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October 2014

From the President’s Desk: Building a quality tradition, 10/14

October 2014—Laboratory medicine is a human endeavor with zero tolerance for error. “Human endeavor” and “zero error” make for an awkward pairing, but those are the rules and they’re good ones. So we create systems to protect quality, sustain excellence, and provide education. We are vigilant. CAP quality assurance programs are instruments of that vigilance and of our member-driven commitment to patient safety.

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Q & A Column, 10/14

October 2014—My laboratory reports the color of a body fluid after it’s spun down. So bloody fluid may be reported as “color: yellow, appearance = bloody.” Is this common practice? We have had phone calls from a neurologist who questioned the color and pointed out that it doesn’t make sense, except for spinal fluid when it’s important to record xanthochromia versus a bad tap.

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AABB ramps up donor screening to help stem TRALI

October 2014—When it comes to the blood supply, the tradeoffs between safety and availability are a tightrope that blood centers walk with extreme care. For several years now, TRALI (transfusion-related acute lung injury) has topped the list of causes of transfusion-related mortality in the U.S. Defined as acute lung injury that occurs during or within six hours of transfusion of a blood product, TRALI is fatal to six to 10 percent of the patients it strikes.

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In free CytoAtlas app, 750 images for 100+ diagnoses

October 2014—Like many cytopathology trainees, Charanjeet Singh, MD, who recently completed a cytopathology fellowship at MD Anderson Cancer Center in Houston, found it challenging at times to find classic examples of entities to learn from and to study for exams. Most texts he consulted contained just one or two images of a particular diagnosis. And the material in training programs from all specialties varies. Even though there is a large volume of cytology cases at MD Anderson, for example, it wasn’t enough to learn gynecologic cytology, which is why he pursued an elective rotation at Houston Methodist Hospital.

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In lab QC, how much room for improvement?

October 2014—The debut of the CMS’ new quality control option, IQCP, has sharpened the focus on QC in the laboratory and raised hopes that risk management concepts can make QC more robust. But one of the most highly regarded quality control experts in the U.S. voices skepticism about the impact of IQCP—and indeed, about U.S. quality control standards in general.

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Clinical Pathology Selected Abstracts, 10/14

October 2014—Benefits of green tea extract to brain connectivity during working memory processing: Green tea extract or its main ingredient has been shown to have a beneficial impact on cognitive functioning and prevention of cognitive decline. The benefit to cognition could be related to altered brain activity in regions engaged during higher order cognitive functioning. Some recent studies demonstrated increased brain activation in the fronto-parietal regions during working memory processing.

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Put It on the Board, 10/14

October 2014—Leading pathologists and the CAP are encouraging laboratory professionals to use the social media website Twitter as a way to amplify lab medicine’s voice among clinicians, policymakers, news organizations, patients, and the public. It is advice that at least one prominent social media expert and nonpathology physician says lab professionals ought to heed. “Pathologists have a problem being recognized by society because we don’t see patients directly. This is an opportunity for us to get out there in society and to contribute value in that regard,” says Timothy Craig Allen, MD, JD, a newly elected member of the CAP’s Board of Governors and director of anatomic pathology at the University of Texas Medical Branch, Galveston.

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Anatomic Pathology Selected Abstracts, 10/14

October 2014—Role of STAT6 immunohistochemistry in diagnosis of solitary fibrous tumors: Solitary fibrous tumor is an uncommon fibroblastic neoplasm. Although histologic characteristics and frequent CD34 expression allow for an accurate diagnosis in the majority of solitary fibrous tumor (SFT) cases, a wide histologic spectrum and occasional unexpected immunophenotype may pose diagnostic challenges. Molecular analyses have shown that almost all SFTs harbor a NAB2-STAT6 fusion gene, which is considered specific to this tumor type.

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Newsbytes, 10/14

October 2014—A conundrum: teaching pathology informatics to residents: Just as high schoolers are prone to protest, “We’re never going to need to use quadratic equations/literary theory/the periodic table in real life,” pathology residents have been known to question the value of subjects for which they don’t envision a practical application—such as pathology informatics.

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Molecular Pathology Selected Abstracts, 10/14

October 2014—A gene panel to examine mosaic somatic mutations in cerebral malformations: Somatic mutations are widely recognized in cancer, often affecting prognosis and determining candidacy for use of molecular targeted treatments. These somatic mutations may lead to a mosaic population of cells. Recent advances in technology involving deep next-generation sequencing have allowed for detection and quantification of these mosaic variants.

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Molecular tumor boards: fixture or fad?

October 2014—Along with everything else the genomics revolution has wrought, there’s this: Molecular testing is threatening to turn medicine into an ongoing episode of “Hoarders.” So much information and so many possible uses for it—including, in some cases, none at all. The expansion of molecular testing is also upending the role of the traditional tumor board.

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21 honored for patient care, strategy, safety, and service

October 2014—Stanley J. Robboy, MD, was presented Sept. 7 with the Pathologist of the Year award during an evening event at the CAP ’14 annual meeting in Chicago. At the same event, at the Hyatt Regency Chicago, Seema Sethi, MD, was honored as Resident of the Year, and Samir Sami Amr, MD, received the Pathology Advancement award. The CAP Foundation Gene and Jean Herbek Humanitarian award went to Barbarajean Magnani, PhD, MD, who was given a second award: the Distinguished Patient Care award.

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