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Surgical Frozen Section Accuracy

A recent article in Pathology Case Reviews discussed a case report of a head and neck cancer. Frozen sections are routinely requested by surgeons performing carcinoma resection. Frozen sections assist the surgeon in identifying complete resection of the tumor(s) which impacts patient survival. Accuracy of the frozen section is paramount. "The evaluation of margin status can present many challenges including how to define a positive or safe surgical margin, whether the presence of intraepithelial dysplasia is significant, and how to sample margins of the specimen." The case studied presented recommends methodology and interpretation of margin status.

Blood Analysis Game Changer

Biomedical engineers at UVA have designed an ultrasonic device that significantly cuts the time to analyze the blood's clotting. Cutting the time it takes to identify what the problem is will save lives. HemoSonic plans to launch  in Europe first due to a less stringent regulatory environment. The product is set to launch in the U.S. about six months later. The timeline for European launch is fifteen months.

Conflict of Interest Impacts Clinical Guidelines?

A March 28 study published in the Archives of Internal Medicine found financial conflict of interests (COIs) were "highly prevalent" among experts who drafted the most recent guidelines published by the American College of Cardiology and the American Heart Association. The study authors concluded these disclosed conflicts were a cause for concern. Interestingly, the abstract of the article contains the following "Clinical practice guidelines serve as standards of care in practice." Many medical experts involved in litigation refute this claim.

Arch Intern Med. 2010;171:577-584

New Guidelines on Management of Acute VTE

Circulation, the journal of the American Heart Association, has recently published a scientific statement regarding the management of venous thromboembolism (also known as blood clots). Included in the recommendations are fibrinolytic agent use, interventions and filters. American Heart Association issued a press release listing two statement highlights

  • More than 250,000 Americans are hospitalized yearly because of blood clots that form in veins deep inside the body.
  • A new American Heart Association statement gives doctors guidance on diagnosing and treating these potentially deadly blockages.

Lumbar fusion and Worker's Comp

A recent study published in the journal Spine looked at the effect of lumbar fusion in specific diagnoses in Worker's Compensation cases concluding, " Lumbar fusion for the diagnoses of disc degeneration, disc herniation, and/or radiculopathy in a WC setting is associated with significant increase in disabil­ity, opiate use, prolonged work loss, and poor RTW status." Free download of the article published in February 2011 - Click HERE

Nursing Home Abuse Investigations May Expand

A bill sailing through the Virginia General Assembly would expand the attorney general’s power to investigate nursing home abuse and neglect, even in cases where the patient does not receive government assistance. Currently under Virginia law, state investigators can subpoena only records of patients receiving state medical assistance, even if there are other potential abuse cases involving those paying with private insurance in the same facility. Click HERE for the rest of the story from Virginia Lawyers Weekly

New Guidelines Target MRSA

The Infectious Diseases Society of America (IDSA) is publishing clinical guidelines for treatment of methicillin-resistant Staphylococcus aureus (MRSA) including skin and soft tissue infections. The directions cover both community and hospital acquired infections. The evidence-based guidelines, which will be published in the Feb. 1, have been endorsed by the Pediatric Infectious Diseases Society, the American College of Emergency Physicians, and the American Academy of Pediatrics.

Executive summary of the guidelines