Advanced Laboratory Services Newsletter 501 Elmwood Ave, Sharon Hill PA 19079 Toll Free: 855-238-4949 Fax. 855-238-4946 Email: [email protected] July, 2012 Volume 1, Issue 1 Update from the Lab Director Special points of interest:  Testing is currently available in all states except New York; including California, Florida, Maryland, Pennsylvania and Rhode Island! Greetings from Advanced Laboratory Services! We have experienced many new developments in the past year and we have continued progress in our laboratory test offerings, including our Borrelia Culture. We are pleased to announce additions and refinements to our revolutionary Borrelia blood culture test, to be available by August 1, 2012. In addition to confirming cultures by immunostaining, we will now offer confirmation by nucleic acid testing, using a combination of DNA PCR plus DNA sequencing. This is very exciting news and offers additional tools for clinicians and patients to employ in the detection of Borrelia infections. We have processed well over one thousand Borrelia culture patient samples to date and greatly appreciate the excellent feedback that we have received from physicians in the field. This initial newsletter details other new testing options and topics of interests for our patients and the medical commu- nity. Please encourage your friends, family and colleagues to join our mailing list in order to learn about the most up-todate announcements from Advanced Laboratory Services. As always, we welcome your questions, comments and suggestions; thank you for your interest and we look forward to working with you in the future! -Raymond A. Rogowski, MD Laboratory Director  New saliva test for Oral Cancer is now available Inside this issue: Update from the Lab Director 1 Saliva Test for Oral 1 Cancer Protect yourself from tick-borne diseases 2 Pediatric Blood Draw guidelines 2 Neurological mani- 3 festations of Lyme Conference Update 4 Advanced Lab launches new Saliva Test for Oral Cancer Advanced Laboratory Services has recently launched a new test for the early detection of Oral Cancer. This saliva test is exclusive to Advanced Lab, and is set to revolutionize the medical world by allowing oral cancer to be detected at earlier (and more treatable) stages than has ever before been possible. Cancers of the oral cavity have some of the worst prognoses of all cancers, with low survival rates1. Oral cancer kills roughly one person in the US every hour, and of newly diagnosed individuals, only 57% will be alive 5 years later. Early detection is the key to improving these outcomes. Risk factors for developing oral cancers include tobacco use, alcohol use and exposure to human papilloma virus (HPV). Unlike traditional methods that rely on locating a lesion in the oral cavity, Advanced Lab’s new test allows detection earlier than ever before possible by measuring biomarker levels in saliva. The test is non-invasive and easy to administer. In addition to early detection, these biomarker levels can be monitored over time and used to predict prognosis and recurrence. The test was developed in collaboration with researchers from the University of ... Southern California, whose research was recently published in the prestigious “Oral Oncology” medical journal2. Collection kits consist of a saliva collection tube, instructions, refrigerator pack, requisition form and FedEx mailer. Collection kits are provided to healthcare professionals free of charge, with no upfront fees or set-up costs. The cost of the test, billed when the sample is received, is $179.99. Some practitioners may also charge an additional collection and processing fee. Orders for collection kits must be placed by a licensed health professional – inquiries and orders should be directed to [email protected]. Unfortunately we cannot accept orders from international doctors, naturopaths, chiropractors or doctors in New York at this time. Testimonials “Up until now, the technology for the detection of oral cancers has been stagnant— but the only way that survival can be improved is by early detection This test has the potential to revolutionize the treatment and diagnosis of Oral Cancers” - Dr Uttam SInha, Assoc Prof of Otolaryngology at USC. (continued next page) Page 2 Volume 1, Issue 1 (Continued from p.1) “The impact of having a simple screening tool for a commu- nity cancer center is huge. Its useful in very department— oncology, dentists, primary care physicians and so on” — Dr Warren S. Line, Otolaryngologist. References: 1. Suejung G. Kim, Mysore S. Veena, Saroj K. Basak, et al. (2011). Curcumin Treatment Suppresses IKKb Kinase Activity of Salivary Cells of Patients with Head and Neck Cancer: A Pilot Study. Clin Cancer Res 2011;17:59535961. 2. Korostoff, A, Reder, L, Masood, R, Sinha, U. (2011). The role of salivary cytokine biomarkers in tongue cancer invasion and mortality. Oral Oncology 47: 282-287. Protect yourself from tick-borne diseases Reproduced with permission from Lymedisease.org The best strategy is to avoid exposure to ticks. Unfortunately, if you spend time outdoors for work or play, that’s not always possible. Ticks are often found in wooded or grassy areas and are most active during cool, damp, or humid weather. They climb onto logs and tree trunks. Nymphal (immature) ticks are often found in leaf litter, while adults may perch on the tips of grasses. High risk activities include walking through a grassy field, gathering firewood, sitting on logs and leaning against tree trunks. Wear long sleeves, long pants, and a hat. Apply insect repellent to exposed skin. (Consider clothing pre-treated with permethrin, available through outdoor recreation stores.) out. Don’t squeeze, twist, burn or squash the tick. Save it for possible testing in a plastic bag with a green leaf or damp tissue for moisture. Saliva collection kit for the Oral Cancer screening test Pets should also be checked, for their sake and yours. Pets Check yourself for ticks regucan carry ticks into your larly while outdoors. Once house, where they can then you’ve returned home, shower crawl onto you. to remove unattached ticks Stay alert to anything that and check your whole body. might suggest you have conPay attention to “hidden” tracted a tick-borne disease, spots like hairline, ears, besuch as a rash or flu-like hind the knees, and the navel. symptoms. If so, contact your Remove attached ticks physician immediately. For promptly with tweezers or a more information, see tick-removal tool. Grasp close www.lymedisease.org. to the skin and pull straight Pediatric Blood Draw guidelines—Borrelia culture A culture is especially useful in pediatric patients. Interpreting antibody levels in serologies of infants is difficult if not impossible (due to presence of the mother’s antibodies) – in these cases, a culture makes the most sense because it is a direct test. A positive culture means that there was an active infection at the time the blood was drawn. The current Borrelia Culture collection kit requires that four 10mL tubes of blood be drawn – one of these is then transferred to the 4th tube containing the BSK medium, before being shipped. Of course, getting four full vials often isn’t possible with pediatric patients, so in these cases it is preferable to get one or two full vials (as opposed to three partially filled), so that the samples aren't compromised by exposure to air. The practitioner should include a note about why there are only one or two vials. Also, if they can only get one vial, the blood should be transferred and sent in the bsk tube. For all patients, the amount of blood that it is safe to draw should be at the practitioner’s discretion. It’s important that practitioners and patients are aware that with less blood, the lab has to do fewer sets when attempting the culture. With this in mind, the patient may need to submit more than one sample to be confident that a negative culture indicates no active infection. Any positive culture is considered significant. Now that PCR and DNA sequencing options are available, receiving less blood will also mean that the lab will be less able to perform these additional steps. “A positive culture means that there was an active infection at the time the blood was drawn” Page 3 Volume 1, Issue 1 Neurological Manifestations of Lyme Disease This article is intended as a stand-alone sheet that can be distributed to neurologists—Dr Burrascano’s symptom checklist can be found at http://lymedisease.org/resources/handouts1.html Lyme disease is the fastest growing and most prevalent vector-borne infection in America and is found in every state (Johnson & Stricker, 2004). Unfortunately, the sensitivity of serologic testing is low and may miss anywhere from 30% to as many as 70% of cases of Lyme (Stricker, BMJ 2007; 335 (7628): 1008). Therefore, clinical suspicion and patient history are paramount in making a diagnosis. Neurological symptoms that are consistent with Lyme disease include headaches, photophobia, dizziness, peripheral neuropathy, autonomic neuropathy, unexplained chronic pain syndromes, cranial neuropathies of all types, encephalitis and encephalopathy. There are many common symptoms shared between Lyme Disease and diagnoses such as MS, ALS, CFS/ ME, Fibromyalgia and PANDAS. Lyme has also been linked to complex partial seizure disorder (Bransfield, 1999), and Alzheimer’s (MacDonald, 2006; Miklossy, 2011). This highlights the importance of patients being tested for Borrelia using the newly available Bb blood culture, before a differential diagnosis can be made. In addition, it has been shown numerous times that erroneously treating Lyme disease with steroids and immune suppressants can actually worsen the course of the disease – steroids have been shown to exacerbate and cause treatment resistance in Lyme disease not only in animals (Chang et al, 2001; Pachner et al, 2001; Straubinger, 2000; Chang et al, 2000), but also humans (Dattwyler et al, Lancet 1988). Thus it is also essential that a culturebased bacterologic test be done on all patients for whom immunosuppressive therapy is being considered. Orders for Borrelia collection kits can be placed with the lab directly (questions@advanced- lab.com), and the price for the basic immunohistochemistry analysis has been set at $595 (this is in addition to any collection and processing fees that the practitioner may charge). The test results include an immunostained photograph of any spirochetes that are grown. Initial results are available in 7 -10 days, with full results in 2 months (for slow-growing cultures). Unfortunately we cannot accept orders from international doctors, naturopaths, chiropractors or doctors in New York at this time - please see the press releases on the Advanced Laboratory Services website for more information. Please do not hesitate to contact the lab with any sales-related or general questions – science-related questions should be sent to [email protected]. The abovementioned journal articles are available upon request— please email [email protected]. OTHER RED FLAGS FOR DISSEMINATED LYME DISEASE – Johnson & Stricker, 2004 • Severe headaches of new type and intensity, with negative neurologic workup • New onset of insomnia • New onset of panic attacks or anxiety • Joint pains with normal Xrays and negative rheumatologic workup • A “flu” that never ends or is recurrent • Unusual constellation of neurologic symptoms that a clinician has been unable to diagnose • A neurologic illness such as MS or ALS that is labeled “atypical” • Bell palsy (Lyme until proven otherwise) 501 Elmwood Road, Sharon Hill PA 19079 Toll Free: 855238-4949 Fax. 855-238-4946 Email: questions@adva nced-lab.com Advanced Laboratory Services, Inc. is a state of the art medical laboratory testing company that offers our clients a broad spectrum of clinical and anatomical testing services. Our mission is to establish a comprehensive laboratory testing facility that will meet the needs of physicians, clinics, and their patients, and to fulfill the needs of private and confidential testing throughout the United States. Our patients range from those concerned with basic health, to diagnosing fatigue and screening for infectious pathogens. We are staffed by the most qualified employees and we utilize the most advanced testing equipment and methods. We pride ourselves on personalized service and providing accurate, reliable lab results in a timely fashion (24-hour turnaround for applicable in-house tests). Our streamlined service is possible because we make every effort to ensure consistent quality throughout our system, high standards for personnel, the latest instrumentation, updated methodology, in-service education, as well as one of the most thorough quality control and continuous quality improvement programs in the industry. With both clinical and research divisions, Advanced Laboratory Services is committed to developing and releasing new cutting-edge lab tests to aid clinical diagnosis and treatment, including our recently launched, exclusive Spirochete/Borrelia culture test and saliva test for Oral Cancer. Advanced Laboratory Services, Inc 501 Elmwood Ave Sharon Hill, PA 19079 Toll Free: 855-238-4949 Toll Free Fax: 855-238-4946 Email: [email protected] “Providing the diagnostic solutions you need” www.advanced-lab.com Conference update and upcoming events Advanced Laboratory Services thanks everyone who stopped by at the ACAM Spring Workshop in San Diego and the May Ridgefield Lyme Conference in CT, where we were an official sponsor. Mark your calendars and visit our booths at:  bia University 13th Annual Lyme and tickborne diseases conference, Sept 29-30th in Philadelphia, PA  13th Annual ILADS Lyme Disease Conference, November 2-4 in Boston, MA Lyme Disease Association (LDA) and Colum- Meet the sales team Peter Sartini, Snr VP of Sales Tamara Apted, VP of Sales, Western Territory Manager —[email protected] Stephen Miskevish, Northeast Territory Manager—[email protected] Donna Peterson, Southern and Eastern Territory Manager—[email protected] Brian Rodgers, Midwest Territory Manager—[email protected] Do YOU have a story to share about how one of Advanced Laboratory Service’s specialty tests has helped with diagnosis or treatment? We want to hear from you! Email [email protected]