2016 Annual Convention Workshop Abstracts

Friday September 16, 2016
8:30 – 11:30 AM

Part I) Overview of Allergy Medicine: Diagnostic Approach in Primary Care Testing
Part II) Cardiac Biomarkers: The Changing Landscape
Part III) Syphilis: Clinical Disease and Testing Algorithms
165-100 – 3.0 CE (note: you must attend all three parts to receive credit) – Level of Instruction: Intermediate
Monet Sayegh, MD, PhD
Senior Medical Consultant Physician
Siemens Healthcare Diagnostics
Los Angeles, CA
Sponsored by Siemens Healthcare Diagnostics
Abstract (Part I): Allergy care is critical for millions of Americans. Too often patients are suffering from allergy symptoms because they do not have access to adequate care. Lack of care can lead to asthma attacks and emergency room visits creating a preventable burden on the healthcare environment. Allergists and primary care physicians need to work together to ensure appropriate care for all allergy sufferers. This presentation describes various aspects of allergies and allergy testing including: allergy defi nition and common allergens, clinical signs and symptoms, the allergy march and comparison of in vivo and in vitro allergy testing methods.
Abstract (Part II): The diagnosis of acute myocardial infarction (AMI) poses a challenge for clinicians, particularly in the absence of clear electrocardiographic (EKG) evidence. In 2000, a consensus conference of experts redefi ned MI on the basis of cardiac biomarkers, with cardiac troponin (cTn) proposed as the preferred test. Recognizing that any detectable cardiac troponin is abnormal, the ESC and ACC selected a highly sensitive cut-point that signifi cantly lowered the value previously advocated by WHO. In 2007, the National Academy of Clinical Biochemistry (NACB) released similar guidelines, also adopting a new low cut-point for cTn for the diagnosis of an MI. This seminar reviews the utility of cTn for diagnosis of a patient presenting with suspected ischemia. In addition, the most recent cut-points, clinical interpretation, and signifi cance of elevated cTn are reviewed, including non-ischemic causes suggestive of alternate pathologies.
Abstract (Part III): Syphilis is an easily spread infection of humans caused by the bacterium Treponema pallidum. After years of decline in the United States, syphilis infections are again on the rise. This seminar reviews the pathology, epidemiology, and laboratory testing involved in a diagnosis of syphilis. New testing algorithms are discussed that may enhance detection of late-stage infections as well as allow automation of the screening assay.

Part I) Pre-Analytical Variables in the Coagulation Lab: What do they matter?
Part II) Commonly Asked Coagulation Questions on the CAP Checklist
165-101 – 3.0 C E (note: you must attend both parts to receive credit) – Level of Instruction: Basic
Katherine Whelchel, MT(ASCP)SH
Technical Sales/Advanced Application Support
Diagnostica Stago, Inc.
Rogers, AR
Sponsored by Diagnostica Stago, Inc.
Abstract (Part I): Coagulation testing is particularly vulnerable to pre-analytical variables. This session will help identify best practices to minimize the variables that impact patient results. Abstract (Part II): College of American Pathologists (CAP) has added several new sections to the Coagulation Checklist in recent years, including Analytical Measurement Range, Calibration Verifi cation and Laboratory developed tests. This presentation will seek to clarify the confusion on these requirements and discuss ways to meet these requirements. We will also discuss the requirements in using D-Dimer for venous thromboembolism (VTE) exclusion.

Part I) Dealing with Preanalytic Errors
Part II) Reducing Phlebotomy Draw Volumes
165-102 – 3.0 CE note: you must attend both parts to receive credit) – Level of Instruction: Intermediate
Michelle McLean, MS, MT(ASCP), BS
Product & Clinical Applications Manager
Greiner Bio-One, Preanalytics
Raleigh, NC
Sponsored by Greiner Bio-One North America, Inc.
Abstract (Part I): Preanalytic error is a common problem for all laboratories with potential impact to the healthcare facility as a whole and, more importantly, the patient. There are several things to consider in recognizing and resolving these errors. This presentationwill focus on the most common preanalytic errors that plague laboratories including hemolysis, pseudohyperkalemia and short draws as well as offer suggestions on troubleshooting and fi nding solutions for these issues. Abstract (Part II): This discussion will shift to recent initiatives to improve patient outcomes resulting from changes in healthcare. More specifi cally, we will explore how phlebotomy draw volumes contribute to hospital-acquired anemia and what can be done to reduce the impact of laboratory testing on our patients.

Friday September 16, 2016
1:30 – 4:30 PM

Multiple Applications of Capillary Electrophoresis: From Identifying Monoclonal Proteins to Hb A1c
165-200 – 3.0 CE – Level of Instruction: Intermediate
Aigars Brants, PhD
Scientific Affairs Officer
Sebia, Inc.
Norcross, GA
Sponsored by Sebia, Inc.
Abstract: Electrophoresis is unique among the laboratory methods since it provides both quantitative and qualitative results. The attendees will learn the principles behind this separation technique. The differences between normal and abnormal profi les will be discussed and illustrated with relevant cases. The attendees’ participation will be encouraged. Serum protein electrophoresis is used to detect various disorders, including multiple myeloma (a cancer formed by malignant plasma cells). The cancerous cells produce monoclonal protein presented as a peak or extra fraction on the serum protein curve. Immunotyping allows typing of the monoclonal protein and provides some relevant prognostic information. The immunotyping principles and the result interpretation will be discussed. The attendees will be encouraged to interpret the presented cases.
Hb A1c concentration is used to diagnose/monitor diabetes. The epidemiology of diabetes and its burden on national healthcare will be briefl y discussed. The principles behind various methodologies, the role of the results standardization and the importance of precision and accuracy in determining the reliability of the results will be reviewed. Some common interferences – both biological and analytical –and their effect on the results will be presented. At the end of the session, attendees will understand why Hb A1c is not just a number.

Are We What We Eat? – celiac disease, gluten sensitivity, FODMAP, microbiome, neuropathy, and more
165-201 – 3.0 CE – Level of Instruction: Intermediate
Wen Kumfert, PhD
Senior Product Manager, Clinical Immunology Division
Bio-Rad Laboratories, Inc.
Benicia, CA
Sponsored by Bio-Rad Laboratories, Inc.
Abstract: In this workshop, we will discuss a wide range of topics related to celiac disease and non-celiac non-allergy gluten sensitivity, including history, clinical spectrum, athophysiology, clinical diagnosis, treatment, diet, and most recent scientifi c advances in the field of gluten-related disorders. How our understanding and defi nition of the diseases and development of diagnostic tools infl uence and intertwine with each other, and what insight the evolvement of this relationship offers to the clinical laboratory will be highlighted. There has been an increasing public awareness for celiac disease and gluten. This seminar encourages audience participation and discussion.

Technical Advances Revolutionizing the Role of Human Leukocyte Antigen (HLA) in Medicine: HLA Typing and
Characterization of HLA Antibodies
165-202 – 3.0 CE – Level of Instruction: Intermediate to Advanced
Lee Ann Baxter-Lowe, PhD, d(ABHI)
Director, HLA Laboratory
Adjunct Clinical Professor, University of Southern California
Los Angeles, CA
Abstract: Recent developments in understanding human leukocyte antigen (HLA) structure and function will be discussed with emphasis on how these discoveries provide insights into the critical role that HLA plays in human disease and transplantation. HLA genetics will be reviewed to illustrate the basis for the extreme diversity which is a hallmark of HLA. Methods for HLA typing ranging from the basic serology method to the latest next generation sequencing technology will be described. Methods for characterizing HLA antibodies will be described with emphasis on microparticle arrays assays that are revolutionizing the fi eld. The strengths, weaknesses, and clinical applications of tests that are routinely used for HLA typing and detecting HLA antibodies will be discussed. Case studies will be used to illustrate clinical application of tests for HLA typing characterizing HLA antibodies.

Saturday, September 17, 2016
8:30 – 11:30 AM

Implementation of the Anti-Xa Assay for Monitoring Heparin
165-300 – 3.0 CE – Level of Instruction: Intermediate
James F. DeMase, BS & Marcus Margand, MS
Accounts Managers
Instrumentation Laboratory, Inc.
Bedford, MA
Sponsored by Instrumentation Laboratory
Abstract: This lecture will review the origins of Heparin and its anticoagulation action as the initial anticoagulant of choice in the hospital setting. We will review the different options for the laboratory monitoring of Heparin, comparing the activated partial thromboplastin time (APTT) vs. the AntiXa assay. The benefi ts of monitoring with the anti-Xa chromogenic assay will be explored, highlighting the benefi ts to patient care and increased laboratory effi ciency. The successful implementation of the anti-Xa assay in the lab, as well ashospital-wide, will be discussed.

Part I) Screening for Gestational Diabetes Mellitus: Challenges and Controversies
Part II) The Clinical Chemistry of Pregnancy
165-301 – 3.0 CE (note: you must attend both parts to receive credit) – Level of Instruction (both parts): Basic
David G. Grenache, PhD
Medical Director, Special Chemistry | Co-Medical Director, Electrophoresis/Manual Endocrinology | Section Chief, Chemistry
ARUP Laboratories
Salt Lake City, UT
Sponsored by ARUP Laboratories
Abstract (Part I): Gestational diabetes mellitus (GDM) is associated with several adverse outcomes for the fetus, newborn, and mother. Evidence clearly shows that identifying and treating pregnant women with GDM ameliorates poor outcomes. There continues to be controversy regarding the most appropriate methods to screen for and diagnose DM. This presentation will describe the controversies in GDM testing and review the current evidence regarding the various screening recommendations.

Abstract (Part II): Normal pregnancy is associated with a multitude of physiological adaptations. Although most pregnancies progress without complications, problems can arise in the mother, fetus, or placenta. This presentation describes normal pregnancy-related physiological changes and several disorders that are associated with pregnancy that can affect laboratory test results.

Antiphospholipid Syndrome: Symptoms, Diagnosis, and New Markers for Risk Stratifi cation
165-302 – 3.0 CE – Level of Instruction: Intermediate
Carl Schroder, MT(ASCP), MPA
Manager, IFA Technical Sales
Inova Diagnostics
San Diego, CA
Sponsored by Inova Diagnostics
Abstract: In this session we will discuss Antiphospholipid Syndrome (APS), its symptoms, diagnostic criteria, treatments, current testing techniques, and new tests being introduced. We will describe the history and antigen make up of current and future assays. Also discussed will be how these non-invasive tests can be used to aid physicians’ diagnosis, decrease missed diagnoses, reduce healthcare costs and patient suffering, and increase quality of life and survival rates for both fetuses and patients.

Part I) Women’s Health – Biomarkers in Clinical Practice and Future Approaches
Part II) Natriuretic Peptides and Troponin: Testing Today
165-303 – 3.0 CE (note: you must attend both parts to receive credit) – Level of Instruction: (I) Basic; (II) Intermediate
Ursula Klause, PhD, Senior Scientifi c Affairs Manager
Theresa M. Joseph, RN, BSN, Medical Scientifi c Liaison
Roche Diagnostics Corporation
Indianapolis, IN
Sponsored by Roche Diagnostics Corporation
Abstract (Part I): The presentation will cover diseases that are specifi c to female patients (breast- and ovarian cancer) or have a signifi cantly higher prevalence in women (osteoporosis) or are related to pregnancy (preeclampsia). We will discuss the use of biomarkers for screening, diagnosis, therapy monitoring, or recurrence testing and how new biomarkers might infl uence and improve clinical practice.
Abstract (Part II): This program is intended to familiarize health professionals and laboratorians with data supporting evidence-based practice guidelines related to care of the patient with Acute Coronary Syndrome and/or Heart Failure. The focus will be on diagnostic and prognostic value of troponin and natriuretic peptides. Analytical and clinical considerations will be discussed, as will pathophysiology of the heart in Acute Coronary Syndrome and Heart Failure.

Saturday, September 17, 2016
1:30 – 4:30 PM

Part I) Lysosomal Storage Disorders: The Mucopolysaccharidoses
Part II) Inborn Errors of Metabolism: A Review of Fatty Acid Oxidation Disorders
165-400 – 3.0 CE (note: you must attend both parts to receive credit) – Level of Instruction (both parts): Intermediate to Advanced
Rubén X. Bonilla-Guerrero, MD, FACMG, FACB, CGMBS
Medical Director Medical Affairs, Genetics
Associate Medical Director, Genetics
Quest Diagnostics Nichols Institute
San Juan Capistrano, CA
Sponsored by Dr. Bonilla-Guerrero
Abstract (Part I): Inborn errors of metabolism (IEM) are a rare group of disorders characterized by a blockage at a specifi c step of a particular metabolism pathway. Most of these disorders are due to a primary enzymatic defi ciency most commonly inherited from the parents. In some instances, secondary inhibition of the primary enzyme can occur, too. The objective of this presentation is to provide a comprehensive review of the principles of biochemical genetic disorders and diagnosis. To exemplify those principles, we will review The Lysosomal Storage Disorders and the Clinical Presentation of IEM in the neonate patient as well as the Mucopolysaccharidoses. We will also review case study presentations to engage the audience to put in practice the material covered by this presentation.

Abstract (Part II): Continuing to exemplify the principles of biochemical genetic disorders and diagnosis, we will review two specifi c groups of disorders: Fatty Acid Oxidation Disorders and Bile Acids Biosynthesis Disorders. We will also review case study presentations to engage the audience to put in practice the material covered by this presentation.

Hot Topics in Microbiology! Zika, C. difficile and Antimicrobial Stewardship
165-401 – 3.0 CE – Level of Instruction: Intermediate
Margie Ann Morgan, PhD
Scientifi c Director Microbiology
Cedars-Sinai Medical Center
Los Angeles, CA
Abstract: During this three-hour session, three separate “hot” topics in microbiology will be covered: (1) Discuss the virology and epidemiology of Zika, Dengue and Chikungunya viruses, provide current recommendations for the diagnosis of Zika virus infection, and overview of how to prevent infection; (2) Discuss the current testing controversies for the detection of C. diffi cile infection; and (3) Discuss the role of the microbiology laboratory in the effort to better use antibiotics.

What Made Sally Sick? The Use of Multiplex Polymerase Chain Reaction (PCR) Panels as First Line Tests for
Detection of Respiratory and Intestinal Pathogens
165-402 – 3.0 CE – Level of Instruction: Intermediate
Alex L. Sterling, BS
Sales Manager / Laboratory Diagnostics
BioFire Diagnostics
Salt Lake City, UT
Sponsored by BioFire Diagnostics, LLC
Abstract: Multiplex PCR panel has been available since 2008. Today, numerous PCR panels for detection of several respiratory and gastrointestinal pathogens are commercially available. In the area of testing for an infectious disease, these products have become a disruptive technology in their ability to integrate molecular diagnostics and microbiology. Some of these tests are labor intensive, while others provide simple workflows; all of them are more expensive than standard technique to the laboratory and patient. Many of the assay panels can detect up to 22 pathogens. More confounding to the clinician is how these pathogens can cause similar symptoms, yet lead to different manifestations of infection within the same organ system. While some laboratories and hospitals have limited the frequency at which patients can be tested, others have allowed the ordering provider to exercise clinical judgment as to whether they are appropriate for first line diagnostic testing.

Part I) Rescue of Alpha Thalassemia Fetus and In-Utero Treatments
Part II) Neonatal Transfusion Practices
165-403 – 3.0 CE (note: you must attend both parts to receive credit) – Level of Instruction (both parts): Intermediate
Charif El Masri, MT(ASCP)SBB
Manager, Transfusion Medicine
Children’s Hospital Los Angeles
Los Angeles, CA
Abstract (Part I): Alpha Thalassemia is a genetic condition often misdiagnosed during pregnancy. This condition is often associated with adverse outcomes for the fetus and for the mother. This presentation will describe the screening tools used to identify Alpha Thalassemia and review all possible management options available to clinicians and families facing this situation.

Abstract (Part II): Neonatal Transfusion is an important and frequent component of neonatal intensive care. Transfusion indicators for low birth weight infants are still controversial and mainly based on expert clinical opinions. This presentation will review the controversies regarding the transfusion triggers as well as large volume of blood transfused and complications presented during neonatal blood transfusions.

Sunday, September 18, 2016
8:30 – 11:30 AM

Massive Transfusion, Trauma and Obstetric
165-500 – 3.0 CE – Level of Instruction: Intermediate
Holli M. Mason, MD
Associate Director, Transfusion Medicine
Medical Director, Core, Emergency Department, and Cancer Center Laboratories
Medical Director, Laboratory Support Services, Informatics, Clinical Laboratory Scientist Training Program, and Ebola POC
Cedars-Sinai Medical Center
Associate Professor of Pathology, Step 2
David Geffen School of Medicine at UCLA
Los Angeles, CA
Abstract: This discussion will concentrate on the physiological changes that occur during a massive transfusion, the defi nition of massive transfusion, and the rationale for having a massive transfusion protocol. We will look at the differences and similarities in emergency transfusions for obstetric and trauma patients and review the recent update of the California Maternal Quality Care Consortium’s Obstetric Hemorrhage Toolkit, 2.0. We will also discuss the nuts and bolts of implementing both the toolkit and a massive transfusion protocol.

Part I) Next-Generation Sequencing Approaches in Cancer
Part II) Molecular Diagnosis of Genetic Diseases: From Single Gene, Gene Panel to Exome
165-501 – 3.0 CE (note: you must attend both parts to receive credit) – Level of Instruction (Part I): Basic; Level of Instruction (Part II):
Matthew Hiemenz, MD
Assistant Director, Clinical Genomics | Center for Personalized Medicine | Children’s Hospital Los Angeles
Los Angeles, CA
Jianling (Jenny) Ji, MD, MS, FAMG
Assistant Director, Clinical Genomics | Center for Personalized Medicine | Children’s Hospital Los Angeles
Assistant Professor of Clinical Pathology | Keck School of Medicine at USC
Los Angeles, CA
Abstract (Part I): Next-Generation Sequencing (NGS) is a powerful tool for detecting mutations in DNA and RNA. This lecture describes some of the current applications of GS for tumor samples in the clinical laboratory. Practical challenges and opportunities involved in implementing and operationalizing this testing for clinical cancer testing will be emphasized.

Abstract (Part II): (1) Before you begin ... introduction of basic molecular test techniques; (2) Single gene/multiplex techniques and gene panels; (3) Clinical exome sequencing. This lecture will provide a review and update on a number of techniques including single gene-multiplex testing, gene panels (fi rst half) and clinical exome sequencing (second half). We will discuss the technical differences and clinical applications between the methods.

Laboratory Diagnosis of von Willebrand Disease
165-502 – 3.0 CE – Level of Instruction: Intermediate
Larry J. Smith, PhD, SH(ASCP), HCLS/CC(ABB)
Liaison Manager, Medical and Scientifi c Affairs
Abbott Diagnostics Division – Hematology Unit
Santa Clara, CA
Sponsored by Abbott Diagnostics Division
Abstract: von Willebrand Disease (VWD) is the most common congenital bleeding abnormality in the world affecting approximately 1 – 2% of the general population. Accurate diagnosis can often be challenging. After a brief review of the structure and function of von Willebrand factor, the speaker will describe current classifi cation scheme for VWD and assays used to diagnose the disorder.

Sunday, September 18, 2016
1:30 – 4:30 PM

Hematology Essentials: A Foundation for Accurate Smear Reviews
165-600 – 3.0 CE – Level of Instruction: Basic
Christine Hinz, MS, MLS(ASCP)CM
Product Manager, IT
Sysmex America, Inc.
Lincolnshire, IL
Sponsored by Sysmex America, Inc.
Abstract: Reviewing hematology slides can be challenging. A patient’s blood picture is dependent on condition and treatment and can change over time. How can you distinguish a blast from a reactive lymphocyte? How do growth factor drugs affect WBC morphology? This workshop will take the attendees beyond the textbook on a journey through case studies that provide a basic review of hematology cells and morphology.

Role of Whole Blood Platelet Lumiaggregometry in Clinical Practice
165-601 – 3.0 CE – Level of Instruction: Intermediate to Advanced
Oksana Volod, MD, FCAP
Director, Coagulation
Cedars-Sinai Medical Center
Los Angeles, CA
Abstract: Platelet aggregometry has been the reference method employed to detect, diagnose, and monitor qualitative platelet disorders since the early 1960s. Lumiaggregometry and impedance-based whole blood lumiaggregometry (WBA) have advantages over light transmittance aggregometry in that they provide for enhanced specimen management and increase the test sensitivity to impairment of platelet granule secretion. WBA detects and identifies congenital and acquired platelet plasma membrane receptor defects, metabolic pathway secretion disorders, and storage pool defi ciency. WBA is also being applied to antiplatelet therapy monitoring and identifies
aspirin and thienopyridine resistance. There is growing interest in using impedance-based WBA for platelet analysis and antiplatelet therapy monitoring. During this workshop, clinical application of WBA in evaluation of antiplatelet drugs effect, bleeding and thrombotic disorders will be discussed. Interesting case studies will be presented.

Laboratory Diagnosis and Monitoring: Myeloma
165-602 – 3.0 CE – Level of Instruction: Intermediate
Steven Marionneaux, MS, MT(ASCP)
Global Scientifi c Affairs Manager
Abbott Hematology
Santa Clara, CA
Sponsored by Abbott Hematology
Abstract: We will explore the multi-laboratory evaluation of plasma cell myeloma. Patients are diagnosed and monitored in hematology, chemistry, special protein, immunology, cytogenetics, molecular, and flow cytometry labs. Hopefully, attendees will leave with a better understanding of myeloma and how proper assessment and management are heavily dependent on many aspects of laboratory medicine

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