Lab Medicine Rounds

Timestamps:00:00 Intro01:15 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 Intro00:44 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

Justin Juskiewicz, an Assistant Professor at Mayo Clinic and expert in transfusion medicine, sheds light on the critical importance of maintaining blood inventory in hospitals. He discusses innovative strategies to engage donors and improve blood management during a national shortage, including the 'Bring a Buddy' program. Juskiewicz emphasizes the role of healthcare professionals in promoting blood donation and explores the impact of effective management practices like pre-operative anemia clinics on patient care. His insights reveal how collaborative efforts can bridge gaps in blood supply.

In this discussion, Daniela Hermelin, an Assistant Professor of Pathology at St. Louis University and Medical Director at SSM Health, shares her insights on training medical learners. She emphasizes that focusing solely on curriculum isn’t enough; students must observe mentors’ habits for confidence in practice. Hermelin advocates for experiential learning, comparing it to cooking, and stresses the need for medical students to take ownership of their education by engaging deeply with case studies and recognizing knowledge gaps.

Timestamps:00:00 Intro01:19 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 

Shanik Gupta, an Assistant Professor of Pathology at Mayo Clinic and expert in urologic pathology, discusses the groundbreaking role of molecular testing in solid tumors. She highlights its significance in classifying tumors, especially kidney cancer, and how recent advancements have changed treatment options. Gupta delves into the challenges of keeping up with rapid innovations in molecular knowledge and emphasizes the value of interdisciplinary collaboration. She also shares her thoughts on the future of testing and the necessity for standardized protocols in hereditary oncology.

Timestamps:00:00 Intro01:11 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 Intro01:00 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 Intro01:00 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 

00:00 Intro01:15 What’s your origin story? How did you become a forensic pathologist?03:53 What are some of the misconceptions about forensic pathology?06:15 Is there a big public health component to forensic pathology?07:29 Covid is a nice example on how you have partnered with public health, can you elaborate more on that?  10:15 What other types of physicians are you interacting with periodically and what are those conversations about?13:10 Do you approach autopsies differently depending on the case at hand?17:30 In what ways is the field of forensic pathology continuing to evolve and grow?20:50 Outro