PATH News Network Daily Edition

Pathologist Shares Journey Establishing Pathology Program in Malawi

• College of American Pathologists

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SPEAKER_00

Building a pathology practice in Southeastern Africa. A CAP member shares how his journey began. Plus, fun, sun, and small group learning with experts, an inside look at pathology in the park. This is the Path News Network Daily Edition from the College of American Pathologists. I'm Elizabeth McMahon. It's Thursday, May 14th. Your lab may have all the equipment, assays, and technology you need to do your work, but imagine building a pathology lab from scratch in a country where most people live on less than $3 a day. It's an enormous challenge that Dr. Yuri Fedoriou and a team at the University of North Carolina Chapel Hill took on in 2011 in Malawi, where there is about one doctor per 2,000 people. More than a decade later, the program is thriving. It supports diagnostics for general clinical care and cancer research, among other programs. Dr. Fedoriou will share his journey at CAP 26 on October 5th in Las Vegas. His lab is now a cornerstone of cancer care and a model for research programs across the region, but it wasn't an easy start. In Malawi, about 70% of adults who enter a hospital for treatment are HIV positive, a number that's rising partly due to population growth. The persistent levels of HIV are fertile ground for the development of HIV-related and associated cancers, such as lymphoma. That reality drove Dr. Fedoriu and his team to start a major study to understand lymphoma types and track patient outcomes.

SPEAKER_02

That's the beginning of that kind of pathology infrastructure. It was meant to essentially provide a framework for us to be able to treat people with lymphoma. And the chemotherapy and therapies available for cancers are therapies for cancers are available as they are. The cytotoxic chemotherapy is relatively inexpensive. And so it it was by far and still to this day, the biggest cost is the diagnostic cost.

SPEAKER_00

Stay tuned for more of the conversation with Dr. Fedoriu in coming weeks. You can register for CAP 26 under the events tab on the CAP homepage. Hospital-based shootings in the U.S. have increased steadily over the past 25 years, but a third were preventable. That's one of the takeaways from a new analysis of hospital shootings in 47 states in Java Network Open. Large hospitals, those in urban settings and those in the South, saw the most incidents. In their analysis, researchers from the Mayo Clinic focused on screening as a potential solution. Many perpetrators entered facilities unimpeded while carrying firearms in holsters or bags. In recent years, workplace violence in healthcare settings has been an increasing focus in state legislatures with 45 states enacting laws that penalize perpetrators. Peter Satera said it best in the 1980s song by Chicago. Everybody needs a little time away. Those lyrics apply to pathologists too, and from July 15th to 17th, CAP members can take a little time away and throw in some learning at Disney's Boardwalk Inn in Florida. Pathology in the Park is a balanced blend of CME learning and leisure at Walt Disney World with time for family fun and expert-led sessions that will deepen your expertise. One of those experts is Dr. Atur Singhi of the University of Pittsburgh Medical Center. He says the sessions tackle some of the most challenging but relevant diagnostic scenarios that pathologists face in their practice.

SPEAKER_01

I'm personally presenting four sessions with each one addressing really those cases that keep you up at night, I guess. You know, the pancreas finetal biopsies where you have three tiny fragments and the gastrologist needs to know if it's cancer or in this case pancreatitis. Um bile duct biopsy where you're trying to distinguish between reactive atypia from an early, you know, cancer itself, especially in a PSE patient, where there's just limited material, tons of inflammation in the background, which is one of the most challenging things to deal with, but a very real-world high-stakes scenario in general.

SPEAKER_00

All sessions are in the morning, leaving plenty of time for the park and pool in the afternoon. Dr. Singhi says the format also allows for plenty of questions and participation.

SPEAKER_01

One of the nice things about having the format that we have is a small group session where we can kind of go through, you know, different scenarios. In contrast, where you have 50 or 100 people in a lecture hall, pathologists often hesitate to ask, okay, what do you do when you have a KI67 that's borderline between grade 2 and grade 3? Or I have a bile duct case that has small scant groups of atypical epithelium, and I really don't know what to do next. Should I order some stains?

SPEAKER_00

Explore the pathology in the park agenda and the daily sessions by following the link on the CAP homepage. And finally, there are new insights on cancer from researchers who are engineering tumors in the lab. For cancer to grow, cancer cells connect to tissues and increase the amount of the protein collagen to create a scaffolding. This scaffolding determines how the cancer cells push or pull on their surroundings and how drugs get into the cancerous tissue. Scientists long assumed that more scaffolding made tumors stiffer, but a new study from engineers growing tumors in labs at the University of Illinois found that higher amounts of scaffolding proteins actually made the tissue softer. The results, published in the journal Octa Biomaterialia, have implications not only for tumor research in the lab, but also provide insights for improving drug delivery to tumors. That's all for today's daily edition. Be sure to check the show notes for more information on today's stories. Got a story you'd like us to cover on the daily edition? Write to us at stories at cap.org. We're back at 5 a.m. Eastern for another episode of the Daily Edition. I'm Elizabeth McMahon. Have a great day.