We are heading to Chicago to meet up with our friends and colleagues from around the world at the 2014 AACC Annual Meeting. To share what we learn about the latest science and knowledge from our peers, we will be live blogging from the conference. Starting on Sunday, July 27, our guest bloggers will be sharing highlights from the conference, offering some thoughts, and posting photos from around the conference.
- Stop by booth #3857 during the Clinical Lab Expo to say hello and learn more about our featured clinical chemistry resources
- Join the conversation on @MayoClinicLabs and Facebook
- Support our Mayo Clinic colleagues by attending their presentations
July 1:53 p.m.
AACC Wrap-Up: Goodbye from Chicago
By Andy Tofilon
As AACC 2014 draws to a close, we say goodbye to new and old friends and we can't help reflect on this amazing week in Chicago. Here are some wonderful facts about our time here:
- 17+ Mayo Clinic physicians, scientists, and allied-health staff presented in AACC sessions including one plenary session, five symposia sessions, seven short courses, and one brown bag.
- 25+ abstracts were accepted and displayed on Tuesday and Wednesday in the poster hall.
- 5 young scientists won several awards. Enough that it deserves an entire list below.
- 23 Mayo Clinic alumni held a reunion to network and catch up.
- Hundreds of colleagues visited our exhibit to say hello and to learn more about our testing and services.
July 31 at 1:49 p.m.
Congratulations to Our Award-Winning Colleagues
By Andy Tofilon
AACC 2014 was one to remember for Mayo Clinic and its resident, fellows, and staff. Everyone at Mayo Clinic would like to congratulate the following individuals and authors:
- John Mills, Ph.D., and Jeff Meeusen, Ph.D., who received first and second place, respectively, in the AACC Student Oral Presentation Contest.
- Maria Willrich, Ph.D., who received second place in the Student Poster Contest.
- Roxanne Ybabez; Linda Hasadsri, M.D., Ph.D.; and John Mills, Ph.D., for receiving National Academy of Clinical Biochemistry (NACB) 2014 Distinguished Abstract Award.
- Maria Wilrich, Ph.D., and her co-authors for receiving the Pediatric and Maternal-Fetal AACC Division Award for Excellence in Research.
July 31 at 11:11 a.m.
Two Final Symposia Presentations
By Andy Tofilon
AACC 2014 is wrapping up this morning with one last round of symposia sessions. Two Mayo Clinic physicians are participating in two sessions.
- Laboratory Test Utilization: Leading the Charge Towards Lab Stewardship with Jonathan Hoyne, Ph.D.
Session Overview: Unnecessary or inappropriate laboratory testing significantly contributes to rising health care costs. This session will include strategies for identifying and reducing unnecessary testing. The role of laboratory leadership in maximizing efficient use will be discussed. The complexity surrounding utilization of genetic tests will also be addressed.
- Case Studies Using hscTn Assays with Allan Jaffe, M.D.
Session Overview: High sensitivity cardiac troponin (hscTn) assays are being implemented worldwide. This session will use case studies to prepare users for the anticipated increases in abnormal troponin findings. Three 40- minute case presentations will address the analytical and clinical challenges affecting both primary and secondary prevention of cardiac damage, as well as acute and chronic care of cardiac patients. A question and answer period will follow the three case presentations.
July 30 at 3:55 p.m.
11 Mayo Clinic Abstracts, Three Awards
by Andy Tofilon
On the last day of the AACC 2014 poster session, 11 posters were on display with Mayo Clinic physicians, scientists, and allied-health staff listed as the first author. In addition to the strong showing of poster, three abstract-related awards were given to Mayo Clinic authors.
NACB: 2014 Distinguished Abstracts Awards
- Roxanne Ybabez—Moving Patient Averages: A Pilot Study Using Error Simulation
- Linda Hasadsri—Diagnosis of Primary Hyperoxaluria Type III, A Novel Hereditary Disorder of Hydroxyproline Metabolism, By Gas Chromatography-Mass Spectrometry
Pediatric and Maternal-Fetal AACC Division Award for Excellence in Research
- Maria Wilrich, Ph.D., J. Balsanek, Paula Ladwig, David Barnidge, D. Murray, and Melissa Snyder—Antibodies-to-Infl iximab: Assay Development and Correlation with Infl iximab Concentrations in Serum Samples of Treated Patients
July 30 at 3:37 p.m.
By Jeffrey Meeusen, Ph.D.
The world's largest laboratory testing Expo kicked-off at the largest expo-center in North America. This year's AACC Expo has more than 20,000 attendees and over 700 exhibitors unveiling 200 new-to-market products.
The Mayo Medical Laboratories booth has been a busy attraction. Visitors that stop by can chat with product managers and laboratory directors about the clinical testing solutions offered through Mayo Medical Laboratories.
July 30 at 10:57 a.m.
AACC Tuesday: Hot Topics in Clinical Chemistry
by Maria Wilrich, Ph.D.
Dr. Nader Rifai, editor of the Clinical Chemistry journal, was asked to select 3 topics that are considered to have high impact on the practice of laboratory medicine to present in a symposium on Tuesday afternoon.
The topics chosen were:
- Cell-free DNA
- Bioavailable Vitamin D
- Saliva as a sample for drug of abuse testing
Dr. Dennis Lo
Dennis Lo, M.D., Ph.D. was the first speaker. Cell-free fetal DNA in maternal plasma, discovered in 1997, has promoted the advance of non-invasive prenatal diagnosis, including a test to detect trisomy 21 with 99% sensitivity and specificity. Similar approaches are now being used for cancer genome scanning in plasma. The cancer genome is characterized by a number of molecular aberrations, including amplifications and deletions, as well as DNA methylations. Genome wide sequencing of plasma DNA to identify copy number aberrations and DNA methylation abnormalities have been in development for the past years, and seems applicable for several cancers, including hepatocellular carcinoma, breast and lung cancer, and others. Circulating tumor DNA can be more specific than a protein or protein byproduct to diagnose cancer. Laboratory scientists and clinicians must prepare for the implementation of next generation sequencing in clinical practice.
Requests for the measurement of total 25-hydroxyvitamin D (25OHD) have skyrocketed because of epidemiologic observations relating decreased concentration to multiple diseases. Ravi Thadhani, M.D., has recently published data raising the question that bioavailable - rather than total - 25OHD is a more appropriate measurement. The concept is borrowed from other hormones, and if vitamin D behaves under similar principles, then bioavailable 25OHD (loosely bound to albumin and free 25OHD) will be the carrier of vitamin D intracellularly. If true, this may change our interpretation of the accumulated knowledge base of this vitamin.
The third topic was discussed by Marilyn Huestis, Ph.D., considering the use of saliva as a sample matrix for drug testing. Collection is non-invasive and directly observed, so that reduces drastically the potential for adulteration of specimens. Saliva as a sample makes it possible to offer drug of abuse testing at the roadside, as impaired driving has received much attention and is a safety concern. Saliva is used in several countries outside the US, but questions remain as to what metabolites to measure, their disposition, what to measure relative to time of exposure, and court of law recognition of such testing.
I’m convinced that these topics will evolve with time and we will hear more about them as more evidences become available and future studies are performed to continue advancing the science.
July 29 at 5:17 p.m.
AACC Monday Wrap-up: The Student Research Awards
By Maria Willrich, Ph.D.
The first full day of the conference was a big one for Mayo Clinic fellows. Being around 20,000 of your peers can be overwhelming and exciting at the same time.
Monday was the day when AACC celebrated the future of laboratory medicine with the Student Research Awards Contests. These events, which highlight research by students, offer presentations in oral and poster formats. The oral presentation contest featured presentations from the four students who received the highest scores in the preliminary judging phase. In the poster contest, the remaining students discussed their posters. Students competed for cash awards as they are judged on scientific content, originality, and presentation skills.
Mayo Clinic swept several awards at this year’s student contests! We are very proud! Two out of four oral presentations in the Student Contest granted John Mills, Ph.D., and Jeff Meeusen, Ph.D., first and second place, respectively.
John Mills presented results from his work on Monitoring Minimal Residual Disease in Multiple Myeloma using Time of Flight Mass Spectrometry, and judges were very impressed with the revolutionary potential of the technology. Dr. Murray, Dr. Katzmann, and Dr. Barnidge who mentored him should be very proud!
Jeff Meeusen presented a novel equation for calculation of LDL cholesterol, which is slightly more accurate when compared to Friedewald, except when LDL-c is below 70 mg/dL. He analyzed data from 23,000 different patients.
The two amazing fellows became instantly famous and are pictured on today’s Clinical Laboratory News (a publication by AACC Press during the conference), see below!
Additionally, Hema Ketha, Ph.D., and I presented our work in a poster format with 52 other students from all over the world.
Hema Ketha presented an acute case of vitamin toxicity in a neonate, which was considered a hidden gem by our peers and judges! Finally, I presented a laboratory-developed test for antibodies-to-infliximab and its correlation with infliximab concentrations, at the poster contest (I got second place for the work, pretty exciting!) and also at the afternoon symposia on Laboratory Developed Tests.
Mayo Clinic produces high-quality research studies that directly improve and impact patient care, so it felt really good to have the endorsement and recognition of AACC, reinforcing that what we do every day really matters, and we make a difference in laboratory medicine!
Congratulations to my colleagues for their awesome work! I’m honored to work with all of you!
July 29 at 3:18 p.m.
Sixteen Mayo Clinic Posters, One NACB Distinguished Abstract Award
Today at AACC, Mayo Clinic has 16 posters on display in the Tuesday poster session. The poster hall is open until 5 p.m.
Congratulations to John Mills, Ph.D., for receiving one of 34 NACB 2014 Distinguished Abstract Award. His poster was titled, "High sensitivity detection of residual disease in multiple myeloma using mass spectrometry."
July 29 at 1:34 p.m.
July 29 at 12:23 p.m.
Mayo Clinic Alumni Meet Up in the Windy City
By John Mills, Ph.D.
The Mayo Clinic Alumni Association organized a luncheon at the Chicago Firehouse restaurant on Monday at noon. It offered a great opportunity for Mayo clinical chemistry alumni to catch up with old friends. In attendance were:
- Erin Kaleta, Houston Method Hospital
- Allena Ji, Genzyme
- Donald Giacherio, University of Michigan Hospital
- Jeff Meeusen, Mayo Clinic Rochester
- Jonathan Hoyne, Mayo Clinic Jacksonville
- John Black Mayo Clinic Rochester
- Ronald Whitley, University of Kentucky
- Timothy Uphoff, Marshfield Clinic
- Mary Burritt, Mayo Clinic Rochester
- Nichole Korpi-Steiner and husband Josh Steiner, University of North Carolina – Chapel Hill
- Maria Willrich, Mayo Clinic Rochester
- Nicole Tolan, Beth Israel Deaconess
- Melissa Snyder, Mayo Clinic Rochester
- Stephan Grebe, Mayo Clinic Rochester
- Kazunori, Memorial Sloan Kettering
- Daniel Hoefner, Health Diagnostics Laboratory
- Nikola Baumann, Mayo Clinic Rochester
- Linnea Baudhuin, Mayo Clinic Rochester
- Leslie Donato, Mayo Clinic Rochester
- Robert Benirschke, Peoria Tazwell Pathology Group
- Steven Goss, Siemens Health Diagnostics
- John Mills, Mayo Clinic Rochester
- Hema Ketha, Mayo Clinic Rochester
The new clinical chemistry fellowship program director, Dr. Niki Baumann was introduced as well as two new consultants at Mayo Clinic Rochester – Dr. Jeff Meeusen co-director of the Cardiovascular laboratory and Dr. Maria Willrich co-director of the Immunology and Metals laboratories. It was a successful event and we look forward to catching up at the 2015 AACC meeting in Atlanta.
July 29 at 11:22 a.m.
Digitizing the Human Body—“We live in a connective world”
by Hema Ketha, Ph.D.
Dr. Topol, recipient of the AACC 2014 Wallace Coulter Lectureship Award, in his plenary session on Sunday, July 27, 2014 mentioned, “We live in a connective world." Clinical chemists around the world are pushing the frontiers of science.
Eric Topol, M.D., from the Scripps Research Institute, La Jolla CA, highlighted many technological advances that are facilitating improved and more efficient patient care. The introduction of cell phones marked the beginning of an era of technology that is now revolutionizing patient care. He discussed what apps the patients are downloading to guide their own medical care. He presented several examples of “add-ons” for smart phone devices that patients are using for real time tracking their health parameters like blood pressure and glucose so that physicians can manage their care from off-site locations. The iconic “stethoscope” a tool doctors have used for about 200 years will likely be taken over by point of care digital ultrasound devices that can provide detailed information on heart wall activity that the physician can “see” instead of hearing the “lub-dubs.” Another example of change and progress.
He then talked about an omics approach to digitize the human body-encompassing the human phenome to the exposome. Where the phenome can provide digital phenotypic information the exposome can give an insight into how all the omics come together to give immense amount of information about human health and disease. He and his team of researchers at Scripps have developed a micro-chip (a study published in the esteemed journal “Cell”) that can be present inside a patient at a high risk of acute myocardial infarction (AMI) that can predict and alert the patient about an impending heart attack up-to two weeks in advance.
Overall Dr. Topol presented a phenomenal overview of what lies ahead: digital innovations in laboratory medicine that will achieve improved patient care.
July 29 at 10:03 a.m.
Piero Rinaldo, M.D., Ph.D., Delivers Tuesday Plenary Session
On Tuesday morning, Piero Rinaldo, M.D., Ph.D., co-presented the AACC 2014 plenary session, "Newborn Screening For Inborn Errors of Metabolism In the 21st Century." His co-presenter was Kaitlyn Bloom, a Clinical Biochemical Genetics fellow at The Children’s Hospital in Philadelphia.
According to the session overview, "Implementation of newborn screening has affected the lives of thousands of children. Forty metabolic diseases can now be detected at birth; with appropriate treatment, these children can lead a longer and better life." The presentation focused on new world-wide data sets, how result interpretation has improved considerably as the science advances, and the critical role new research will play in the continued advancements in newborn screening. The presentation was capped off by a patient, who described how newborn screen affected her life.
July 29 at 9:33 a.m.
— Mayo Medical Labs (@mayocliniclabs) July 29, 2014
AACC starts today!
By Maria Alice Willrich, Ph.D.
Chicago is welcoming chemists from all over the world this week for the AACC Annual Meeting. For me, it is one of the most exciting times of the year—A celebration of accomplishments and efforts of a year of great work, and networking with colleagues with the same open-mindness. A couple of pre-meeting events were held on Saturday and it was the perfect time to reunite with some of the amazing fellows that have trained at Mayo Clinic.
During the afternoon, the Society for Young Clinical Laboratorians hosted a workshop with thought provoking talks, on how to demonstrate the value of laboratory medicine. During the presentations, an artist was capturing the speaker’s words in print, with drawings on a white board. I’m sharing some of it here, so you can have an idea of the discussions! Dr. Rita Horvarth, from Australia, talked about evidence-based laboratory medicine in action, and walked us through expectations of a laboratory director when asked to develop a new assay by a clinician, for instance, and all the questions that should be asked before engaging in such a project. Clinical utility of the test result to improve patient care is key. Dr. Graham Beastall, president of the International Federation of Clinical Chemistry, enlightened us on how to improve laboratory medicine recognition in the healthcare field, and also to the community in general. Patients are well informed and want to be more involved in their healthcare. Dr. Kent Lewandrowski, from the Massachusetts General Hospital in Boston, talked about the role of the laboratory director in establishing a utilization management program, and shared examples of effective interventions that can improve test utilization, and in the end, during an interactive session with all the participants, we were asked how do we add value to lab medicine with our daily activities. Using SCIENCE as categories, all young clinical laboratorians shared their successes and some of the skills needed to move laboratory medicine forward. More to come!
- Clinical Effectiveness
- Evidence-based laboratory medicine
- Novel Applications
- Cost Effectiveness
- Education of Others
Mayo Clinic Presenters at AACC 2014
Mayo Clinic is well represented at this year's conference. Highlights include Tuesday's plenary session, five symposia presentations, and seven short-course presentations.
NEWBORN SCREENING FOR INBORN ERRORS OF METABOLISM IN THE 21ST CENTURY July 29 | 8:45–10:15 a.m. Piero Rinaldo, M.D., Ph.D.
MEETING THE EXPERT
NEWBORN SCREENING FOR INBORN ERRORS OF METABOLISM IN THE 21ST CENTURY  July 29 | 10:30–11:30 a.m. Piero Rinaldo, M.D., Ph.D.
FORGING A NEW PATH: LAB-DEVELOPED TESTS  July 28 | 2:30–5 p.m. Maria Alice Willrich, Ph.D.
APPROACHES TO MONITOR LOT-TO-LOT VARIABILITY IN THE CLINICAL LABORATORY  July 29 | 10:30 a.m.–Noon Alicia Algeciras-Schimnich, Ph.D.
GETTING, STARTING, AND CHANGING JOBS: A PRACTICAL GUIDE TO TRANSITIONING IN THE REAL WORLD  July 30 | 2:30–5 p.m. Paul Jannetto, Ph.D.
LABORATORY TEST UTILIZATION: LEADING THE CHARGE TOWARDS LAB STEWARDSHIP  July 31 | 9:30 a.m.–Noon Jonathan Hoyne, Ph.D.
CASE STUDIES USING HSCTN ASSAYS  July 31 | 9:30 a.m.–Noon Allan Jaffe, M.D.
RESOLVING ERRONEOUS RESULTS IN THERAPEUTIC DRUG MONITORING AND TOXICOLOGY  July 28 | 10:30 a.m.–Noon Loralie Langman, Ph.D.
SURVIVAL TIPS FOR ADJUSTING TO THE RAPID CHANGES IN LABORATORY MEDICINE  July 28 | 12:30–2 p.m. James Hernandez, M.D.
PAIN MANAGEMENT: ANALYSIS, REPORTING, AND CONSULTING  July 28 | 2:30–5 p.m. Paul Jannetto, Ph.D.
IMPACT OF SAMPLE TYPE ON TEST RESULTS  July 29 | 10:30 a.m.–Noon Leslie Donato, Ph.D.
CURRENT CONTROVERSIES IN THE DETECTION AND MEASUREMENT OF ANTINUCLEAR ANTIBODIES/ UPDATE ON LABORATORY DETECTION OF CELIAC DISEASE  July 29 | 2:30–5 p.m. Melissa Snyder, Ph.D., and Joseph Murray, M.D.
FROM MUNCHAUSEN`S TO THE MORTUARY: LABORATORY ANALYSIS AND BIOCHEMICAL DIAGNOSIS OF ADULT HYPOGLYCEMIA  July 29 | 2:30–5 p.m. Loralie Langman, Ph.D.
LABORATORY-DRIVEN TESTING ALGORITHMS: A STRATEGY TO IMPROVE ORDERING ACCURACY, EFFICIENCY, AND UTILIZATION  July 30 | 2:30–5 p.m. Melissa Snyder, Ph.D.; Paul Kurtin, M.D.; Bobbi Pritt, M.D.; and Paula Santrach, M.D.
BROWN BAG SESSION
EXTREME SPORT FOR THE LABORATORY: CHANGING METHODS FOR THE ACTIVATED CLOTTING TIME  July 30 | 7:30–8:30 a.m. & 12:30–1:30 p.m. Lori Sorenson