April 16-18, 2009 ASCLS-IDAHO Spring Convention Program

A Greener Future for Laboratory Medicine:
Doing More with Less

Thursday, April 16th

1:00 to 4:30
A1. Flow Cytometry I
A2. Flow Cytometry II  
Speaker: Dave Osborn MT (ASCP)
Sponsor: Beckman Coulter
Contact Hours: 3
This session will introduce the participants to the basics of flow cytometry.  These basics include: general design of flow cytometers, basic Immunology, and phenotypes of various neoplasms.  Other diseases that the flow cytometer has applications for will be discussed.

Objectives:

1. Understand the basic design of flow cytometry.
2. Understand how we distinguish normal from abnormal in flow cytometry.
3. Understand how to distinguish between basic lymphomas and leukemias. 

A3. Cardiac Testing and Detection
Speaker: Theresa Joseph, RN
Sponsor: Roche Diagnostics
Contact Hours: 1.5

This lecture gives an overview of congestive heart failure (CHF) and myocardial infarction (MI), with afocus on the significance of natriuretic peptide and troponin testing in these disease states. History and FDA-approved uses for the assays will be discussed.

Objectives:

1. Describe the history of and FDA approv3d uses for natriuretic peptide testing
2. Describe the history of and FDA approved uses for troponin testing.
3. Describe the compensatory mechanisms of natriuretic peptides in the stressed heart.
4. Define the pathophysiology of congestive heart failure.
5. Identify the mechanisms of release for natriuretic peptides in the stressed heart.

3:00 to 4:30
A4. Transplants and Immunosuppression
Speaker: Ramani Wonderling, Ph.D.
Sponsor: Abbott Diagnostics
Contact Hours: 1.5
This presentation will provide a brief history and overview of solid organ transplantation and the basics of immunosuppression.  The new guidelines from the 2007 IATDMCT meeting will be reviewed as well as the role of immunosuppressive therapy, drug monitoring, and future trends in the design and dosage of immunosuppressant drugs. Various immunosuppressant drugs, their targets, clinical utility and indications of various drug therapy will be discussed.  Pre and post transplantation immunosuppressive therapy including induction and maintenance therapy will be reviewed.  The need to increase graft and patient survival rate will be discussed along with the data from the minimization studies such as the CAESAR and the SYMPHONY studies.  The new guidelines from the 2007 IATDMCT meeting for monitoring immunosuppressants will be highlighted.  Various drug monitoring methods will be compared highlighting the factors that affect the performance of drug monitoring assays.  Future trends in the design and dosage on immunosuppressant drugs will also be briefly discussed. 

Objectives:

1. List 2 immunosuppressant drugs and describe their targets and clinical utility.
2. Describe one post-transplantation immunosuppressant therapy
3. Summarize 3 guidelines from the 2007 IATDMCT meeting.
   

Friday, April 17th

08:00 to 9:15
Keynote: Pharmaceuticals in the Environment & Monitoring Groundwater for Pharmaceuticals and Personal Care Products
Speakers: Jeff Fromm & Tressa Nicholas
Contact Hours: 1

This presentation will provide an overview on pharmaceuticals in wastewater. The discussion will cover the sources of the pharmaceuticals, occurrence in bodies of water and observed and potential ecological and human health effects, treatment and prevention.  The participants will learn about the results of an Idaho study site where groundwater was monitored.

Objectives:

1.  List 3 sources of pharmaceutical contamination of waste water
2. Explain 2 means of preventing contamination of waste water
3. Identify a potential health hazard from contaminated waste water

10:30 to 12:00
Emerging Diseases
Speaker: Sky Blue, MD
Contact Hours: 1.5
This presentation will provide an update to the participants regarding emerging diseases.

1:30 to 3:00
B1. Automated Urinalysis
Speaker: Linda McGowan MLT (ASCP)
Sponsor: IRIS
Contact Hours: 1.5

Automated urinalysis applications will be presented.  This session will focus on making good decisions when automating urine testing in the laboratory.

Objectives:

1.  List 2 advantages of automating urinalysis testing
2. Describe 2 possible pitfalls with automated urinalysis
3. Develop a proper QC program for automated urinalysis testing

1:30 to 3:00
B3. Biomarkers in Prostate and Breast Cancer
Speaker: Dr. Monet Sayegh MD, MS, BS, MT (ASCP) SH, CLS.
Sponsor: Siemens
Contact Hours: 1.5

This seminar discusses the current utility of PSA testing, along with the newer methods to improve specificity and sensitivity, including ratio testing with free to total PSA, ultra sensitive PSA and direct detection of the complexed PSA isoform.  The role of HER2/neu in the diagnosis and monitoring of breast cancer is also reviewed, including tests that utilize either tissue or serum samples.

Biomarkers play a useful role in the diagnosis and treatment of cancer.  The use of PSA, along with the digital rectal exam, can detect prostate cancer as much as 5-10 years earlier than a digital rectal exam alone.  However, the current PSA test is limited in both sensitivity and specificity, resulting in both missed cancers and unnecessary biopsies.  This seminar discusses the current utility of PSA testing, along with the newer methods to improve specificity and sensitivity, including ratio testing with free to total PSA, ultra sensitive PSA and direct detection of the complexed PSA isoform.  The role of HER2/neu in the diagnosis and monitoring of breast cancer is also reviewed, including tests that utilize either tissue or serum samples.

Objectives:

1. Describe the role PSA plays in the diagnosis and monitoring of prostate cancer
2. Understand the value that ratios and isoforms can play in improving PSA testing
3. Describe the HER2/neu protein in breast cancer and the value of both tissue and serum based HER2/neu tests.

1:30 to 3:00
B5. Case Studies in Hemostasis
Speaker: George Rodgers III, MD, Ph.D.
Sponsor: ARUP Laboratories
Contact Hours: 1.5

The program will identify approaches to the laboratory evaluation of patients with disorders of hemostasis and thrombosis and examine consensus recommendations for coagulation testing.

Objectives:

1.  List 2 approaches in evaluating patients with hemostatic disorders
2. Describe one algorithmic diagnostic approach for thrombosis
3. Discuss consensus recommendations for hemostatic testing.

3:30 to 5:00
B2. Culture vs. Molecular: Is the Cost Worth It?
Speaker: Dr. Raymond Tarr.
Sponsor: Cepheid
Contact Hours: 1.5

 This session will provide a comprehensive overview of the financial burden of MRSA infections. Methods currently available for MRSA surveillance will be discussed. Current models for surveillance and their relative cost impacts will be explored.

Objectives:

1.  Identify all available technologies for MRSA identification and their relative strengths and weaknesses.
2. Discuss the diagnostic and therapeutic implications of making correct organism identification rapidly.
3. Recommend the appropriate testing and surveillance options to the individual learner’s administration and Infection Control personnel that best suits their institution’s needs.

3:30 to 5:00
B4. Hematology Case Studies
Speaker: Dawn Robertson, MT(ASCP)SH.
Sponsor: Beckman Coulter
Contact Hours: 1.5

The presentation will include an overview of the current VCS technology and in-depth discussion of the new “Research Population Data” information available along with a variety of case studies.

Objectives:

1.  Explain how scattergrams are used in troubleshooting unusual results
2. Correlate abnormal results to specific disease states
3. Discuss benefits of using Research Population Data information for establishing decision rule criteria.

3:30 to 5:00
B6. Transfusion Medicine Updates
Speaker: Anne Strupp, MD
Sponsor: American Red Cross
Contact Hours: 1.5

This session will review a potpourri of current information in transfusion medicine along with information on various experimental blood products.

Objectives:

1.  Describe 2 experimental blood products currently being researched.
2. Discuss one “hot topic” in transfusion medicine.
3. Compare and contrast methods used in the individual participant’s laboratory with the latest trends in the field of transfusion medicine.

Saturday, April 18th

8:00 to 9:30
Scientific Assembly: ISU Student Presentations & Forum
Contact Hours: 1.5

This session will provide a forum for this year’s class of ISU CLS students to present and discuss their research project designs. Each group of students developed a webpage to showcase their research and this forum will provide them the opportunity to share their project and their webpage design.

Objectives:

1. Summarize the findings represented in one webpage presentation.
2. Explain how the webpage was used to convey the research results.

9:45 to 10:45
Lab Zebras:  Weird Laboratory Case Studies  
Speaker: Jim Peterson, Ph.D.
Sponsor: Quest Diagnostics
Contact Hour: 1

Pre-analytical events can have great influence on laboratory testing to the point that the results are too strange to believe.  This session discusses some example cases where strange pre-analytical influences went undetected until some time after testing occurred.  After this session, participants will be able to name some of the potential pre-analytical influences and use some of the strategies given to effectively investigate problems.

Objectives:

1.  Name some of the potential pre-analytical influences on some popular laboratory tests.
2.  Use some of the strategies used to unravel these cases to mount effective investigations in the future.
3.  Admit that there is no such thing as something being too weird to impact testing

10:50 to 11:50
Involving Patients and Families in Their Laboratory Services 
Speaker: Susan Morris, CLS (NCA), MS
Contact Hour: 1
The Joint Commission is holding accredited healthcare organizations accountable for compliance with National Patient Safety Goal (NPSG) 13.  NPSG 13 promotes patients’ active involvement in their own care as a patient safety strategy and as part of a national agenda for improving the safety of healthcare. Due to the laboratories interactions with the majority of hospital patients, Laboratorians have an opportunity to take the lead in developing systems for patient involvement within their organizations. Participants will learn about the challenges that must be resolved, share strategies that their organizations are using to achieve compliance and improve the safety of the care they provide.

Objectives:

1. Participants will be able to describe several ways that involvement with patients can improve the safety of laboratory care and services.
2. Participants will be able to list patient rights related to laboratory testing.
3. Participants will be able to identify 3 resources available to laboratories to encourage patient involvement and communication

2:00 to 4:00
C1. CLIA Regulations
Speaker: Dave Eisentrager, MT (ASCP)
Contact Hours: 2

The CLIA seminar will be covering several topics that are of current interest and include: package inserts, equivalent quality control, validations and instrument performance specifications.  Microbiology issues and transfusion fatalities will also be discussed.

Objectives:

1. Define equivalent quality control
2. Explain one accepted method of validating POCT analyzers.
3. List three specifications that must be validated on new instrumentation or methodologies

2:00 to 4:00
C2. Body Fluids
Speaker: Jeri Walters, SH (ASCP)
Sponsor: Sysmex
Contact Hours: 2

One of the most feared procedures in the laboratory is body fluid analysis. Body fluids are unique, hard to obtain samples which often contain cells that are not routinely encountered in a routine hematology blood specimen. This presentation will provide a logical approach to the hematologic examination of CSF, serous, and synovial fluids. A brief introduction into the pathophysiology of these fluids – why they are there and why we test them – will be presented. Primary emphasis will be cell identification in these various fluids and differentiation of benign and malignant cells. Cell counting techniques, both manual and automated will be discussed.

Objectives:

1. Review the basic reasons why BF examination provides valuable information to the clinician.
2.  Discuss the difference and significance of linearity and the clinically reportable range. Identify clinically significant hematologic in CSF, serous and synovial fluids.
3.  Differentiate benign and malignant body fluid cellular morphology Interpret automated body fluid cell count scattergrams and histograms.

2:00 to 4:00
C3. Kappa/Lambda Light Chains The Binding Site
Speaker:  Anne L. Sherwood, Ph.D. and Brian Carrier
Sponsor: The Binding Site
Contact Hours: 2
Free light chain assays provide a sensitive indicator of patient status in the diagnosis, treatment and remission of Multiple Myeloma and other B-cell dyscrasias. Concepts of the biology of free light chain processing in vivo as it affects test results in clinical samples will be presented. Utilization of the free light chain assay and / free light chain ratios for risk stratification, diagnosis and monitoring of monoclonal gammopathies and updates on recent studies that describe the utility of the sFLC assay for patient management will be discussed.  

Objectives:

1. Explain the role of the sFLC assay in the diagnosis and monitoring of patients with MM and other B-cell dycrasias.
2. Describe the processing of free light chains in vivo.
3. Describe how the sFLC assay and / free light chain ratios are utilized for risk stratification, diagnosis and monitoring of monoclonalgammopathies.