CAPcasts

Patients treated with opioids for noncancer chronic pain are known to exhibit aberrant drug behaviors. The urine drug screen or UDS complements behavior monitoring as an objective means to assess patient compliance. UDS results can impact decisions related to a patient’s treatment, including discontinuation of opioid therapy or removal of the patient from the treatment program, explains Barbarajean Magnani, MD, PhD, FCAP, in this CAPcast interview.

Dr. Magnani, a renowned expert in toxicology, helped developed a Clinical Pathology Improvement Program or CPIP course on this topic (https://capatholo.gy/3cz90XA).

Technology continues to move at a fast pace, and many tools are available to streamline practice. However, the busy pathologist may not have time to seek out and keep pace with all the latest developments and technologies, explains Raul S. Gonzalez, MD, FCAP, in this CAPcast interview. Dr. Gonzalez is one of the instructors of a CAP20 course on this topic.

Register and learn more about CAP20, which will be held virtually this year on Oct. 10-14, please visit www.capannualmeeting.org. Follow #cap20virtual on social media for updates on this event.

Fluid samples are one of the most commonly-encountered samples in cytopathology, and may show a range of benign, inflammatory, and neoplastic disease processes. A structured approach to these samples is important, according to Xiaoyin "Sara" Jiang, MD, FCAP, who will be teaching a course on this topic at CAP20, which will be held virtually this year on Oct. 10-14. In this CAPcast, Dr. Jiang discusses efforts to standardize cytology reporting and how pathologists can enhance their ability to recognize key cytologic features of inflammatory and malignant processes.

For more information on this virtual event, please visit www.capannualmeeting.org and follow #cap20virtual for the latest updates.

Drug testing is critical to patient care, whether it’s for compliance to prescribed medications, identification of drugs in the immediate overdose setting, or exposure to toxins that may cause long term deleterious effects, such as lead. But there’s an important resources to help pathologists address these challenges--the second edition of Clinical Toxicology Testing: A Guide for Laboratory Professionals (https://capatholo.gy/2IfWvlJ). This edition features expanded sections on testing in the clinical setting, methodologies, and more user-friendly information on specific analytes, as renowned pathologist and co-author Barbarajean Magnani, MD, PhD, FCAP, explains in this CAPcast interview.

The novel coronavirus, 2019-nCoV or COVID-19, is rooted in Wuhan, China but has since arrived in the United States, stoking fears of a global pandemic. In this CAPcast interview, Dr. Michael Mina, Associate Medical Director of Clinical Microbiology and Molecular Virology at Brigham and Women’s Hospital’s Department of Pathology in Boston, discusses the current outlook of the virus and what pathologists need to know about their role in diagnosis and treating patients suspected to have contracted this virus.

For updated information on the coronavirus or COVID-19, please visit CAP.org (https://www.cap.org/) or CDC.gov (https://www.cdc.gov/coronavirus/2019-ncov/index.html).

Determining obsolescence for clinical tests in each setting requires discussion between laboratory staff and clinicians, influenced by reimbursement determinations, explains Dr. Robert Dufour in this CAPcast. Dr. Dufour led the development of a Clinical Pathology Improvement Program (CPIP) course on this topic (https://capatholo.gy/39Alig1).

The advent of new molecularly targeted treatment strategies for patients with advanced colorectal cancer places anatomic and molecular pathologists as key players in the delivery of care for this large patient population. Specifically, advanced colorectal cancer encompasses patients presenting with Stage IV cancer, or those who experience a cancer recurrence, explains Dr. Joseph Willis in a new CAP.org article (https://capatholo.gy/37Pdt5A), "Testing of Specimens From Patients With Advanced Colorectal Carcinoma."

Dr. Willis is Vice Chair for Pathology Translational Research and a GI pathologist at Case Western Reserve University and University Hospitals Cleveland Medical Center in Ohio. In this role, Dr. Willis has pursued better understanding of pathogenesis and prediction of outcomes of patients with GI cancers. He also currently serves on the Personalized Healthcare Committee of the CAP. This committee curates the Precision Medicine section of CAP.org (https://capatholo.gy/37R8WiX). Visit this page to access articles and presentations on precision medicine topics, such as PD-L1 or the use of liquid biopsies.

Surprise billing continues to be a priority for Congress in Washington, DC. In this CAPcast, Dr. David Gang and Dr. Matthew Foster--two leaders with the CAP’s Federal and State Affairs Committee--discuss their recent trips to Capitol Hill to meet with their legislators on surprise billing. Also interviewed is Michael Hurlbut, CAP Assistant Director, Legislation & Political Action, who will provide a recap of the legislative process to fix surprise billing and where it may go in 2020.

For more information, please go to the Advocacy section of CAP.org: https://www.cap.org/advocacy. From there, you can sign up for upcoming meetings and learn more about how you can participate in our lobbying programs. Also, be sure to register for the Pathologists Leadership Summit, which will be held May 2-5 in Washington, DC (https://www.pathologistsleadershipsummit.org). Advocacy will be a central theme of this meeting, and CAP members will have the opportunity to meet with their lawmakers on Capitol Hill.

The Atlas of Fundamental Infectious Diseases Histopathology: A Guide for Daily Practice contains real-world, practical information on commonly encountered infectious diseases for all levels of pathologists, from trainees to attendings. In this CAPcast, editor Dr. Bobbi Pritt discusses how the book is designed to be a valuable resource for pathologists, including using algorithms to help study patterns of inflammation for clues to the presence and potential types of organisms.

For more information and to purchase the book, please visit https://capatholo.gy/2svyYsK.

By the end of 2019, the CDC had reported over 2,000 hospitalizations and over 60 confirmed deaths due to vaping associated lung injury. While research into the pathology of vaping-associated lung injury is in its early phases, Dr. Brandon Larsen and his pathology colleagues at the Mayo Clinic published research in the New England Journal of Medicine in early October (https://www.nejm.org/doi/full/10.1056/NEJMc1913069) finding that lung injuries from vaping most likely are caused by direct toxicity or tissue damage from noxious chemical fumes. In addition, Dr. Larsen and his colleagues published subsequent correspondence in this same publication cautioning clinicians against performing lipid stains on bronchial fluid or lung tissue from adult patients (https://www.nejm.org/doi/full/10.1056/NEJMc1914980). In this CAPcast interview, Dr. Larsen discusses what CAP members need to know about the pathology of vaping-associated lung injury.