ADVANCE Discourse: Lab

Saliva-based Diagnostics

Todd Smith — Thu, 03 Jul 2008 15:20:00 GMT

The following is a guest blog submitted by John G. Thomas, PhD, director of the Biofilm Research Laboratory for Translational Studies and senior consultant for Clinical Microbiology, West Virginia University Hospitals.

Saliva: A Diagnostic Fluid

Most present day laboratories assays of immunology markers use older generation ELISA; but recognition of biomarkers and need for greater sensitivity have scientists looking at newer, molecular test methods.

UCLA and its Collaborative Oral Fluid Diagnostic Research Center designed a new hand-held device called Oral Fluid NanoSensors Test (OFNASET). The lead scientist was David T Wong, among others.

Preliminary testing using OFNASET-like devices against head and neck cancers were, and continue to be, very predictive. By using four genes from Normal Salivary Transcriptone Core (NSTC) (IL8, OA21, SA7 and ILIB) researchers were able to determine whether a saliva sample was from a normal or cancer patient with a sensitivity and specificity of 91 percent.

In essence, this is saliva diagnostics powered by nano-technology, genomes and proteomics.

Eye of a Spy

Lynn Nace — Wed, 02 Jul 2008 13:05:00 GMT

A recent “Good Morning America” segment gained my interest. It discussed spy patients—individuals hired to enter emergency rooms and inpatient settings with fictitious symptoms to evaluate healthcare workers’ interactions with patients and accordance to policies and procedures. Apparently, some physicians are up in arms over this and have two primary arguments. Their first, I totally agree with—that fake patients are wasting valuable time and money that could be spent on real patients. However, I totally disagree with their second argument—that they shouldn’t be monitored. Why not? Every other industry has stringent quality control mechanisms in place. Isn’t this a form of QC? Why not hold physicians to high standards? What would make them an exception to this rule?

Career Paths: Detours and Straight-aways

Lynn Nace — Mon, 12 May 2008 17:58:00 GMT

When I have opportunities to network with people, such as at national conferences or ADVANCE-hosted Job Fairs, I really enjoy learning about how people chose their career paths and landed jobs. Sometimes the stories are serious in nature; other times, they're downright comical. A friend of mine from high school, for example, had a passion for the drums. He played in a "garage" band with friends, the marching band for high school and I suspect his college band. Now, he lives in Las Vegas and tours with the Blue Man Group. A childhood neighbor, on the other hand, knew from about the age of 10 that she wanted a career in medicine. Now, she's a well-respected ophthalmologist. How did you end up in clinical laboratory science management? Was this a planned endeavor, or one that you stumbled upon?

A Long-Awaited Approval

Kelly Graham — Tue, 06 May 2008 15:09:00 GMT

Although many states already have similar laws protecting individuals from discrimination on the basis of genetic information, the recent passage of the Genetic Information Nondiscrimination Act (GINA) through the Senate and the House marks an important-and long awaited-milestone for the clinical lab, as it illustrates just how seriously this matter is considered. Valuable genetic tests exist that may predict future problems, and patients made aware of their risk may be able to implement lifestyle changes that can reduce that risk. However, fear of discrimination in employment or ability to get health insurance may have prevented some patients from seeking out these tests.

Now that federal law bans discrimination based on patients' genetic information, how do you think the utility of these tests will change? Will there be more of a research push to develop predictive genetic tests? Will those in existence be more frequently utilized? Or are most patients unaware of these tests, and physicians uncertain about them, so that it won't make a difference?

The “Text” Level in Glucose Monitoring

Todd Smith — Tue, 22 Apr 2008 14:08:00 GMT

We may be witnessing the wi-fi tipping point, as the convergence of medical devices with wireless technologies has produced a cellular phone that doubles as a glucose meter. The meter can be fitted onto any regular cell phone. Software can be downloaded into the cell phone that can interface with the attached meter to test and read the patient's glucose level. The patient sticks the test strip into the side of the phone, just as they would any meter. The difference is that the patient can then immediately "text" the results to an online database that is accessed by the healthcare provider. The concept allows patients to discreetly perform their glucose testing virtually anywhere and have the results sent automatically and instantaneously. In addition to being sent to an online medical management database, the results also are stored in the cell phone. The patient can choose to have the results sent automatically to other sources, such as his physician, family members, etc.

The device appears to be on a level of innovation that could impress even the most fanatical "techie." But is it possible that such advanced technologies could ultimately sacrifice the benefit of "personal" care? For the consumer, one of the enticements of such POC technologies is that they minimize office visits and interaction. But when speaking with Dr. David Sacks, associate professor of Pathology at Harvard Medical School, he reminded me that one of the key constituents to improving outcomes in diabetes is personal interaction with, and reinforcement from, healthcare workers.

I encourage you to share your thoughts about whether such brilliant consumer POC technologies may have the potential to undermine the importance of regular interaction with nurses, dieticians and other healthcare workers that may provide the patient with more personal guidance, education and overall direction.

Raise MRSA Awareness

Lynn — Tue, 08 Apr 2008 13:00:00 GMT

The risks, dangers and test methods of MRSA have been covered extensively by ADVANCE and other media. But despite the discussions among the medical community, its threat still exists and the infection continues to be spread in schools and hospitals.

It's time to take discussions and education to another level. As a medical community and advocates for MRSA prevention, let's raise awareness in the public sector. Below are just a few ways we can do that. If you have other ideas, please share them by commenting on this blog.

1. Create information/fact sheets on MRSA for your hospital's lobby, cafeteria and information boards-anywhere that might be viewed by the public.
2. Volunteer to host talks and discussions at local schools. Many recent cases have been reported by high school sports teams, so a lesson on recognizing signs/symptoms, how not to share towels and equipment and the importance of taking showers right after practice would be valuable for students, coaches and players alike.
3. Distribute MRSA information/fact sheets-and be available for a question and answer session-at local health fairs. It's a great way to share your MRSA knowledge with the public while raising awareness of the importance of the clinical laboratory.