Novità nel mondo di Medicina di Laboratorio

The results of a 'meticulous' study on the prognostic impact of tumor budding in colon cancer gives Dr David Kerr pause and causes him to reflect on digital pathology and artificial intelligence.
Medscape Oncology

Most gynecologic oncologists adhere to surgical guidelines for risk-reducing salpingo-oophorectomy, compared with less than half of other obstetrician-gynecologists, researchers report.
Reuters Health Information

Typical MI symptoms are more common and have greater predictive value in women than men, and guidelines should be updated to reflect this, researchers say.
Medscape Medical News

Clinical practice is already shifting toward an early-rule-out pathway with a single high-sensitivity troponin test, but this is the first randomized controlled trial to support the strategy.
Medscape Medical News

Medical and dental schools parted ways around the 1920s; however, specialists are renewing common ground to work together on patient care.
Medscape Medical News

Patients with advanced non-small-cell lung cancer (NSCLC) who are treated with the anti-PD-1 antibody nivolumab continue to have better survival than those given docetaxel after four years, according to pooled data from four CheckMate trials.
Reuters Health Information

Higher baseline absolute eosinophil counts (AECs) are associated with an increased risk of oral-immunotherapy-induced gastrointestinal symptoms and eosinophilic responses (OITIGER), researchers from Israel report.
Reuters Health Information

Flow cytometry is an incredibly powerful diagnostic tool in the evaluation of primary and secondary immune deficiencies. Assay design and setup involves a methodological consideration of specimen collection, marker and fluorochrome selection, antibody titration, instrumentation, compensation, gating, reference range development, and cross validation. Commonly used analyses for lymphocytes are the lymphocyte subset, T-cell subset, B-cell and T-cell naive/memory, double-negative T-cell, and plasmablast panels. Flow cytometry has direct clinical applicability to the workup of severe forms of primary immune deficiency disorders and is used diagnostically and for therapeutic monitoring in the context of secondary immune deficiency disorders.

Immunology testing is relevant for the diagnosis of many autoimmune conditions. However, diagnostic pitfalls arise owing to incorrect interpretation of results and incomplete understanding of the underlying technique or immune-mediated condition. Here, we review the diagnostic considerations related to commonly used immunology tests. Specifically, we summarize the caveats pertinent to the interpretation of rheumatoid factor, antinuclear antibodies, antiphospholipid antibodies, antineutrophil cytoplasmic antibodies, and serum IgG4 testing.

Guidelines for the management of acute STEMI patients undergoing PCI may need to be revised after a genotype-guided protocol giving clopidogrel to responders reduced bleeding rates, say experts.
Medscape Medical News

A new study involving the whole of New Zealand suggests that oxygen may be beneficial for patients with saturation levels below 95%.
Medscape Medical News

This study compared four automated methods of measuring fecal calprotectin, a noninvasive biomarker that can distinguish inflammatory bowel disease from irritable bowel syndrome.
American Journal of Clinical Pathology

What is the role of thromboelastography in the field of orthopedics? Find out what surgeons need to know.
Journal of the American Academy of Orthopaedic Surgeons

Three medical stories that we didn't cover, explained.
Medscape

Salt substitution at the population level has the potential to improve blood pressure control and alarming rates of nonadherence to hypertension drug therapy globally, the authors say.
Medscape Medical News

The safer use of medications and the compelling evidence for catheter ablation have led to a complete overhaul of the ESC guidelines for the management of supraventricular tachycardia, says an expert.
Medscape Medical News

Life expectancy for US adults infected with HIV has risen dramatically since the early 1980s, but patients are still dying from HIV-related causes rather than age-related conditions.
Medscape Medical News

Primary immunodeficiency diseases are a heterogeneous group of rare inherited disorders of innate or adaptive immune system function. Patients with primary immunodeficiencies typically present with recurrent and severe infections in infancy or young adulthood. More recently, the co-occurrence of autoimmune, benign lymphoproliferative, atopic, and malignant complications has been described. The diagnosis of a primary immunodeficiency disorder requires a thorough assessment of a patient’s underlying immune system function. Historically, this has been accomplished at the time of symptomatic presentation by measuring immunoglobulins, complement components, protective antibody titers, or immune cell counts in the peripheral blood. Although these data can be used to critically assess the degree of immune dysregulation in the patient, this approach fall short in at least 2 regards. First, this assessment often occurs after the patient has suffered life-threatening infectious or autoinflammatory complications. Second, these data fail to uncover an underlying molecular cause of the patient’s primary immune dysfunction, prohibiting the use of molecularly targeted therapeutic interventions. Within the last decade, the field of primary immunodeficiency diagnostics has been revolutionized by 2 major molecular advancements: (1) the onset of newborn screening in 2008, and (2) the onset of next-generation sequencing in 2010. In this article, the techniques of newborn screening and next-generation sequencing are reviewed and their respective impacts on the field of primary immunodeficiency disorders are discussed with a specific emphasis on severe combined immune deficiency and common variable immune deficiency.

For patients with type 2 diabetes and stable coronary artery disease, ticagrelor had no net clinical benefit in the overall trial, but results in patients with a previous PCI were more promising.
Medscape Medical News

Given the few effective therapies for HFpEF, should a new expensive drug be adopted on the basis of a borderline clinical trial result? John Mandrola, MD, weighs in.
theheart.org on Medscape