Mayo Clinic Laboratory and Pathology Research Roundup: Oct. 24
The Research Roundup provides an overview of the past week’s research from Mayo Medical Laboratories consultants, including featured abstracts and complete list of published studies and reviews.
New Developments in Clinical Bacteriology Laboratories
There are a number of changes underway in modern clinical bacteriology laboratories. Panel-based molecular diagnostics are now available for numerous applications, including, but not limited to, detection of bacteria and select antibacterial resistance markers in positive blood culture bottles, detection of acute gastroenteritis pathogens in stool, and detection of selected causes of acute meningitis and encephalitis in the cerebrospinal fluid. Today, rapid point-of-care nucleic acid amplification tests are bringing the accuracy of sophisticated molecular diagnostics closer to patients. A proteomic technology, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, is enabling rapid, accurate, and cost-effective identification of bacteria, as well as fungi, recovered in cultures. Laboratory automation, common in chemistry laboratories, is now available for clinical bacteriology laboratories. Finally, there are several technologies under development, such as rapid phenotypic antimicrobial susceptibility testing, whole-genome sequencing, and metagenomic analysis for the detection of bacteria in clinical specimens. The paper was published in Mayo Clinic Proceedings.
Ruling in Myocardial Injury and Ruling out Myocardial Infarction with the European Society of Cardiology 1-Hour Algorithm
High sensitivity cardiac troponin (hscTn) assays are used everywhere except in the United States. One potential advantage of these assays is the ability to triage patients with possible ischemia more rapidly and, there is an understandable desire to find easy, facile algorithms to do this. Mayo Clinic researchers took this approach with hscTn in the evaluation of patients with possible acute myocardial infarction (AMI) using an algorithm developed by the Advantageous Predictors of Acute Coronary Syndromes Evaluation (APACE) trial. Intrinsic to it is the concept that both ruling-out and ruling-in AMI rapidly (within one hour) is based on initially low concentrations or small changes over the first hour for ruling out and the use of larger changes and fixed cut off concentrations for ruling in. Unfortunately, the validation of this algorithm has often left a good deal to be desired. Despite that fact, it was incorporated into the European Society of Cardiology guidelines. The study was published in Circulation.
Published to PubMed This Week
- Chromoplectic TPM3-ALK Rearrangement in a Patient with Inflammatory Myofibroblastic Tumor Who Responded to Ceritinib After Progression on Crizotinib
Annals of Oncology
- Analysis of Biopsies From Duodenal Bulbs of All Endoscopy Patients Increases Detection of Abnormalities but has a Minimal Effect on Diagnosis of Celiac Disease
Clinical Gastroenterology and Hepatology
- Renal Leiomyoma and Leiomyosarcoma: A Study of 57 Cases
The American Journal of Surgical Pathology
- Radiographic Size of Retroperitoneal Lymph Nodes Predicts Pathological Nodal Involvement for Patients with Renal Cell Carcinoma: Development of a Risk Prediction Model
- Increased Rates of Clostridium difficile Infection and Poor Outcomes in Patients with IBD with Cytomegalovirus
Annals of Surgical Oncology
- Cardiac Myxoma: Simplifying a "Complex" Case
Journal of Thoracic and Cardiovascular Surgery
- Spectrum of Autoimmune Diseases and Systemic Inflammatory Syndromes in Patients with Chronic Myelomonocytic Leukemia
Leukemia & Lymphoma