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October 2016

Labs enter a MALDI-TOF state of mind

October 2016—When MALDI-TOF mass spectrometry enters the microbiology lab, it’s a little like watching Sir John Falstaff settle his considerable girth onstage. Things happen. Characters fret and flee, scheme, opine, panic, and, in the case of Prince Hal, ascend to greatness. (And, if we’re honest, some just get drunk.) Both, in brief, are an upending presence.

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Blood bank: On guard against daratumumab interference

October 2016—As fans of spycraft know, offensive counterintelligence can include an arsenal of strategies: initiating a diversion, sowing confusion, creating false identities—anything that makes another party believe something that isn’t true. If the cancer treatment drug daratumumab were capable of deceptive intent, it might be accused of all those ploys when it comes to interfering with blood transfusion crossmatching. The reason: For patients receiving daratumumab, marketed as Darzalex by Janssen Pharmaceuticals, antibody testing for transfusion is subject to erratic false-positives, often leaving transfusion services confused, uncertain, and on hold.

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The President’s Desk: How clarity can bridge our silos, 10/16

October 2016—I had been looking forward to Cancer Biomarkers Conference II at Houston Methodist Hospital, even though early September wasn’t the best time to travel. Work was busy and CAP16 was only two weeks away. During the weekend meeting, I rediscovered the value of stepping back from business as usual. The program was fast-paced and stimulating, and I learned a lot. Even the nonpathologists I met clearly appreciated what I shared about how much pathologists do to facilitate the adoption of these new diagnostic tools.

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Yale researchers dig for new kidney biomarkers

October 2016—An automated immunoassay has been created for symmetric dimethylarginine, or SDMA, a biomarker that can detect chronic kidney disease between 10 to 17 months earlier than creatinine, with 100 percent sensitivity and 91 percent specificity. And, unlike with creatinine, a patient’s muscle mass does not influence the biomarker’s reliability.

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AMP case report: Laser capture microdissection: Vanishing roles in tissue microdissection revalued in salvaging a melanoma with micrometastasis for BRAF V600E mutation detection, October 2016

October 2016—CAP TODAY and the Association for Molecular Pathology have teamed up to bring molecular case reports to CAP TODAY readers. AMP members write the reports using clinical cases from their own practices that show molecular testing’s important role in diagnosis, prognosis, and treatment. The following report comes from the University of Florida College of Medicine, Jacksonville.

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CAP16: All-star team presented with CAP and Foundation awards

October 2016—Gene N. Herbek, MD, was presented Sept. 25 with the Pathologist of the Year award during the spotlight event at the CAP16 annual meeting in Las Vegas. At the same event, Cordelia E. Sever, MD, was given the Pathology Advancement award, Sang Wu, MD, the CAP Foundation Gene and Jean Herbek Humanitarian award, Carey Zimmerman August, MD, the Outstanding Communicator award, and Denise K. Driscoll, MS, MT(ASCP)SBB, the CAP Staff Outstanding Achievement award.

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When pain management testing calls for a consult

October 2016—Surprises might work for birthday parties—and even then they’re not everyone’s cup of tea—but not in drug screening programs. Perhaps the most common reason for doing a toxicology consultation is when a urine drug screen yields an unexpected result, either positive or negative, says Nicholas Heger, PhD, assistant director of clinical chemistry at Tufts Medical Center and assistant professor of anatomic and clinical pathology, Tufts University School of Medicine, Boston.

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Anatomic Pathology Abstracts, 10/16

October 2016—Features of columnar-lined esophagus in gastroesophageal junction biopsies; Significance of Paneth cells in histologically unremarkable rectal mucosa; MicroRNA expression profile related to lymph node status in endometrial cancer; Plasma cells in melanoma: prognostic significance and possible role of IgA; Human epidermal growth factor receptor 2 testing in invasive breast cancer

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Clinical Pathology Abstracts, 10/16

October 2016—Risk factors for transfusion in cesarean section deliveries at a tertiary hospital: Obstetrical hemorrhage is a major cause of morbidity and mortality in young women and may be difficult to predict. In some regions of the world, postpartum hemorrhage (PPH) may account for up to 25 percent of maternal deaths. Many studies have focused on the predictors of PPH before delivery.

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Q&A column, 10/16

October 2016—What are the guidelines for proper handling and processing of blood specimens collected in serum separator tubes? Are there regulations guiding the practice of taking additional blood samples from a patient even though there are no orders for the blood samples? These “just in case” specimens are sent to our laboratory by the emergency department when a port or catheter is placed in the patient. The ED’s reasoning is that it prevents a patient from being stuck twice if there is an order for blood tests later. Our lab has to either store the samples or process them (centrifuge or separate RBCs from serum) so they are ready in case an order is entered later. Should this practice be banned? Should we refuse to accept these samples?

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Newsbytes, 10/16

October 2016—Process improvement software more than online suggestion box; Viewics launches analytics tool for diabetes management; Hc1.com joins forces with Experian Health; OptraScan introduces whole slide imaging scanner; Contracts and installations

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Put It on the Board

October 2016—Cancer Moonshot has diagnostic thrust: Vice president Joe Biden’s Cancer Moonshot now has a flight plan, drafted by a blue-ribbon panel and published in September. Coming as it does in the final year of president Obama’s term in office, there are doubts about whether the ambitious $1 billion program—aimed at achieving 10 years’ progress in cancer research and treatment in a five-year period—will ever get off the launching pad.

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