viernes, 28 de agosto de 2015

DLS|HEALTHCARE NEWS|August 27, 2015 ► Centers for Disease Control and Prevention (CDC) Healthcare News Update


CDC. Centers for Disease Control and Prevention. CDC 24/7: Saving Lives. Protecting People.

A Weekly Compilation of Clinical Laboratory and Related Information
From The Division Of Laboratory Systems

August 27, 2015

News Highlights

  • FDA, CDC, NLM Workshop on Promoting Semantic Interoperability of Laboratory Data to be Held September 28, 2015
  • 'Universal' Flu Vaccines Work in Animals
  • Study Reports Results of Genetic Testing for 22 Genetic Causes of Neonatal Diabetes
  • Cytopathology and More—Primary HPV Screening, Pap-HPV Cotesting: Interim Guidance and a Retrospective Study
  • New Ring Can Diagnose Sexually Transmitted Diseases in a Single Test
  • Urinalysis Overuse Inflates Antibiotic Orders for Elderly
  • Scientists Claim Fix to Stem Cell Immune Rejection Problem
  • Virginia Tech Researchers Find Biomarker for Pre-Diabetes
  • Study Finds Tests Used to Measure Internal Bleeding for Patients May Not Be Reliable
  • CDC Releases Tool to Track Antibiotic Resistance
  • Vaccinations Bring Hope, Bracelets Deliver Reminders
  • Wipe Out Polio in Africa for Good
  • Duke, UNC Researchers: This Smartphone App Knows if You'll Get the Flu This Year
  • White House Cybersecurity Czar: Threat Awareness Has Improved, but Protection Hasn't
  • New Texas Law Supports School-Based Telemedicine

View Previous Issues - Healthcare News Archive

Leading News

FDA, CDC, NLM Workshop on Promoting Semantic Interoperability of Laboratory Data to be Held September 28, 2015
The Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), and the National Library of Medicine (NLM) are announcing the following public workshop entitled “FDA/CDC/NLM Workshop on Promoting Semantic Interoperability of Laboratory Data.” The purpose of this workshop is to receive and discuss input from stakeholders regarding proposed approaches to promoting the semantic interoperability of laboratory data between in vitro diagnostic devices and database systems, including laboratory information systems and electronic health records. The meeting will be held at the FDA White Oak facility (10903 New Hampshire Avenue, Silver Spring, MD 20993) on September 28, 2015 from 8:00am until 5:00pm. Additional information and information for registering to participate in this meeting -
'Universal' Flu Vaccines Work in Animals
—Much more work needed before use in humans
Vaccines that protect against multiple influenza strains are possible, according to two studies, raising hopes for more persistent immunization than current products can provide. The current research builds on the observation that the H1N1 flu strain responsible for the 2009-2010 pandemic elicited some antibodies to the relatively stable stalk of the HA protein rather than to the highly variable head. To follow up, researchers led by Barney Graham, MD, PhD, of the NIH's Vaccine Research Center in Bethesda, Md., developed immunogens that lack the HA head but instead mimic the stem of the protein. They fused those "stabilized stalk" immunogens to ferritin, a naturally occurring protein that forms nanoparticles. The resulting vaccine nanoparticles, dubbed HA-SS-np and HA-SS-np', preserved the structure of the original HA stalk, they reported online in Nature Medicine.
Study Reports Results of Genetic Testing for 22 Genetic Causes of Neonatal Diabetes
Over a 10 year period, the time that babies receive genetic testing after being diagnosed with diabetes has fallen from over four years to under two months. Pinpointing the exact genetic causes of sometimes rare forms of diabetes is revolutionising healthcare for these patients. Babies with diabetes are now being immediately genetically tested for all possible 22 genetic causes while previously they would only get genetic testing years after diabetes was diagnosed and then the genes would be tested one at a time. Crucially, this means that the genetic diagnosis is made early, giving the doctor information on how best to treat the patient and inform them of the medical problems the patients are likely to develop in the future. This is a paradigm shift in how genetic testing fits in with the patients' clinical symptoms. In the past symptoms were used to select which gene would be tested - now the early comprehensive gene testing means that the genetic result predicts clinical features that have not yet developed. This new paradigm means doctors can anticipate the likely problems for their patients and put the appropriate care in place to reduce their impact
CAP Checklists 2015: Signposts Are Clarity, Consistency
The most noteworthy changes relate to quality terminology, personnel records, specimen labeling, laboratory-developed tests, cancer protocols, and next-generation sequencing. In a major move toward increased consistency, the 2015 checklists now describe specimen labeling requirements as part of the All Common checklist. The newly formulated definitions are helpful for laboratories with less common specimen types too, Dr. Hoeltge notes. The specimen labeling changes continue the Checklists Committee’s efforts to move as much as possible of the specialty checklists into the All Common checklist.
“There were a couple of problems that we needed to address,” says Stephen Sarewitz, MD, member of the Council on Accreditation and chair of the Workgroup on Laboratory-Developed Tests. “The first is that both the CAP and the CLIA validation requirements, while they’re quite detailed, are actually very non-specific about certain elements of the analytic validation of laboratory-developed tests.” The second problem, Dr. Sarewitz says, is that with the exception of the molecular pathology checklist requirements, there are no clinical validation requirements in CAP for LDTs and there are none at all in CLIA. “That represents a potentially significant problem. Just because a lab can produce a test that performs well analytically, it doesn’t mean that the test is good for diagnosing a certain condition or disease unless there is solid evidence in the literature, or the lab does a clinical validation study.” As part of the 2012 revisions, the LDT validation requirements were moved from the Laboratory General checklist to the All Common checklist. “The inspector who uses the All Common checklist is the discipline-specific inspector, not the laboratory general inspector,” Dr. Sarewitz says. “We felt that the inspector looking at individual sections of the lab is better suited to evaluate whether a test is properly evaluated.”

Laboratory Testing / Diagnostics

Cytopathology and More—Primary HPV Screening, Pap-HPV Cotesting: Interim Guidance and a Retrospective Study
The 2011 screening guidelines addressed the issue of primary HPV screening, stating that “in most clinical settings, women aged 30 years–65 years should not be screened with hrHPV testing alone as an alternative to cotesting at 5-year intervals or cytology alone at 3-year intervals” because there were insufficient data to recommend primary HPV screening at that time. To reconcile the various testing options, 13 experts representing multiple professional societies convened to develop an interim guidance document to address primary HPV screening. The panel sought expert opinion and conducted a literature review, which included review of data from European randomized controlled screening trials, the ATHENA (Addressing THE Need for Advanced HPV Diagnostics) trial, and a Medline query. A second significant article, colloquially known as the Quest Diagnostics Health Trends study, aimed to provide a real-world retrospective comparison between three screening approaches for cervical cancer.
In summary, based on the results, the authors concluded that a greater number of cancers and precursor lesions would be identified by the HPV-Pap cotesting method than either test alone. The American Cancer Society estimates that 12,360 women are diagnosed with cervical cancer each year. In this study, 19 percent of all cervical cancers were HPV-negative, meaning that 2,400 cervical cancers in the U.S. would be missed, including an even higher proportion of adenocarcinomas. Readers may be interested in a recent point-counterpoint publication written by a proponent of primary HPV screening and a proponent of Pap-HPV cotesting. The cotesting proponent is one of the coauthors of the Quest Diagnostics study.
New Ring Can Diagnose Sexually Transmitted Diseases in a Single Test
A ring with the ability to diagnose sexually transmitted diseases like syphilis, gonorrhea, chlamydia and trichomoniasis was designed by the Mexican Ernesto Rodríguez Leal. The portable medical device called Hoope is a ring that is placed in the thumb, contains a disposable cartridge with a retractable needle for single use and sends the data to a smartphone in less than a minute. Ernesto Rodriguez Leal, native from Monterrey, in northern Mexico, and a PhD in mechanical engineering, told that the ring is placed only at the time of the test, a button is pressed and activates a needle that draws blood, which is transported by capillary action and taken to a lab-on-a-chip, a recent concept based on immobilizing reagents to look for changes and make measurements. Furthermore, Hoope has an anesthetic system by which an electrical pulse generates numbness, preventing pain at the time of the puncture. The ring functions as a home diagnostic tool that distributes blood into four microfluidic channels. "We put antigens (substance that triggers the production of antibodies) specifically synthesized to catch antibodies for each of the diseases, their interaction functions as a lock and key mechanism. If antibodies for any of the conditions exists, the antigens trap them and produce an electrochemical reaction." After, these data is wirelessly transmitted to a smartphone or tablet, where an app gives results in less than a minute.
Urinalysis Overuse Inflates Antibiotic Orders for Elderly
Urinalysis was ordered for more than half of elderly patients on admission to an emergency department at a large tertiary care center, even though most lacked an appropriate clinical indication, according to findings in a new study. Urinalysis has excellent predictability for ruling out urinary tract infection (UTI); however, a positive result is less informative because it occurs in as many as 90% of asymptomatic elderly patients, the study authors say. The results were published online August 17 in JAMA Internal Medicine.
Celiac Urine Test May Offer Accurate Way to Monitor Glutening
For celiac patients, finding out whether they’ve been glutened may soon get easier and more accurate thanks to the development of a test that can detect the presence of gluten immunogenic peptides (GIP) in urine. A new study, presented at the International Celiac Disease Symposium in Prague in early August, shows that researchers were able to detect GIPs in urine after consumption of as little as 50 milligrams of gluten, as early as four to six hours after gluten intake and up to one to two days afterwards. That means the new test can detect the smallest amount of gluten known to cause damage to celiac patients’ intestines.
Suicidal Behaviour Predicted by Blood Test Showing Gene Changes
CAN you spot whether someone is likely to try to take their own life? In hindsight, it can seem obvious, but at the time, doctors and relatives rarely have much more than intuition to go on. Now a blood test could help doctors identify those most at risk. The idea marks a shift in diagnostic approaches to mental health, and has drawn criticism from some psychiatrists. Nearly a million people worldwide take their own lives each year. Prevention efforts have done little to curb suicide rates in most countries, in part because it is often so difficult to tell if someone is planning to do it. Chemicals in the blood may provide a much-needed clue. Alexander Niculescu of Indiana University in Indianapolis and his colleagues have developed a questionnaire and blood test that together predicted with 92 per cent accuracy who among a group of 108 men receiving psychiatric treatment would develop suicidal feelings over the next year (Molecular Psychiatry, Preliminary evidence suggests the test also works for women. Because only about 16 in every 100,000 people end their own lives, a test with such a level of accuracy will give many false positive and false negative results if used on the general population.
A DNA-Based Screening Assay to Streamline Sexual Assault Sample Processing
Sexual assault kit (SAK) samples account for a significant portion of backlogged cases in forensic laboratories. It can take 4–6 hours to screen SAK evidence, and there may be wide variation among the type and age of samples collected, which can require further analysis time. As an alternative to time-consuming, labor-intensive differential extraction, the DNA Y-Screen assay (Applied Biosystems, Foster City, Calif. [part of Thermo Fisher Scientific]) assesses swab evidence from SAKs to rapidly detect the presence of a male contributor. In conjunction with other presumptive serological and microscopic slide screening methods, the assay allows the forensic laboratory to confirm serology results, and is an effective tool for detecting male/sperm DNA when slide-screening results are questionable.
New Phlebotomy Company Wants to Bring Innovation to the Way Clinical Pathology Laboratory Specimens Are Collected and Transported
Even as Uber and Lyft are bringing a new business model to the taxicab business, a group of entrepreneurs in Virginia want to do the same thing to the phlebotomy services offered by clinical laboratories. Since launching this service in January, the new phlebotomy company operates in 18 states. The company is called Iggbo. It describes itself as an on-demand anytime/anywhere blood draw service and hopes to streamline the way blood samples move from patients to medical laboratories as the start-up looks to revolutionize phlebotomy the way Uber disrupted taxi service. Based in Richmond, VA, Iggbo is introducing the sharing economy to the laboratory test collection process, a move that could benefit independent clinical laboratories and pathology groups that join Iggbo’s growing network of labs and independent phlebotomists.

Research and Development

Scientists Claim Fix to Stem Cell Immune Rejection Problem
Last year, Japanese researchers announced that the first human patient would be treated with induced pluripotent stem cells in an attempt to reverse a degenerative eye condition called macular degeneration that leads to vision loss. Now, a team of scientists headed by biologists at UC San Diego has discovered how induced pluripotent stem (iPS) cells, which are derived from an individual’s own cells, could be programmed to avoid rejection from the immune system. Their findings, published online ahead of print in the journal Cell Stem Cell, show that iPS cells can differentiate or change into various types of functional cells with different fates of immune rejection. The authors say it is the first study to evaluate these cells’ immunogenicity – their ability to provoke an immune response and the degree to which it provokes a response. “With the new findings, we cannot assume anymore that all cells derived from patient-specific iPS cells will be immune-tolerated by the patient,” said Yang Xu, a biology professor at UC San Diego who headed up the research, in an interview.
Virginia Tech Researchers Find Biomarker for Pre-Diabetes
Virginia Tech researchers have identified a biomarker in pre-diabetic individuals that could help prevent them from developing type 2 diabetes. Publishing in Clinical Epigenetics, the researchers discovered that pre-diabetic people who were considered to be insulin-resistant—unable to respond to the hormone insulin effectively—also had altered mitochondrial DNA. Blood samples revealed participants had lower amounts of mitochondrial DNA with a higher amount of methylation—a process that can change the expression of genes and mitochondrial copy numbers in cells—than healthy people. "If the body is insulin-resistant, it could affect a person’s mitochondrial function and overall energy levels," says co-author Zhiyong Cheng, PhD, an assistant professor of human, nutrition, foods, and exercise in the College of Agriculture and Life Sciences and a Fralin Life Science Institute affiliate. "Mitochondrial alterations have previously been observed in obese individuals, but this is the first time we’ve made the molecular link between insulin resistance and mitochondrial DNA changes."
Study Finds Tests Used to Measure Internal Bleeding for Patients May Not Be Reliable
A recently-published study found that while internal bleeding may be uncommon as a result of taking blood thinners such as Xarelto® (rivaroxaban) and Eliquis® (apixaban), the normal coagulation tests physicians use to check for the side effect of bleeding may not be reliable. The study, published online inAnnals of Emergency Medicine, found that in cases reported to Poison Centers, the routine labs used to monitor for clotting factors, such as prothrombin time (PT), PTT or INR commonly ordered to help diagnose internal bleeding may be elevated in a minority of cases, but appear unreliable to measure the risk of internal bleeding in patients. "Blood thinners are helpful drugs and we do not want people to stop taking them," said Henry Spiller, D.ABAT, a co-author of the study, toxicologist, and director of the Central Ohio Poison Center at Nationwide Children's Hospital. "We may need to get better about how we monitor patients on these drugs."
Markers of Ethanol Use
Ethanol consumption has been part of the human condition for centuries, yet excessive amounts can lead to serious medical problems. Measuring ethanol directly is a challenge in that it has a short half-life in bodily fluids, but newer blood and urine markers show promise in detecting this substance over longer periods of time, writes Matthew H. Slawson, PhD, and Kamisha L. Johnson-Davis, PhD. Slawson and Johnson-Davis describe the methods for measuring ethanol through breath analysis and in blood. “A major disadvantage of measuring ethanol directly is its short half-life of 2 to 14 hours,” the authors emphasized. Some of the newer markers have shown promise in detecting ethanol consumption days or even weeks later. One blood marker, phosphatidylethanol (PEth) has shown effectiveness in detecting chronic heavy drinking.
RA: Lung Disease Risk Tracks Biomarkers
—Standard RA biomarkers appear to raise risk of interstitial lung disease
Rheumatoid factor (RF) and antibodies against cyclic citrullinated peptide (anti-CCP) were among the laboratory factors associated with interstitial lung disease (ILD) in rheumatoid arthritis (RA), researchers reported. Among more than 700 patients with RA, 69 (8.8%) were diagnosed clinically with ILD.
Biomarkers May Predict Aggressive Prostate Cancer in Black Men
Specific genes may signal aggressive prostate cancer (PCa) in African American men, according to researchers of a new study. The findings may partly explain ethnic disparities in PCa, which have been linked to both biologic and socioeconomic factors. Investigators led by Kosj Yamoah, MD, of Thomas Jefferson University Hospital in Philadelphia, examined mRNA expression of 20 biomarkers associated with prostate cancer initiation and progression by ethnicity. According to results published in the Journal of Clinical Oncology, 6 biomarkers showed significant differential expression in black men: ERG, AMACR, SPINK1, NKX3-1, GOLM1, and androgen receptor.
Could a Laser Skin Test Someday Replace Biopsy to Spot Melanoma?
Skin cancer remains the most common cancer for Americans, and invasive biopsies for lesions that could be dangerous melanomas have long been routine. Now, researchers say they've developed a non-invasive test that can spot melanoma skin cancer without a biopsy, according to a new study. Researchers led by Aneta Stefanovska, of Lancaster University in the United Kingdom, say they've used a laser to identify slight differences in blood flow beneath the lesion, which differentiate melanoma from non-cancerous moles. The test, which takes about 30 minutes, was assessed in 55 people with irregular moles. Follow-up biopsies showed that the test was 100 percent accurate in identifying patients with melanoma.
Optical Probe Looks for Signs of Shock without a Blood Draw
Clinicians sometimes gather the evidence of hypovolemic and septic shocks by looking at patient’s central venous oxygen saturation (ScvO2) from blood samples taken from the central internal jugular vein. This procedure is invasive for patients and cumbersome for clinicians. Now researchers at the University of Electronic Science and Technology of China are reporting on a new non-invasive optical probe that can measure continuous tissue blood oxygen saturation (StO2) just over the jugular vein area.

Public Health and Patient Safety

CDC Releases Tool to Track Antibiotic Resistance
The Centers for Disease Control and Prevention released an easy-to-use data tool on its website that tracks trends in antibiotic-resistant bacteria across the country from 1996 to 2013. The spread of antibiotic resistance has prompted repeated warnings among health officials who fear a day will come when physicians no longer have any medications to treat life-threatening infections. The CDC estimates that 23,000 people each year die from antibiotic-resistant bacteria. The tool, at, allows users to look at trends across the country and also among individual states for four types of bacteria: salmonella, shigella, E. coli O157:H7 and campylobacter. Each type can then be compared with 17 common antibiotics.
Vaccinations Bring Hope, Bracelets Deliver Reminders
Vaccine schedules are increasingly complex, and young mothers often forget to take children in for shots on time. A clever solution occurred to Lauren Braun, a former Cornell pre-med student, when she spent a summer working in Peru, traveling to villages to remind mothers to bring children to clinics for immunizations. Her nonprofit company, Alma Sana, makes flexible silicon bracelets — like the yellow Livestrong bands so popular a decade ago. But hers come in pink or blue, fit around a newborn’s ankle, and serve as tiny calendars. For example, beneath the number 4 on the bracelet — four months of age — are a triangle, a circle, an X and a square. They represent the vaccines against polio, pneumonia and rotavirus, as well as the pentavalent shot, which protects against five diseases. As the baby gets each one, a nurse uses a hole punch to puncture the appropriate mark. When every mark on the bracelet is punched, the baby is fully protected.
Wipe Out Polio in Africa for Good
Only a few years ago, Nigeria was Africa's last outpost of polio and seemed to be losing the battle against the disease. In 2012, Nigeria recorded 122 cases -- more than half of all cases worldwide. With dedication and hard work from the Nigerian government and Global Polio Eradication Initiative partners such as Rotary International, the Centers for Disease Control and Prevention, World Health Organization, UNICEF and the Bill and Melinda Gates Foundation, as well as tens of thousands of health workers, nearly every child in the country was vaccinated against polio. Special efforts were focused on hard-to-reach areas. Last year, the payoff from these efforts became clear. Only six new cases were recorded in 2014 compared to 53 in 2013. And this year, the number has fallen to zero. In the next few weeks, intensive laboratory testing at CDC as part of the Global Polio Laboratory Network will help confirm whether polio is truly gone from Nigeria. Getting to this point wasn't easy. Emergency Operations Centers were set up in the capital, Abuja, and six other locations in northern Nigeria to coordinate polio elimination activities and increase countrywide collaboration. CDC supported more than 200 Nigerian doctors and other health experts to work in more than 150 of Nigeria's riskiest areas to improve vaccine program performance.
CDC Releases Death Rate Estimates for Seven Common Causes
Death rates for influenza/pneumonia, heart disease, stroke, Alzheimer’s disease and diabetes are on the rise, according to the Atlanta-based Centers for Disease Control and Prevention. In a report that examined the first quarter of 2014 through the first quarter of 2015, the CDC’s National Center for Health Statistics outlined death rates for seven common causes.
Poor Diabetic Control in the Elderly
Research suggests it’s difficult for elderly patients to manage their diabetes on multiple levels. A report published in Diabetes Care found that just one-third of elderly diabetics met targets for three measures of diabetic control. Even under less stringent targets for diabetes risk factors, it appears that many older diabetics have problems managing their condition, researchers found. In another disconcerting finding, the ability to control this disease was especially poor among black women.
Targets set by the American Diabetes Association (ADA) on three key measures of diabetes control include: below 7% for hemoglobin A1c (HbA1c); under 100 mg/dL for low-density lipoprotein cholesterol (LDL-C); and under 140/90 mmHg for blood pressure. In assessing these targets among the test subjects, researchers determined that more than 70% met the blood pressure and HbA1c goals, while 63% met the target for LDL-C. Collectively, however, just 35% of these individuals with diabetes achieved all three measures for good diabetes control. Results improved slightly once these targets were loosened to less desirable levels (under 8% for HbA1c, under 150/90 mmHg for blood pressure, and 130 mg/dL for LDL-C), with 90%, 87% and 86% meeting the targets for HbA1c, blood pressure and LDL-C respectively. Again, a lower percentage (68%) or two-thirds met all three measures under the less stringent standards.
Experimental MERS Vaccine Induces Immunity in Rhesus Macaques
A novel synthetic DNA vaccine can, for the first time, induce protective immunity against the Middle East Respiratory Syndrome (MERS) coronavirus in animal species, reported researchers from the Perelman School of Medicine at the University of Pennsylvania. The vaccine was able to prevent MERS disease in the monkeys and offered benefit to 100 percent of the animals in this study in terms of minimizing symptoms. In addition, the vaccine induced antibodies that are linked with protection in camels, a species that is thought to be a major source of transmission to humans in the Middle East, showing that this vaccine could be deployed to break this link in the MERS transmission cycle. In the field, say the researchers, this vaccine could decrease person-to-person spread of infection in the event of an outbreak and help to protect health care workers or exposed individuals.
RML Researchers Make Strides towards Ebola Vaccine
Scientists at Rocky Mountain Laboratory in Hamilton recently published the results of a study proving for the first time that a single dose of an experimental Ebola virus (EBOV) vaccine completely protects cynomolgus macaques against the current EBOV outbreak strain in West Africa, EBOV-Makona. The live-attenuated vaccine, VSV-EBOV, also called rVSV-ZEBOV, uses genetically engineered vesicular stomatitis virus (VSV) to carry an EBOV gene that has safely induced protective immunity in macaques. The vaccine is undergoing clinical trials on humans in Guinea. According to the lead author of the report, Andrea Marzi, PhD, of NIAID’s Laboratory of Virology, the study on the macaques at RML showed that the vaccine was very effective and only a single dose of the vaccine is completely effective on the monkeys if given seven days before they are infected with the virus and when given three days before infection with the virus, two out of three survive.  Marzi said that the preliminary reports form clinical trials on humans underway in Guinea, where the Ebola virus is active, indicate that the vaccine is working on humans as well but may need to be taken at least 10 days prior to exposure to provide maximum protection.

Health IT

Duke, UNC Researchers: This Smartphone App Knows if You'll Get the Flu This Year
A group of Triangle researchers say they’ve developed a flu-prediction app – just in time for flu season. Statistician Katherine Heller of Duke University teamed up with a different shade of blue, UNC-Chapel Hill epidemiologist Allison Aiello, to develop a model that would allow them to predict the spread of influenza from one person to the next over time. The theory is that health care providers could use the data to alert at-risk patients before they get sick – even encouraging them to stay at home to avoid passing the germs forward. Heller says it’s game changing.
White House Cybersecurity Czar: Threat Awareness Has Improved, but Protection Hasn't
Federal agencies are increasingly engaged in cybersecurity issues and understand they have something to protect, said the White House's cybersecurity czar, but he added that most agencies, like their private-sector counterparts, are not protecting themselves as well as they should. "There's still a great deal of vulnerability out there and ... very few organizations have cracked the code on how to do this mission well," Michael Daniel said during an Aug. 17 discussion at the Technology Policy Institute's Aspen Forum.
New Texas Law Supports School-Based Telemedicine
A new law in Texas going into effect Sept. 1 will allow school-based telemedicine visits for children covered by Medicaid, reports The Texas Tribune. The school-based telemedicine programs would be modeled after that of the Children's Health hospital system in North Texas, which recently expanded its program to 57 schools. State Rep. Jodie Laubenberg, the bill's author, has argued that parents shouldn't have to take off work and children shouldn't miss school in order to see a doctor. A school nurse would oversee the video chat, using tools such as an electronic stethoscope allowing the doctor to hear a child's heartbeat, and a digital otoscope for looking into a child's ear, according to the article. If the doctor prescribes medication, parents could pick up the prescription from their preferred pharmacy on their way home from work.
Cytopathology and More—Telecytopathology’s Potential Starting to Be Seen
There is a growing body of literature referencing the uses of telecytopathology in clinical care. Telecytopathology is the interpretation of cytopathology material at a distance using digital images. It can be subdivided into three basic applications: rapid on-site evaluation (ROSE), primary specimen diagnosis, and second opinion consultation. Although there is a long history of attempts at implementing telecytopathology for broad clinical use, it still has limited but important applications in patient care. The technology has improved from low-grade video quality images to higher-grade static digital images and, more recently, whole-slide imaging with submicron resolution scanning capabilities. Still, the nature of cytology material itself, in terms of quantity and often quality of cells that can be imaged and viewed at a distance, remains a challenge. While fine-needle aspiration is not a new technique, recent developments in advanced imaging, molecular testing, and targeted therapy have coincided with a rapid rise in the number of FNA procedures being performed. Consequently, the demand for ROSE has also increased, outstripping the capacity of available cytopathologists at many institutions. Whole-slide imaging offers the prospect of true virtual microscopy and may in time even replace glass slides in routine practice. We are rapidly approaching this reality as vendors continue to build newer, faster, and cheaper scanners with sophisticated software to improve digital pathology workflow. Telecytopathology’s potential is only just beginning to be realized. Cytologists can look forward to accessing, reviewing, sharing, and even analyzing the digital data in their digitized slides.
Google Flu Trends Site Shuts Down
Signal data will go to Columbia, Boston Children's, CDC
The Google Flu Trends website has shut down, members of the Flu Trends team announced in a blog post. Instead, the team now will send its flu and dengue data from its search signals directly to partners including Columbia University's Mailman School of Public Health, Boston Children's Hospital/Harvard and the Centers for Disease Control and Prevention. "We also will continue to make historical flu and dengue estimate data available for anyone to see and analyze," the post says.
3 Ways Patients Can Safeguard PHI
As breaches at hospitals grow, and patients increasingly are seeing their personal health information compromised, there are ways not just hospitals, but consumers themselves can keep their data secure. Three ways patients can help to keep their information secure, according to the Times, include:
  1. Only share private information when it's absolutely needed: Social Security numbers are required when first seeing a provider, but should not be needed for care delivery.
  2. Get credit monitoring: If a hack occurs and credit monitoring is offered, take advantage of it. "The important thing is to actually access the website or read the reports," healthcare attorney David Harlow told the Times.
  3. Watch your health records: Patients should request their full health record to make sure there is nothing off about them and confirm all the information is correct, the article notes. In addition, people should check the benefits from their health insurer to make sure they aren't being billed for services they didn't receive.

Special Issue of the Journal of Empirical Research on Human Research Ethics Focuses on the Ethical Implications of Sharing Health Research Data in Low and Middle Income Settings
With the globalization of biomedical research and growing concerns about possible pandemics of diseases such as HIV, SARS, and Ebola, international data-sharing practices are of growing interest to the biomedical science community. But what are the advantages and disadvantages of sharing data in low and middle-income settings? What challenges stand in the way for researchers in countries such as India, Kenya, and Vietnam? A new special issue of SAGE's Journal of Empirical Research on Human Research Ethics (JERHRE) presents guidelines, protocols, models, and new resources to improve data sharing across the globe.

Other News
Make all Public Places 100% Smoke-Free to Protect Public Health
Smoke-free environments are crucial for protecting the public from the harms of secondhand smoke, and there is very strong public support for making public places smoke-free in China. Strong laws are needed – and where they exist and are rigorously enforced, they work. These are the key findings from the results of the China City Adult Tobacco Survey, released in Beijing. “Secondhand smoke is toxic, and deadly. Yet this report shows that far too many people across cities in China – more than 4 in every 10 people in workplaces, for instance – are still being exposed.  There is no safe level of secondhand smoke, and the only way to protect against its harms is to make all indoor places 100% smoke-free,” said Dr Bernhard Schwartländer, World Health Organization (WHO) Representative in China.
Clinical Labs Likely to Face Challenges under ICD-10
When ICD-10 implementation becomes a reality on Oct. 1, 2015, clinical laboratories will continue to experience challenges related to the submission of test requisitions, no matter how prepared they are internally. Administrative problems that exist under ICD-9 will not go away; in fact, they could worsen under ICD-10 if the ordering providers are not ready for the change. As with ICD-9, incomplete or noncompliant test requests can impact laboratory revenues, interfere with patient testing, and, in some instances, delay patient care. Laboratory personnel will need to be just as, if not more, diligent about these requests than ever, and the following information may help them.

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