MedWorm: Pathologists

Do You See What I See?

ADVANCE Discourse: Lab — Tue, 07 Feb 2012 14:26:00 +0100

Here's an opportunity you might like to share with your staff -- especially those with a creative eye. The National Science Foundation is sounding a call for entries in its 2012 International Science and Engineering Visualization Challenge, which opens...(read more) (Source: ADVANCE Discourse: Lab)

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Practice Fusion Supported by Advertising and Owns Anonymized Data

Lab Soft News — Tue, 07 Feb 2012 13:12:06 +0100

In my blog note yesterday, I suggested that physicians might consider Practice Fusion as an alternative to Care360 for their office EMR (see: Quest Diagnostics Offers Reduced Price for Deployment of Care360). Luckily, a reader named Sam submitted a comment about a "catch" associated with this latter product. Here is his comment: ...Practice Fusion...has the same issues as Epocrates in that is it supported by ads (unless you pay the $100/mo/provider to remove them). Practice Fusion goes a step further and takes ownership of the anonymized patient records which it in turn sells. See: [Why Peter Thiel Likes Electronic Health Record Provider Practice Fusion]: Thanks, Sam, for your useful new information. Here's a relevant quote from the Forbes article cited at the end of his comm...

Caffeinated Coffee May Protect Against Liver Fibrosis In Certain Patients

Digital Pathology Blog — Tue, 07 Feb 2012 05:00:00 +0100

Nonalcoholic steatohepatitis is associated with obesity, hyperlipidemia, diabetes and other associated metabolic conditions. Fibrosis in chronic liver disease, regardless of etiology is generally thought to be irreversible. Good news from Army medicine suggesting that if you drink coffee with your hamburger, fries and milkshake you may gain some protective effect from the coffee in terms of liver injury and fibrosis. Bad news is that other caffeinated drinks may not have as a protective effect as coffee. Medscape (2/7, Newman) reports, "Drinking caffeinated coffee protects against liver fibrosis in patients with" nonalcoholic steatohepatitis (NASH), according to a study published in the February issue of Hepatology. "The new finding comes from a validated caffeine questionnaire a...

Time to revise your Alzheimer brain autopsy template

neuropathology blog — Mon, 06 Feb 2012 19:23:00 +0100

Time to put the NIA-Reagan criteria for the neuropathologic diagnosis of Alzheimer's behind you and revise your autopsy reports to reflect the consortium report by the National Institute on Aging and Alzheimer's Association (the NIA-AA criteria). Neuropathologist Tom Montine, MD, PhD headed up the effort to revise the 1997 criteria. According to Medscape News, Montine said there were three main points to be made regarding the new criteria:Dr. Thomas Montine'"The first is that it's no longer necessary that someone carry a clinical diagnosis of dementia in order to make a pathological diagnosis of [AD]. We have separated those 2 entities because we now understand that there is a preclinical stage of the disease. That's the major philosophical point... The second point is more on the technica...

Case of the Week 194

Creepy Dreadful Wonderful Parasites — Mon, 06 Feb 2012 14:48:00 +0100

A corneal biopsy was obtained from a man with corneal opacities and painful erosions. He had not been able to wear his contact lenses for over 1 month due to the pain. (CLICK ON IMAGES TO ENLARGE)H&E, 40 x original magnificationH&E, 100x original magnificationH&E, 400x original magnificationThe corneal biopsy was also cultured in a peptone-yeast extract-glucose broth and the following were identified.Diagnosis? (Source: Creepy Dreadful Wonderful Parasites)

Quest Diagnostics Offers Reduced Price for Deployment of Care360

Lab Soft News — Mon, 06 Feb 2012 12:37:06 +0100

Here's a recent and interesting blog note regarding a discount offer for physicians to install the Quest office EMR called Care360 (see: Quest Diagnostics Offers Big Discount On Its EMR-Practice Management System). I discussed this product six years ago, which at that time was called a lab portal (see: Quest Software Heats Up the Lab Portal Wars). Below is an excerpt from the current note. ...Quest Diagnostics has kicked off a program offering medical practices a steep 85 percent discount off of the retail price of its Care360 EMR and practice management bundle....The deal, which reduces the physicians’ out of pocket cost to less than $100 per month, also includes training, hosting, maintenance and 24/7 support for Care360. The lab giant says physicians can get Care360 ...

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Innovative Imaging Concepts is the Authorized Distributor in USA for ViewsIQ

Digital Pathology Blog — Mon, 06 Feb 2012 05:00:00 +0100

Canadian-based slide imaging technology company, ViewsIQ, announces their entrance to the digital pathology market in USA with the authorized Distributor Innovative Imaging Concepts. Their flagship product, Panoptiq, is designed to bring real-time slide digitization and affordable telepathology to the world of virtual microscopy. Oxford, Massachusetts (PRWEB) February 06, 2012 Canadian-based slide imaging technology company, ViewsIQ, announces their entrance to the digital pathology market in USA with the authorized Distributor Innovative Imaging Concepts. Their flagship product, Panoptiq, is designed to bring real-time slide digitization and affordable telepathology to the world of virtual microscopy. ViewsIQ develops innovative microscopy imaging systems for hospitals, research instit...

Case Western's Gary Landreth explores bexarotene as a pontential Alzheimer therapeutic

neuropathology blog — Sun, 05 Feb 2012 14:15:00 +0100

Gary Landreth, PhDDr. Mark Cohen tells me that a guy worth watching on the Alzheimer research front it Dr. Gary Landreth from Case Western Reserve University. And, as anyone who reads this blog regularly knows, when Mark Cohen talks, I listen. According to the Alzheimer Research Forum (from which I am blatantly plagarizing in the remainder of this post), Landreth works on ApoE-directed therapeutics. As one of the genes involved in cholesterol homeostasis, ApoE is regulated transcriptionally by receptors which form heterodimers with the retinoid X receptor (RXR). Working with APP transgenic mice, Landreth found that an RXR agonist, bexarotene, induces brain ApoE quickly and robustly. This induction precedes a rapid decline in brain amyloid, an increase in plaque-clearing microglia, an...

Blog App to be Launched

Digital Pathology Blog — Sun, 05 Feb 2012 05:00:00 +0100

Coming to an iPhone near you soon. The Digital Pathology Blog App. Look for iPad and Android OS versions to follow. Stay connected and up to date from your mobile device to the blog with Twitter (@tissuepathology) and Pathology 2.0 Facebook (http://www.facebook.com/pathology2.0) tabs. (Source: Digital Pathology Blog)

Ethical Issues in the Lab

ADVANCE Discourse: Lab — Fri, 03 Feb 2012 20:18:00 +0100

What kind of ethical issues have you been faced with in the lab? Have you struggled with the best way to handle difficult situations? On Tuesday, Feb. 7, we'll be hosting a webinar to discuss some common and not-so-common ethical issues that may arise....(read more) (Source: ADVANCE Discourse: Lab)

Highest Rate for Testicular Cancer and Mortality in Chile

Lab Soft News — Fri, 03 Feb 2012 14:36:26 +0100

Here's an interesting observation. Chile ranks first in the world for deaths from testicular cancer, according to the World Health Organization (WHO) and Chile’s Ministry of Health (see: Highest death rates for testicular cancer found in Chile). Read on, if you are interested, in the following excerpt from the article: In 2009, 121 Chilean men died from the disease and 63 of those were 15 to 30 years old, the age group most at risk from the disease. In the U.K., however, where the population is three and a half times the size of Chile, there were only 70 deaths from testicular cancer in 2008, according to the Cancer Research U.K.’s figures. “Testicular cancer figures are low in Chile in relation to the other types of cancers found here, but yes, the figures are high in comparison...

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Groundhog Day and digital pathology

The Daily Scan — Thu, 02 Feb 2012 20:20:00 +0100

Today is Groundhog Day, and I must tell you when I think about it I don't think about a large hibernating ground squirrel nor six more weeks of winter, I think about the awesome 1993 film starring Bill Murray, in which he is relives the same day over and over hundreds of times before he changes and ends up with Andie MacDowell. He finds out the hard way that unless he approaches things differently, the results remain the same. The same thing is true of many pathology labs. They do the same thing over and over every day, with the same results. The consistency is good, it leads to accurate and predictable medicine and good patient care. But you have to change in order to improve. In today's healthcare environment there is pressure to do more with le...

Exclusive Content

ADVANCE Discourse: Lab — Thu, 02 Feb 2012 20:18:00 +0100

ADVANCE wants to reward our loyal community of readers. We've gathered an exclusive collection of resources, spotlights and tools you won't find anywhere else. We'll continue compiling valuable information accessible only by ADVANCE members. Not yet a...(read more) (Source: ADVANCE Discourse: Lab)

Hospital Website Smackdown: Mayo Clinic versus Cleveland Clinic

Lab Soft News — Thu, 02 Feb 2012 16:14:41 +0100

I knew that this time would ultimately arrive but we appear to be there now. Two prestigious hospitals are being compared on the basis of the quality of their web sites. A recent article posits a web site smackdown between Mayo Clinic and Cleveland Clinic (see: Website Smackdown: Mayo Clinic vs. Cleveland Clinic). Following is an excerpt of the article: In this week's Website Smackdown, I’m taking a look at the websites for two of the biggest hospital complexes in the world, the Mayo Clinic and the Cleveland Clinic....The Mayo Clinic and Cleveland Clinic rank neck and neck (third and fourth respectively) on US News & World Report’s Honor Roll of Best Hospitals, but there’s a huge difference in the quality of their websites.(1) Most people coming to the website for a ma...

BREAKING: Healthcare Hero SAVES HIMSS12!

Digital Pathology Blog — Thu, 02 Feb 2012 05:00:00 +0100

Confused by EHRs, Meaningful Use, medication management, federal regulations, and other health IT topics? Want more, positive clinical outcomes, greater information exchange, increased office efficiency, and cost savings?Visit booth 5456 at HIMSS12 to meet the DRFIRST Defender and learn how he helps protect providers! Comment on the video, Tweet us @DrFirst #HIMSShero, or comment on www.facebook.com/drfirstinc to be entered into a drawing for a night on the town in Vegas at HIMSS12! (Source: Digital Pathology Blog)

Recently published articles in Journal of Pathology Informatics

Digital Pathology Blog — Thu, 02 Feb 2012 05:00:00 +0100

Number of great articles recently published in the increasingly popular Journal of Pathology Informatics. Number of recent works dealing with digital pathology related projects: Multi-field-of-view strategy for image-based outcome prediction of multi-parametric estrogen receptor-positive breast cancer histopathology: Comparison to Oncotype DXAjay Basavanhally, Michael Feldman, Natalie Shih, Carolyn Mies, John Tomaszewski, Shridar Ganesan, Anant MadabhushiJ Pathol Inform 2011, 2:1 (19 January 2012)[ABSTRACT] [HTML FULL TEXT] [PDF] [Mobile HTML Full text ] [EPub] Local isotropic phase symmetry measure for detection of beta cells and lymphocytesManohar Kuse, Yi-Fang Wang, Vinay Kalasannavar, Michael Khan, Nasir RajpootJ Pathol Inform 2011, 2:2 (19 January 2012)[A...

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Celebrate Your Staff

ADVANCE Discourse: Lab — Wed, 01 Feb 2012 16:22:00 +0100

Although National Medical Laboratory Professionals week is two months away, I hope by now your plans to celebrate the teamwork, dedication and achievements of your staff are well under way. (If not, be sure to check out the special NMLPW on our web site...(read more) (Source: ADVANCE Discourse: Lab)

iPad proves equal to regular screens for TB evals

Digital Pathology Blog — Wed, 01 Feb 2012 05:00:00 +0100

Admittedly, mobile small screen technologies afford portability and perhaps in some cases, access to basic health care services that would not normally be availalable. True in pathology, just as it is radiology. Look for more news to come on this related to digital pathology. Based on some recent papers I have reviewed for publication, small screen technologies will show their effectiveness for primary H&E diagnosis and extend the pathologist's reach. From: FierceMobileHealthcare By Sara Jackson Comment | Forward | Twitter | Facebook | LinkedIn iPads are just as good as LCD monitors when it comes to diagnosing tuberculosis, according to a follow-up study recently conducted by the University of Maryland. The original study, which too...

Sales Account Manager Position Open at Aperio

Digital Pathology Blog — Wed, 01 Feb 2012 05:00:00 +0100

This position is focused and very skilled in the area of Digital Pathology The Digital Pathology Sales Account Manager will possess specialized and in-depth comprehensive knowledge and experience in Digital Pathology as the Subject Matter Expert in image analysis for the US Healthcare Sales Team. Candidate will develop and execute successful Digital Immunohistochemistry (DIHC) solution sales strategies, update sales tools and tactics to drive growth and revenue to the hospital market throughout the US. You will partner, train and support all US Healthcare Sales Representatives in Digital IHC sales and marketing skills allowing pathologist to significantly streamline clinical workflow and improve patient care through digital pathology. Candidate must have an impressive history of ...

Clinical Labs Have Much to Learn from the Genetic Testing Web Sites

Lab Soft News — Tue, 31 Jan 2012 18:36:33 +0100

The clinical labs have much to learn about genetic web sites such as 23andme and ancestry.com (see: FDA Cracks Down on Consumer-Oriented Genetic Testing Web Sites; 23andMe Builds Online Sarcoma Research Community). This latter company is extending their genealogy business model into genetic testing. I was trying recently to better understand the pricing options offered by 23andme and sent a query to their help desk about this topic. I got the following explanation back from the company. It provides some useful insights about the company and its future direction: The 23andMe Personal Genome Service is a genotyping analysis of about one million SNPs resulting in interpreted data for both your genetic ancestry as well as your genetic disease risks and traits. There are three pricing options a...

Former Aperio Executive and Digital Pathology Market Expert, Dr. Martin Stuart, Joins Definiens Executive Team

Digital Pathology Blog — Tue, 31 Jan 2012 05:00:00 +0100

Munich, Germany – January 31, 2012 - Definiens, the global leader in Health Image Intelligence and Quantitative Digital Pathology, has appointed Martin Stuart, PhD, as its Executive Vice President and General Manager North America and Asian Pacific. In his new role, Stuart will be responsible for expanding the Definiens business in North America and Asia and providing leadership to the sales and field operations. Martin Stuart, a former Senior Vice President and General Manager of Aperio, is one of the most influential leaders in the Digital Pathology industry. He has more than 25 years of experience in international sales and marketing, specializing in the introduction of new and disruptive technologies. In his previous global sales and marketing position he was a key driver...

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HealthTap’s Social Network of 5,000 Doctors Is Ready to Give Free Advice

Digital Pathology Blog — Tue, 31 Jan 2012 05:00:00 +0100

Back in the 1990's when our department had a website, I started uploading several powerpoint lectures from various sources with the intent that such material would be used as what was then a growing source of information online that was peer-reviewed, accurate and current. It quickly became apparent the need and desire by patients to reach out and inquire about their own individual cases based on the lecture material. One in particular stands out, a lecture dealing with cervical cytology, abnormal pap smears, therapy and follow-up. At first there were only a handful of e-mails which quickly became dozens and hundreds of such inquiries. Initially, I referred the questions (and essentially the patients) to gynecology and gynecology oncology colleagues who at first were willing to resp...

Paper-to-person Germ Contamination

Changing Face of Lab Medicine — Tue, 31 Jan 2012 00:47:00 +0100

An article in American Journal of Nursing : December 2011 - Volume 111 - Issue 12 - pp 30-34 discussed the fact that the "shuffling of papers" may be attributed to nosocomial infections. Makes electronic records look more and more inviting. As a manager,...(read more) (Source: Changing Face of Lab Medicine)

An estimated 7% of Population Carry Oral HPV; Oral Cancer Incidence to Rise Sharply

Lab Soft News — Mon, 30 Jan 2012 15:45:09 +0100

In a previous post, I raised the issue of the relationship between oral sex, HPV, and oral cancer (see: HPV Now Shown to Cause Oral Cancer in Men). Here are two quotes from it: The HPV virus now causes as many cancers of the upper throat as tobacco and alcohol, probably due both to an increase in oral sex and the decline in smoking. Of the 300 study participants [in a recently published study], those infected with HPV were also 32 times more likely to develop [cancer of the tonsils or at the base of the tongue] than those who did not have the virus. These findings dwarf the increased risk of developing this so-called oropharyngeal cancer associated with the two major risk factors: smoking (3 times greater) or drinking (2.5 times greater). HPV infection drives cancerous growth, as it is wid...

Kaiser Permanente launches EHR mobile app

Digital Pathology Blog — Mon, 30 Jan 2012 05:00:00 +0100

By Sara Jackson Comment | Forward | Twitter | Facebook | LinkedIn Kaiser Permanent today launched a mobile app giving more than 9 million patients access to their online medical records. The healthcare giant created a mobile-optimized version of its member website, kp.org, with a companion Android app. The company promises an iPhone app later this year. Kaiser officials say members will be able to view information from past visits, access lab results and pharmacy orders and see other data from their records. They also will be able to check appointments and exchange texts with clinicians via smartphone. It's remarkably quick work, considering that just last August, Kaiser IT reps admitted they had virtually no mobile strategy crafted, and no apps under developme...

Case of the Week 193

Creepy Dreadful Wonderful Parasites — Sun, 29 Jan 2012 20:18:00 +0100

The week's case is a tough one!The following were found in the stool of animal handler with exposure to primates. The objects shown measure approximately 40 microns in diameter. Identification? (CLICK ON IMAGES TO ENLARGE)(Unstained, 400x original magnification) (Source: Creepy Dreadful Wonderful Parasites)

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Answer to Case 193

Creepy Dreadful Wonderful Parasites — Sat, 28 Jan 2012 16:55:00 +0100

Answer: Bertiella sp. eggsGreat job everyone! I thought this would be a tough one, but received lots of correct answers. Bertiella is a genus of cestodes (tapeworms) that typically infect non-human primates, although humans are also occasionally infected.The diagnosis can be made from the presence of the classic pyriform apparatus, an inner membrane with projections around a 6-hooked embryo. (Source: Creepy Dreadful Wonderful Parasites)

Healthcare missing from State of the Union

The Daily Scan — Sat, 28 Jan 2012 01:06:00 +0100

Like you, I watched the State of the Union address, and like you, I was amazed... Healthcare was missing! The centerpiece of President Obama's plans, the thing he would say he was most proud of as an accomplishment, and yet it was not mentioned at all. Of course it is a contentious subject and many healthcare organizations are waiting to see whether Obama will be reelected, in which case implemention of Obamacare will press forward, or whether a Republican challenger will take his place, and most probably work to repeal much of the legistlation. For an interesting perspective you might enjoy this discussion on MedScape: Healthcare gone missing: The State of the Union Address. Where you surprised by the omission? What do you think that means for President Obama'...

Digital Pathology and the FDA; WSI Systems Called Class III Devices

Lab Soft News — Fri, 27 Jan 2012 17:14:51 +0100

CAP Today has just published what I consider to be the definitive article on the latest ruling by the FDA on digital pathology (see: Regulators scanning the digital scanners). It was written by Karen Titus. Here's an excerpt from the lead paragraphs: A recent panel on whole-slide imaging launched a clear message from the Food and Drug Administration: The agency views WSI systems as Class III medical devices and plans to regulate them as such....While the FDA’s decision was clear, the next steps are anything but. Vendors, pathologists, the FDA, and the Centers for Medicare and Medicaid Services could head in any number of directions next, but they won’t be moving swiftly....Depending on one’s view, the news will slow efforts to bring WSI for primary diagnosis into U.S. laboratorie...

Enough is Enough, Academic Journals!

The 1x Objective — Fri, 27 Jan 2012 16:06:05 +0100

Catch the rest of the story after the break... (Source: The 1x Objective)

'The Rabbit Died!'

ADVANCE Discourse: Lab — Thu, 26 Jan 2012 21:17:00 +0100

Here in the ADVANCE office today, we got on the topic of outdated laboratory practices. From mouth pipetting (shudder!), to smoking and even eating lunch at the bench, we've heard some crazy stories from our readers about how things used to be. As we...(read more) (Source: ADVANCE Discourse: Lab)

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India’s first virtual Cancer Pathology diagnostic centre

pathtalk.org — Thu, 26 Jan 2012 18:45:08 +0100

Its is my great pleasure to inform you that Oncopath Diagnostics-India’s first virtual Cancer Pathology centre has started at Pune. !!!! With the help of India’s first and Only digital pathology slide scanning system at Oncopath diagnostics, pathologists from USA, UK and Canada will be able to provide expert consultation to patients in India !!!! This centre will be specially helpful for patients and physicians/pathologists in getting second/expert opinion in difficult cases. Some of the newspaper articles published in local news papers in India ,which highlights Oncopath Diagnostics work in India are mentioned below. Newspaper articles: click the below links -Indian express More info. about Oncopath Diagnostics is available at www.OncopathDx.com...

India's first virtual Cancer Pathology diagnostic centre in Pune

Oncopathology — Thu, 26 Jan 2012 17:51:00 +0100

It is my great pleasure to inform you that Oncopath Diagnostics-India's first virtual Cancer Pathology centre has started at Pune. !!!! With the help of India's first and Only digital pathology slide scanning system at Oncopath diagnostics, pathologists from USA, UK and Canada will be able to provide expert consultation to patients in India !!!! This will specially helpful for patients and physicians/pathologists in getting second/expert opinion in difficult cases. VALUE ADDED SERVICES OF ONCOPATH DIAGNOSTICS The highly qualified medical staffs includes including well known national and International pathologists specialised in breast pathology, genitourinary pathology, OBGYN Pathology, GI / liver pathology,...

Software for Comparing Changes in Pulmonary Nodule Size on Chest X-Rays

Lab Soft News — Thu, 26 Jan 2012 14:25:23 +0100

Most healthcare consumers are familiar with the new digital imaging modalities such as CT, MRI, and PET scans. However, fewer may be aware of the image analysis software that is in common use for analyzing digital images in radiology. A recent article was fascinating for me in terms of cost-saving and quality opportunities that are being made available by such software, even for the common chest x-rays (see: FDA Approves New Chest X-Ray Scanning Software). Below is an excerpt from the article: Software that could lead to low-cost early detection of lung cancer won US Food and Drug Administration (FDA) clearance this month....Development of an inexpensive tool for early diagnosis could have a tremendous effect on cancer screening and disease survival, said [a radiation oncologist]. The new ...

Data on Health Improvement Goals Released

ADVANCE Discourse: Lab — Wed, 25 Jan 2012 18:14:00 +0100

The National Priorities Partnership (NPP), a group of healthcare leaders convened by the National Quality Forum (NQF), just released case studies addressing application of priorities for improving healthcare. Specifically, the case studies explore ways...(read more) (Source: ADVANCE Discourse: Lab)

Innovation in Immunohistochemistry (IHC) Staining: Single Piece Flow IHC Slide Processing

Digital Pathology Blog — Wed, 25 Jan 2012 05:00:00 +0100

Conclusion — Page 22 References — Page 23 Appendices A-1 About the Authors — Page 25 A-2 About Venta Medical Systems, Inc./Roche — Page 26 A-3 About DARK Daily — Page 27 A-4 About The Dark Intelligence Group, Inc., and THE DARK REPORT — Page 28 A-5 About the Executive War College on Laboratory and Pathology Management — Page 29 A-6 About Mark Terry — Page 31 Terms of Use — Page 36 (Source: Digital Pathology Blog)

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CAP Today: Regulators scanning the digital scanners

The Daily Scan — Wed, 25 Jan 2012 01:40:35 +0100

Of the FDA’s decision to regulate whole-slide imaging systems as Class III devices, Aperio president Dirk Soenksen says, “They’ve made up their mind.... You’re talking five years at the earliest when someone’s going to get approval.” How broad will Aperio's submission be? “As broad as FDA allows,” he says. Hi y'all. You're probably familiar with CAP Today already - it's a great publication for anyone interested in Pathology, and it's available free online - but today's new issue has great article about the FDA panel discussion held at Pathology Visions in October: Regulators scanning the digital scanners: A recent panel on whole-slide imaging launched a clear message from the Food and Drug Administration: The agency views WSI systems as Class ...

Improved Diagnostic Tools Lead Way to Better Patient Outcomes

ADVANCE Discourse: Lab — Tue, 24 Jan 2012 13:49:00 +0100

A massive new-millennium expansion of medical arts has everything to do with technology; as capabilities race forward, so do the practical, implementable benefits to laboratorians, diagnosticians, direct care providers, and ultimately patients. Check...(read more) (Source: ADVANCE Discourse: Lab)

BREAKING: Healthcare Hero SAVES HIMSS12!

Digital Pathology Blog — Tue, 24 Jan 2012 05:00:00 +0100

Regulators regulating digital scanners

Digital Pathology Blog — Tue, 24 Jan 2012 05:00:00 +0100

In the words of Harry Caray - "Holy Cow!" Karen Titus does an excellent job putting together this piece. Who else could use "Gentlemen, start your turtles", "Alan Greenspan" and also work in "From that perspective, a Class III, or even a Class II, classification, is overkill—like dropping a V8 engine into an Amish buggy" in the same article. So much blog fodder here I have copied the entire article available for free from CAP Today with my comments below on some of my thoughts on this matter. Courtesy of CAP Today - Regulators scanning the digital scanners by Karen Titus A recent panel on whole-slide imaging launched a clear message from the Food and Drug Administration: The agency views WSI systems as Class III medical devices and plans to regulate them as such. Gentlemen, s...

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No approval necessary

Digital Pathology Blog — Tue, 24 Jan 2012 05:00:00 +0100

Dr. John M., cardiac electrophysiologist, cyclist, learner and of course physician blogger recently put out 6 reasons why he blogs recently at http://www.drjohnm.org/2012/01/six-reasons-why-doctors-blog/. Over a year ago, Drs. Mark Pool, Bruce Friedman and I put together an editorial for the Journal of Pathology Informatics entitled "Ten important lessons we have learned as pathology bloggers". However, John, Mark, Bruce and I failed to mention one important idea/lesson on why physicians blog, or perhaps more specifically on why physicians should blog and a persona motivator for me. No approval is necessary. Physicians are some, if not, the most highly regulated and controlled professionals/human beings in our society. Hospitals, practices, insurance companies, state licensing...

The Next Step in the Development of Personalized E-Newspapers

Lab Soft News — Mon, 23 Jan 2012 17:41:28 +0100

In previous posts, I have discussed both Flipboard and Zite (see: Blogs Becoming Increasingly Popular and Blending with Other Media; Zite Receives Cease-and-Desist Letter from Big Media). Both apps serve as examples of how the much-anticipated, personalized, e-newspaper will evolve. Note that CNN understands this strategic direction, as exemplified by its purchase of Zite (CNN Buys Zite and Pursues Big Screen, Small Screen Media Strategy. This evolutionary process goes on unabated. Twitter, a key player in the shift to e-newspapers has purchased startup Summify (see: The Startup That Could Turn Twitter Into Your Newspaper). Below is an excerpt from this article: Twitter ]has] purchased the small Vancouver startup Summify..., but it could be a big step for the company's value as a news ...

Free Webinar from 3DHISTECH - February 22 - Register Now!

Digital Pathology Blog — Mon, 23 Jan 2012 05:00:00 +0100

"Automated High Throughput Whole Slide Imaging Using Area Sensors, Flash Light Illumination and Solid State Light Engine"presented by Varga Viktor Sebestyén, PhD from 3DHISTECH Ltd.Program of the webinar:1. Camera technologies:- a.) Line versus Area camera- b.) CCD versus sCMOS sensors- c.) Scanning speed2. Multifocal capability3. Dark Field Preview. Date: 22th of February, 2012Please choose one of the following sessions: Session 1 starting at 9.00 CET(13:30IST, 16:00 SGT, 17:00 JST) sessionSession 2 starting at 17:00 CET(11:00 EST, 10:00 CST, 8:00 PST) sessionIf you choose the first session please follow the instructions described in this mail.If you prefer the second session please follow the instructions in our next e-mail!Topic: Automated High Throughput Whole Slide Imaging Using Ar...

Case of the Week 192

Creepy Dreadful Wonderful Parasites — Sun, 22 Jan 2012 17:28:00 +0100

The following hematoxylin and eosin (H&E) stained sections of brain are from a 1-year old child with fatal meningoencephalitis. The child was otherwise healthy and had not traveled outside of the U.S. (CLICK ON IMAGES TO ENLARGE)Identification of this devastating infection?20 x original magnification100 x original magnification400 x original magnification400 x original magnification400 x original magnification400 x original magnification (Source: Creepy Dreadful Wonderful Parasites)

Answer to Case 192

Creepy Dreadful Wonderful Parasites — Sat, 21 Jan 2012 20:03:00 +0100

Answer: Baylisascaris procyonis, the raccoon intestinal roundwormEggs of this nematode get into the environment and may be accidentally ingested by humans (typically young children) resulting in visceral larva migrans (VLM) as shown in this case. The larvae hatch from the ingested eggs and enter the blood stream to migrate readily throughout the body, with a predilection for the brain and spinal cord.The diagnosis can be made by serology (available only at specialized centers) in association with a suggestive clinical presentation or through finding characteristic larvae in tissues. A peripheral eosinophilia and eosinophilic response in tissue sections is common.The larvae are relatively large (50-60 microns in diameter) and have lateral alae (arrows below), and excretory columns (internal...

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Is Notch signaling involved in lung carcinogenesis?

The Daily Sign-Out — Fri, 20 Jan 2012 19:40:14 +0100

This is the question asked by Joyce Osanyingbemi-Obidi and colleagues from Johns Hopkins in an interesting recent paper published in Molecular Cancer Research. The cancer stem cell hypothesis proposes that there is a small proportion of tumor cells with stem... (Source: The Daily Sign-Out)

Genomics-Based EHR: Is This a Realistic Expectation?

Lab Soft News — Fri, 20 Jan 2012 16:50:21 +0100

Although I generally agree with what John Lynn posts on his blog over at EMR and EHR, one of his recent posts caused me to wince a little bit (see: Genomics Based EHR). He raises the issue of the "smart EMR" with genomic data as one its "core elements". Here's his note: Genomics is one of the core elements that I think a “Smart EMR” will be required to have in the future. I really feel that the future of patient care will require some sort of interaction with genomic data and that will only be able to be done with a computer and likely an EHR....As I think about genomics interacting with EHR data and the benefits that could provide healthcare going forward, I realize that at some point doctors won’t have any choice but to adopt an EHR software. It will eventua...

On the Hunt

ADVANCE Discourse: Lab — Thu, 19 Jan 2012 20:49:00 +0100

(Editor's Note: This blog post is brought to you by Managing Editor Kerri Hatt.) Are you looking for a job? Career blogger Penelope Trunk tells us nearly 75 percent of workers are. In fact, she says most people change jobs every 2 years, and it can be...(read more) (Source: ADVANCE Discourse: Lab)

How we're doin'

neuropathology blog — Thu, 19 Jan 2012 20:48:00 +0100

I just checked the stats on Neuropathology Blog just to see where we stand. Here's where we stand at the moment:So far today:Number of pageviews: 291Entire history since blog's inception in October of 2011:Blog posts: 364Comments: 746Pageviews total: 189,440 Not too bad! (Source: neuropathology blog)

More on Epic's (Non)-Interoperability and the Recent NYT Puff Piece

Lab Soft News — Thu, 19 Jan 2012 13:09:28 +0100

I was convinced that Milt Freudenheim's glowing, uncritical puff-piece about Epic in the NYT would not provoke any critical blow-back (see: Digitizing Health Records, Before It Was Cool). I was certainly not expecting any criticism from hospital CIOs and CEOs who are anxious to stay within the good graces of the company and are contractually constrained from any visceral outbursts. However, Vince Kuraitis, who blogs over at e-CareManagement, has informed me via a comment that there is a heated discussion going on at Google+ about the NYT article and Epic in general. You may also want to refer to my recent blog note about Epic (non)-interoperability (see: A Reader Comments on Epic Interoperability and Care Everywhere). Here is Vince's comment: FYI, there is heated discussion going o...

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Feeling Under the Weather?

ADVANCE Discourse: Lab — Wed, 18 Jan 2012 15:35:00 +0100

There’s a reason “under the weather” describes a person’s health status: Scientists have found a link between La Nina patterns and flu epidemics. According to an article in Summit County Voice, climate patterns affect bird migrations and, therefore, genetic...(read more) (Source: ADVANCE Discourse: Lab)

A Reader Comments on Epic Interoperability and Care Everywhere

Lab Soft News — Wed, 18 Jan 2012 14:41:10 +0100

In response to a recent note about Epic's Care Everywhere (see: Sharing Medical Records across Hospitals with Epic's Care Everywhere), a reader (Open Standards) posted a comment which I thought was instructive and worthy of promotion to the level of a note. I present it below in its entirety: Per the Epic technical manual, Epic's Care Everywhere is [described in] the following [way]: 1. For Epic institutions, it is an XML file containing Epic proprietary extenstions to the continuity of care document. 2. For non-Epic institutions, it is an XML file containing the standard continuity of care document. Both of the above are variations of the same theme: the CCD document, an XML marked up document with the demographic, medication, medical history, and most recent encounter data ab...

Second opinions in pathology and medicine

The Daily Sign-Out — Wed, 18 Jan 2012 12:30:00 +0100

Laura Landro, in her Wall Street Journal column, "The Informed Patient," has taken on the controversial subject of second opinions in medicine. Inevitably, the "attention-grabber" of such an article is an anecdotal patient initially "misdiagnosed" at one institution who goes... (Source: The Daily Sign-Out)

Introducing ViewsIQ to Digital Pathology

Digital Pathology Blog — Wed, 18 Jan 2012 05:00:00 +0100

Many are predicting 2012 will be a tipping point for the digital pathology market. With that prediction, comes the latest slide scanner company to enter the space. Introducing ViewsIQ out of Vancover offering an interactive slide scanning system that integrates with rather than replaces the microscope. Check out their YouTube videos and images on their website. Their website also mentions they will be exhibiting at USCAP 2012 at booth #814. Look forward to seeing their technology in action. Canadian-based slide imaging technology company, ViewsIQ, announces their entrance to the digital pathology market. Their flagship product, Panoptiq, is designed to bring real-time slide digitization and affordable telepathology to the world of virtual microscopy. ViewsIQ develops inno...

What the Healthcare Industry Can Learn From Technology Start-Ups

The Daily Scan — Wed, 18 Jan 2012 02:21:00 +0100

This is an interesting post on The Health Care Blog, by David Shaywitz: What the Healthcare Industry can learn from Technology Start-ups: I’ve been struck by some of the profound differences between a tech start-up (even one ostensibly in the healthcare space) and a biopharma start-up. In the standard biopharma model, you spend years developing a product, without having any real idea of (a) whether it will work, (b) whether it will be safe and well-tolerated, and (c) whether by the time you’ve demonstrated (a) and (b), anyone will care, or pay you for your efforts. In contrast, [tech startup] MassiveHealth has managed to get a product in customer hands after a few months of work. True, they’ve probably not made any money thus far, and (not insignificantly) it’s entirely unclear whe...

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I Have a Dream in Healthcare...

Changing Face of Lab Medicine — Tue, 17 Jan 2012 16:23:00 +0100

In the words of Dr. Martin Luther King, Jr., as we set aside a day to honor him, I DO have a dream... What is yours? For me, my dream on a day to day basis is survival in this crazy world of healthcare. As a manager, I am always aware of issues such as...(read more) (Source: Changing Face of Lab Medicine)

Usefulness of Software for Analyzing Digital Pathology Images Highlighted

Digital Pathology Blog — Tue, 17 Jan 2012 05:00:00 +0100

Hard to miss this news item which I saw reproduced on dozens of media outlets and sites. Ul Balis and his team, including Jason Hipp using their SVIQ technology were able to differentiate benign from malignant bladder tissue in cases of micropapillary urothelial carcinoma. This type of technology which uses concentric rings to identify key features for recognition rather than square blocks in the query is a welcome addition to the surgical pathologist's toolkit and I think the tip of the iceberg in the type of value added propositions digital pathology will offer over analogue. Reproduction of the glass slide is just the beginning. The ability to differentiate normal from malignant and dozens of other applications helps add science to the "art and science" practice of path...

Docs Going Mobile

Digital Pathology Blog — Tue, 17 Jan 2012 05:00:00 +0100

Courtesy of Dark Daily: QuantiaMD’s survey confirms that physicians will increasingly seek real-time connectivity and consultation with medical laboratory service providers Physicians are quickly becoming fans of mobile computing. Clinical laboratory managers and pathologists will be interested to learn that, in fact, mobile computing is taking hold among physicians faster than in the general population. This was one conclusion from a recent survey, according to an article in Healthcare Informatics. QuantiaMD, a Waltham, MA-based mobile and online physician community, conducted a survey of 3,798 physicians. More than 80 % of the respondents said they own a mobile device capable of downloading applications. That means that a far higher percentage of physicians are using mob...

Preparing for Lab Week

ADVANCE Discourse: Lab — Mon, 16 Jan 2012 16:37:00 +0100

As supervisors, managers or directors of clinical laboratories, National Medical Laboratory Professionals Week (April 22-28) is an important time to express appreciation for your laboratorians, set aside some time to celebrate and, perhaps most importantly,...(read more) (Source: ADVANCE Discourse: Lab)

Some Independent Physician Practices on the Brink of Financial Failure

Lab Soft News — Mon, 16 Jan 2012 13:00:00 +0100

There are a number of factors contributing to the financial pressures being placed on community physicians. One of the most significant is that the federal government, the most important payer of medical costs, tends to favor inpatient and ambulatory care delivered by hospitals. A recent story provided the details (see: Doctors going broke). Below is an excerpt from it Doctors in America are harboring an embarrassing secret: Many of them are going broke. This quiet reality, which is spreading nationwide, is claiming a wide range of casualties, including family physicians, cardiologists and oncologists. Industry watchers say the trend is worrisome. Half of all doctors in the nation operate a private practice...."A lot of independent practices are starting to see serious financial issue...

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Lab uses Groupon to market testing

The Daily Sign-Out — Mon, 16 Jan 2012 13:00:00 +0100

This is a really intriguing use of social media by a lab to market their services! Affordable Labs in Vernon Hills, Illinois (a northern suburb of Chicago) is using Groupon to market a lab panel including cholesterol and liver function... (Source: The Daily Sign-Out)

Audio Conference: HIPAA Form 5010 Implementation: Real-World Solutions to Ease the Transition from 4010 to 5010 and Avoid Reimbursement Delays

Digital Pathology Blog — Mon, 16 Jan 2012 05:00:00 +0100

The first 18 days: Lessons learned about how labs can generate clean lab-test claims for speedy payment YOUR PRESENTERS: Lâle White, Executive Chairman and CEO, XIFIN, Inc. Jackie Griffin, Director, Client Services, Training & Project Implementation, Gateway EDI Matt Warner, Associate Vice President, Operations, XIFIN, Inc. Every clinical lab is about to learn whether the transition to form 5010-required as of January 1, 2012-will be handled flawlessly by payers or not. Ideally, clean claims should mean that payers send timely remittances to your lab. But things are less than perfect. Certain payers have already admitted that they weren’t 100% ready for form 5010 implementation on January 1. And in the days since, other payers have struggled to process cla...

Case of the Week 191

Creepy Dreadful Wonderful Parasites — Sun, 15 Jan 2012 17:38:00 +0100

The following arthropods were found on a 50-year old man and were submitted for identification to the clinical parasitology laboratory. No further history was given. Identification?Anyone have any idea what the 2 arthropods on the right are doing? (Source: Creepy Dreadful Wonderful Parasites)

Answer to Case 191

Creepy Dreadful Wonderful Parasites — Sat, 14 Jan 2012 17:12:00 +0100

Answer: Pediculus humanus, body or head lice. It is not possible to tell body lice and head lice apart morphologically, although as L.R. says, head lice are generally smaller than body lice. Furthermore, as Vanessa CH points out, body lice are hardier than head lice and are much more likely to remain alive after being separated for more than 24 hours from their host. These lice were definitely separated for more than 24 hours (probably more like 48-36 hours) and therefore are more likely to be body lice.Now as for what the 2 on the right are doing, that's an interest question! Thank you for the guesses. Despite some interesting speculation (fighting? mating? feeding on each other?) I think that B.A.M. got it right by saying that they probably are just stuck together and are trying to get l...

Best Post of July 2011: Formal Guidelines for Alzheimer's Genetic Testing Issued

neuropathology blog — Sat, 14 Jan 2012 01:44:00 +0100

The next in our "Best of the Month" series is from July 19, 2011:Dr. Edward B. LeeIn recent posts, I discussed the availability of direct-to-consumer ApoE testing and the fact that I myself submitted buccal cells to 23andMe.com to discover my own ApoE status. The illustrious Eddie Lee, MD, PhD just emailed me news that the American College of Medical Genetics and the National Society of Genetic Counselors have recently issued formal guidelines regarding ApoE testing in patients. Reported and discussed on the Alzheimer Research Forum, the guidelines, published in the June issue of Genetics in Medicine, identify which individuals may benefit from genetic testing. (Source: neuropathology blog)

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Connectivity and Hospital-Based EMRs; The EMR as an Operating System?

Lab Soft News — Fri, 13 Jan 2012 13:00:00 +0100

John Lynn, who blogs over at EMR and EHR, had this to say recently about a company called Emdeon (see: Emdeon’s EHR Lite) I’d been meaning to do a post about Emdeon‘s EHR lite ...since I first heard about it at MGMA. While I think that EHR Lite might be some good branding, I’m not sure you can really classify Emdeon’s EHR as lite. I’m sure they’re just trying to differentiate themselves from the 300+ EHR companies out there....I think I found the thing that most differentiates Emdeon from many other EMR companies. it’s their network. Here’s a summary they sent me of their network. Emdeon’s network encompasses: 340,000 providers 1,200 government and commercial payers 5,000 hospitals 81,000 dentists 60,000 pharmacies 600 vendor partners ....I strongly believe that healt...

New Standard Assists in Better Diagnosis of Cytomegalovirus

ADVANCE Discourse: Lab — Fri, 13 Jan 2012 12:52:00 +0100

The National Institute of Standards and Technology (NIST) has a new clinical Standard Reference Material (SRM) that will help healthcare professionals more accurately diagnose and treat cytomegalovirus (CMV). Many of the antiviral agents used to moderate...(read more) (Source: ADVANCE Discourse: Lab)

Last Chance to Register for PathXL Simulator Webinar

Digital Pathology Blog — Fri, 13 Jan 2012 05:00:00 +0100

PathXL Simulator: Prebuilt Simulations for Pathology Training 18th January 2012 – two time slots are available: Session 1 - 10.15am GMT / 11.15am CET / 05.15am EST / 02.15am PSTSession 2 - 4.15pm GMT / 5.15pm CET /11.15am EST / 08.15am PST PathXL Simulator is a comprehensive set of training modules designed for early stage training by residents in Pathology and Biomedical Scientists. Customers include Thames and Medway Training Schools, Liverpool Training School, South West Deanery Training School and the RCPA (Royal College of Pathologists of Australia) and Astra Zeneca. Guest Speakers: Professor Chris Womack, Astra Zeneca Dr Jim Diamond, PathXL Click here to register Why Attend? Learn about PathXL Simulator and modules available Listen to other users experience...

The $1,000 genome

The Daily Scan — Thu, 12 Jan 2012 02:03:00 +0100

The Wall Street Journal reports Soon, $1,000 will map your genes: The quest to harness the power of DNA to develop personalized medicine is on the threshold of a major milestone: the $1,000 genome sequencing. Life Technologies Corp., a Carlsbad, Calif., genomics company, plans to introduce Tuesday a machine it says will be able to map an individual's entire genetic makeup for $1,000 by the end of this year. Moreover, the machine and accompanying microchip technology, both developed by the company's Ion Torrent unit, will deliver the information in a day, the company says. That's pretty amazing. The cost of mapping an entire genome is rapidly approaching the cost of individual genetic tests; you can imagine that soon it will be just as inexpensive to sequence an entire ge...

Geisinger Follows Cleveland Clinic; Won't Hire Smokers

Lab Soft News — Wed, 11 Jan 2012 14:50:01 +0100

Cleveland Clinic established a ban on hiring smokers more than two years ago and similar policies are now spreading to other hospitals (see: Want a Job at the Cleveland Clinic?: Smokers Need Not Apply; Tobacco-Free Hiring Takes Hold; Both Smoking and Smokers Excluded; The Financial Stakes Escalate for Employees Who Smoke). Geisinger Health System has now introduced a similar policy (see: Hospital Quits Hiring Smokers, Introduces Nicotine Tests For Medical Workers). Below is an excerpt from the story Smokers in the medical field now have another reason to quit as a Pennsylvania hospital has said it will no longer hire smokers and is introducing nicotine tests in order to enforce the rule....Those exposed to second hand smoke will be exempt from the test, which screens applicants for cigaret...

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Stem Cell Therapy: More Encouraging News

ADVANCE Discourse: Lab — Wed, 11 Jan 2012 14:38:00 +0100

I’m very interested in advances with stem cell therapy. In fact, I recently blogged about the latest advances and revealed that I was a stem cell donor for my late brother, Todd. Today there’s positive news on the potential impact stem cell therapy has...(read more) (Source: ADVANCE Discourse: Lab)

Human Genome for $1000

Digital Pathology Blog — Wed, 11 Jan 2012 05:00:00 +0100

The Wall Street Journal (1/10, A2, Winslow, Wang, Subscription Publication) reports that Life Technologies Corp, developer of the Ion Torrent sequencing platform, is planning to offer the sequencing of a human genome for $1,000 by the end of 2012. The National Human Genome Research Institute (NHGRI) set the goal of a $1,000 genome in 2004, and the Journal notes that the initiative has already helped lower the cost of sequencing a human genome. However, American Society for Clinical Pathology spokeswoman Karen Kaul points out that understanding the biological or medical implications contained with genomic sequences will require far more research. Similarly, NHGRI director Eric Green was quoted as saying, "We can sequence the genome for dirt cheap... but we don't know how to deal with the ...

Researchers Map Mutations Lung Cancer in Never-Smokers

The Daily Sign-Out — Tue, 10 Jan 2012 19:24:02 +0100

Researchers Map Potential Genetic Origins, Pathways of Lung Cancer in Never-Smokers. Interesting preliminary data presented at AACR/IASLC Joint Conference on Molecular Origins of Lung Cancer currently underway in San Diego. The team from the Translational Genomics Research Institute performed whole-genome... (Source: The Daily Sign-Out)

New AACC President Seeks to Expand Group’s Influence on Lab Medicine

ADVANCE Discourse: Lab — Tue, 10 Jan 2012 12:25:00 +0100

On Jan. 1, Greg Miller, PhD, assumed the American Association for Clinical Chemistry (AACC) presidency for a 12-month term. Dr. Miller has said key areas of focus during his term will be expanding AACC's member services and influence on laboratory medicine....(read more) (Source: ADVANCE Discourse: Lab)

January Case of the Month from CAP

Digital Pathology Blog — Tue, 10 Jan 2012 05:00:00 +0100

2012 — January Case of the Month Posted January 10, 2012 CLINICAL SUMMARY: Jejunum View case with: PC users: ImageScope First-time use of ImageScope? * Download (required) Why use ImageScope? ImageScope offers many additional features including:• Ability to view multiple slides concurrently; synchronize panning/zooming.• Facility to author annotations.• Capability to run analysis algorithms, and display results.• Modify image brightness, contrast, color balance, etc. • Generally faster and more responsive. MAC/PC Users: WebViewer A 78-year-old man presented with small bowel obstruction. A partial small bowel resection was performed. The 15.0 cm resected portion of bowel ...

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Health Discovery Corporation Enters into Worldwide Licensing Agreement with NeoGenomics

Digital Pathology Blog — Tue, 10 Jan 2012 05:00:00 +0100

BusinessWire · Jan. 9, 2012 Health Discovery Corporation (OTCBB: HDVY), a molecular diagnostics leader in the use of patent protected advanced mathematical techniques for personalized medicine, has entered into an exclusive worldwide licensing agreement with NeoGenomics, Inc. (OTCBB: NGNM) for laboratory developed tests (LDT’s) in the Field of hematopoietic and solid tumor cancers excluding breast cancer, which was previously licensed to Quest Diagnostics (NYSE:DGX) and Smart Personalized Medicine and excluding cancer of the retina which was previously committed to Retinalyze, LLC. HDC retains all rights to in-vitro diagnostic (IVD) test kit development in cancer. In addition, HDC’s pre-existing licenses remain in effect. Under the terms of the Agreement, NeoGenomics paid $1 mi...

Five years of iPhone

The Daily Scan — Tue, 10 Jan 2012 01:42:00 +0100

As the iPhone and iPad become an ever bigger and more important tool for physicians - including pathologists - it is interesting to ponder five years of iPhone: Five years ago today, Steve Jobs unveiled the new iPhone at Macworld Expo. The company has since delivered five generations of new hardware and iOS software as its mobile competitors have scrambled to defend their positions and take share back. Jobs started his keynote with the words, "We're going to make some history together today... This is a day I've been looking forward to for two and a half years.". "Every once in a while a revolutionary product comes along that changes everything. One is very fortunate if you get to work on just one of these in your career. Apple has been very fortunate that it...

The Area Postrema is not the only place where the BBB is lacking

neuropathology blog — Mon, 09 Jan 2012 22:07:00 +0100

I'll paraphrase a question posed by one of my 2nd-year students at Southern Illinois University School of Medicine:I understand that the Area Postremawas a site where there was increased penetrability of the blood brain barrier.I am not sure, but thought I had come across additional sites of increasedpenetrability last year in my reading. Are there other sites where there isincreased permeability of the BBB?In pondering an answer to this question, I immediately thought of the illustrious Dr. John Donahue, consummate neurologist, neuropathologist, and neuroanatomist. I posed the question to him and got the following response:Dr. John Donahue, Brown University, Providence, RI"Not increased permability of theBBB. NO BBB! Area postrema is one of the circumventricular organs,a...

Risk Factors Relating to the Rising Trend of Hepatocellular Cancer in the U.S.

Lab Soft News — Mon, 09 Jan 2012 15:04:37 +0100

Hepatocellular cancer (HCC) is a common neoplasm in Asian countries because of the high incidence of hepatitis infection. Here are the three most common risk factors for (HCC): (1) alcoholism; (2) hepatitis B; (3) hepatitis C that causes 25% of causes globally (see: Hepatocellular carcinoma). Although HCC has been relatively rare in the U.S., the incidence is now rising quickly (see: Mayo Clinic Studies Identify Risk Factors In Rising Trend Of Liver Cancer). Here's more details from a recent article: Doctors have known for years that the incidence of deadly liver cancer is on the rise, but what is causing that trend has remained a mystery. Two recent studies...offer a clearer picture of the rise of hepatocellular carcinoma (HCC), or liver cancer, which has tripled in the U.S. in...

New Articles Published in Journal of Pathology Informatics

Digital Pathology Blog — Mon, 09 Jan 2012 05:00:00 +0100

Telecytology: Clinical applications, current challenges, and future benefitsMichael Thrall, Liron Pantanowitz, Walid KhalbussJ Pathol Inform 2011, 2:51 (26 December 2011)[ABSTRACT] [HTML FULL TEXT] [PDF] [Mobile HTML Full text ] [EPub] An open-source software program for performing Bonferroni and related corrections for multiple comparisonsKyle Lesack, Christopher NauglerJ Pathol Inform 2011, 2:52 (26 December 2011)[ABSTRACT] [HTML FULL TEXT] [PDF] [Mobile HTML Full text ] [EPub] Heterogeneity of publicly accessible online critical values for therapeutic drugsColt M McClain, Richard Owings, Joshua A BornhorstJ Pathol Inform 2011, 2:53 (26 December 2011)[ABSTRACT] [HTML FULL TEXT] [PDF] [Mobile HTML Full text ] [EPub] So...

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Register Now for Early Bird Rates for APF Spring Conference

Digital Pathology Blog — Sun, 08 Jan 2012 05:00:00 +0100

For online conference registration visit: www.apfconnect.org American Pathology Foundation's 2012 Spring Conference "Charting a New Course for Pathology; Navigation and Leadership In Turbulent Times" February 29 - March 2, 2012, Marriott Marquis, San Diego ONE MONTH REMAINING FOR EARLY REGISTRATION RATES! Make plans to join the American Pathology Foundation in San Diego for our 2012Spring Conference. Attendees can look forward to three days of information-rich sessions on best practices in the business of pathology and plenty of practical "take home" ideas for better managing their time, practice and resources. The APF Program Committee has worked to select timely topics and knowledgeable speakers to help you address critical prac...

A New Face of Philanthropy: Do-It-Yourself Drug Development

Lab Soft News — Fri, 06 Jan 2012 16:39:11 +0100

It's said that the philanthropic goals of younger individuals often differ from that of older generations in that they favor a more hands-on approach to their giving. They want to exercise more control over their charitable contributions. This approach was apparent in a recent article about "do-it-yourself drug development" (see: Do It Yourself Drug Development — With Some Help). Below is an excerpt from it: The effort by two families to buy and develop a drug that holds promise in treating Duchenne muscular dystrophy...is the result of an innovative new model set up to support the burgeoning phenomenon of do-it-yourself drug development. Before the Seckler and Wicka families bought halofuginone, a drug that showed promise in experiments done with Duchenne mice, they set up...

DigiPath Announces PathGuarantee Protection

Digital Pathology Blog — Fri, 06 Jan 2012 05:00:00 +0100

DigiPath®, Inc, provider of affordable, innovative, and reliable digital pathology solutions yesterday announced its PathGuarantee™. According to DigiPath, their PathGuarantee is the "digital pathology industry’s first Money Back Guarentee program". Perhaps DigiPath offering these terms and conditions will allow interested folks to test the waters for themselves and lower the potential fiscal barrier to adoption. It has been my experience that short, low or no-cost, no obligation type trials for scanning devices are hard to come by and not offered widely. I think if more companies did so to allow potential clients to "test drive" the device and software for an agreed period of time, sales could potentially increase. After all the due diligence a group, hospital, laboratory o...

Pathology Labs Replace Microscopes with Digital Imaging

The Daily Scan — Thu, 05 Jan 2012 19:04:00 +0100

LabMedica reports on mainstream adoption of digital pathology in Sweden: Pathology Labs Replace Microscopes with Digital Imaging: Microscopes are being replaced with digital imaging in pathology laboratories in the southern part of Sweden. Traditional microscope glass slides are turned into digital images, which are then analyzed by pathologists directly from the computer screen, instead of using regular microscopes. The revolution, which has already occurred in radiology, is now taking place in pathology. The contracted delivery not only digitizes the slides but also will completely renew IT support for all workflows of the pathology laboratories in the Skåne region. It is interesting to ponder why Sweden has become a world leader in the adoption of digital pathology for clinical applica...

Resolving Issues in the New Year

Changing Face of Lab Medicine — Thu, 05 Jan 2012 18:18:00 +0100

Holidays are over, tree is gone, holiday coverage schedules have been taken down, our days off (if we had any) are in the past and the question is "Where do we go from here?" As a laboratory manager, I have some thoughts on where I will go both at work...(read more) (Source: Changing Face of Lab Medicine)

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Sharing Medical Records across Hospitals with Epic's Care Everywhere

Lab Soft News — Thu, 05 Jan 2012 13:54:19 +0100

Health information exchanges (HIEs) have had a mixed record of success. This type of organization can be defined in the following way, courtesy of Wikepedia: Health information exchange (HIE) is defined as the mobilization of healthcare information electronically across organizations within a region, community or hospital system. HIE provides the capability to electronically move clinical information among disparate health care information systems while maintaining the meaning of the information being exchanged. The goal of HIE is to facilitate access to and retrieval of clinical data to provide safer, more timely, efficient, effective, equitable, patient-centered care. The key to success of HIEs is sustainability, both financial and organizational. Here's a key quote relating to HIE f...

Aperio to Present at 30th Annual J.P. Morgan Healthcare Conference

Digital Pathology Blog — Thu, 05 Jan 2012 05:00:00 +0100

Vista, CA – January 4, 2012 - Aperio, the global leader in digital pathology solutions that improve patient care, today announced that David Schlotterbeck, chief executive officer, will present an overview of the company’s business at the 30th Annual J.P. Morgan Healthcare Conference on Wednesday, January 11, 2012, at the Westin St. Francis Hotel in San Francisco. The Aperio presentation is scheduled to begin at 10:00 a.m. (PST). During his formal presentation, Mr. Schlotterbeck will discuss the multi-billion dollar digital pathology market and highlight Aperio’s new direction in digital pathology solutions for both healthcare and life sciences. These solutions will accelerate adoption and allow pathologists to be more effective. David Schlotterbeck is the retired chairman and ch...

Frosted Cerebellum

neuropathology blog — Wed, 04 Jan 2012 16:31:00 +0100

In frigid Massachusetts, forensic neuropathologist Peter Cummings, MD awoke this morning to find a cerebellum frosted on his bedroom window. Atrophic, yes, but a cerebellum nonetheless. (Source: neuropathology blog)

Should Hospitals Begin to Charge a Fee for Autopsies?

Lab Soft News — Wed, 04 Jan 2012 16:17:30 +0100

I have posted two notes pertaining to the intrinsic value of autopsies and whether virtopsies should be substituted for the classic autopsy (see: A Clinician Laments the Decline of the Autopsy; More on the Value of the Classic Autopsy Based on a Reader's Comment). Here's a comment from Dr. Karl Robstad in response to the second of these notes: As an aside, perhaps charging for autopsies might reduce the number of "unnecessary" autopsies. It's one thing to perform them in cases of sudden death, unclear cause of death or even in cases where the diagnosis is known but is rare or has high educational value; but, in my opinion, it is completely another to do restriction-less dissections of 90+ year-olds with a laundry lists of acronymous chronic diseases and obvious COD...

Pathology Labs Replace Microscopes with Digital Imaging

Digital Pathology Blog — Wed, 04 Jan 2012 05:00:00 +0100

By Labmedica International staff writersPosted on 29 Dec 2011 Non-US deployment of Aperio platform with image storage on a Hitachi platform. 400,000 glass slides annually at a rate of 300 TB of storage per year. Very cool. Look for more adoption overseas this year. Microscopes are being replaced with digital imaging in pathology laboratories in the southern part of Sweden.Traditional microscope glass slides are turned into digital images, which are then analyzed by pathologists directly from the computer screen, instead of using regular microscopes.The revolution, which has already occurred in radiology, is now taking place in pathology. The contracted delivery not only digitizes the slides but also will completely renew IT support for all w...

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Lucid, Inc. Announces Closing of Public Offering

Digital Pathology Blog — Wed, 04 Jan 2012 05:00:00 +0100

PRESS RELEASE Dec. 30, 2011, 12:46 p.m. EST ROCHESTER, N.Y., Dec 30, 2011 (BUSINESS WIRE) -- Lucid, Inc. LCDCU 0.00% today announced that it has closed its previously announced underwritten public offering of 1,388,000 units, with each unit consisting of one share of common stock and one warrant to purchase one share of common stock. Net proceeds received by Lucid were approximately $5.30 million, after deducting the underwriting discount and corporate finance fee, but before taking into account estimated offering expenses. The Company has granted the underwriters a 45 day option to purchase an additional 208,200 units to cover over-allotments, if any. The Company will use the net proceeds to repay certain indebtedness and to fund its continuing operations. Roth Capita...

More on the Value of the Classic Autopsy Based on a Reader's Comment

Lab Soft News — Tue, 03 Jan 2012 14:16:54 +0100

Pathologist Mark Pool commented on my recent note regarding the value of the classic autopy and the adoption of the virtopsy as an improved form of the procedure (see: A Clinician Laments the Decline of the Autopsy). His comment was so useful that I decided to promote it to the level of a note. It is presented below in its entirety: Thanks...for another provocative post on the autopsy. I guess I'll take the bait! The subject of this post reminds me of a saying I used to hear as a boy: "Two can live as cheap as one, if one don't eat." We talk the talk of wanting to improve quality, but the fact of the matter is that the autopsy (as it is currently) is a time- and energy-consuming endeavor whose value to medicine (as measured by its compensation) it exactly: zero. Encour...

Welcome to Digital Pathology Blog (Russian version)

Digital Pathology Blog — Tue, 03 Jan 2012 05:00:00 +0100

For folks who can read/speak Russian -- check out a blog about digital pathology (sound familiar minus the Russian part) over at Digital Pathology -- "The first blog about digital pathology in russian language" or "Первый блог о цифровой патологии на русском языке". Check out Google translator, if, like me, you have forgotten most if not all of your high school Russian. Welcome to the blogosphere! (Source: Digital Pathology Blog)

Happy New Year! 2011 was quite a year, and 2012 here we come...

The Daily Scan — Mon, 02 Jan 2012 18:58:00 +0100

Happy New Year everyone! Well 2011 was quite a year, and 2012 here we come... so what do we think will happen this year? More adoption of digital pathology, more applications, more success stories, and more learning about the best uses of this incredible technology. And more mainstream acceptance. What do you think? Please post your comments to let us know! (Source: The Daily Scan)

Case of the Week 190

Creepy Dreadful Wonderful Parasites — Mon, 02 Jan 2012 18:10:00 +0100

The following was seen on skin biopsy within a hair follicle. How would you sign this case out? (CLICK ON IMAGE TO ENLARGE)(Hematoxylin and Eosin, x1000)Many thanks to Dr. Holkmann Olsen for donating this great case! (Source: Creepy Dreadful Wonderful Parasites)

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FDA Warned French Company Founder about Breast Implant Safety Issues

Lab Soft News — Mon, 02 Jan 2012 16:05:49 +0100

You may be aware of recent news about a recall of French silicone breast implants manufactured by a company named Poly Implant Prothese (PIP) (see: France ponders removing recalled breast implants). It turns out that the FDA issued a warning letter to the founder of the company in 2000 about irregularities in the manufacture of PIP's saline implants (see: FDA warned French plant on implant safety in 2000). Note that the plant inspected by the FDA was also used to manufacture the silicone implants for PIP. Here is an excerpt from the article: As early as 2000, U.S. health authorities raised concerns about the French breast implant maker at the heart of a scandal affecting hundreds of thousands of women worldwide. That was almost 10 years before the company came under scrutiny from Europ...

Autopsies and Caviar Dreams

Digital Pathology Blog — Mon, 02 Jan 2012 05:00:00 +0100

A colleague sent this to me over the holidays. From the world of strange news items comes this tale of an entrepenurial funeral service owner and a morgue attendant in St. Petersburg, Russia. Not a big fan of performing autopsies but perhaps if there was some Russian red caviar to be had as part of the work I might reconsider. Just like a Thanksgiving dinner does not count if there is no turkey, a Russian New Year's party is not complete without caviar on the table. Even if it is a morgue party, police discovered. More than 175 kilograms of red and black caviar were stored in a morgue of a St. Petersburg hospital, local police said on their web site Wednesday. The caviar, which comes from endangered species, belonged to a 64-year-old entrepreneur who ran a funeral ser...

Answer to Case 190

Creepy Dreadful Wonderful Parasites — Sun, 01 Jan 2012 17:25:00 +0100

Answer: Demodex miteThese ubiquitous ectoparasites are found on most individuals in hair follicles (Demodex folliculorum) and sebaceous glands (D. brevis) and are considered to be normal skin flora. As such, they are commonly seen by dermatopathologists in skin biopsies.I particularly like this photo because you can make out the appendages and mouthparts of this mite:The intact organism can be seen on my previous CASE 58. (Source: Creepy Dreadful Wonderful Parasites)

A Clinician Laments the Decline of the Autopsy

Lab Soft News — Fri, 30 Dec 2011 14:00:56 +0100

It may be time for me to print another lament about the decline of the autopsy as a follow-up to my blog note from August of this year (see: The Declining Autopsy Rate and an "Unattainable" Solution for the Problem). This new essay was written by Dr. Sandra Gompf who is an infectious disease specialist (see: A eulogy for the autopsy, and a call for its return). Here is an excerpt from it: Evidence-based medicine and health insurers generally focus on what’s medically necessary, not what’s epidemiologically relevant, not what soothes the mind of the bereaved or of the physician grieved and mystified by the loss of a patient. Once, the autopsy was a venerated tool for medical advancement and humility. An invaluable means of learning one’s own limitations and the extraordinary...

Best Wishes for a Healthy 2012!

Digital Pathology Blog — Fri, 30 Dec 2011 05:00:00 +0100

Many thanks to my readers, followers, critics, contributors, commentors and sponsors. The intent of the blog remains as it did 4 years ago - to educate and inform the pathology and laboratory community on digital pathology, other technology news items and occassional dips into government and regulatory issues for the broader picture of healthcare and pathology's opportunities and weaknesses as we look ahead. No doubt healthcare reform changes, medicare/medicaid issues, FDA regulation, changes in the practice and business of the practice of pathology and laboratory medicine will affect some change on all of us. And no doubt that social media will affect how that news and commentary is shared and honored to be a part of it in this growing community. Best wishes for a healthy 2012 and a...

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Strategies Developed by States for Retaining and Attracting Physicians

Lab Soft News — Thu, 29 Dec 2011 12:47:42 +0100

As medical schools and teaching hospitals proliferate in the various states, state government officials, academics, and healthcare executives ponder how to retain this physician talent (see: How states are keeping doctors from moving out). A recent article provided details about some of the answers. Below is an excerpt from it: Widespread concerns about physician shortages have many states working to keep doctors trained in medical schools and residency programs there from crossing state lines to practice medicine....On average, only 39% of U.S. physicians practice in the same state where they went to medical school. Forty-eight percent practice in the state where they completed graduate medical education, said [a] report...by the AAMC Center for Workforce Studies. As a result, medical sch...

Bags of blood, and not a donor in sight: Lab-grown blood used for the first time

Digital Pathology Blog — Thu, 29 Dec 2011 05:00:00 +0100

Promising news out of Paris for suitable blood products when inventories remain tight for donor blood. Will see if subsequent use and experimentation can both create viable red cells that can remain in circulation and maintain their oxygen-carrying capacity. The Chicago Tribune (12/29) reports that according to a study in published in the journal Blood, "red blood cells generated in a lab have been successfully injected into a human volunteer for the first time." French researchers extracted "hematopoetic stem cells from a volunteer's bone marrow" and used various growth factors to induce the cells to differentiate into red blood cells (RBC). "After five days, 94 to 100 percent of the cells remained in circulation, while after 26 days, 41 to 63 percent remained -- a survival rate comparab...

Penn State Researchers Make Progress in the Fight Against Cancer

ADVANCE Discourse: Lab — Wed, 28 Dec 2011 20:41:00 +0100

I'm sure everyone knows at least one person who has been affected by cancer. So when news such as that from Penn State University and its success in curing leukemia in mice is revealed, it's certainly welcomed news. According to a report last week , researchers...(read more) (Source: ADVANCE Discourse: Lab)

Comments on CAP Proposed Revision to Stomach Cancer Protocol

The Daily Sign-Out — Wed, 28 Dec 2011 16:24:09 +0100

Comments are now available for viewing concerning proposed revisions to CAP Stomach Cancer Protocol. It's obvious that those who reviewed the protocol and offered their comments gave this matter careful consideration. (Source: The Daily Sign-Out)

Companion Diagnostics Gains Wider Acceptance in FDA Despite Challenges

Lab Soft News — Wed, 28 Dec 2011 14:49:48 +0100

The future of cancer therapy and molecular diagnostics lies with personalized medicine, with each new drug coming to market with a companion diagnostic. The FDA and its physician panels are getting much more serious about the need for the latter as evidenced by some recent news (see: A Push to Tie New Drugs to Testing). Below is an excerpt from the story: The Food and Drug Administration last year rejected the company’s drug to treat a subset of leukemia patients whose tumors had a particular genetic mutation. The main problem was not the drug itself, the agency said. Rather, ChemGenex had not specified a companion test that could reliably detect the mutation so that the drug could be given to the patients it is intended to help. These days, it is often not enough for pharmaceutical comp...

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Healthcare Reform Said To Be Affecting Millions and Medicaid Cuts

Digital Pathology Blog — Wed, 28 Dec 2011 05:00:00 +0100

USA Today (12/28, Kennedy) reports that "it can be difficult to dig through the rhetoric to determine just what the 2010 health care law has done," but "proponents and foes say big pieces of the law have been enacted and have already affected millions of people's lives." Don Berwick former administrator of the Centers for Medicare and Medicaid Services, remarked, "It's complicated, but there are very many benefits affecting millions of people. They will not know it's the Affordable Care Act, but it is." The piece highlights "five major changes in health care that occurred in 2011 because of the health care law," including a crackdown on fraud and more benefits for young adults and seniors. The AP (12/28) reports, "Just as Medicaid prepares for a vast expansion under the federal health care...

IVF Clinics in the U.K. Accused by Pioneer in Field of "Ripping Off" Couples

Lab Soft News — Tue, 27 Dec 2011 16:27:10 +0100

It's rare that physician "insiders" complain about the price of healthcare services in their field. A recent article about the cost of IVF in the U.K. therefore caught my attention (see: IVF clinics 'are ripping off desperate couples). Below is an excerpt from it: Fertility clinics are charging women who want to have children three times the actual cost of their treatment – with the NHS [National Health Service] as guilty as private practitioners in exploiting desperate couples. The accusation comes from the fertility pioneer Lord Robert Winston, who today launches a scathing attack on the high cost of fertility treatment in the UK and the unfettered use of expensive, unproven tests by private clinics. The Labour peer and former head of the NHS IVF clinic at Hamm...

ASM Launches Global Resource for Clinical Microbiologists

ADVANCE Discourse: Lab — Tue, 27 Dec 2011 12:50:00 +0100

The American Society for Microbiology (ASM) has launched a clinical microbiology web portal that focuses all of ASM's clinical and external relevant content into a user-friendly site. "The portal will offer in one site a wealth of information needed for...(read more) (Source: ADVANCE Discourse: Lab)

Volkswagen turns off Blackberry email after work hours

Digital Pathology Blog — Tue, 27 Dec 2011 05:00:00 +0100

Smart move by Volkswagen. Mobile technologies, in my own experience, can disrupt the delicate work-life-family balance. It is good to be "connected" but checking e-mail as often as you can, likely for many items that can wait until after dinner or the next morning is a trap. Of course, I suppose one could do this themselves but perhaps the employees felt a sense of having to use this service or perhaps it gave them a sense of belonging to always be "connected" to the office and their colleagues. Pathology call aside, when my phone and I get home, it gets plugged in and rarely (OK - seldomly) gets checked before the next morning. I just get out my laptop and check e-mails... For the past year on family vacations I do leave my phone and iPad in the room and guess what - do not ...

Fragmentation of Healthcare Delivery as a Barrier to Participatory Medicine

Lab Soft News — Mon, 26 Dec 2011 21:22:28 +0100

Participatory medicine is the term used to describe the empowerment of patients to take a more active role in decisions relating to their healthcare, a variant of consumer empowerment (see: Interpreting the Tea Leaves: Ten Hot Trends in Healthcare, Lab Medicine, and Pathology Informatics; Participatory medicine). A recent blog note by Dr. Kevin Pho discussed the extent to which participatory medicine is influenced by the personality of the treating physician as well as that of the patient and barriers to patient involvement (see: How much guidance do patients want with their medical decisions?). Below is an excerpt from the article: There is a spectrum of how much physician involvement patients want. Some may want physicians only to suggest and inform but leave the ultimate decision to the...

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Lab results in: BGH appeal slides over top

Digital Pathology Blog — Mon, 26 Dec 2011 05:00:00 +0100

Nice story for the holiday season -- Brockville General Hospital in Ontario, Canada recently exceeded their annual fundraising goal and will use the donations to purchase a telepathology system for purposes of secondary consultation. BGH raises $142,300 for laboratory They answered the pleas and put patients at ease. Donations to this year's Brockville and District Hospital Foundation Annual Appeal surpassed the goal of $135,000, coming in with a total of $142,300 as of Thursday. The result has officials at Brockville General Hospital once again astounded at the generosity of local residents. "The generosity of the community is always heartening to see," BGH chief executive officer and president Ray Marshall told The Recorder and Times. "There are so many causes out there at this tim...

Case of the Week 189

Creepy Dreadful Wonderful Parasites — Fri, 23 Dec 2011 18:07:00 +0100

Dear Readership of Creepy Dreadful Wonderful Parasites,May you have a wonderful holiday season with friends and family! Thank you for your continued support and comments.Here is the 'case' for this week - a simple identification: (Source: Creepy Dreadful Wonderful Parasites)

REFCOR Chooses mScope for National Expert Pathology Panel

Digital Pathology Blog — Fri, 23 Dec 2011 05:00:00 +0100

Aurora will supply the French Expert Network for the Diagnosis of Rare Otolaryngology (ENT) Cancers (REFCOR) for their medical multi-disciplinary team meetings (MDTMs) and their case reviews by the national pathology expert panel MONTREAL (CANADA), December 22, 2011 - Aurora Interactive Ltd., the world leader in digital pathology communications, announced today that the company has signed a contract for the supply of its mScope clinical communications platform following a request for proposal from the REFCOR group for the establishment of a national telepathology network to implement: information sharing; case management; and the viewing and analysis of diagnostic pathology images. The system allows for remote diagnostics and collaboration among expert pathologists and clinicians. "REFC...

Answer to Case 189

Creepy Dreadful Wonderful Parasites — Thu, 22 Dec 2011 18:05:00 +0100

Answer: Phthirus pubis, a.k.a the crab louse, or as my readers said:"the Yuletide pubic louse", "Pthirus barbae viridis: green bearded louse", "Pine-scented pubic louse", and "Louse found in Bad Santa's trousers"Happy 2012!Parasite gal (Source: Creepy Dreadful Wonderful Parasites)

Ho, Ho, Humbug: Manage Holiday Stress

Changing Face of Lab Medicine — Thu, 22 Dec 2011 17:54:00 +0100

As a manager, you are accountable for not only your own stress but also that of all of your employees. The holiday season brings many different kinds of stress not only to the home but also to the workplace. Employees are torn in many directions: Days...(read more) (Source: Changing Face of Lab Medicine)

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GOP Poised to Postpone Doc Pay Cut

Digital Pathology Blog — Thu, 22 Dec 2011 05:00:00 +0100

As I mentioned in a recent prior note, the show that never ends - the issue of professional reimbursement from Medicare for physicians has gone through one more year and the result is another short-term patch with no long-term permanent fix, correction, adjustment or controls... From Medscape Medical News December 22, 2011 — In what some see as a capitulation in the face of mounting pressure in and outside the party, House Republican leaders reached an agreement this evening that, among other things, would postpone the 27.4% cut in Medicare physician reimbursement schedule to take effect on January 1. Along with delaying the cut until March 1, the deal, if pushed to a successful full vote of the House, would also extend the payroll tax cut and unemployment benefits ...

New eBook on Companion Diagnostics Worth a Look

Digital Pathology Blog — Thu, 22 Dec 2011 05:00:00 +0100

Many thanks to Digital Pathology Insights for the tip on a book published on "Companion Diagnostics - The Future of Medicine". Just a brief glance of the book on my Kindle - the book starts with a case study making the case for companion diagnostics and therapeutics and follows with the story of HER2 and Herceptin therapy. Looks like regulatory issues and other approaches to personalized diagnoses and cure follow in the glance I took. The piece from FiercePharma mentions: "The balanced perspective offered in this unique work is both daunting and refreshing. Tracy outlines the many problems with these sorts of treatments in today's insurance company-ruled healthcare industry. Reimbursement for experimental drugs, terminology and marketing strategy are among those hurdles facing...

ATA: Telehealth 'birthing networks' could save Medicaid $186M

Digital Pathology Blog — Thu, 22 Dec 2011 05:00:00 +0100

Via FierceMobileHealthcare by Sara Jackson No doubt a study such as this could show positive savings for "high-risk" pathology cases. Medicaid could save $186 million over the next 10 years if it uses telehealth services for high-risk pregnancies, according to a new analysis commissioned by the American Telemedicine Association. And that's a conservative estimate, researchers say. Conducted by Washington, D.C.-based health research company Avalere Health, the new study analyzed Medicaid's costs for pre-term babies, NICU admissions and unplanned physician visits by Medicaid patients. Researchers then applied analytical tools--like those used by the Congressional Budget Office--to create projects that legislators might be more likely to accept, it seems. The proposal doesn't ...

Happy Holidays from the Daily Scan

The Daily Scan — Wed, 21 Dec 2011 19:13:00 +0100

Greatings readers just wanted to wish everyone a Happy Holiday, whatever you may celebrate this time of year. It's been quite an interesting year, and quite a year for the growth of digital pathology. Many labs and pathologists have become more comfortable with this technology and are exploring the many ways it can deliver value for them, and adoption seems to be moving from "if" to "when". And next year should be even more interesting... I'm tempted to make predictions, but every time I do they are both too optimistic (regarding time) and yet not wild enough (regarding all the possible applications people will uncover). Happy New Year and stay tuned! (Source: The Daily Scan)

‘Serious Reportable Events’ Update

ADVANCE Discourse: Lab — Wed, 21 Dec 2011 14:00:00 +0100

The National Quality Forum (NQF) has finalized its list of Serious Reportable Events (SREs) , a compilation of serious, largely preventable and harmful clinical events designed to help the healthcare field assess, measure and report performance on providing...(read more) (Source: ADVANCE Discourse: Lab)

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Biotech Billionaire Invests in a "High Speed Rail System" for Genomic Data

Lab Soft News — Tue, 20 Dec 2011 13:00:00 +0100

This article indicates that there is a new component in support of the genomic research supercomputers that are cropping up around the country -- fiberoptic networks that will connect them and allow them to share data. One of them is the National LambdaRail (NLR). Needless to say, cancer diagnosis and treatment is the epicenter of genomic research and entrepreneur/ philanthropists like Dr. Patrick Soon-Shiong are helping to make integrated and collaborative research computing a reality. It also make sense that individuals such as he are investing in information technology rather than making bricks-and-mortar donations to universities and hospitals. Such investments would seem to come naturally to individuals who have make their fortune in biotech. (Source: Lab Soft News)

COLA Employees to Greet Returning Military

ADVANCE Discourse: Lab — Tue, 20 Dec 2011 13:00:00 +0100

Employees of COLA will greet returning troops at Baltimore/ Washington International Thurgood Marshall Airport on Dec. 22, part of Operation Welcome Home Maryland (OWHM). The COLA volunteers will cheer on an estimated 350 soldiers arriving from combat...(read more) (Source: ADVANCE Discourse: Lab)

Different Christmas, Same Story

Digital Pathology Blog — Tue, 20 Dec 2011 05:00:00 +0100

Around this time of year wonder if my work will be reimbursed at 30% of what it was the year before or not. Historically, not. Actually small raises. Now tangled up with an oil pipeline...Predict a cut on order of less than 10% if any... December 20, 2011 — Medscape — The House today voted to reject a Senate bill postponing a 27.4% cut in Medicare reimbursement to physicians from January 1 to March 1, and to try to meld conflicting legislation through a House–Senate conference committee. The tortured Congressional proceedings increase the odds that the cut will take effect New Year's Day. The fight is not over physician compensation, but larger issues that have taken it hostage. The drama dates back to last Tuesday, when the Republican-controlled House voted 234 to 193 to ...

Real-time Colon Polyp Histopathology

Digital Pathology Blog — Tue, 20 Dec 2011 05:00:00 +0100

Technologies Are Advancing But Face Some Hurdle by Gabriel Miller - Gastroenterology and Endscopy News I was going along with story and understand the background, need and data to biopsy what amounts to normal or minimally abnormal tissue of no clinical significance until the author appropriately mentioned the key issue here for adopting this in the 3rd to last paragraph of the story. We are not talking about missing a signifcant lesion that could be a precursor to a colon cancer down the road. I undertand this even more if imaging technologies improve to appreciate at the in-vivo level what would be anticipated by histologic examination and predictive of morphology and hence clinical behavior and outcome. I also recognize that of the millions of colonoscopies that generate mill...

Interpreting Statistics in the Lab

ADVANCE Discourse: Lab — Mon, 19 Dec 2011 22:44:00 +0100

We’re working on something new for 2012 that we hope will be of great value to you, and we’d love to have your questions, insight and input to help us kick it off. A new column, “Interpreting Statistics in the Lab” will launch on our website in January...(read more) (Source: ADVANCE Discourse: Lab)

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PathXL BioBank™ - a global solution for biobanking

Digital Pathology Blog — Mon, 19 Dec 2011 05:00:00 +0100

Belfast, Northern Ireland: December 2011 Earlier this year, PathXL announced it had been commissioned to develop digital pathology software for the Northern Ireland Biobank. Biobanks play a crucial role in diagnosis and the development of the new targeted treatments and stratefied therapies for cancer and other diseases, so PathXL has further developed it’s biobank solution and today is introducing PathXL Biobank™ to the global market. PathXL Biobank™ is a fully web-enabled workflow management solution for biobanks. It provides a comprehensive platform for biosample management including the ability to create new sample records, manage patient consent, track sample preparation, store sample location, coordinate applications to the biobank and release of samples to researchers. Desi...

Quorum Technologies Names XStor Systems Exclusive Pathology Image Storage Partner for Canadian Market

Digital Pathology Blog — Sun, 18 Dec 2011 05:00:00 +0100

Partnership with Leading Biomedical Equipment Distributor Includes XStorPath™, a Digital Image Storage and Management Solution Developed Specifically for Pathologists MOUNTAIN VIEW, Calif.--(BUSINESS WIRE)--XStor Systems, Inc., a provider of next-generation, specialty-specific digital imaging storage and connectivity solutions for radiology, pathology, and oncology, announced today an exclusive partnership with Quorum Technologies, Canada’s leading provider of microscope-based equipment and image processing solutions for scientists, clinicians and laboratories. Through this new partnership, Quorum will be the exclusive distributor of the XStorPath digital image storage and management system for the Canadian pathology market. “Our patented technology is designed with the reali...

Applications Pre-Sales Consultant / Specialist, Healthcare (Lab Workflow, IHC, Pathology)

Digital Pathology Blog — Sat, 17 Dec 2011 05:00:00 +0100

Aperio is hiring. See below fron LinkedIn Aperio - Vista, CA (Greater San Diego Area) Job Description This person will be directly involved with the sales team and responsible for pre-sales activities with prospective and existing customers. You will also have interaction with other departments including Operations, Marketing, Development and Quality. (Internal Job Title - Digital Pathology Consultant - This is a regular employee position with Aperio, consulting with our customers and potential customers) In this position you will: Perform in-house and field based activities including but not limited to: Pre-sales on-site and / or WebEx presentations regarding Aperio hardware, software and applications, including workflow, Spectrum Plus, Image Analysis and basic IT infrastruc...

Naegleria-tainted neti pots possiblely killed two people

neuropathology blog — Fri, 16 Dec 2011 20:59:00 +0100

Naegleria fowleriNow that it's winter and our noses and sinuses are being dried out by our heating systems, many of us turn to neti pots (also known as 'nose bidets'). The illustrious J. Clay Goodman, MD, neuropathologist at Baylor, just sent me an article from The Houston Chronicle warning people to use distilled, bottled, or boiled water. Officials in Louisiana are investigating whether a 51-year-old woman and a 20-year-old man both contracted the brain-eating amoeba Naegleria fowleri after using tap water in their neti pots. The disease, while rare, is most commonly contracted after inhaling water from a lake, pond or river. If investigators confirm the two victims died after using tap water from a neti pot it will be the first time the disease has been contracted from tap water. (Sourc...

Naegleria-tainted neti pots possibly killed two people

neuropathology blog — Fri, 16 Dec 2011 20:59:00 +0100

Naegleria fowleria (photo courtesy of Dr. Mark Cohen)Now that it's winter and our noses and sinuses are being dried out by our heating systems, many of us turn to neti pots (also known as 'nose bidets'). The illustrious J. Clay Goodman, MD, neuropathologist at Baylor, just sent me an article from The Houston Chronicle warning people to use distilled, bottled, or boiled water. Officials in Louisiana are investigating whether a 51-year-old woman and a 20-year-old man both contracted the brain-eating amoeba Naegleria fowleri after using tap water in their neti pots. The disease, while rare, is most commonly contracted after inhaling water from a lake, pond or river. If investigators confirm the two victims died after using tap water from a neti pot it will be the first time the disease has be...

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ASGE Urges Colorectal Cancer Screening for New Year’s Resolutions

ADVANCE Discourse: Lab — Fri, 16 Dec 2011 13:02:00 +0100

As 2012 approaches, the American Society for Gastrointestinal Endoscopy (ASGE) encourages all men and women age 50 and over to add getting screened for colorectal cancer to their list of New Year's resolutions. Recent studies have confirmed that screening...(read more) (Source: ADVANCE Discourse: Lab)

Do Patients Need Protection from Hospital-based Medical Apology Programs?

Lab Soft News — Fri, 16 Dec 2011 13:00:00 +0100

Are hospital "medical apology programs" a problem for patients who choose to participate in them? They seem to be, at least according to a recent blog note by Gabriel Teninbaum of Suffolk University Law School (see: Protecting patients from medical apology programs). Below is an excerpt from his post: To deal with the aftermath of medical errors, an increasing number of providers are encouraging injured patients to participate in “medical apology programs.” The idea, proponents say, is for patients to meet with facility representatives to learn what happened and why. It gives the patient a chance to ask questions and it gives providers a chance to apologize, and as appropriate, offer compensation. These programs are promoted as humanitarian, and, at least in ter...

2nd International Scanner Contest (ISC) - Register Now

Digital Pathology Blog — Fri, 16 Dec 2011 05:00:00 +0100

P. Hufnagl1, T. Schrader1, 2, M.G. Rojo3, A. Laurinavicius4, G. Kayser5, Y. Yagi6 1Institute for Pathology, Charité – Universitätsmedizin Berlin, Germany, 2University of Applied Sciences Brandenburg, Brandenburg, Germany, 3Servicio de Anatomia Patologica, Hospital General de Ciudad Real. 4National Centre of Pathology, Vilnius, Lithuania, 5Institute of Pathology, University of Freiburg, Freiburg, Germany, 6Massachusetts General Hospital, Boston, United States All manufacturers of slide scanners are invited to participate in the Second International Scanner Contest (ISC) in Berlin, under the auspices of the European Society of Pathology, German Society of Pathology, and the Berufsverband Deutscher Pathologen e.V. (German Professional Organization of Pathologists). The 1st ESC wa...

POC Genetics Becoming Reality

ADVANCE Discourse: Lab — Thu, 15 Dec 2011 16:36:00 +0100

The recent RAPID GENE (Re-Assessment of Anti-Platelet Therapy Using an Individualized Strategy Based on Genetic Evaluation) clinical trial used the Spartan Bioscience RX CYP2C19 to test patients being treated with cardiac stenting for an acute coronary...(read more) (Source: ADVANCE Discourse: Lab)

Posthum(or)ous recognition of Pick a Pathologist Pal Day

Digital Pathology Blog — Thu, 15 Dec 2011 05:00:00 +0100

A reader recently let me know that I failed to recognize "Pick a Pathologist Pal Day" on Tuesday, December 13th: Pick A Pathologist Pal Day Wellcat strikes again with Pick A Pathologist Pal Day claiming Pathologists and coroners are an especially jovial lot, and befriending one of them offers an ongoing reminder than “tomorrow” is not necessarily a guarantee. They consider coroners and pathologists a happy group of people. They suggest being friends with one will help you realize tomorrow is no guarantee. Buddhists would call this "living in the now." Live in the Now suggests these methods for enjoying each moment: * Say yes to the present moment by accepting it or taking action to make changes now (not later). * Just breathe, focus on your breath. * Stop and enjoy the det...

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Brigham and Women's Hospital Names Neuropathologist as New Chairman

neuropathology blog — Wed, 14 Dec 2011 22:28:00 +0100

Dr. Jeffrey A. GoldenIn an obvious attempt to keep up with Massachusetts General Hospital, whose pathology chief is neuropathologist Dr. David Louis, Brigham and Women's Hospital in Boston has just announced that another neuropathologists, Dr. Jeffrey Golden, will become chair of pathology at that institution. Effective March 1,2012, Dr. Golden will become the Ramzi S. Cotran Professor of Pathology at Harvard Medical School. Brigham President Betsy Nabel, MD had this to say in a statement released today: Dr. Golden comes to BWH "from The Children's Hospital of Philadelphia, where since 2008, he has been serving as Pathologist-in-Chief in CHOP's Department of Pathology and Laboratory Medicine, cited as one of the leading pathology and developmental biology programs in the U.S. and one...

The Business of Health Care

ADVANCE Discourse: Lab — Wed, 14 Dec 2011 14:34:00 +0100

Many healthcare professionals choose their career path because they want to practice some type of medicine—be it lab medicine, radiology, nursing and more—and perhaps be a valuable part of helping patients get well. But as you climb up the ranks, the...(read more) (Source: ADVANCE Discourse: Lab)

Eight Reasons Why Nurses Get Fired; Drug Abuse among Nurses

Lab Soft News — Wed, 14 Dec 2011 13:00:00 +0100

A recent article that included a list of eight reasons why nurses get fired caught my attention (see: 8 Reasons Nurses Get Fired). Below is the list: Giving into Temptation—Abuse of Prescription Drugs Demand for Perfection—Making Too Many Mistakes Cyberspace Collides With Reality — Facebook Usage & Information Put On a Happy Face—Grumpy or Negative Attitude Obtain Proper Licensing—Failure to Renew or Receive Nursing License Patient Treatment—Abuse of Patients The Disappearing Act—Too Many Absences Inner Politics—Proper Handling of Management True enough, but these are also the reasons why most people get fired. All you need to do to get such a universal list is to delete the word "prescription" from item #1 and substitute "customer" for "patie...

UCT Digital Pathology Collection

Digital Pathology Blog — Wed, 14 Dec 2011 05:00:00 +0100

An online catalogue with thousands of pathology specimens used as a teaching collection. Detailed cases and exhibitions are available. Go to UCT Digital Pathology collection This website gives electronic access to several thousand pathology specimens in our pathology teaching collection. It is intended for use by undergraduate and postgraduate students in the health sciences. There are currently three main catalogues for (1) the anatomical pathology collection (2) the forensic pathology collection and (3) the obstetrics and gynaecology collection. (A paediatric pathology section is in the pipeline). This is an historical collection (begun in the 1920’s) so the cataloguing is rather old fashioned. The specimens are catalogued by organ or system e.g. “kidneys” and then by broad p...

Medscape: most-read Pathology articles of 2011

The Daily Scan — Tue, 13 Dec 2011 18:59:00 +0100

If you're a Medscape subscriber, you'll find this interesting: the most-read Pathology articles of 2011. (Subscribing to Medscape is free.) #3 on the list is FDA approves test to determine Her2 status in breast cancer, about a new ISH genetic test using digital pathology. #2 on the list is Pathology Consultation: Reporting of Critical Values. This is typical of the articles indexed by Medscape, a scholarly review article. #1 on the list is NSCLC: Histology first, then mutation testing, a report from the National Comprehensive Cancer Network annual conference. Check out the entire list, and Medscape itself if you haven't before, it's a great resource. I wonder what will be the articles of most interest in 2012? (Source: The Daily Scan)

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Ventana Medical Systems, Inc. and Advanced Cell Diagnostics Enter Worldwide Co-Promotion Agreement for Fully Automated RNA In Situ Hybridization Assay Systems

Digital Pathology Blog — Tue, 13 Dec 2011 05:00:00 +0100

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Transferring Laboratory Data Into The Electronic Medical Record: Technological Options For Data Migration In The Laboratory Information System

Digital Pathology Blog — Tue, 13 Dec 2011 05:00:00 +0100

Conclusion — Page 36 References — Page 37 Appendices A-1 About Mark Terry — Page 39 A-2 About About NetLims — Page 40 A-3 About DARK Daily — Page 41 A-4 About The Dark Intelligence Group, Inc., and THE DARK REPORT — Page 42 A-5 About the Executive War College on Laboratory and Pathology Management — Page 43 A-6 About Julie Pekarek — Page 45 Terms of Use — Page 48 (Source: Digital Pathology Blog)

Improvements Recently Made to the AANP Website

neuropathology blog — Mon, 12 Dec 2011 21:52:00 +0100

The website for the American Association of Neuropathologists has recently undergone some improvements that might be of interest to NeuropathologyBlog readers:- The membership directory should be changed so itis searchable by location (hospital, city, or state), as well as by name.- The Education Section provides useful links for those of us (myself included) who need to get our SAM credits in to the American Board of Pathology for maintenance of certification. - A new tab has been added under the ProfessionalAffairs heading, entitled “Survey". Results of recent AANP surveys are posted here.- A new heading for the left hand column onthe home page has been added entitled “Links of interest". Several links pertinent to neuropathologists are listed. (Hey, where's Neuropatholog...

Case of the Week 188

Creepy Dreadful Wonderful Parasites — Mon, 12 Dec 2011 16:18:00 +0100

The following objects were found in the clothing of an 18 month old child. They measure approximately 3mm in length.By manipulating them with a wooden applicator stick, the following was expressed out of these objects (CLICK ON IMAGES TO ENLARGE):(100x original magnification)(400x original magnification)Thanks to Emily in my lab for these beautiful photos! (Source: Creepy Dreadful Wonderful Parasites)

Impressive Growth in Hospital-Based Palliative Care Teams

Lab Soft News — Mon, 12 Dec 2011 13:00:00 +0100

One of the most interesting and worthwhile recent trends in healthcare is the rise in palliative care. It can provide a set of important choices when patients and their families face life-threatening illnesses. A recent article discussed the its upward trend. Below is an excerpt from the article (see: Hospital-based palliative care rises 19%) The nation has improved its overall grade on providing hospital-based palliative care to a B, up from a C in 2008. The higher grade is due to a 19% rise in the number of hospitals with palliative care teams since 2008, according to a report released in October. The number of 50-plus bed hospitals with palliative care teams has nearly tripled since 2000 to 63%, said the research conducted by the Center to Advance Palliative Care...Eighty-five percent o...

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Answer to Case 188

Creepy Dreadful Wonderful Parasites — Sun, 11 Dec 2011 18:06:00 +0100

Answer: Proglottids and egg packets of Dipylidium caninum, the double-pored dog tape worm.This small tape worm is acquired through ingestion of infected Ctenocephalides spp. fleas, prompting one of my readers to ask if the child got infected by ingesting the specimen from the previous case of the week! Another reader, MicrobeMan, had a similar inquiry "Was it merely coincidental that you posted Ctenocephalides last week? Regardless, it's very appropriate, seeing as that both adult C. canis and C. felis can carry the cysticercoid form of D. caninum to people."To answer these questions - it was actually a complete coincidence that we happened to have a Ctenocephalides flea and D. caninum proglottids submitted to my lab in such a short time period of time, and I wasn't really considering the ...

Cutty Come Back

Digital Pathology Blog — Sun, 11 Dec 2011 05:00:00 +0100

A colleague from Northwestern medical school and fellow despondent Bears fan sent this one along. After getting Tebow'd in the fourth quarter earlier today I could not agree with this song more. Thanks to "Chad in Portland - "Do you think you can throw left handed?" 4 minutes well spent. Million views by weeks end as folks digest this latest Bears disaster. (Source: Digital Pathology Blog)

Dr. R2D2--Computerized pathologist?

The Daily Sign-Out — Sat, 10 Dec 2011 15:47:03 +0100

Meet C-Path, the iJobPlodd version of the 21st century pathologist. The December 3rd-9th, 2011issue of The Economist has an article in this "Technology Quarterly" section entitled, "Indolent or Aggressive: A computerised pathologist that can outperform its human counterparts could transform... (Source: The Daily Sign-Out)

When Blago leaves prison …

Digital Pathology Blog — Sat, 10 Dec 2011 05:00:00 +0100

Not anything related to digital pathology. Taken from Chicago Tribune. It is possible the president in 2024 might be 22 now. Playing Xbox right now. Let's hope the Bulls have 6 more championships by then but I kind of doubt it. Medicare running out of money could be a bad thing, particularly since I will still need it as a source of income and a plan I have been paying into and will continue to for years and will need long after it is gone. As much as any Chicagoan would like to see the Olympics in our hometown I think it is more likely Medicare could run out of money by then. And who will be the Bears quarterback then? Where is he right now? Let's hope playing Pop Warner football in Mississippi, Louisiana or Western PA. Some good ones have come out of there. If former Gov. Rod ...

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