Included below are news items from the last six months.
A new DNA blood test for Rhesus-D negative women during pregnancy could spare treatment for thousands
A new prenatal DNA blood test reliably determines the Rhesus-D (RhD) status of the baby being carried by a woman whose red blood cells are RhD negative. Currently all RhD negative women are offered an anti-D immunoglobulin injection during pregnancy to reduce the possibility of problems in future pregnancies. But those carrying an RhD negative baby do not need the injection. The new test was recommended by the National Institute for Health and Care Excellence (NICE) in draft guidance on 14 July 2016. NICE said research indicated that about 40,000 RhD negative women each year would be spared treatment with anti-D immunoglobulin; in addition there would be potential NHS cost-savings of more than £50,000 a year.
In Dr James Le Fanu’s online health clinic, published in the Daily Telegraph on Tuesday 28 June 2016, visitors were directed to Lab Tests Online-UK as a result of a letter submitted to the online health clinic. A reader wrote to inform Dr Le Fanu of the website, and described it as a useful, respectable source of information, endorsed by the Royal College of Pathologists.
The World Health Organization (WHO) released recommendations on 12 May 2016 that aim to speed up the detection, and improve the treatment of multidrug resistant tuberculosis (MDR-TB). A novel molecular diagnostic test is recommended for use in national TB reference laboratories that can identify genetic mutations in MDR-TB strains within 24 – 48 hours and reliably rule out resistance to second-line TB drugs. Early detection of MDR-TB has been one of the major bottlenecks in tackling the global TB epidemic.
Symptom-free carriers of C difficile admitted to hospital can potentially transmit the bacterium to other patients. Research workers from Québec, Canada took rectal swabs from 7599 patients admitted to their hospital from the emergency department to identify those carrying C difficile from its tcdB gene that codes for B toxin. The 368 (4.8%) who had a positive test result were placed in modified contact isolation. The researchers reported online in JAMA Intern Med on 25 April 2016 that, over the 15 months after the introduction of this intervention, the incidence of hospital-acquired C difficile infection decreased to less than half that experienced during the previous six years, falling from 6.9 to 3.0 cases per 10,000 patient-days.
If a healthcare professional thinks a woman may have pre-eclampsia she is likely to be admitted to hospital for observation. On 11 May 2016 the National Institute for Health and Care Excellence (NICE) published an assessment of four new blood tests based on placental growth factor (P1GF) measurement, that are designed to help with the diagnosis of pre-eclampsia. Although showing promise, none has yet been recommended for diagnosis. However, for women between weeks 20 and 35 of pregnancy, two tests were able to predict with 98 to 99% accuracy that eclampsia could be ruled out for the next 7 to 14 days. NICE advised that either test could be used to help decide whether the anxiety, inconvenience and expense of hospital admission was necessary, and if monitoring could continue in the community.