Lab Medicine Rounds

Timestamps:
00:00 Intro

01:10 Why is reference laboratory testing important for physicians and laboratorians to understand?

02:00 No lab does all the testing in their own laboratory. Labs can’t really have a whole panel of laboratory tests; it just doesn’t make sense, right?

04:39 What have we learned in the last couple years about reference laboratories, how we can best support clinical practice?

06:10 Do you have an insight for how that communication goes? 

8:46 How might a hospital reach out and partner with their reference laboratory? 

11:06 What does the future of reference laboratories look like? What might be in store for us?

15:00 Outro

Register for Leveraging the Laboratory:
www.news.mayocliniclabs.com/2021levlab

Timestamps:

00:00 Intro

01:15 Why are external rotations in pathology important from the student perspective?

03:51 Do you get to understand the particulars of a program or maybe what kind of questions you might be asking when you later interview because you do a rotation? 

05:03 What is unique from an international perspective? 

07:53 Can you compare and contrast the in-person pathology elective, with some of the virtual resources that are available at this point and time?

11:02 Are there any additional resources that you want to point out that are available now in 2021?

12:34 Can you kind of dive in and provide advice for people that are following in your shoes who might be doing later electives this year or in the near future who are looking at applying to pathology in the next cycle?  

13:41 Can you dive in and elaborate on what are some of the helpful things when students get onsite for one of these rotations?

17:26 Can you help us understand how you go about cultivating those relationships? 

19:36 Are there any kind of parting words of wisdom that you want to leave with future applicants that are checking out this podcast episode?

20:47 Outro 

Timestamps:

00:00 Intro

00:44 With this latest outbreak of the Delta variant with COVID-19, are laboratorians still working on new innovations for COVID?

02:23 Could you go into more detail, elaborate for us about this COVID-19 innovation around sequencing? 

04:25 Could you help us understand a little bit on what work is being done in those areas? 

07:47 Could you help our audience understand what have these conversation been like now that we’re into this pandemic this far, and the way that laboratory medicine testing is moving? I imagine you’re having more conversations with some of your Infectious Disease colleagues and you’re having more conversations with public health these days?

09:35 How do you answer that question?

11:18 Are there one or two COVID-related challenges that have really been running around in your mind the past week?

13:25 How is the Delta variant impacting what we’re thinking about for starting school?

14:38 Outro

Resources:
American Academy of Pediatrics

Timestamps:

00:00 Intro

01:05 From your perspective, why is the blood inventory important to a hospital?

04:17 What have you learned about managing a hospital’s blood inventory these past 18 months or so?

08:09 I was wondering if you could give us a specific example on how are they trying to bridge that gap? 

08:55 Can you explain who the Dream Team is?

12:34 How does PVM look different on the hospital side? How is that being worked?

16:33 How might physicians, non-pathologists, help their hospital’s blood inventory? What are the practical things that is within their sphere of control that they can help?

20:52 What do you hope that our learners take away from these blood shortage challenges that we’re navigating right now?

23:20 Outro 

Timestamps:

00:00 Intro

02:15 Why is it not enough for learners just to focus on the curriculum of their program?

04:30 What are two or three things that learners should pay attention to during their training?

07:19 Paying attention to the habits of our mentors and understanding that those habits are what is reassuring them, that is a key source for their confidence in their clinical practice. What’s another thing?

09:50 Do you have a third one that we should pay attention to?

12:45 How could learners take ownership for their education and get that knowledge that’s inside their mentor’s heads, into their heads? Any strategies that you recommend?

19:56 What are you thinking about explicitly incorporating into your training program with residents and fellows?

25:05 Outro 

Timestamps:

00:00 Intro

01:19 Could you help us understand, why should I consider getting an ethics consult? What value could this bring to my clinical practice?

07:49 What should our audience understand in order to really work better with our local med ethics team?

13:58 Could you help us understand about organizational ethics? How does that compare and contrast with that hospital ethics committee that you said everybody has and are most used to turning to?

22:24 What would be your recommendation for how to reach out to who is doing organizational ethics at our institution?  

25:00 I was wondering if you would be willing to share one or two predictions for the future of medical ethics to open our mind up to what are the main issues and questions, and how is your field evolving? 

30:35 Outro 

Timestamps:

00:00 Intro

00:45 Why is it important to perform molecular testing on solid tumors?

02:47 What is the significance of this testing for the patients and physicians?

07:18 Can you share with us, what are some recent examples that have blown this door open about hereditary oncology?

10:28 Can you talk a little bit about the challenge on how do we get the rapid rise in molecular knowledge and testing? What is your perspective?

15:25 Can you elaborate a little bit on how you interact with your clinical colleagues on how to keep people up to date, or how to explore what’s the right thing to bring on to that test menu? 

18:11 What’s your secret to leveraging those relationships?

20:00 What does the future of molecular tumor testing look like?

21:48 Outro 

Timestamps:

00:00 Intro

01:11 What are frozen sections, and why are they an important part of patient care?

04:50 What are some of the challenges of actually performing a frozen section diagnosis?

07:03 How has frozen section changed in recent years, or over the course of practice? Has it been practiced similarly over the years, and are there differences in frozen section practice in different hospitals?

14:37 Given this uptick in the complexity of cases, how do you mentor people who are trying to find their way, i.e., the students and trainees?

19:14 As a practicing Pathologist, where do you solicit your feedback from, and maybe an example of how you use that feedback to get better? 

24:32 Looking at the future in pathology and surgical pathology, there’s so much interest in artificial intelligence and informatics; is that thought to play a role in the future of the frozen section practice?

27:51 Outro 

Timestamps:

00:00 Intro

01:00 How does the cardiovascular laboratory support patient care?

01:47 Can you tell us a bit about ceramides? What are they?

04:14 When should ceramides be tested? 

06:04 Can you modify someone’s ceramides such that the test can be repeated and monitored, or is it once in a lifetime because ceramides or more static?

08:05 What is the controversary around ceramides? 

09:52 Could you give our listeners an introduction to Lipoprotein(a)?

11:45 Who should be tested for Lipoprotein(a)?

13:59 How do we treat elevated Lipoprotein(a)? 

17:20 How did your interests in laboratory medicine develop? How has this brought meaning for you in your career professionally? 

19:23 Outro

Resources:
1.  Ceramides and Ceramide Scores: Clinical Applications for Cardiometabolic Risk Stratification. Hilvo M, Vasile VC, Donato LJ, Hurme R, Laaksonen R. Front Endocrinol (Lausanne). 2020 Sep 29;11:570628. doi: 10.3389/fendo.2020.570628. eCollection 2020. PMID: 33133018 Free PMC article. Review.

2.  Measuring the contribution of Lp(a) cholesterol towards LDL-C interpretation. Fatica EM, Meeusen JW, Vasile VC, Jaffe AS, Donato LJ. Clin Biochem. 2020 Dec;86:45-51. doi: 10.1016/j.clinbiochem.2020.09.007. Epub 2020 Sep 28. PMID: 32997972

3.  Ceramides improve atherosclerotic cardiovascular disease risk assessment beyond standard risk factors. Meeusen JW, Donato LJ, Kopecky SL, Vasile VC, Jaffe AS, Laaksonen R. Clin Chim Acta. 2020 Dec;511:138-142. doi: 10.1016/j.cca.2020.10.005. Epub 2020 Oct 12. PMID: 33058843

4.  Ceramide Scores Predict Cardiovascular Risk in the Community. Vasile VC, Meeusen JW, Medina Inojosa JR, Donato LJ, Scott CG, Hyun MS, Vinciguerra M, Rodeheffer RR, Lopez-Jimenez F, Jaffe AS. Arterioscler Thromb Vasc Biol. 2021 Apr;41(4):1558-1569. doi: 10.1161/ATVBAHA.120.315530. Epub 2021 Feb 18. PMID: 33596665

5.  High-Sensitivity Cardiac Troponin for the Diagnosis of Patients with Acute Coronary Syndromes. Vasile VC, Jaffe AS. Curr Cardiol Rep. 2017 Aug 24;19(10):92. doi: 10.1007/s11886-017-0904-4. PMID: 28840515 Review.

6.  Natriuretic Peptides and Analytical Barriers. Vasile VC, Jaffe AS. Clin Chem. 2017 Jan;63(1):50-58. doi: 10.1373/clinchem.2016.254714. Epub 2016 Oct 10. PMID: 28062611 Review.

7.  Diseased skeletal muscle: a noncardiac source of increased circulating concentrations of cardiac troponin T. Jaffe AS, Vasile VC, Milone M, Saenger AK, Olson KN, Apple FS. J Am Coll Cardiol. 2011 Oct 18;58(17):1819-24. doi: 10.1016/j.jacc.2011.08.026. Epub 2011 Sep 29. PMID: 21962825

8.  Elevated cardiac troponin T levels in critically ill patients with sepsis. Vasile VC, Chai HS, Abdeldayem D, Afessa B, Jaffe AS. Am J Med. 2013 Dec;126(12):1114-21. doi: 10.1016/j.amjmed.2013.06.029. Epub 2013 Sep 28. PMID: 24083646

Timestamps:

00:00 Intro

01:00 Can you give us the lay of the land and explain how does the cardiovascular laboratory provide patient care?

03:24 Can you elaborate for us what it looks like when you have clinical chemists, cardiologists, and other professionals with different backgrounds working together?

05:56 Can you talk about bringing these people into the laboratory and developing a test that provides a lot of value to patients? How is that blended and what’s the output?

07:31 Talking about meetings that you guys do -- how is this meeting not some hierarchy of people who come together? How do these meetings work as an interprofessional utopia?   

11:21 How do you keep your clinical colleagues educated about laboratory science?

14:25 Are other laboratories adopting this leadership model?

15:42 What have you learned about establishing the culture and getting them to understand what the plan is?

17:59 Turning to medical laboratory scientists, what’s your pitch for why they should go into clinical chemistry?

20:12 Outro