Automated Lab relies on robotics

An automated lab employee checks specimens as they run through
the MPA.

In 1997, The Medical Foundation was the first laboratory in the United States to install the Clinical Laboratory Automation Systems (CLAS) robotics system enabling the process of automating specimen testing. It was a process, according to the Director of General Laboratory Operations, Brett Colter, that allowed the Foundation to centralize a large portion of testing which made it more efficient, eliminated redundant equipment, and lowered labor costs.
The robotics system, which was upgraded to the Roche Modular Pre-Analytic (MPA) in 2008, is the current system that is used to process approximately 2,500 to 3,000 specimens daily. 
“This system takes up about 25% of the space the old system used to take. It has a lot more logic function that can handle more algorithms for handing specimens.  It also has a higher capacity and is much faster,” said Colter.
The MPA system is housed in The Medical Foundation’s Automated Laboratory on Lafayette Boulevard in South Bend.  The automated lab is focused on very high volume, common laboratory tests. A lot of routine screening tests are run through the automated lab which is designed to move specimens through quickly by using the robotics which has a lot of algorithms and decision logic in the software which can quickly identify specimens with abnormal results. Those specimens are then isolated and are investigated by Foundation employees.
A lot of automated laboratory processes in the pre-analytic processing system also take place in the automated lab such as the splitting of samples so they can be divided into a number of tubes and routed automatically through the processing center for additional testing.
“We keep about 40,000 samples in our archive at any given time.  We have an automated tracking system to find those samples so when we do have an add-on test, we can decide very quickly if we have enough of the sample and the right sample before any additional blood is taken from the patient.
Also housed near the Automated Lab is the Manual Lab at the Foundation.  This area is where more esoteric testing, lower volume testing takes place.  These tests are done at individual instruments and are usually done in batch testing.  Approximately 250 tests are done on the automated side and about 250 tests are done on the manual side. 
The Medical Foundation is a leader in laboratory medicine and has been on the cutting edge since it began in 1912.  With the use of robotics and the knowledge of our laboratory experts, we’ll continue to process specimens needed for physicians to make educated decisions pertaining to the clients we serve.

Shedding light on the importance of Vitamin D

Over the last few years you may have heard some buzz about Vitamin D.  Although you may have heard bits and pieces, and you obviously know there is such a thing as Vitamin D, do you know its benefits? How much you should have on a daily basis? Read on to find out why Vitamin D is such a hot topic.

Vitamin D is needed in your body for the regulation of the minerals calcium and phosphorus.  Having the proper amounts of Vitamin D in your system is important because it has proven to aid in preventing the weakening of bones, bone loss and low calcium.

It can also be used to help conditions such as high blood pressure, high cholesterol, diabetes, obesity, weak muscles, multiple sclerosis, rheumatoid arthritis, asthma, and even tooth and gum disease. 

So how much Vitamin D is enough? And where does it come from? The recommended dietary allowance for vitamin D is 600 IU (international units) per day for adults up to age 70. Adults above the age of 70 should aim for 800 IU daily.  Amounts for children and newborns vary and can be viewed here.  Those of us in Indiana during the winter may be a bit lacking as far as receiving natural Vitamin D lately, because the sun hasn’t been shining very much!   Experts for vitamin D is 600 IU suggest that if you can tolerate two 15 minute sessions of sunlight each week, it will be enough natural Vitamin D from sunlight.

There are also several foods which include Vitamin D.  These include: some fish, fish liver oils, egg yolks, and fortified diary and grain products. 

So if you are one of those people who isn’t in the sun very much, suffer from milk allergies and are on a strict vegetarian diet, you might be Vitamin D deficient. But how can you be sure?

Although there are some warning signs for people who are lacking in Vitamin D, such as bone pain or muscle weakness, blood tests can tell you for sure if you are deficient.

The Medical Foundation offers the two most common types of Vitamin D testing: Vitamin D, 1,25-Dihydroxy and Vitamin D, 25-hydroxy, total.  Vitamin D undergoes two hydroxylations in your body for activation.  The first is in the liver where it is converted to Vitamin D 25-hydroxy.  The second occurs in the kidney and creates Vitamin D, 1, 25-hydroxy.  The concentration of Vitamin D 25-hydroxy is the best indicator of your Vitamin D status.  It reflects the amount of Vitamin D produced and obtained by your body.  However, this test does not indicate the amount of Vitamin D stored in your body’s tissue.  To see how much is stored in your tissue, opt for the Vitamin D, 1, 25-hydroxy, which is a better indicator.

Although it is still a little too soon to tell and further studies are being conducted, it is thought that maintaining adequate Vitamin D levels will reduce the likelihood of colon cancer and may help to prevent both breast and prostate cancer. It has also been associated with boosting the immune system and preventing autoimmune disease.

While it may seem as though the benefits far outweigh the negatives associated with Vitamin D, more isn’t necessarily the best option.  Rather, too much Vitamin D can damage blood vessels, causing damage to the heart and kidneys.

So as the snow flies throughout the Midwest and Vitamin D from the sunshine is a little less than preferred, let your ears perk up next time you hear some buzz about Vitamin D.  And if you want to be sure you are getting all the benefits from this wonderful mineral regulator, consult your physician about ordering labs to keep tabs on your Vitamin D.  

Without a doubt, gout causes pain for many

Have you ever felt like a jackhammer was trying to break apart your big toe? Or maybe you’ve felt like you have walked across a bed of hot coals with bare feet.  If you’ve experienced this type of pain, you may have experienced Gout.

Gout is caused by high levels of uric acid in your blood.  The excess uric acid forms crystals in the joints of the body which cause them to become inflamed with swelling and tremendous pain.

These flares of gout can come quickly and often begin throughout the night, causing the affected area to become red, swollen, hot and tender.

While 76% of those with gout experience pain in their big toe, gout also affects other areas.  Statistics from gout experts claim that 25% experience gout in a finger, 10% in the wrist, 50% in the ankle or foot, 10% in the elbow, 32% in the knee and 11% claim that they have pain in more than one joint location. 

If you are a child or a young adult, there’s good news. Gout usually doesn’t prey upon you!  Rather, the inflammatory arthritis typically affects men over the age of 40, women who are post-menopausal, and those who have a genetic link of gout in their family.

In addition, people with certain conditions such as diabetes, high cholesterol, high blood pressure and/ or other kidney problems are typically at a higher risk for gout.

Although some people think that diet has a huge influence as to whether or not someone gets gout, that isn’t exactly true.  Instead, certain foods tend to trigger bouts with gout once a person has already been susceptible to getting it. Therefore, diet can be an important aid in managing gout.  Approximately 10% of people with gout produce too much uric acid and approximately 90% of people with gout have kidneys that are not able to eliminate the acid.

Below is a table of foods that tend to trigger gout flares.

 

Other ways to lower the possibility of experiencing gout flares are to maintain a healthy weight, exercise regularly, drink lots of water and add low fat dairy items to your diet.  Also, try and keep your uric acid levels under 6 mg/dL. 

There are four basic stages of rout.  The first stage is when someone has high levels of uric acid without any symptoms.  Although not everyone with high levels of uric acid will experience gout, those who do usually have high levels for many years without having a flare. 

The second stage is when you have a gout attack.  This occurs when the excess uric acid forms the crystals in the joints which causes inflammation and swelling. The bad news is that once you experience gout, flares will die down and become dormant, but 78% of gout sufferers will have another flare within 6 months to 2 years after their first bout.

Stage three is that period of time between gout flares.  As long as you have high uric acid, even though you might not be experiencing a flare, you still have gout. 

The final phase is referred to as, “chronic tophaceous gout.”  This is the most debilitating phase which can lead to joint damage and deformity of the joints if left untreated.  This happens after several years of suffering.

The Medical Foundation offers both urine and blood testing daily for uric acid.  This non-fasting test is used in the diagnosis and treatment of renal and metabolic disorders, including renal failure, gout, leukemia, psoriasis or starvation.   

Are you heart healthy? February is American Heart Month!

For some people, the image of a heart seen during February symbolizes Valentine’s Day.  For others, it symbolizes American Heart Month.

Approximately 715,000 Americans have heart attacks each year, while 600,000 die from heart disease.  That’s an astounding 1 in 4 people and accounts for the leading cause of death among both men and women. 

Although those numbers are shocking, there’s hope! Prevention plays a huge role in combating heart disease.  Monitoring cholesterol levels can prevent stroke and heart attacks.  According to the National Cholesterol Education Program (NCEP), guidelines urge people over 20-years-old to have a fasting lipid panel which includes HDL, LDL and triglycerides every five years.  This test requires the patient to fast between 9-12 hours beforehand.

The HDL removes cholesterol from the bloodstream and artery walls and is often referred to as, “the good cholesterol.”  The LDL deposits cholesterol in the artery walls, which help build plaque and if often referred to as, “the bad cholesterol.”  Triglycerides are stored in fat cells and are used for energy.

If you are a blood donor at The Medical Foundation, you have had a non-fasting total cholesterol.  This test is made up of both the HDL and LDL levels plus 20% of the triglyceride levels.  The cholesterol levels are available to each blood donor and are free of charge.  If you would like to make an appointment to donate blood click here.

For non-fasting cholesterol tests, results should fall within these guidelines:

Less than 200 mg/dl is desirable lessens the risk of heart disease
200-239 mg/dl is borderline high
240+ mg/dl is high blood cholesterol

Along with monitoring your cholesterol, experts recommend that to decrease your risk of heart disease or heart attack, you should refrain from smoking, eating foods high in saturated or trans fat and participate in a minimum of 30 minutes of physical activity five days a week.

A heart attack happens when blood flow that brings oxygen to the heart muscle is severely reduced or stopped.  This happens because coronary arteries become thicker and harder from a buildup of fat, cholesterol, and other substances called plaque.  If the plaque breaks open and a blood clot forms that blocks the blood flow, then a heart attack with occur.

There are a few signs or symptoms that may be present when a person is having an actual heart attack, but they can be different for men and women. According to the American Heart Association, some symptoms may include chest discomfort in the center of the chest which lasts more than a few minutes or goes away and returns.  Other symptoms include discomfort in one or both arms, back, neck, jaw, stomach, shortness of breath, cold sweats, nausea or lightheadedness.

“Twenty percent of women have different symptoms than men,” said Marianne Legato, MD, Gender Medicine. “Men often refer to the elephant on the chest, pain radiating down one arm.  One in five women feel indigestion, shortness of breath and or nausea.”

There are several events in the Michiana area that both men and women can take part in to learn more about being heart healthy. 

The Elkhart County Go Red for Women Affair in Red will host a Women’s Heart Health Expo, Doctors and Style Show on Thursday, February 27^th from 5pm until 8pm at the Lerner Crystal Ballroom in Elkhart.  For more information click here.

The St. Joseph County Go Red For Women Lifestyle Forum and Luncheon will be held on Thursday, May 8^th at the Morris Inn Ballroom at the University of Notre Dame.  For more information click here.

Although patients may feel some of the warning signs leading up to a heart attack, there aren’t too many signs ahead of time.  Blood can offer many clues about your heart health.  High levels of “bad cholesterol” or LDL can lead to an increased risk of heart disease. 

Blood tests to consider having completed are High Sensitivity C-Reactive Protein which measures CRP, a protein in the blood that is a strong indicator of inflammation throughout the body.  When plaque injures blood vessels, it triggers inflammation and CRP levels in the body.  Women with high CRP levels are four times more likely to suffer from cardiac problems.  This test is recommended by the American Heart Association for those with a known risk and not just the general public.  This test along cannot indicate heart risk, but with aid in conjunction with other tests.

A test for Fibrinogen measures the protein in your blood that helps it to clot.  Too much can cause a clot to form in an artery which could lead to heart attack or stroke.

A blood test called Homocysteine detects a substance your body uses to make protein and build and maintain tissue.

All of these blood tests are available at The Medical Foundation. Remember, prevention is the key to avoiding a heart attack and heart disease.

 

Visit our patient service center at the University Commons Medical Plaza

In September of 2011, The Medical Foundation opened the doors of suite 410 at the University Commons Medical Plaza located at 6301 University Commons Drive.
Unlike the other Medical Foundation locations, this site implemented a process which eased the process for elderly patients by combining the registration and drawing process in one room.
“At the University Commons location, the patient is brought into one room where they are registered and drawn by the same phlebotomist.  It means less movement from one room to another for each of the patients, while it also allows the patient to interact one-on-one with the same phlebotomist,” said Connie Bratton, Manager of Patient Services for The Medical Foundation.
The location, which is conveniently located in the University Medical Plaza, is a short walk from several medical offices in the plaza and currently serves approximately 70 patients each day.  Hours of operation are Monday – Friday from 7:30am until 5pm and the office is closed daily from 1pm until 2pm. 
For the many patients who are fearful of needles or just not sure what to expect, the friendly faces at the University Commons Lab are sure to put you at ease.  Mary, Barb and Laura have 53 years of experience collectively as phlebotomists with the Foundation. 
“I really enjoy waiting on the patients and talking to them about their jobs or their families. Many of them come in on a regular basis and we get to know them on a personal level,” said Barb, a phlebotomist at the Foundation for the past 13 years.
“We work hard to interact with patients and put their minds at ease, while maintaining a quick turn-around –time for patients, because we know that everyone has a schedule they try and keep, whether they need to get back home or back to work,” said Laura. The Foundation doesn’t accept appointments, all lab work is completed on a first come, first serve basis.
So if you’re nervous, don’t be, because the phlebotomists have experience drawing roughly 70 patients a day and have been with the organization for many, many years.

February 4th is World Cancer Day!

It seems as though the perception of cancer in the United States has changed over time. What used to immediately be thought of as a death sentence, now seems to be something maybe people approach head on with the thought that they can beat it. But that isn’t the case everywhere in the world.

World Cancer Day has been celebrated since 2005 when it was introduced by the International Union Against Cancer. Since then, each year the group has brought awareness and education around the world to those with and without cancer.

This year, the organization is working to “Debunk the Myths” of cancer by focusing on four myths they feel need to be debunked!


The first myth is, “We don’t need to talk about cancer.” The truth is: although cancer may be a difficult topic to address, particularly in some settings or cultures, dealing with the disease openly can improve outcomes at an individual, community or policy level.


Along with a cancer diagnosis comes a lot of emotion and talking with loved ones or friends may help to alleviate some of the emotions and concerns. In some settings, cancer may even be thought of as taboo, or have a stigma attached. This type of taboo may even lead some people to shy away from methods of cancer prevention or early detection.


Open lines of communication may make tackling cancer easier on the person with the cancer and the person or people taking care of him/her. This type of communication should include feelings about finances and employment, establishing some sort of routine or stability and feelings about body image. For some men and women, especially those with breast and testicular cancer, emotions can be extra sensitive when having discussions with a partner. It’s important to have those hard conversations about cancer and emotions.
The second myth is, “There are no signs or symptoms of cancer.” The truth is: for many cancers, there are warning signs and symptoms and the benefits of early detection are indisputable.


Although not all cancers have notable warning signs, many do such as breast, oral, skin, cervical, colorectal and some childhood cancers. Education is the key to early detection, especially in low resource settings.

The Michiana region has several screenings available for people who qualify in the community. For example, if you are in need of a mammogram and are unable to afford one, the Secret Sisters Society has developed a program for women, age 40-49 for a free screening. They also offer many support groups and offer other resources for prevention and healing.
RiverBend Cancer Services located at 919 Jefferson Boulevard in South Bend, offers support services, financial services, nutrition counseling and other wellness tools. They are also instrumental in cancer screening services with free PSAs for men at their Touch Base at the Cove event each summer.

For more information about types of cancer screening, visit the National Cancer Institute website for recommendations.

The third myth is, “There is nothing I can do about cancer.” The truth is: there is a lot that can be done at an individual, community, and policy level, and with the right strategies, a third of the most common cancers can be prevented.


Promoting healthy lifestyles is very important to the prevention of cancer. The conditions, such as a smoke free workplace, healthy options in the lunchroom or vending machines, discouraging the use of alcohol and promoting physical activity, help influence health and the quality of life. According to the myth busters, tobacco use is the most common risk factor and is estimated to kill 1 billion people in the 21st Century. Other known high risks are obesity and prolonged exposure to UV light.


The fourth myth is, “I don’t have the right to cancer care.” The truth is: all people have the right to access proven and effective cancer treatments and services on equal terms and without suffering hardship as a consequence.
This way of thinking seems to be the belief of people in low resource areas and is sometimes attributed to a lack of education and/ or thoughts that their cancer is not curable. Over 85% of the 275,000 women who die each year from cervical cancer are from third world countries. Often times, poor and vulnerable populations are not able to afford the cost of prescriptions and other cancer treatments.


While these myths may be geared a little more to third world countries and their awareness of cancer, these myths are important to be aware of and to remind each other that talking about cancer is therapeutic for those suffering and those caregivers who are supporting them.

As we stay aware of cancer and its impact on people, it’s interesting to take a look at some cancer statistics in the United States.

In 2010, the top 10 cancers affecting men of all races are in order from most popular: prostate, lung and bronchus, colon and rectum, urinary bladder, melanoma of the skin, non-hodgkin lymphoma, kidney and renal pelvis, oral cavity and pharynx, leukemias and pancreas.


The top 10 cancers affecting women of all races in order from most popular: breast, lung and bronchus, colon and rectum, uterine corpus, thyroid, non-Hodgkin lymphoma, melanomas of the skin, ovary, kidney and renal and pancreas.


Finally, with rankings by state in 2010, Kentucky had the highest rate of cancer occurrences, while Arizona had the least and Indiana fell 35th out of 50, with Michigan at the 5th highest ranking. Women, during the same time frame, also had the highest rate of cancer occurrence in Kentucky and the lowest was in New Mexico. Indiana fell at number 28 and Michigan at 17.