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September 2016

Beauty fad’s ugly downside: test interference

September 2016—It’s the kind of health promotion advice one might pick up casually over lunch with friends, in a quick Google search, or during a visit to the hairdresser. Take megadoses of an over-the-counter vitamin called biotin—a common supplement in multivitamin compounds—and watch your skin improve and your hair and nails thicken and gleam. In recent years, online social networks and health-related websites have begun to teem with ads claiming that people have seen a transformation since they jumped on the biotin bandwagon.

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From the President’s Desk: In the eye of the brainstorm, 9/16

September 2016—Radiolab is a radio show and podcast about (mostly) scientific curiosities co-hosted by a perpetually interested guy who majored in music. You might describe it as a talk show for science geeks. These are people who know how to ask the right questions and put the answers in context. A recent installment (“Colors”) questions whether color is a concrete characteristic of the physical world or simply a mental overlay we apply to our perception. Early on, you learn that a young Isaac Newton pursued the mechanism of color perception by piercing his own eye with a knife. I was hooked.

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Mass spec up front for pain management testing: Interest growing in oral fluid testing as alternative to urine testing

September 2016—This fall, Brigham and Women’s Hospital, Boston, is taking the mass spec leap. A plucky PR person might be tempted to refer to it as MassSpec LEAP!™ but Stacy Melanson, MD, PhD, doesn’t have time for such nonsense. As the associate director of clinical laboratories and co-director of chemistry, Dr. Melanson has more important matters to attend to. She and her colleagues are shifting from using a screening immunoassay for pain management drug testing to up-front definitive testing by LC tandem mass spectrometry.

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Laboratory accreditation program 2016 checklists: Less legwork, more clarity seen in personnel changes

September 2016—For the CAP Laboratory Accreditation Program, inspection checklist requirements covering personnel are a perennial concern. They are the leading source of disparities between the findings of the program’s inspectors and inspection audits done by the Centers for Medicare and Medicaid Services. Personnel is also high on the list of questions asked of Laboratory Accreditation Program staff. “Personnel is a hot topic for the College,” says CAP Checklists Committee chair William W. West, MD.

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New from CAP Press: Inspired by pathology, connected through art

September 2016—When Ray Paul was diagnosed with sarcoma in 2011, he wanted to understand his disease. His neighbor was a resident in the radiation department at Moffitt Cancer Center, Tampa, Fla., where Paul was being treated, and that neighbor was happy to introduce him to the pathologist on Paul’s case. An artist and biologist, Paul told the pathologist: “‘I want to see what my tumor looks like. I want to stare my devil in the eye,’” recalls Marilyn M. Bui, MD, PhD, a senior member of the Departments of Anatomic Pathology and Sarcoma, section head of bone and soft tissue pathology, and scientific director of the analytic microscopy core, Moffitt Cancer Center, and a professor and cytopathology fellowship director, University of South Florida Morsani College of Medicine.

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Quizzed in Ansbach, then key to a drug trial for mast cell disease

September 2016—In December 2007, American hematopathologist Tracy I. George, MD, spent a weekend in the small town of Ansbach in central Bavaria in the laboratory of Hans-Peter Horny, MD, whom she calls “the father of mast cell pathology.” Dr. Horny was at that time a privately practicing hematopathologist after having spent most of his career in academia. Plans for an international clinical trial were underway to evaluate the investigational drug midostaurin in advanced systemic mastocytosis, a rare group of diseases for which there was no effective therapy, and Dr. Horny would be the study pathologist. Dr. George, who had been diagnosing mast cell diseases for several years, wanted to take part as well.

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Method or test? Providing clarity to clinicians on NGS

September 2016—Whether it was “This is your brain on drugs,” “Take a bite out of crime,” or “Friends don’t let friends drive drunk” popping up onscreen, few of us watching TV in the 1970s and ’80s enjoyed having our programs interrupted by those public service announcements. Yet those important messages stuck in viewers’ brains—and stuck hard, if homages such as the Washington Post’s “10 Best PSAs of All Time” are anything to go by.

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Anatomic Pathology Abstracts, 9/16

September 2016—Digital image analysis versus manual biomarker assessment in breast cancer; Clinical and cost impact of EGFR and ALK testing in early stage NSCLC; Switch/sucrose nonfermenting complex protein expression in an aggressive endometrial cancer; Immune microenvironment of breast ductal carcinoma in situ; Adverse histological features in malignant colorectal polyps; Use of ancillary molecular analysis for diagnosis of soft tissue tumors

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Molecular Pathology Selected Abstracts, 9/16

September 2016—Mutations causing acquired resistance to PD-1 blockade in melanoma: Immunotherapy in metastatic cancer has achieved durable responses in a wide variety of cancer types. Antibodies that block programmed cell death protein-1 (PD-1) are particularly effective in metastatic melanoma, but a recent study showed that approximately 25 percent of patients that achieved a durable response ultimately had disease progression at a median follow-up of 21 months.

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Q&A column, 9/16

September 2016—We know we can count fewer than 100 cells for a manual differential if there is a very low white cell count. But if the white cell count is very high, should we count more than 100 cells? Some references state that >30,000 WBC/µL require a 200 cell differential, others >50,000 WBC/µL, and many do not mention at all the need to increase above 100 cells counted.

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Newsbytes, 9/16

September 2016—Graph database technology: what it can do given the chance; Group seeks participants to help foreign labs meet needs; ONC tool grades C-CDA documents for interoperability; BBCS releases new version of ABO Express; Prototype device provides fast bacterial infection diagnosis; Voicebrook announces software installation

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Put It on the Board, 9/16

September 2016—AMP lays out clinical utility standard for molecular Dx: The Association for Molecular Pathology has published a 14-page report its leaders hope will reset the conversation payers, policymakers, and medical guideline panels have when assessing the clinical utility of molecular diagnostics in oncology and inherited diseases. The key to AMP’s approach is to broaden the standard for what is considered a clinically useful molecular diagnostic test.

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