is right for which patients?

.I MLO201603-COVER-NOLABEL.indd COVERI 2/12/2016 2:52:29 PM Which HPV test 1. cobas® HPV Test [package insert]. Indianapolis, IN: Roche Diagnosti...
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Which HPV test

1. cobas® HPV Test [package insert]. Indianapolis, IN: Roche Diagnostics; 2014. COBAS and LIFE NEEDS ANSWERS are trademarks of Roche. © 2016 Roche. PP-US-05706-0316 Roche Diagnostics 9115 Hague Road, Indianapolis, IN 46256

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is right for which patients?

cobas—the only one for all. More screening options for more patients. The cobas HPV Test is approved for the broadest intended use for HPV testing in cervical cancer screening.1 Whether you co-test, genotype, ASC-US reflex or primary screen, we do it all. So, clinicians can be confident they’re providing the best care for all of their patients, and you can be confident you’re offering the most approved options available. To learn more, visit www.hpv16and18.com.

cobas—the only HPV screening assay to cover ALL options outlined in the 2016 ACOG Practice Bulletin

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2/10/2016 2:36:22 PM

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MARCH 2016

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Vol. 48, No. 3

8 FEATURES

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CLINICAL ISSUES

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Hepatitis C: challenges and opportunities in the laboratory diagnosis of infection

By Beatriz Montull, MP, Rosario Menéndez, MD, PhD, Antoni Torres, MD, PhD, and Raúl Méndez, MP

By Tara Vijayan, MD, MPH, and Jeffrey D. Klausner, MD, MPH

SPECIAL FEATURES

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Predictors of severe sepsis among patients hospitalized for communityacquired pneumonia

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Increasing evidence supports the need for multiplex testing of sexually transmitted infections

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Point-of-care testing and its implications for STIs By Maj. Paul R Eden, MT (ASCP), PhD, and Jessica Johnson, MLS(ASCP), MSPH

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Molecular diagnostics, automation, and enhancing lab workflow By Biju Joseph, PhD, MT(ASCP), MB(ASCP), and Nefize Sertac Kip, MD, PhD

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From the editor The observatory Tips from the clinical experts

THE PRIMER

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The pending wave of point-of-care molecular testing: outlook and initial observations By John Brunstein, PhD

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FUTURE BUZZ

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The case for RFID in blood banking EDUCATION Emerging education program assists cytotechnologists in a changing landscape By Lynnette Savaloja, MBA, SCT(ASCP), and Jennifer Clark, SCT(ASCP)

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The 2016 Annual Salary Survey By MLO Staff

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Lab sales compensation: contexts and considerations By Peter Francis

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Product spotlights Advertiser index

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Leading the way toward genomic analysis as a key component in clinical practice and prescription Don Rule, Founder and CEO Translational Software, Inc.

What are lab orders costing you? By Aaron Harper, MD, and David Novis, MD, FACP

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2/10/2016 2:18:36 PM

FROM THE EDITOR

By A lan L enhof f, Edi tor

Autism research offers new hope WHEN I

.

4

WAS IN GRAMMAR SCHOOL, maybe third, fourth, fifth grade—50 years ago, I’m no spring chicken— there was a kid in my class who had a lot of problems. His name was L, and he just didn’t know how to fit in, didn’t know how to act. He would sometimes get into sudden, angry fights with other kids; more often, he would seem to insulate himself from class activities, downcast at his desk. He sometimes raised his hand to answer a question, but instead of answering it, he started in on long, rambling monologues, about events in the life of his family, about his hobbies (he had a rock collection, it’s funny what one remembers), about a movie he had seen two years ago— all in a raspy, whining voice. He went on for so long that the class would groan and say, “L, get to the point,” or worse. The teachers didn’t really know how to handle him, and sometimes they would roll their eyes or lash out in frustration, which only encouraged the class to mock him in the cruel way kids can pile on an outcast. I remember thinking, “He wants us to like him, but he doesn’t know how to get people to like him.” He was a frustrated, tormented, friendless figure. Thinking back on L now, I realize that he very likely suffered from autism spectrum disorder (ASD), and unfortunately for him, there was almost no recognition of ASD then. The term autism has existed for more than 100 years, and by the 1960s researchers and specialists were beginning to define it more precisely and refine it as a diagnostic classification, but autism was certainly not part of the vocabulary of the average family doctor then, much less the average grammar school nurse or psychologist, so there was no help for L. Now there would be; he would be diagnosed, surely, with Asperger syndrome— he checked all the boxes for that ASD—and receive appropriate therapies. What occasioned this childhood flashback for me was a fairly steady stream of news about research into more refined diagnostics for ASD—both genetic and serological—and other useful research. • Using a novel approach that hones in on families severely affected by autism, a Johns Hopkins-led team of researchers has identified a new genetic cause of the disease. The team compared the gene sequences of autistic members of 13 such families to the gene sequences of people from a public database. They found four potential culprit genes and focused on one, CTNND2. When they studied the gene’s effects in zebrafish, mice, and cadaveric human brains, the researchers found that the protein it makes affects how many other genes are regulated. • Scientists from Touro College of Osteopathic Medicine (New York) and Hadassah University Hospital, Jerusalem, have called for the testing of umbilical cord blood for levels of a growth protein that could help predict an infant’s propensity to later develop autism. They propose that depressed levels of a protein called insulin-like growth factor (IGF) could potentially serve as a biomarker that could anticipate autism occurrence. • Researchers at Cincinnati Children’s Hospital Medical Center have used electronic medical records and birth information to verify and strengthen an already suspected link between autistic children and pregnant mothers with obesity and diabetes. According to study data, pregnant mothers with obesity or gestational diabetes were 1.5 times more likely to have a child with ASD. The increased risk of ASD for pregnant mothers with both obesity and gestational diabetes was two-fold. And hot off the presses: A University of Missouri-Columbia study suggests that the common hypertension drug propranolol might improve communication and social interaction skills of children with autism. Today’s targeted research promises help on the way for today’s L’s.

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MARCH 2016

MEDICAL LABORATORY OBSERVER Vol.48, No.3 Publisher/Executive Editor/President Kristine Russell [email protected] Editor Alan Lenhoff [email protected] Associate Editor Lisa Moynihan [email protected] Graphic Artist Glenn Huston [email protected] Graphic Artist Emily Baatz [email protected] Ad Contracts Manager Laura Moulton [email protected] Ad Traffic Manager Kathleen Shook [email protected] Subscriptions [email protected] LABline/eProduct Insider Mary Haberstroh [email protected] Reprints Deborah Beebe [email protected] ADVERTISING East Coast/Midwest Sales (except IL) Classified/Recruitment Advertising Carol Vovcsko (941) 321-2873 [email protected] South/West Coast/Illinois Sales Lora Harrell (941) 328-3707 [email protected] MLO EDITORIAL ADVISORY BOARD John Brunstein, PhD, Biochemistry (Molecular Virology) President & CSO PathoID, Inc., British Columbia, Canada John A. Gerlach, PhD, D(ABHI) Laboratory Director Michigan State University, East Lansing, MI Barbara Strain, MA Director, Supply Chain Analytics University of Virginia Health System, Charlottesville, VA Jeffrey D. Klausner, MD, MPH Associate Clinical Professor of Medicine Divisions of AIDS and Infectious Diseases University of California, San Francisco, CA Susan McQuiston, JD, MT(ASCP) Instructor, Biomedical Laboratory Diagnostics Program Michigan State University, East Lansing, MI Donna Beasley, DLM(ASCP) Manager Huron Healthcare, Chicago, IL Anthony Kurec, MS, H(ASCP)DLM Clinical Associate Professor SUNY Upstate Medical University, Syracuse, NY Suzanne Butch, MLS(ASCP)CM, SBBCM, DLMCM Administrative Manager, Blood Bank and Transfusion Service, University of Michigan Health System Department of Pathology, Ann Arbor, MI Paul R. Eden, Jr., MT(ASCP), PhD Major, United States Air Force Toxicology Program Manager, 711 HPW/RHDJ Wright-Patterson AFB, OH

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