seth Herzon, Peter Glazer, and colleagues show that the molecule nicks, cleaves, and ultimately destroys cancer cells’ DNA, preventing replication. Results were published May 11 in the journal Nature Chemistry.


Have Cervical Cancer Rates Been Underestimated?

The estimated rate of invasive cervical cancer increased by almost 60% after excluding women who had hysterectomies and were no longer at risk for the cancer, an analysis of a national database showed. The overall rate increased from 11.7 cases per 100,000 women to 18.6 after correcting for hysterectomy. The largest increase occurred in women 65 to 69, an age group with historically low rates of cervical cancer, reported Anne F. Rositch, PhD, assistant professor of epidemiology and public health at the University of Maryland School of Medicine, and colleagues. Additionally, adjusting for hysterectomy substantially increased the incidence disparity between black and white women. The findings suggest a need to reconsider cervical cancer screening guidelines, particularly the age at which women should stop being screened, they wrote online inCancer.


The Genes Responsible for Deadly Prostate Cancer Discovered

Treating prostate cancer has always been trickier than most patients anticipate. Unlike other cancers, most prostate tumors are slow-growing and emerge late in life, so the majority of men affected are more likely to die of other causes than their cancer. For up to 15% of cases, however, the disease can be fast-moving and life-threatening, and because doctors don’t have good ways of separating these aggressive cases from the less dangerous ones, many physicians and patients prefer to err on the side of over-treatment. Recent changes to prostate screening recommendations advising men not to get routine blood tests that can signal the disease have made matters more confusing for men worried about the disease. That may soon change, thanks to a test that can pick out the slow-growing cancers from the faster-growing ones. Researchers at Columbia University report in the journal Cancer Cell that they have identified two genes that are likely driving the most aggressive cases of prostate cancer. Other scientists had linked the genes, FOXM1 and CENPF, to cancer, but none had connected them to prostate growths. And more importantly, none had figured out that the two genes’ cancer-causing effects only occurred if they are turned on at the same time.


Smart Seniors Might Have This Gene Variant

A gene variant that scientists already knew to be associated with longer life also seems to make people smarter, and may help offset the effects of normal cognitive decline in old age, according to a team of San Francisco researchers. The findings, published in the journal Cell Reports, are encouraging news for the roughly 1 in 5 people who have the genetic trait, which is a variant of the klotho gene. Beyond that, scientists hope the findings will help them develop tools for retaining, or even boosting, intelligence in people who have suffered cognitive losses, either from disease or through the normal course of aging.


Human Stem Cells Reverse Multiple Sclerosis in Mice

Researchers in California have discovered – almost by accident – that human stem cells can reverse a multiple sclerosis type condition in mice. The findings, which will soon be published in the journal Stem Cell Reports, could potentially lead to new types of treatment for multiple sclerosis (MS). When scientists first transplanted the stem cells into severely disabled MS mice, they thought the cells would be rejected, much like donor organs are rejected after a transplant. But the experiment had surprising results.


Drug to Fight Leukemia in Sight, say Australian Researchers

After discovering a potential molecular "target" for leukemia, Australian researchers say a drug to fight the disease is "in their sights," although it is still very early days. Writing in the journal Blood, they describe how the interaction of two proteins - Myb and p300 - appears to be essential to the development of acute myeloid leukemia and how its disruption "could lead to a potential therapeutic strategy."


Red Wine and Health: Resveratrol Health Benefits a Myth?

Resveratrol -- an antioxidant found in red wine, chocolate, and grapes -- didn't correlate with longevity or lower risk of cancer or cardiovascular disease when dietary intake was directly measured in a prospective study. Older adults in the Chianti wine-making region of Italy with the top dietary intake as indicated by urinary metabolites weren't any less likely to die over 9 years of follow-up, Richard D. Semba, MD, MPH, of Johns Hopkins University, and colleagues found.


Black Death Skeletons Give up Secrets of Life and Death

The medieval Black Death led to better health for future generations, according to an analysis of skeletons in London cemeteries. Tens of millions of people died in the epidemic, but their descendants lived longer and had better health than ever before, a study shows. The Black Death was one of the most devastating epidemics in human history. The improvements in health only occurred because of the death of huge numbers of people, said a US scientist. It is evidence of how infectious disease has the power to shape patterns of health in populations, said Dr Sharon DeWitte of South Carolina University.


Common Chemicals Challenge Sperm

Chemicals known as endocrine disruptors, commonly found in our food and products such as makeup, sunscreen and toothpaste, have been shown to cause fertility problems. Researchers found endocrine disruptors can interfere with human sperm's ability to move, navigate and/or penetrate an egg. Their study results were published in EMBO reports. Endocrine disruptors are chemicals that interfere with your endocrine system - the system in your body that regulates hormones. These hormones control everything from your metabolism to your sleep cycle to your reproductive system, so messing with them can cause serious issues. Scientists have a long list of potential endocrine disruptors, including bisphenol-A (BPA), phthalates, dioxin, mercury and perfluorinated chemicals (PFCs). They can be natural or man-made and are virtually "omnipresent," the study authors write, in our food and in common household and personal care products.


Being Bullied is Bad for Your Health

Victims of bullying may develop long-term physical and mental health problems, and now researchers have found one possible reason: Being bullied raises the blood’s level of C-reactive protein, or CRP, a marker of systemic inflammation and a risk factor for cardiovascular and other diseases. Scientists followed 1,420 boys and girls ages 9 to 21, interviewing bullies, victims and their parents. They assessed CRP levels with periodic blood tests. After controlling for initial levels of CRP and for many factors that affect it — sex, age, race and various health and socioeconomic issues — the researchers found that CRP levels in victims increased in direct proportion to the number of bullying incidents they experienced.


Asthma Risk Up With Early Antibiotic Use

Kids treated with antibiotics before their first birthday have increased risk of asthma, researchers reported. And the risk increases the more often antibiotics are prescribed, according to Kenneth Mandl, MD, of Harvard Medical School, and colleagues. The finding supports the so-called hygiene and microbiota hypotheses put forward to explain the increasing prevalence of asthma, Mandl and colleagues concluded online in Annals of Allergy, Asthma, and Immunology. The association doesn't prove that antibiotic use causes asthma, they cautioned, since it could also be true that some other factor causes both asthma and the need for antibiotics. But the finding is sufficiently strong that doctors should be careful when prescribing antibiotics for infants, they argued.


CO2 'Significantly Reduces' Nutrients in Major Food Crops

Rising levels of CO2 around the world will significantly impact the nutrient content of crops according to a new study. Experiments show levels of zinc, iron and protein are likely to be reduced by up to 10% in wheat and rice by 2050. The scientists say this could have health implications for billions of people, especially in the developing world. The report has been published in the journal Nature. Researchers have struggled over the past two decades to design large scale field trials to accurately model the impacts of increased CO2 levels on the nutritional makeup of crops.


Syphilis Rates in US Doubled Since 2000, Still Rising

Syphilis incidence is continuing to rise and is now twice that of the US nadir, according to an analysis of data from the National Notifiable Diseases Surveillance System (NNDSS), published in the May 9 issue of the Morbidity and Mortality Weekly Report. Rates are highest among black men and men who have sex with men (MSM), with recent increases among Hispanic and white men. In 2013, states reported an overall rate of 5.3 cases of primary and secondary syphilis per 100,000 population, which is more than 2-fold higher than the nadir of 2.1 in 2000, write Monica E. Patton, MD, Epidemic Intelligence Service officer at the Centers for Disease Control and Prevention, Atlanta, Georgia, and colleagues.


Oldest Patients are Often Left out of Drug Trials

“There are almost no data to guide cardiovascular disease management for people who are over 80 and relatively poor data for people over 70,” Forman says. “You have smart and caring doctors trying to practice evidence-based medicine, but there is little evidence.” While doctors and policymakers have long recognized that translating drugs from adults to children might not be as easy as halving the dose, and that the toxicities that are common in men might be different than in women, researchers say that the same understanding lags when it comes to older adults. But now, with aging baby boomers and the so-called oldest old — people age 85 or older — making up the fastest-growing segment of the US population, the issue is gaining attention.


Science Booming

Scientists, as a group, have been quite busy, and have been for quite some time. They have increased the number of papers and research findings they publish at a rate of around eight to nine percent per year, according to a new analysis. That means researchers around the world have been roughly doubling global scientific output every nine years, two bibliometric analysts say, as Nature reports. But how long has this trend been going on? The authors of the study, which is to be published in the Journal of the Association for Information Science and Technology, say they found that scientists have likely been keeping up this rate of increase since the end of World War II.


CDC Targets 5 Parasitic Infections

Five types of parasitic infections have just been labeled priorities for public health action by U.S. health officials. "Parasitic infections affect millions around the world causing seizures, blindness, infertility, heart failure, and even death," Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, said in an agency news release. "They're more common in the U.S. than people realize and yet there is so much we don't know about them. We need research to learn more about these infections and action to better prevent and treat them," Frieden added. The five neglected parasitic infections in the United States are: Chagas disease, cysticercosis, toxocariasis, toxoplasmosis, and trichomoniasis. All were targeted based on the number of people infected, the severity of the illnesses, and the ability to prevent and treat them, the CDC said.


MERS Watch: Second U.S. Case in Florida

A healthcare provider who lives and works in Saudi Arabia is the second confirmed case of the Middle East coronavirus (MERS) in the U.S., the CDC says. The case, which is not linked to the first case reported, is "unwelcome but not unexpected," according to CDC Director Tom Frieden, MD, adding that the risk to the general public is "extremely low." The man left Saudi Arabia May 1 on a flight from Jeddah to London and continued on, through Boston and Atlanta, to Orlando, Frieden told reporters in a telephone briefing. While traveling, the patient began to feel unwell, with fever, chills and a slight cough, according to Anne Schuchat, MD, director of the CDC's National Center for Immunization and Respiratory Diseases. But the illness was not severe enough to seek further medical attention until May 8, when the patient went to Dr. P. Phillips Hospital and was admitted. Hospital staff are using standard contact and airborne infection control measures, she said. Testing by the hospital suggested a MERS infection, which was confirmed by the CDC.


MERS Watch: Florida Hospital Staff Exposed

Two Florida healthcare workers have developed flu-like symptoms after exposure to the second U.S. case of Middle East coronavirus (MERS). They, and 18 other healthcare workers at two Orlando hospitals, are being tested for the virus, which can cause serious illness and death, medical officials said at a media conference. They were exposed to the patient in the emergency room of Dr. P. Phillips Hospital before it was clear he was at risk for MERS, officials told reporters. One of the two with symptoms has been admitted to the hospital and the other is in isolation at home. The patient himself, a 44-year-old Saudi Arabian healthcare provider visiting family in the area, has a low-grade fever and a slight cough and remains in isolation at the hospital. Fifteen of the affected workers were involved in caring for the patient himself, but the other five were exposed when the patient last week accompanied another person to Orlando Regional Medical Center for an unrelated medical procedure.


California Lab Group Sues HHS Challenging Medicare Contractors’ Authority on Local Coverage Policy

Certain members of the California Clinical Laboratory Association and an elderly woman who was denied coverage for pharmacogenetic testing are suing HHS alleging that the use of private contractors by the Centers for Medicare & Medicaid Services to establish local coverage decisions (LCDs) for lab tests is illegal and unconstitutional. HHS or CMS has not yet filed a response with the district court. A CMS spokesperson told PGx Reporter that the agency will not comment on ongoing litigation.


UF Health Successfully Implements Genomic Medicine Program

At the conclusion of the first year of UF Health’s Personalized Medicine Program, the results are in: The program has successfully implemented a process for genetic testing that helps cardiologists identify which patients may benefit from a switch to an alternate anticlotting medication. In June 2012, UF Health began offering a genetic test that assessed how patients would respond to the drug. The test identified more than a quarter of the 1,000 patients who carry genetic traits that prevent them from metabolizing clopidogrel successfully, said Kristin Weitzel, associate director of the Personalized Medicine Program. This means that the drug may be less effective for these patients, leaving them at greater risk for heart attack or stroke.


DTC's Harms?

After the US Food and Drug Administration swung into action last year to stop 23andMe from marketing its service as a source of health information to consumers, one of the criticisms leveled at FDA was that there is no evidence that DTC [direct-to-consumer] tests have caused any harm. Boston Children's Hospital's Vector Blog highlights a new paper which says errors from a DTC can cause harm.


Medicare Pays Billions of Dollars for Wasteful Procedures –Study

As many as 42 percent of U.S. Medicare patients were subjected to procedures providing little if any medical benefit, costing the government program up to $8.5 billion in wasteful spending, according to a study  published. The research, reported in JAMA Internal Medicine, is the first large-scale analysis of what Medicare spends on procedures widely viewed as unnecessary, from advanced imaging for simple lower back pain to pre-operative chest X-rays and putting stents in patients with stable heart disease. The study looked at the frequency at which doctors used 26 such procedures in 2009. It builds on the growing body of work in the field of evidence-based medicine, which applies rigorous scientific scrutiny to common procedures. Using that approach, oncologists, cardiologists and other specialists have identified several hundred questionable procedures as part of the "Choosing Wisely" campaign, which began in 2012.


NIH Launches $20 Billion Governmentwide IT Procurement

A new governmentwide contract worth up to $20 billion includes everything from fax machines to genetic sequencers to enterprise storage, according to solicitation documents. The Chief Information Officer-Commodities and Solutions -- or CIO-CS -- contract aims to support information technology across the federal government, particularly focusing on agencies involved in health care and clinical and biological research, like the National Institutes of Health and its parent, the Health and Human Services Department.


IOM to Study Diagnostic Error

An ad hoc committee of the Institute of Medicine’s Board on Health Care Services will evaluate the existing knowledge about diagnostic error in medicine from a patient safety perspective. The Committee on Diagnostic Error in Medicine will examine current definitions of diagnostic error (and illustrate examples); the epidemiology, burden of harm, and costs associated with diagnostic error; and what is being done to improve diagnosis. Sponsored by the Agency for Healthcare Research and Quality, the Centers for Disease Control and Prevention, as well as a variety of other non-governmental organizations, including ASCP, the study will be a continuation of the IOM Health Care Quality Initiative, which includes the IOM reports To Err is Human: Building a Safer Health System (2000) and Crossing the Quality Chasm: A New Health System for the 21st Century (2001).


A Simple Theory, and a Proposal, on H.I.V. in Africa

While around the world a vast majority of AIDS victims are men, Africa has long been the glaring exception: Nearly 60 percent are women. And while there are many theories, no one has been able to prove one. In a modest public health clinic behind a gas station here in South Africa’s rural KwaZulu/Natal Province, a team of Norwegian infectious disease specialists think they may have found a new explanation. It is far too soon to say whether they are right. But even skeptics say the explanation is biologically plausible. And if it is proved correct, a low-cost solution has the potential to prevent thousands of infections every year. The Norwegian team believes that African women are more vulnerable to H.I.V. because of a chronic, undiagnosed parasitic disease: genital schistosomiasis (pronounced shis-to-so-MY-a-sis), often nicknamed “schisto.” The disease, also known as bilharzia and snail fever, is caused by parasitic worms picked up in infested river water. It is marked by fragile sores in the far reaches of the vaginal canal that may serve as entry points for H.I.V., the virus that causes AIDS. Dr. Eyrun F. Kjetland, who leads the Otimati team, says that it is more common than syphilis or herpes, which can also open the way for H.I.V.
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