By: Bobby Boyanton, M.D. and Barbara Robinson-Dunn, Ph.D., D(ABMM)
In Southeast Michigan, respiratory virus season usually begins in October and lasts through April. During these months, a number of different viruses are responsible for respiratory disease. The most significant of these are influenza and respiratory syncytial virus (RSV), but others such as parainfluenza, rhinovirus, adenovirus, and human metapneumovirus can also cause significant disease. In general, these viruses cause a clinical syndrome termed “influenza-like illness” due to overlapping symptoms (fever, cough, headache, sore throat, fatigue, possibly muscle aches).
The laboratory plays a critical role in obtaining an accurate diagnosis, but this is dependent upon testing strategies. It is common practice to use rapid antigen tests to diagnose influenza and RSV; however, peer-reviewed literature demonstrates this method to be unreliable. As such, false negative test results lead to adverse outcomes, including inappropriate use of antibacterial antibiotics, inability to institute infection control measures and potential spread of disease through healthcare facilities and the community.
In an effort to provide the most accurate testing strategies available, Beaumont Laboratory offers the following testing options:
New molecular test that is replacing rapid antigen testing this year:
- Rapid influenza & RSV by PCR:
- Detects and differentiates influenza A, influenza B, and RSV from nasopharyngeal swab specimens.
- Can be performed in about 90 minutes.
Other well-established tests:
- Respiratory Virus Panel by PCR:
- Detects and differentiates influenza A (with sub-typing), influenza B, RSV, rhinovirus, parainfluenza, adenovirus and human metapneumovirus from nasopharyngeal swab specimens.
- Can be performed within 48 hours.
- Viral culture:
- Detects and differentiates influenza A, influenza B, RSV, parainfluenza, and adenovirus from any type of respiratory specimen. Because this is a culture-based approach, final results may not be available for several days. Viral culture testing can determine exactly which viruses (A, B, or another respiratory virus) and which strains of virus are present.
- Can be performed within 72 hours in most cases.
By: Dr. Amro Almradi
Being a son and a grandson of two great pathologists had a big influence on me and has helped me develop the passion that I have for this specialty. After graduating from medical school, I planned to travel to the United States and participate in medical research dealing with topics related to the basic sciences with clinical correlations before starting my residency. I was lucky to have the chance to work and rotate in both departments of clinical and anatomic pathology at William Beaumont Hospital. After spending several months here, choosing Beaumont Laboratory for my residency was an easy decision.
At Beaumont, I am challenged intellectually. I have a hands-on role in the lab. It is a distinguished program that offers a high level of training by experienced and very kind pathologists. I have reasonable work hours and my residency in the great community of Royal Oak, Michigan, allows me to live a comfortable lifestyle close to my family.
There are a lot of pathology residency programs out there, but the Beaumont Laboratory program has been exactly where I want to stay for at least four years of my life.
By: Dr. Jacqueline Macknis
Many pathology residents have already begun to prepare for the American Society for Clinical Pathology’s annual RISE exam, which will be administered March 15–28, 2014.
The RISE is a comprehensive evaluation tool that can be used to assess progress in all aspects of one’s training. All residents in all years of residency training take the examination annually. Residents are scored in relation to their peer group (PGY level) and an overall percentile is given. Individual score and percentiles are also given for each subspecialty area of pathology. This helps residents assess and track their training and knowledge based. In addition, the RISE assists program directors in evaluating the training program curriculum.
Used by various international and all of the U.S. pathology residency programs, the exam comprises more than 350 multiple choice questions, many with both gross and microscopic images. It tests on all areas of both clinical and anatomic pathology.
Because the RISE is a critical tool to help address medical knowledge strengths and areas for improvement in resident performance, Beaumont Laboratory works closely with our residents to help prepare them for the exam. We offer conferences and lectures, as well as hands-on training and assignments that position our residents to succeed on this examination. We also provide time to study and our dedicated staff is available to our residents who ask for additional one-on-one assistance. That’s one of the benefits of our intimate training program at Beaumont. I am proud of our residents in saying that our overall percentile for our training program for the 2011 RISE examination was the 85th percentile - that is top 15% of all programs in the country! Half of our residents scored at the 90th percentile or greater, with 2 residents at the 99th.
Here are a few more preparation tips, which are helpful for RISE or any other pathology exam:
1. Create a study calendar far enough in advance and stick to it.
2. Find study partners who you can study with without getting distracted.
3. Don’t just go through your notes, re-read them and rewrite them.
4. Take frequent breaks to recharge.
5. After studying for a while, reward yourself by going on a walk to clear your mind, chatting with friends, etc.
6. Use multiple methods - reading textbooks, reviewing notes, flashcards, reviewing images, do old test/practice questions.
By Dr. Ann-Marie Blenc
A hematopathologist is a pathologist that specializes in the analysis of hematopoietic cells to detect diseases. Hematopoietic cells originate from the bone marrow and contribute to the cellular components of blood including red blood cells (erythrocytes), white blood cells (leukocytes), and platelets (megakaryocyte-derived bodies).
In the laboratory, the hematopathologist views samples (blood, bone marrow aspirates and biopsies, and lymph nodes biopsies) on slides under a microscope, and uses ancillary testing such as flow cytometry, cytogenetics and molecular analysis to aid in the diagnosis. A flow cytometer separates, counts and identifies cellular components of these specimens. Using laser light, the flow cytometer reveals individual particles, and the hematopathologist determines if any cells appear abnormal which could indicate disease. With the findings of their analysis, hematopathologists then submit a report to the physician who requested the tests. While the physician makes the final determination of how to treat the patient based on the pathologic findings, the hematopathologist can advise on the severity of a condition including prognosis, and suggestions for the best course of treatment based on his or her expert knowledge of blood diseases. Common diseases include leukemia, lymphoma, myeloproliferative neoplasms (MPNs), myelodysplastic syndrome (MDS), anemia and plasma cell disorders.
Hematopathologists are required to earn a Doctor of Medicine degree from an accredited four-year medical school and complete a four-year residency program, as well as a 1-2 year fellowship in hematopathology. Hematopathology is a subspecialty certified by the American Board of Pathology.
By: Dr. Mark D. Kolins
Beaumont Laboratory offers postdoctoral candidates a variety of challenging and rewarding fellowships in highly specialized areas. As a fellow at Beaumont, you’ll receive a level of personal attention and guidance from our world-class faculty simply unmatched by those of other programs. Each of our four fellowship programs provides an outstanding educational experience to expand expertise and facilitate career development.
Our leading-edge learning environment was designed with you in mind and will help you reach your full potential through the industry’s latest technology, and best practices, and give you the knowledge and experience you’ll need to excel in your field and prepare you for a leadership role in pathology medicine. Our pathology fellowships, accredited by the Accreditation Council for Graduate Medical Education, include:
As a Beaumont Lab fellow, you will gain an in-depth understanding of a highly specialized area of your choosing, and will be prepared for a successful, rewarding career in the pathology field with improved job security.
On behalf of our team and Beaumont Health System, I thank you for taking the time to learn more about our fellowship programs; we look forward to seeing you at the lab!
By: Dr. Mark D. Kolins
Direct-to-consumer genetic tests that are marketed directly via television, print ads, or the Internet have opened a new debate in the medical field. The American Medical Association is calling on the Food and Drug Administration to regulate genetic tests that are sold directly to consumers, saying the tests need to be conducted under the guidance of a physician or another expert.
Traditionally, genetic tests have been available only through healthcare providers such as physicians, nurse practitioners and genetic counselors. Healthcare providers order the appropriate test from a laboratory, collect and send the samples, and interpret the test results. But the at-home tests provide access to a person’s genetic information without necessarily involving a doctor or insurance company in the process.
The American College of Medical Genetics says a knowledgeable professional should be involved in the process of ordering and interpreting a genetic test. Genetic testing is highly technical and complex. A genetics expert such as a certified medical geneticist or genetic counselor can help the consumer determine, for example, whether a genetic test should be performed and how to interpret test results in light of personal and family history.
The patient should be fully informed regarding what the test can and cannot say about his or her health. Genetic testing provides only one piece of information about a person’s health. Other genetic and environmental factors, lifestyle choices, and family medical history also affect a person’s risk of developing many disorders. These factors are discussed during a consultation with a doctor or genetic counselor, but in many cases are not addressed by at-home genetic tests. More research is needed to fully understand the benefits and limitations of direct-to-consumer genetic testing.
The growing market for direct-to-consumer genetic testing may promote awareness of genetic diseases, allow consumers to take a more proactive role in their health care and offer a means for people to learn about their ancestral origins. But without guidance from a healthcare provider, consumers may make important decisions about treatment or prevention based on inaccurate, incomplete, or misunderstood information about their health.
As one of the first molecular pathology laboratory centers in the country, Beaumont’s five accredited molecular pathology laboratories continue to expand services and use state-of-the-art molecular genetic analysis for the detection of various disease states. When molecular diagnostics was still an emerging field, Beaumont Laboratory recognized that building strong partnerships between the anatomic and clinical laboratories would foster cutting-edge and clinically relevant molecular test development. As the field continues to expand, we’ve put a focus not only on technology, but also on medical expertise and quality. It’s the combination that’s setting our labs apart.
With a quality management program, performance improvement program, competency assessment program, laboratory medical director oversight, a bar-code tracking system for specimens and additional structures and procedures, Beaumont’s molecular pathology laboratories are strongly focused on quality assurance.
We understand the critical components of molecular patient testing, from a primary care physician’s needs to the dynamic environment of hospital-based testing. Our medical directors are available for pre- and post-test consultations to communicate directly with hospitals, medical centers, physicians and other health care professionals.
Our molecular tests assist in:
- Evaluation of genetic risk factors for cardiovascular diseases
- Diagnosis infectious diseases
- Identification of inherited disorders
- High complexity specialty molecular tests for solid tumors
- Molecular testing in leukemia, lymphomas,myeloproliferative neoplasms and myelodysplastic syndromes
- DNA testing for both congenital and inherited cancer syndromes
- Molecular cytogenetic analysis for prenatal aneuploidy detection
- Individualizing drug therapies based on pharmacogenomics testing
- Cross-match testing aiding in determining organ recipient donor compatibility
- Genome-wide analysis of DNA copy number changes for hematolymphoid disorders
- Detection of chromosome abnormalities associated with microdelection/microduplication syndromes
In addition, as a leader in molecular pathology research, the lab sponsors the Annual Molecular Pathology Symposium on Clinical Applications of Genomic Medicine each fall for physicians, residents, scientists, technologists, bio-scientific staff who practice in the fields of clinical pathology, hematology/hemostasis, infectious diseases, microbiology, molecular pathology, oncology and toxicology. Our most recent symposium featured sessions on advances in molecular medicine, molecular oncology and hematology, neurogenomics and molecular microbiology.
The molecular labs are accredited by the American Association of Blood Bank (AABB); American Society for Histocompatibility and Immunogenetics (ASHI); The College of American Pathologists (CAP); Approved Children’s Oncology Group protocols (COG); U.S. Food and Drug Administration (FDA); and the Molecular Center of Excellence (MCOE).
In the United States, respiratory virus season usually begins in October and lasts through April, although regional variation does occur. During these months, a number of different viruses are responsible for respiratory disease. The most important of these are influenza and respiratory syncytial virus (RSV), but others such as parainfluenza, rhinovirus, adenovirus and human metapneumovirus can also cause significant disease. In general, these viruses cause a clinical syndrome termed “influenza-like illness” due to overlapping clinical signs and symptoms (fever, cough, headache, sore throat, runny nose, fatigue, possibly muscle aches).
Influenza moves rapidly throughout the population each winter, causing more than 20,000 excess deaths, principally in the elderly, the immunocompromised, and in patients with chronic lung or kidney conditions. A patient might pass on the virus to someone else before they know they are sick, as well as while they are sick. The incubation period is 18-70 hours. Patients are infectious one day before the onset of symptoms and for 3-4 days thereafter.
According to the (CDC) Most experts believe that flu viruses spread mainly by droplets made when people with flu cough, sneeze or talk. These droplets can land in the mouths or noses of people who are nearby. Less often, a person might also get the flu by touching a surface or object that has flu virus on it and then touching their own mouth, eyes or possibly their nose.
Physicians should consider diagnostic testing for early identification of influenza in patients and infection control.
By: Amy Karle, MT (ASCP)
Medical laboratory scientists are an integral part of the laboratory team. These professionals perform tests to diagnose disease, screen for malignancies or other pathologies, perform assays in which may determine a patient’s prognosis, as well as perform tests in which monitor patients during treatments. For these reasons and many more, medical technologists play a key role in the clinical outcome of patients. It’s a highly technical job that demands strict attention to detail, as accuracy and timeliness are paramount.
Medical laboratory scientists work in clean, safe and well-lighted laboratory settings and are often on their feet most of the day, working with computers, microscopes, a large variety of blood analyzers and other sophisticated equipment. They wear protective masks, gowns, gloves, and goggles to ensure their own safety from potential specimen biohazards as well as to prevent contaminating the specimens. On a typical day, a medical laboratory scientist will perform quality control measures on the lab equipment; ensure that all specimens are properly labeled and processed; analyze samples; and evaluate results.
This job tends to be high-paced and requires a lot of multi-tasking. Most labs run on multiple shifts, so work hours may vary. Depending on the lab, a medical laboratory scientist might perform tests in a variety of areas, or they might have an area of specialization. Some medical laboratory scientists may have supervisory roles assisting in the management and budgets of the laboratory. Others may have a role as a lead technologist acting as a go-to person that is well equipped to assist those in the department with difficult questions or troubleshooting instrumentation.
The outlook for this career is positive. Employment for medical laboratory scientists is expected to grow faster than average through 2014 as the volume of laboratory tests increases with population growth and advancements in medical technology.
Explore your educational and career opportunities as a Beaumont medical laboratory scientist. want more information visit here now!
By: Dr. Bobby Boyanton
There are numerous factors that contribute to the successful training of residents in anatomic and clinical pathology. These include dedicated and engaged teaching staff, diverse teaching modalities (didactics, conferences, etc.), review courses, structured rotations, and immersion into every aspect of pathology.
At Beaumont, we are fortunate to have all of these qualities in our training program.
Our laboratory performs nearly 10 million routine and esoteric laboratory tests, originating from our tertiary-care teaching hospital, 25 local hospitals and about 1,600 physician offices in southeast Michigan. This allows our residents to be exposed to cases/specimens displaying the full spectrum of pathologic processes.
As leaders in laboratory medicine, Beaumont is afforded access to cutting-edge, state-of-the art equipment, technology and testing modalities. We engage in numerous translational research endeavors to strengthen our diagnostic testing arsenal. We truly strive for excellence in patient care, while simultaneously training our residents to be future leaders in laboratory medicine. From the routine to the esoteric, Beaumont Laboratory has expertise in every facet of anatomic and clinical pathology.