Observatory
News/ Trends/ Analysis
Michigan girl dies of rare blood infection. A 6-year-old girl in Coopersville, MI, died on Aug. 1 due to sepsis associated with group A beta-hemolytic streptococcal infection, an autopsy showed. The Grand Rapids Press reports the girl likely got the infection, which became aggressive in a very short time, after a fall from her bicycle two days before her death. She was treated at a local healthcare facility on July 31, but a low-grade fever did not indicate the presence of the rare septic blood infection. She was found the next morning in her bed, not breathing.
Scientists find drug-resistant superbug. Scientists say they have discovered new drug-resistant bacteria that appear to be spreading worldwide. A new study has uncovered the spread of New Delhi metallo-a-lactamase 1 (NDM-1), an enzyme that is extremely resistant to antibiotics. NDM-1 can exist inside different bacteria such as Escherichia coli and Klebsiella pneumonia. Scientists say NDM-1 can turn almost any type of bacteria into a powerful superbug, and even the strongest antibiotics are unable to treat these infections. The European Society of Clinical Microbiology and Infectious Diseases says no new antibiotics to treat NDM-1 infections are likely to be available for at least 10 years. An Aug. 11 article in Lancet Infectious Diseases reports that bacteria containing NDM-1 has been found in 37 Britons who had received medical treatment in South Asia. NDM-1 was first discovered in India and Pakistan but has now been seen in the U.S., Netherlands, Australia, Canada, Japan, and the United Kingdom.
Seminal HIV differs from blood HIV. An international team of researchers found differences between the HIV found in semen and HIV found in blood, indicating that HIV in the blood is not always representative of transmitted HIV. In semen, HIV particles can be relatively homogeneous in genetic terms, or they can have patterns of genetic diversity that differ markedly from those seen in the blood of the same patient, according to researchers at the University of North Carolina Center for AIDS Research in Chapel Hill. The finding, from a small cross-sectional study of men with untreated HIV infection, may be important for understanding transmission of the virus, Anderson and colleagues reported in “HIV-1 populations in semen arise through multiple mechanisms” published in June online in PLoS Pathogens.
More states report rise in pertussis cases. Currently, several states are reporting an increase in whooping cough cases, including a state-wide epidemic in California. Health officials estimate that 1,500 Californians have been diagnosed with whooping cough in 2010, which is five times the normal level for this time of year. Doctors are investigating another 700 possible cases. Seven infants in California have died from pertussis so far this year. California health officials have said they believe gaps in tetanus, diphtheria, and pertussis (Tdap) vaccine coverage is contributing to the rise in pertussis cases. Health officials in Idaho, Michigan, Ohio, Oregon, South Carolina, and Texas have also reported rising numbers of pertussis cases. The Centers for Disease Control and Prevention (CDC) has received reports of 7,342 provisional cases, according to the July 30 issue of Morbidity and Mortality Weekly Report.
New studies
Ferroportin levels predict breast-cancer prognosis. A study published online in Science Translational Medicine by researchers at Wake Forest University Baptist Medical Center found that low levels of ferroportin, the only known protein to eliminate iron from cells, are associated with the most aggressive and recurring cancers. The finding suggests that testing for ferroportin levels in women with breast cancer may one day help doctors to more accurately predict whether their patients' cancer will return. It may also help some women with high levels of the protein to avoid invasive or toxic treatments such as chemotherapy.
Celiac-disease diagnosis increasing. Studies from the United States, Europe, and elsewhere indicate that the prevalence of celiac disease (CD) has increased significantly since 1950. Researchers at the Mayo Clinic report an increase in CD, according to an article in the summer issue of the Mayo Clinic's research magazine, Discovery's Edge, after stored blood samples taken from Air Force recruits in the early 1950s for gluten antibodies was analyzed. Researchers assumed that 1% would be positive, mirroring today's rate. The number of positive results was far smaller, indicating that CD was once rare. These results, compared to more recently collected samples, suggest that CD is roughly four times more common now than in the 1950s.
Vitamin D may influence genes. Scientists have discovered a link between vitamin D and genes related to autoimmune diseases and cancer, reports HealthDay News. The findings, published in the Aug. 23 online edition of the journal Genome Research, highlight the serious risks associated with vitamin D deficiency. Vitamin D has an effect on genes through the vitamin D receptor, which binds to specific locations on the human genome to influence gene expression. In this study, the researchers mapped sites of vitamin D receptor binding — information that can be used to identify disease-related genes that might be influenced by vitamin D. The researchers found that vitamin D receptor binding is significantly enhanced in regions of the human genome associated with several common autoimmune diseases, such as multiple sclerosis, type 1 diabetes, and Crohn's disease, as well as in regions associated with leukemia and colorectal cancer.
Scientists working on blood substitute. Researchers are taking several different approaches to develop artificial blood, reports The Independent. Some are using perfluorocarbons, which can carry both oxygen and carbon dioxide, while others are trying to convert stem cells into type-O-negative red blood cells. It has been predicted that human trials of the stem-cell-derived blood could start in 2013. Other researchers are also developing artificial-blood products based on hemoglobin. In one trial involving 688 patients undergoing elective orthopedic surgery, patients received either one unit of real blood or two units of blood-substitute HBOC-201, a hemoglobin-based product. Made from a bovine source, the substitute can be kept at room temperature and does not need to be matched with blood type. Scientists from the University of Sheffield in the U.K. are working on artificial blood designed to be stored as a thick paste that can be dissolved in water before use. It is made from plastic molecules that hold at their core an iron atom that, like hemoglobin, could transport oxygen around the body. Another product in clinical trials — made from hemoglobin taken from outdated human red-blood cells which is wrapped in a coating of polyethylene glycol — is produced in powder form. When it is needed, the powder could be mixed into liquid form and transfused immediately, regardless of a patient's blood type, without any risk of transmitting infectious diseases.
Worth noting
Reference book. Amitava Dasgupta, PhD, explains in Prescription or Poison? The Benefits and Dangers of Herbal Remedies how toxic some alternative remedies can be, alone or in combination with prescribed drug treatments. The author also includes information on how alternative medicines can affect lab results and certain medical conditions. A full review of the book can be found in the October issue of the e-newsletter LABline and the November issue of MLO.
Conferences
Oct. 8. The 6th Annual Clinical Laboratory Day at Wake Technical Community College, Raleigh, NC, will demonstrate a simple model for understanding quality in the laboratory including the 12 building blocks of quality. In addition, it will define four types of quality costs: prevention, appraisal, internal failure, and external failure; and summarize the top 10 deficiencies found during CLIA inspections. Go to www.quia.com/sv/417979.html.
Oct. 9-12. The 2010 AABB Annual Meeting and CTTXPO at the Baltimore Convention Center will offer 120 education sessions, showcase the latest products and services from 200 exhibitors, and provide networking opportunities for attendees from the blood-banking, transfusion medicine, and cellular and related biological-therapy communities worldwide. Visit www.aabb.org.
Oct. 27-31. The ASCP Annual Meeting at the San Francisco Marriot Marquis will include more than a hundred informational and educational sessions, as well as diverse discussions and networking opportunities to address issues that impact the future of pathology. Go to www.ascp.org.
Nov. 2-3. Lab Quality Confab, at the Westin Riverwalk Hotel in San Antonio, TX, is an annual gathering dedicated to advancing the knowledge, skills, and effectiveness of process-improvement and quality-management practitioners in diagnostic medicine. Programs, information, and training are designed for every level of manager and all levels of knowledge and experience. The agenda includes two full days, and more than 50 sessions devoted exclusively to process-improvement and quality-management techniques. Learn more at www.labqualityconfab.com.
Nov. 2-3 in Chicago and Nov. 16-17 in Miami. The Clinical Laboratory Managers Leadership Workshop includes training to learn new ways to motivate lab staff; chart organizational visions; increase productivity by improving middle-management's effectiveness; evaluate and identify the barriers to increased performance and profitability; become a better coach; learn leadership styles and how to use them to motivate staff and improve teamwork; and prepare for the coming wave of retiring managers and staff. Visit www.darkdaily.com/seminars-training.
Nov. 2-3. The 60th Annual Meeting of The American Society of Human Genetics, at the Walter E. Washington Convention Center in Washington, DC, will feature scientific sessions on a diverse range of topics related to human genetics and genomics. Top genetics experts will present information about the latest scientific advances in basic, translational, and clinical human-genetics research and technology. Go to www.ashg.org/2010meeting.
Nov. 17-20. The Association for Molecular Pathology (AMP) 16th Annual Meeting and Exhibits, at the San Jose (CA) McEnery Convention Center, will include lectures, workshops, and sessions in the major areas of clinical molecular diagnostics: hematopathology, infectious diseases, inherited genetic diseases, solid tumors, and more. Go to www.amp.org/meetings/2010.
Webinars
Nov. 4, 1:00 p.m. ET. “Blood Cultures: Current Methods/Future Trends.” Receive an update of the scientific basis of why and how blood cultures are performed, the strengths and limitations of culture-based methods for detecting bacteremia and fungemia, and a review of the current state of using molecular methods as an alternative to culture-based methods. Visit www.aphl.org.
Nov. 9, 1:00 p.m. ET. “Bloodborne Pathogens: Where Current Policies and Practices Merge.” Through a review of case studies involving recent bloodborne pathogens exposures in labs, participants will examine regulatory issues and best practices. Visit www.aphl.org.
Nov. 18, 1:00 p.m. ET. “Quality Indicators: Measure to Manage.” Learn how to develop and apply quality indicators and how to use quality indicators to improve laboratory processes. Visit www.aphl.org.
Teleconferences
Nov. 16, 1:00 p.m. ET. “Successful Strategies for Difficult Draws.” The most challenging situations healthcare professionals face when drawing blood samples for laboratory testing include geriatric, oncology, pediatric, needle-phobic, obese, and intensive-care patients. This presentation discusses strategies to successfully obtain blood under a wide variety of difficult circumstances. Learn more at www.phlebotomy.com/Webinars.
Dec. 8, 2:00 p.m. ET. “Acute Kidney Injury (AKI): Improving Patient Outcomes through Early Detection.” New markers are now emerging that identify early stress response of the kidneys to acute injury. The most promising stand-alone marker is neutrophil gelatinase-associated lipocalin (NGAL). This program will review the latest developments in AKI diagnosis including NGAL. Learn more at www.aacc.org.
