viernes, 31 de enero de 2014



Healthcare News

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


January 30, 2014

View Previous Issues - Healthcare News Archive

NIH to Researchers: Credibility Counts 

The NIH is planning "significant interventions" to ensure that basic biomedical studies stand the test of time, its two top officials say. In the long term, science remains self-correcting, according to NIH Director Francis Collins, MD, PhD, and Principal Deputy Director Lawrence Tabak, DDS, PhD. But in the short term -- and especially in preclinical research using animal models -- "the checks and balances that once ensured scientific fidelity have been hobbled," they argue in a Comment article in Nature. One report has suggested that "as many as two-thirds of studies related to preclinical animal trials were not able to be reproduced," Tabak told MedPage Today.


Don’t Rely on Quick Flu Tests, CDC Tells Doctors

Flu is now widespread in 41 U.S. states, and as patients fill clinics and emergency rooms, federal health officials are advising doctors not to rely entirely on quick flu tests. The H1N1 swine flu — which first emerged in 2009, when it caused a pandemic — is causing 99 percent of the cases that are being tested, the Centers for Disease Control and Prevention said in its weekly flu report. It’s not clear why, but the rapid flu tests used in many clinics are getting what are called false negatives — that is, they indicate someone does not have influenza when in fact they do, said Dr. Angela Campbell, a medical officer in CDC’s respiratory diseases branch.


Lab Services Grow Despite Payment Cuts

The demand for clinical laboratory services is accelerating even in the face of large reimbursement cuts, especially from Medicare, a report from Kalorama Information has found. The world market for clinical lab service grew just 1.2 percent over the past five years to $99.1 billion for 2013 from $92.7 billion in 2008. Of that, the U.S. clinical lab market share increased 1.4 percent to $54.1 billion for 2013 compared to $50.6 billion in 2008. The increasing incidence of chronic diseases, aging populations, emphasis on diagnosis and disease monitoring and more advanced testing technologies and practices are driving increased use of clinical lab services. The use of preventive and risk-factor testing has been especially strong in oncology, endocrinology and gynecology, the report said.


Waived Testing: The Last Mountain

Have you noticed how much more attention waived testing is getting these days? 
We know that CLIA has defined waived tests as laboratory procedures which employ methodologies that are so simple and accurate as to render the likelihood of erroneous results negligible; and which pose no reasonable risk of harm to the patient if the test is performed incorrectly. Tests cleared for home use by the FDA are also classified as waived; We also know that facilities performing only waived tests have no routine oversight and no personnel requirements and are only required to obtain a Certificate of Waiver (CW), and follow manufacturers' test instructions. The latter account for over 70% of all clinical laboratories in the U.S.
As efforts intensify to reduce medical errors, improve health-care quality, and increase patient safety, there is a renewed focus on how to better monitor waived testing. After all, since 1988, the number of CLIA approved waived tests has increased from 8 to 120.  As the number of approved analytes for waived testing has increased, the potential for serious impacts on healthcare has also increased. The concern is usually not about the kits or instruments themselves, but the human factor: is the testing staff adequately trained and competent to perform the testing as required by the manufacturer? Is quality control monitored, and corrective action taken if needed, before patient results are reported? Are reagents and specimens properly stored? Who is supervising the staff?


Pre-analytical Errors: Working With Manufacturers to Help Improve Quality

Laboratory medicine is integral to clinical decisions, providing healthcare professionals with information for prevention, diagnosis, treatment, and management of patients’ health. Up to 60% to 70% of all medical decisions are based on laboratory testing results. But errors occur in clinical laboratories—often in the pre-analytical phase. Laboratory professionals can reduce the frequency of errors by aggressively investigating their causes. In the pre-analytical phase, as in all phases, working with the applicable product or service manufacturer(s) can be an important part of helping to ensure that the error is not repeated. When an error occurs in the clinical laboratory, a complaint registered with the applicable product or service manufacturer(s) can be an opportunity to gain needed support and information to help resolve the error. This support and information from a manufacturer is a valuable tool for the laboratory in finding the solution to an error that can, in the long run, help contribute to the laboratory’s overall continuous quality improvements.


Call Genetic Counselors, Maybe?

The steady rise of the numbers of genetic tests being used in clinical care, the ever-expanding number of known functional genetic markers, and the possibility that whole-genome sequencing may be used more widely in treatment, all suggest that there may be a need for more genetic counselors. Telephone consultations could make it easier for patients and consumers to get more information about what tests and results mean, and these tele-sessions are likely just as effective as face-to-face visits, a new study says. It also could save money.


Less Is More? Multistage CVD Screening Could Eliminate LDL Lab Tests

A screening approach that selectively uses laboratory-based cholesterol testing to assess cardiovascular risk is able to identify patients at risk for cardiovascular disease to a similar extent as a widely used risk model, according to the results of a new study. The multistage primary cardiovascular disease screening approach, in which only patients first identified as at intermediate risk of cardiovascular events are sent to the laboratory to measure cholesterol levels, performed as well as the Framingham Risk Score (FRS), which utilizes laboratory testing in all patients to assess cholesterol levels, in terms of discriminating risk of cardiovascular disease.


Why Do We Test for Urea and Electrolytes?

Urea and electrolytes (U&Es) are the most frequently requested biochemistry tests. They provide useful information about several aspects of health, such as the volume of blood and its pH. The most important aspect of U&Es is what they tell us about kidney functioning. The kidneys have the following three main functions:
  • Homoeostasis: regulating blood volume, and maintaining the acid/base balance (pH) and levels of electrolytes, principally sodium and potassium;
  • Endocrine activity: regulating blood pressure, supporting red blood cell production and contributing to blood calcium;
  • Excretion: removing urea and creatinine.
The glomerular filtration rate 
Despite the value of the U&Es, the ultimate test of kidney function is the rate at which blood is filtered by passing over the glomerulus to begin urine production, known as the glomerular filtration rate (GFR). It is accepted that the GFR falls slowly with age, and the minimum level for concern is 90ml/minute/1.73m2. GFR was previously assessed by taking a 24-hour urine sample, but is now estimated (eGFR) from one of two equations. The Cockcroft-Gault equation uses serum creatinine, weight, age and sex, while the MDRD formula takes in to account age, sex, creatinine and ethnicity to determine the eGFR. Free online calculators are available for both equations (Box 1), but health professionals must check with their local pathology laboratory to find out which they should use.


HPV Test Awareness, Knowledge Still Low

Americans are more aware that there is a test for the human papilloma virus (HPV) than counterparts in the UK and Australia, according to a new study, but few people knew much more than that. "Awareness of HPV has tended to be low but has been rising since the introduction of testing and vaccination," said Jo Waller, the study's senior author. People seem to be more aware of HPV vaccination than testing, however, which is not surprising given the publicity around the vaccine, added Waller, a public health researcher at University College London. The Pap test, used to look for abnormal cell changes in the cervix, is much older and generally familiar to most people, but the newer HPV test looks for the virus that causes those changes, Waller said. The HPV test was only introduced in the 1990s and it's used a little differently in each of the countries that were included in the new study, Waller pointed out.


Cytopathology and More: Evidence Emerging for HPV-negative Cervical Cancer

Some studies indicate that nearly all cervical cancers are high-risk human papillomavirus (hrHPV)-related. Recent studies suggested hrHPV testing had a very high sensitivity; therefore, the American Society for Colposcopy and Cervical Pathology recommended Pap cytology and hrHPV co-testing as the preferred screening method in women 30 or older. However, a wide range of negative detection rates of hrHPV have been reported in cervical cancers by different HPV testing methods, including the HC2 test (Qiagen), the most widely used HPV assay in the United States.


High Risk of Poor Pap Tests for Female-to-male Transgender Patients

Before the introduction of cervical cancer screenings, the disease used to be the leading cause of cancer death for women in the US. Though it is now the 14th cause of death, new research suggests that compared with female patients, female-to-male transgender patients are much more likely to have inadequate cell samples taken during screening. The research team, led by Dr. Jennifer Potter, director of women's health at Fenway Health in Boston, MA, published their findings in the Journal of General Internal Medicine.


Procalcitonin Levels Predict Positive Blood Culture in Sepsis Patients

Procalcitonin testing can predict whether sepsis patients will have positive blood cultures, a new pilot study shows. Among 40 patients admitted to the hospital with a diagnosis of sepsis, using a cutoff of 1.35 ng/ml identified all 10 who had positive blood cultures, Dr. Walid Saliba of Technion School of Medicine in Haifa, Israel, and colleagues found. They reported their findings January 3 in the American Journal of Emergency Medicine. Although the results need to be replicated, "this approach may be time and resources saving by precluding the need for obtaining blood cultures from almost half of the patients with sepsis while still enabling the detection of all positive blood cultures," Dr. Saliba told Reuters Health.


DNA Test Unravels Titanic Claim

A DNA test has solved a long-standing mystery surrounding a possible Titanic survivor, the Telegraph reports. Years after the ocean liner sank in 1912, Helen Kramer came forward to say that she was Loraine Allison, a two-year-old traveling on the ship who was thought to have died when it sank. The results indicated that Kramer was not Loraine Allison. Loraine, then, the Telegraph notes, was the only child in first or second class to die in the sinking of the Titanic. 


NIH Research Network Finds Many Youth Have High Levels of HIV

More than 30 percent of young males who had sex with other males and who were subsequently enrolled in a government treatment and research network were found to have high levels of HIV, reported researchers from the National Institutes of Health and other institutions. The health status of the study participants, who ranged in age from 12 to 24 years, was monitored as part of their participation in the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN).


Diagnostic Tool and Biomarker Promising in Pancreatic Cancer

Pancreatic cancer continues to have one of the highest mortality rates of any of the major cancers, mostly because of late diagnosis, so there is a great interest in developing improved diagnostic tools and biomarkers. Two new studies are addressing this. In one, researchers found that circulating tumor cells (CTCs) could be used to distinguish between benign and malignant disease and could identify metastasis. In the second, patients with pancreatic cancer who had low serum levels of matrix metalloproteinase (MMP)-7 were most likely to benefit from adjuvant treatment with gemcitabine. Although the data are very early, results from both studies were presented at the 2014 Gastrointestinal Cancers Symposium.


New Hope for Lupus Screening and Treatment

Researchers from the University of Alabama at Birmingham (UAB) have discovered a new immune protein influencing autoimmune diseases such as lupus and multiple sclerosis. In autoimmune diseases like lupus, the body's immune system overreacts and attacks healthy tissue, instead of just eliminating germs. Lupus can affect lots of different areas of the body including the joints, skin, kidneys, lungs, heart and the brain. The researchers behind the new study think a new mutation of an immune protein called an "Fc receptor" may help scientists develop more personalized autoimmune disease treatments. 


Danish Duo Introduces Microbe Identification Scheme Based on Random Subset of Raw Sequence Reads

Danish researchers have developed a computational search method for identifying organisms from a small subset of raw reads randomly selected from across a newly sequenced genome — a tool that they hope will be applicable in infection tracking, food safety, and other settings. The approach, known as TAPIR, uses randomized raw reads and a k-mer-based scoring algorithm to identify organisms represented within a large database of genome sequences. It can be used with or without additional software that aligns the newly sequenced reads to the reference genomes of organisms identified during the initial search step for more detailed local analyses.


NCCC Physicians Use New Gene Sequencing Equipment for Testing Abnormal DNA in Cancerous Tumor Cells

Clinical laboratory experts and physicians at Dartmouth-Hitchcock Norris Cotton Cancer Center (NCCC) achieved 100 percent accuracy in testing for abnormal DNA in cancerous tumor cells with its new gene sequencing equipment and panels. The results, published in the journal Clinical Chemistry and Laboratory Medicine, confirm the precision of the test for routine patient care so physicians can tailor treatment to an individual person's DNA, improving the chances of a successful outcome.


More Consolidation in the Clinical Laboratory Industry, as Quest Diagnostics Agrees to Pay $570 Million to Acquire Solstas Lab Partners

Another big lab domino fell in the continuing consolidation of the clinical laboratory testing industry. This time it was Solstas Lab Partners, which announced that it would be acquired by Quest Diagnostics Incorporated. Quest Diagnostics will pay $570 million to acquire Solstas, which is based in Greensboro, North Carolina. Solstas provides medical laboratory testing services to clients in nine states across the South. Quest Diagnostics says it expects to close the sale by the middle of this year, subject to the usual regulatory reviews of such transactions.
Source: Web Site Icon

Sony and M3 Join Forces

Sony and M3 have joined forces, with backing from Illumina, to form a company that will offer genome analysis services in Japan. The endeavor will also aggregate genomic data with medical and other related information. The new company, currently called P5, is to "facilitate genome research that further advances Japanese medical care, and, in the future, establish a new service platform for the medical industry," Tadashi Saito, a corporate executive officer, executive vice president, and officer in charge of Sony's Medical Business, said in a statement.


NIH Researchers Infect Live Subjects With Influenza in Study Intended to Improve Vaccine

As seasonal influenza sweeps much of the country, scores of study volunteers are allowing government scientists — in a rare live study — to infect them with influenza, in hopes of soon improving vaccine capability. Study leader Matthew Memoli, of the National Institutes for Health (NIH), told the Associated Press in an interview, “Vaccines are working, but we could do better.” A few thousand Americans die every year of seasonal influenza, according to estimates from the Centers for Disease Control and Prevention. During the next year, Memoli and his colleagues will deliberately infect as many as 100 healthy volunteers, younger than age 50, who will stay for nine days in an isolated hospital ward at NIH headquarters in Bethesda, Md. Government scientists wish to study the immune system’s flu response in young adults to ascertain the immunological component missing in elderly people, who are more susceptible to influenza viruses. In use for decades, the vaccine was designed to raise antibody levels to fight the influenza infection by targeting a protein — hemagglutinin — serving as a viral bodyguard, of sorts. Yet, medical science has yet to determine an optimum level of antibody response, or what causes some people to get sick when others stay healthy, all things being equal. “As mind-boggling as it is, we don’t know the answer to that,” Anthony Fauci, leader of the National Institute of Allergy and Infectious Diseases at NIH, told the AP. “We made some assumptions that we knew everything about flu.”


Molecular Nano-spies to Make Light Work of Disease Detection

A world of cloak-and-dagger pharmaceuticals has come a step closer with the development of stealth compounds programmed to spring into action when they receive the signal. Researchers at the University of Nottingham’s School of Pharmacy have designed and tested large molecular complexes that will reveal their true identity only when they’ve reached their intended target, like disguised saboteurs working deep behind enemy lines. What is then exposed – an active pharmaceutical compound, a molecular tag to attach to diseased tissue, or a molecular beacon to signal activation – depends on what function is needed. 


Cervical Screening up to Age 69 May Prevent Cervical Cancer in Older Women

A study published in PLOS Medicine suggests that screening women for cervical cancer beyond age 50 clearly saves lives, and also that there are benefits for women with normal (negative) screening results to continue screening up to the age of 69 years. Peter Sasieni and colleagues, from Queen Mary University of London, UK, examined the link between screening women aged 50 to 64 for cervical cancer and cervical cancer diagnosed at ages 65 to 83. Their study included all 65 to 83-year old women in England and Wales diagnosed with cervical cancer between 2007 and 2012, a total of 1,341 women.


Bubonic Plague Could Return, Warn Scientists After Discovering New Strain Of Black Death Bacterium

A similar form of bubonic plague to the Black Death could make an unwelcome reappearance on Earth, according to researchers. Scientists studying the Plague of Justinian (AD 541–542), one of the most lethal pandemics in human history, which wiped out half of the world's population, extracted the teeth of two 1,500-year-old victims. By doing so, they were able to trace the genetics of the ancient plague, concluding that the Justinian outbreak was caused by a different bacterial strain from that responsible for the later Black Death (AD 1348–50).


Sex Hormone Controls Blood Stem Cells, Researchers Show

Blood-forming stem cells in male and female mice differ in their abilities to divide and their response to estrogen, presumably to allow females to cope with the blood-forming demands of pregnancy and childbirth. They published their findings in the Jan. 23, 2014, advance online issue of Nature. As surprising as they are, the findings had to some degree been hiding in plain sight. Senior author Sean Morrison told BioWorld Today that his team had noticed high variability in their studies of blood stem cells “for years . . . but no one had picked up on the fact that the variability correlated with the sex of the mouse. “It’s kind of remarkable,” he added, “that no one has seen this before.”


Dogs Carry the Oldest Known Living Cancer

Canines are in a rare category when it comes to cancer: They and Tasmanian devils are the only two animals that can transmit it from one individual to another. A new genetic study reveals that the dog form of the cancer, which causes genital tumors, is 11,000 years old—making it the oldest continuously living cancer. Canines can also develop cancers that are akin to human cancers, but their transmissible cancer spreads when cells from one dog's tumor rub off during sexual contact and grow into a new tumor on the other animal. The study notes that the cancer originated in an ancient dog closest to the modern-day breeds of Alaskan malamutes and huskies.


Largest Genome Ever Sequenced Belongs to Locust Species

The whole genome sequence of Locust (Locusta migratoria), the most widespread locust species, has been successfully decoded by researchers from the Institute of Zoology, Chinese Academy of Sciences, BGI and other institutes. The researchers were surprised by the remarkably large (6.5 gigabytes) yielded genome, which is the largest animal genome sequenced so far. Researchers have been surprised to find that a single locust is able to eat its own body-weight in food in a single day. Proportionately, this amount is 60 times a human’s daily consumption. Locusts are capable of inflicting famine and wiping out livelihoods during swarms, which can cost countries billions of dollars in lost harvests and eradication efforts.


Growing Artificial Bone Marrow

Artificial bone marrow may be used to reproduce hematopoietic stem cells. A prototype has now been developed by scientists of KIT, the Max Planck Institute for Intelligent Systems, Stuttgart, and Tubingen University. The porous structure possesses essential properties of natural bone marrow and can be used for the reproduction of stem cells at the laboratory. This might facilitate the treatment of leukemia in a few years. The researchers are now presenting their work in the Biomaterials journal. Blood cells, such as erythrocytes or immune cells, are continuously replaced by new ones supplied by hematopoietic stem cells located in a specialized niche of the bone marrow. Stem cell reproduction therefore requires an environment similar to the stem cell niche in the bone marrow. The newly developed artificial bone marrow that possesses major properties of natural bone marrow can now be used by the scientists to study the interactions between materials and stem cells in detail at the laboratory. 


Good Cholesterol 'can Turn Nasty and Clog Arteries'

Good cholesterol also has a nasty side that can increase the risk of heart attacks, according to US doctors. "Good", or HDL, cholesterol normally helps to keep arteries clear and is good for heart health. But the team at the Cleveland Clinic showed it can become abnormal and lead to blocked blood vessels. They say people should still eat healthily, but that the good cholesterol story is a more complex tale than previously thought. Low-density lipoprotein (LDL) cholesterol is "bad" because it is deposited in the walls of arteries and causes hard plaques to build up that can cause blockages, resulting in heart attacks and stroke.
High-density lipoprotein (HDL) cholesterol is "good" because the cholesterol is instead shipped to the liver. The evidence shows that having a high ratio of good to bad cholesterol is good for health. However, researchers at the Cleveland Clinic say trials aimed at boosting levels of HDL have "not been successful" and the role of good cholesterol is clearly more complicated. In their study, published in the journal Nature Medicine, they showed how HDL cholesterol could become abnormal. One of the researchers, Dr Stanley Hazen, said HDL cholesterol was being modified in the walls of the artery. He told the BBC: "In the artery walls it is acting very differently to in the circulation. It can become dysfunctional, and contributes to the development of heart disease."


Scientists ID New Genes Linked to Belly Fat

Researchers who identified five new genes linked to belly fat say their findings could help efforts to develop medicines to treat obesity or obesity-related diseases such as heart disease, diabetes and cancer. The investigators looked at more than 57,000 people of European descent and searched for genes associated with abdominal fat, independent of overall obesity. They examined more than 50,000 variants in 2,000 genes. The team pinpointed three new genes associated with increased waist-to-hip ratio in both women and men, and identified two other genes that appear to affect waist-to-hip ratio in women only. Waist-to-hip ratio is used to measure a person's belly fat. It's believed that genetics account for 30 percent to 60 percent of waist-to-hip ratio. Abdominal fat is a predictor of obesity-related disease, according to the U.S. Centers for Disease Control and Prevention.


FDA Checks Into 'Caramel Coloring' After Consumer Reports study

The Food and Drug Administration says it is taking a new look at a brown food coloring in sodas and other foods after Consumer Reports said it found higher than expected levels of a potentially cancer-causing agent in some soft drinks. The group said its tests of soft drinks using caramel coloring show some contain higher-than-necessary levels of a compound called 4-methylimidazole or 4-MEI. The FDA says there’s no evidence the compound is unsafe as used, but a spokeswoman said the agency would look closer after the Consumer Reports complaints.


Fish Oil May Help Preserve Brain Cells, Study Suggests

Women with high blood levels of fish oils have larger brain volumes then those with lower levels, suggesting the oils may delay the normal loss of brain cells due to aging, research found. Those who raised their levels of two major omega-3 fatty acids by eating fish or taking supplements had larger total brain volume than those who didn’t, according to research posted online today by the journal Neurology. As people age, their brains get smaller but the shrinkage is accelerated in those with dementia or Alzheimer’s disease, the authors said. While today’s findings suggest that larger brain volumes equal a one- to two-year delay in the normal loss of brain cells, more studies are needed to look at what that means for memory, said James Pottala, the lead study author.


Caffeine Enhances Memory Consolidation

Caffeine appears to have an enhancing effect on memory consolidation, a new study suggests. Those individuals who had taken the caffeine were better able to discriminate the new items and were more likely to detect that the similar items were different from those viewed the day before, senior author Michael A. Yassa, PhD, Johns Hopkins University, Baltimore, Maryland, and University of California, Irvine, told Medscape Medical News.


Study Examines Reasons for Delay, Denial of New Drugs by FDA

Several potentially preventable deficiencies, including failure to select optimal drug doses and suitable outcome measures for a study, accounted for significant delays in the approval of new drugs by the Food and Drug Administration (FDA), according to a study in the January 22/29 issue of JAMA.
Among the reasons for failure to initially receive approval:
•               Uncertainty about the optimal dose to maximize efficacy and to minimize safety risks;
•               Populations that were studied did not reflect the populations likely to use the drug;
•               End points used in clinical trials were unsatisfactory;
•               Inconsistent results for multiple predefined end points in clinical studies;
•               Inconsistencies in efficacy for portions of the study population.


Hospitals Rank Alarm Fatigue as Top Patient Safety Concern

Nineteen out of 20 hospitals surveyed rank alarm fatigue as a top patient safety concern, according to the results of a national survey presented last week at the annual meeting of the Society for Technology in Anesthesia. Alarm fatigue occurs when clinicians become desensitized to the constant noise of alarms or overwhelmed by the sounds and turn alarms down or off. The problem has become so widespread that last month The Joint Commission named it a National Patient Safety Goal and now requires accredited hospitals and critical access hospitals to improve their systems.


Healthcare in the Cloud: the Opportunity and the Challenge

All software vendors for the clinical laboratory—and their customers—should be preparing for two major changes that are converging within healthcare today. The first is the arrival of cloud computing in a way that is comparable to that which is already well established in the consumer space. One study has recently suggested that the healthcare cloud computing market, which is currently just 4% of the industry, is expected to grow to nearly $5.4 billion by 2017. Another change is the practice of medicine in a growing number  of disparate areas. Ultimately, as these two shifts take place, our goal in healthcare must be continual improvement of patient outcomes.


Docs in for Stage 2 Rude Awakening

The Stage 2 numbers for eligible docs are, some might say, a little bit scary. Most office-based physicians are not prepared for the October 2014 beginning attestation date. In fact, many aren't even close. Only 13 percent say their electronic health record systems have the abilities to support 14 of the 17 core Stage 2 objectives, according to a new CDC trends report released.   The numbers aren't all bad, however. The HITECH Act, which allocated $27 billion to eligible providers and hospitals that demonstrate meaningful use of EHRs, appears to have had a considerable effect on adoption rates.  


'Digital Divide' Persists in Health IT Adoption

Adoption of electronic medical records by primary care physicians has grown substantially, but the "digital divide" between large and small physician practices persists, according to a new study from the Commonwealth Fund. Between 2009 and 2012, adoption grew from 46 percent to 69 percent. A majority of physicians use core health IT functions such as e-prescribing, electronic ordering of lab tests and certain types of clinical decision support. Practice size, however, is the major factor affecting adoption. Ninety percent in practices of 20 or more physicians use EMRs, compared to just half of those in solo practices.


Report: States May Be Unprepared to Manage Infectious Disease Threats

Many states may be ill prepared to protect their citizens from outbreaks of infectious diseases, according to a report by the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation. The report examined 10 indicators of state readiness to manage infectious disease threats and found most (33) scored a 5 or lower out of 10 ( Web Site Icon). The rankings suggest that for many key indicators of infectious disease preparedness, most states are lacking. New Hampshire scored the highest with 8 out of 10 and Georgia, Nebraska, and New Jersey tied for the lowest score with just 2 out of 10.


Are Hospital Faucets Putting Patients at Risk?

Water taps in hospitals are full of bacteria, increasing the risk of infection in immunocompromised patients, according to a new study published in Infection Control and Hospital Epidemiology. Researchers monitored bacterial growth in cold and hot water samples at two tertiary care hospitals over the course of a year, from faucets used for hand washing, surgical washing and cleaning of medical equipment. Study authors, led by Maria Luisa Cristinia, Ph.D., then compared the samples taken from faucets with aerators to those from deeper in the plumbing system. The total microbial load of the water samples was as much as 10 times greater with aerators than after sterilization, with opportunist microorganisms like Legionella and Acinetobacter much more common at the faucet level than deeper in the system. 


Community Health Systems Completes $3.9 Billion Acquisition of HMA

The Franklin, Tenn.-based group is now the largest chain in the country by hospital count, unseating HCA. The deal, coming on the heels of other big plays such as Tenet Healthcare Corp.'s acquisition of Vanguard Health Systems and the merger of Trinity Health and Catholic Health East, speaks to the growth of the hospital mega-system and the mounting pressures on smaller systems and standalone facilities that have to compete against well-capitalized Goliaths' benefit from economies of scale.


CARTER CENTER: 148 Cases of Guinea Worm Disease Remain Worldwide

Carter Center announced that 148 Guinea worm cases were reported worldwide in 2013. These provisional numbers, reported by ministries of health in the remaining four endemic nations and compiled by the Center, show that cases of the debilitating disease were reduced by 73 percent in 2013 compared to 542 cases in 2012. When the Center began leading the first international campaign to eradicate a parasitic disease, there were an estimated 3.5 million Guinea worm cases occurring annually in Africa and Asia.


Ugandan Lab Tests Blood, Flies Nonstop

At the Carter Center's field office in Kampala, the capital city of Uganda, a busy scientific laboratory is devoted to a single cause: the surveillance, and ultimate elimination, of river blindness. For the past five years, lab staff  have performed two exacting processes hundreds of thousands of times. One is the analysis of blood samples using the OV-16 antigen to detect the presence of onchocerciasis microfilaria, the pre-larval-stage parasitic worms that can infect the body. The other is the testing of black flies and "skin snips" of human tissue to learn whether they contain the parasite's DNA. Established in 2007 by The Carter Center and the Ministry of Health Vector Control Division, the lab tests about 17,000 blood samples each year. It is estimated that this lab has performed more OV-16 analysis than any other in the world.

Disclaimer- The information provided in this news digest is intended only to be general summary information. It does not represent the official position of the Centers for Disease Control and Prevention and is not intended to take the place of applicable laws or regulations.

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