Included below are news items from the last six months.
The American Society of Clinical Oncology (ASCO) and the College of American Pathologists (CAP) have joined forces to issue an updated guideline on testing for human epidermal growth factor receptor 2 (HER2) in patients with invasive breast cancer. Such testing identifies patients who could benefit from treatment that targets HER2.
The Endocrine Society and the American Association of Clinical Endocrinologists (AACE) have joined the Choosing Wisely® campaign, making recommendations for the appropriate use of certain laboratory tests ordered as part of patient care related to hormone disorders and conditions.
Although current standards for creatinine blood tests do not require fasting, a new study recommends a 12-hour fast or refraining from eating cooked meat prior to testing. Consuming cooked meat can temporarily increase the level of creatinine in the blood, possibly causing artificially high test results.
Patients who choose to use an online interactive personal health record (IPHR) are almost twice as likely to be up to date with recommended preventive health services, including laboratory screenings, as those who don't, according to a recent study. Researchers evaluated use of an online system that created personalized recommendations for patients based on their input on health questionnaires, their medical records, and guidelines from the U.S. Preventive Services Task Force. Findings suggest that IPHRs may prove to be a valuable tool for improving healthcare for patients who wish to take a more active role in their care.
A recent study suggests that a blood test for neutrophil gelatinase-associated lipocalin (NGAL) is a valuable tool for predicting which patients admitted to the hospital will develop a sudden loss of kidney function, known as acute kidney injury (AKI). If not detected and treated quickly, AKI can cause permanent kidney damage and can be life-threatening.
A number of cases of the mosquito-borne illness dengue fever have been reported in Florida recently, prompting a public health alert by the Florida Department of Health. The cases were reported in the Martin, St. Lucie, and Miami-Dade counties and, as of September 18th, the count is at 20. Florida residents and anyone traveling to the counties where the recent cases have been reported are being encouraged to take preventive measures to avoid mosquito bites. Anyone who experiences a high fever within two weeks of travel to an area where dengue fever is endemic, or travels to or lives where current cases have been reported, should consult their health care provider to determine if testing for dengue fever would be appropriate.
The CDC has released preliminary new data on the number of people in the U.S. who are diagnosed with Lyme disease each year and it's ten times what was previously thought. The new, higher estimate is based on findings from three ongoing studies and helps to give a more accurate picture of Lyme disease as a public health problem, particularly in those states with high rates of the disease.
Public health officials have been closely tracking a recent outbreak of cyclosporiasis, a type of intestinal infection caused by a single-celled parasite rare to the U.S. known as Cyclospora cayetanensis that has sickened more than 600 people and caused 45 hospitalizations as of August 28. Testing for cyclosporiasis is important because it allows health officials to track the origins and spread of an outbreak as well as develop measures to prevent further cases. Most U.S. labs do not routinely screen for it and the test must be specifically requested by health care providers, who are encouraged to request testing for Cyclospora whenever symptoms are prolonged.
A new testing strategy for screening and diagnosing HIV is more effective than traditional ones in detecting the disease early in its course when risk of transmission is higher, according to two new studies. Wider implementation of the new strategy, as urged by state and local public health laboratories, plus the possible addition of a newly FDA-approved rapid combination test as a screening tool, may help to limit the spread of disease from people with acute, early infections and help them receive appropriate treatment sooner.
A new study analyzing Methicillin-resistant Staphylococcus aureus (MRSA) prevention strategies found that decontaminating all ICU patients (universal decolonization) using procedures intended to remove the drug-resistant bacteria from the skin and from within the nose was the most effective of the three strategies that were evaluated, compared to MRSA screening and isolation or targeted decolonization.
The U.S. Preventive Services Task Force (USPSTF) has released new guidelines recommending that all pregnant women be screened for gestational diabetes—diabetes that develops during pregnancy—after 24 weeks of pregnancy. Since this condition may produce no obvious signs or symptoms yet result in serious complications for both mother and baby, glucose testing is recommended to screen women at the end of their second trimester. The updated guidelines from the USPSTF come into closer alignment with the advice of several other medical organizations, including the American College of Obstetricians and Gynecologists and the American Diabetes Association.
On June 13, 2013, the U.S. Supreme Court unanimously decided that naturally occurring human genes are not protected by patent. The case arose from a patent held by Myriad, a commercial molecular diagnostics laboratory, for the BRCA1 and BRCA2 genes, in which mutations are associated with a substantially increased risk for breast cancer. Because it held the patent on the BRCA genes, only Myriad could perform tests for these genes. Some scientists interested in the case say the decision will increase availability and lower the cost of the tests while generally promoting further genetic research. Others say that without protection from patents, companies will be reluctant to fund the research necessary to find similar breakthroughs.
The American Urological Association is the latest health professional group to revise its screening recommendations for prostate cancer and now says that the widely used prostate specific antigen (PSA) blood test should be done primarily in men 55 to 69 who decide to be screened for prostate cancer. Other groups have also recently revised their PSA testing guidelines, and no group recommends the sweeping screening that had been the norm for many years.
A new virus called Middle East Respiratory Syndrome Coronavirus (MERS-CoV) that was first detected in Saudi Arabia last year has health officials concerned because of the mortality rate associated with it and about its potential spread, although at this point there is no evidence that MERS-CoV can be generally transmitted in communities. Both the CDC and WHO say countries need to be on alert about the virus as health authorities learn more about its origin and exactly how it is transmitted.
Only half of all Americans identified as having hepatitis C antibodies on screening tests have had a follow-up test to determine if active virus is present. Such follow-up testing is recommended by the CDC to ensure that those who are infected get appropriate care and treatment to prevent serious and potentially life-threatening health consequences, including liver cancer, which is the fastest-rising cause of cancer-related death in the U.S. The CDC recommends that everyone in the U.S. born from 1945 through 1965 as well as those with risk factors be screened for hepatitis C.