2008 MAPA Course Agenda A Thursday evening social event will be held at the New Deck Tavern for those that are arriving Thursday evening.Please check the MAPA website events section for details. Day 1 – Friday, May 30, 2008 7:30- 8:15AMREGISTRATION AND CONTINENTAL BREAKFAST 8:15-8:30AMWELCOME AND INTRODUCTION 8:30-9:30AMThe Lung – What Should You Be Thinking, What You Should Be Doing and Why? Leslie Litzky, MD University of PA Health System The general topic of Pulmonary Pathology and pulmonary specimen processing with special attention to recent issues in lung cancer. 9:30-9:40AMBREAK 9:40-10:40AMTungiasis Kevin Hirokawa, PA(ASCP) University of PA Health System Tungiasis is a disease predominantly of the southern hemisphere.It is believed to have originated in South America, and migrated to Africa and Southern Asia in the late 1800's and early 1900's.With the advent of greater tourism in these areas, it is slowly becoming a more common finding in northern hemisphere countries. This lecture will focus on the clinical presentation, pathological gross and histological findings, and treatment options. 10:40-11:00AMBREAK 11:00-12:00PMImportant Aspect of the External Examination Gary Collins, MD Assistant Medical Examiner, Philadelphia, PA To understand the important aspects of the external examination in a medico legal (forensic) postmortem examination. 12:00-1:00PMLUNCH 1:00-2:00PMUpdate on Digital Imaging Technology Michael Feldman, MD, PhD University of PA Health System This lecture will provide an overview of current imaging techniques used in the pathology gross lab.Applications of current technology will be reviewed, and future imaging technologies will be discussed. 2:00-2:10PMBREAK 2:10-3:10PMThe Making of a Pandemic: Bubonic Plague in the 14th Century James T. Eastman III, MD Lancaster General Hospital We will explore the various factors and events that seem to have occurred to initiate the “Perfect Infectious Storm”.In addition we will look at some of the socioeconomic, political, and religious effects which this catastrophe of this magnitude may have had.The study of such a far-reaching cataclysm presents to us with challenging questions and opportunities.To the extent that we can know and understand these events in the 14th century, it may enable us to more successfully deal with our current pandemic.Finally, one can hope that such an understanding can help prepare us to prevent or mitigate future pandemics. 3:10-4:10PMApproach to the Luminal GI Tract Emma Furth, MD University of PA Health System This lecture will focus on the key gross features of idiopathic inflammatory bowel disease within the lumen of the gastrointestinal tract.The discussion will include the discrimination of inflammatory bowel disease and other processes which mimic the findings of IBD.Proper handling, including photography and sectioning techniques, will be discussed. The Department of Anatomic Pathology and Laboratory Medicine would like to welcome the attendees of the MAPA 2008 conference to the University of Pennsylvania.A reception will be held at the College of Physicians and Mutter Museum on Friday, May 30, 2008, 5-8:00 p.m. Day 2 – Saturday, May 31, 2008 8:00- 8:25AMREGISTRATION AND CONTINENTAL BREAKFAST 8:25-8:30AMWELCOME AND INTRODUCTION 8:30-9:30AMMolecular Advances in Surgical Pathology: New technologies and the gross room Antonia Sepulveda, MD, PhD University of PA Health System This session will focus on new and emerging molecular technologies that impact on the practice of surgical pathology. Microarray testing for global gene expression, microRNA analysis, and approaches used for mutation detection and genomic profiling will be reviewed. The application of these new technologies for tumor diagnosis, prognosis, and targeted treatment selection, and molecular methods for specimen identity testing will be discussed. 9:30-9:45AMBREAK 9:45-10:45AMThyroid Cancer: The Legacy of Chernobyl Virginia LiVolsi, MD University of PA Health System The lecture will review the 22 year experience with pediatric thyroid cancers in affected countries after the Chernobyl nuclear accident. The histopathology, molecular biology and prognostic data will be illustrated and discussed. 10:45-11:00AMBREAK 11:00-12:00PMDiagnostic Imaging: Surgical Pathology - Where Are We Going? John E. Tomaszewski, MD University of PA Health System Diagnostic imaging in Surgical Pathology is primed for revolutionary changes.Image data of the future will be high dimensional, scaled, and quantitative.Computer assisted diagnosis will become a common paradigm.The collection of high resolution images by minimally invasive techniques will begin to blur the boundary between surgical pathology and radiology. 12:00-1:00PMLUNCH 1:00-2:00PMPediatric Autopsy Linda Ernst, MD Children’s Hosp of Philadelphia Discussion of major pathologic processes leading to fetal and neonatal death with emphasis on common malformation syndromes.Common morbidities associated with prematurity will also be discussed. 2:00-2:10PMBREAK 2:10-3:10PM
The Other Emboli
Brooke Walsh, PA Student, Drexel University
All too often when we think of pulmonary embolism we think of thromboembolism, but material other than blood clot could be responsible.The entities discussed here: fat embolism, air embolism, tumor embolism, and amniotic fluid embolism are uncommon disorders that occur in specific clinical settings.
Erroneous Blood Glucose Measurements by Hand-Held Devices in Diabetic Patients Undergoing Peritoneal Dialysis Chevanni Akanbi, PA Student, Drexel University
Stringent glycemic control is an essential paradigm in type II diabetics.In cases where these patients have compromised renal function due to progression of the diabetes or from other concomitant pathologies, this protocol is even more critical.Frequently, end stage renal disease patients receive continuous ambulatory peritoneal dialysis.With the advancement of icodextrin-containing dialysate, the threat of either hyperglycemia or alterations in peritoneal membrane ultrafiltration efficacy caused by the traditional dextrose-containing dialysate, is alleviated. However, icodextrin undergoes biochemical transformation in vivo to produce maltose and maltose polymer metabolites which compromise the sensitivity of hand-held blood glucose monitors that rely on a pyrroloquinolinequinone-glucose dehydrogenase coupled mechanism of operation.In a case study documented from literature, a patient was diagnosed as severely hyperglycemic using data from a hand-held device, when, in fact, the patient was severely hypoglycemic per data retrieved from the central laboratory.Due to this overestimation, the patient was treated for hyperglycemia inappropriately.Despite intervention with intravenous dextrose, the patient later expired.Though certain labeling initiatives have been instituted by glucose meter manufacturers, under advisement by the Food and Drug Administration, there is serious demand for reiteration of the very dire consequences of overestimated blood glucose in these patients by hand-held devices.