7/13/2016
Congratulations to Tia Labarge, who has received the 2016 Rising Star Award from the American Society for Histocompatibility and Immunogenetics.
The award is given to an outstanding human leukoctye antigen (HLA) technologist who has worked in the field for less than three years and wants to pursue a career in HLA.
Labarge has worked at URMC since 2004 and joined the HLA/Tissue Typing Lab in 2014. Prior to this, she worked in other lab areas including Flow Cytometry and Microbiology.
In her current role, she is responsible for testing that will determine which patients will receive a solid organ or stem cell transplant.
Labarge will accept the award at the ASHI Annual Meeting in September.
6/29/2016
Have you ever wondered what happens to blood, urine, or other types of patient specimens after they are collected?
Specimen Management Services, or SMS, is a 24-7 operation of UR Medicine Labs. Its main headquarters is located on the ground floor of Strong Memorial Hospital, down the hall from the Emergency Department and Wilmot Cancer Center where patients are waiting on lab test results.
In addition to inpatient specimens processed at Strong, SMS receives many samples from outpatient facilities that include area nursing homes and 29 patient service centers across the Greater Rochester region.
Lab couriers pick up samples from these various outpatient sites and transport them to SMS collection points that include the SMS lab at Strong, a smaller SMS lab at the Ridgeland Road facility, Surgical Pathology, and Microbiology.
SMS, which includes Surgical Pathology, Accessioning, and Cytology, is the first point of contact for incoming specimens ranging from blood to urine, stool, spinal fluid, pap smears, and patient tissue samples.
Millions of specimens pass through SMS collection points each year. The lab at Strong processes over 8,000 specimens every day, with another 3,500 outpatient-only specimens delivered to Ridgeland Road.
The Microbiology specimen receiving area also receives specimens of all types for culture, while Surgical Pathology receives 465 surgical specimens – many directly from the operating room – on a daily basis.
“We’re the front end,” said Sue Hurlbutt, chief supervisor of SMS. “We’re the pre-analytical operations. We tell our staff to think about getting that sample out to the labs as if it belonged to you or your loved one.”
Once they arrive at SMS, each specimen sample is scanned by barcode and entered into an electronic database to be tracked.
The SMS lab in Strong is a beehive of activity with about 90 full-time-equivalent employees. On any given day, you will see technologists in white lab coats moving briskly with specimens in hand.
SMS technicians are non-licensed and cannot release final test results (these must come from a physician). Nevertheless, they play a key role in preparing each sample for final diagnosis.
“There’s a very technical aspect to the job,” said Scott Musial day shift supervisor. “There is a lot of work that goes into getting a specimen resulted.”
In order to be analyzed, most blood samples are put through an instrument called a modular pre-analytics system, or MPA. This spins each blood sample at high speed, separating it into its component serum and plasma.
Next, the samples are labeled, capped, sorted, and transported to another lab area for testing. Those that stay in the SMH laboratory for testing are strategically sorted and taken to another instrument to be analyzed.
Not all blood samples start at the MPA. Others needed for certain testing – hematology, coagulation, or toxicology, for example, will be delivered to the appropriate testing area and/or stabilized according to protocol for each laboratory.
Once logged and sorted, courier staff known as “scouriers” are responsible for taking samples to various in-house laboratories, like Microbiology, Flow Cytometry, or Cytogenetics, for specialized testing.
Many steps in specimen processing are high priority and time sensitive in nature. When Blue 100, Urgent or Stat tests come to the lab from Emergency and/or Cancer Center, turnaround time is extremely critical to ensure results are reported back as soon as possible so that patient treatment can be determined.
Outpatient testing is generally more routine, although healthcare providers will often ask for additional tests, known as add-ons, to tests that had been done previously.
As you might imagine, the workload for SMS is always a heavy lift. The team at Strong has managed to form its own sense of community through different efforts.
For example, SMS has a staff newsletter and large whiteboard where workers draw pictures, or start writing a story that’s continued by the next person.
Their “Ever Better Board,” or “E.B.B.” is a place where staff can share suggestions or offer feedback. The board was also featured in a university-wide training video as an example of best workplace practices, and staff celebrated the 200th E.B.B. post with a party.
“I think everyone works really well together,” said Musial. “Our group is relatively tight-knit. And although the lab seems big, you’re in a relatively confined space. You move through the same area and are working together each and every day.”
And by “every day,” he means just that. Even if the hospital loses power or extreme weather hits Rochester, SMS will stay open. They still need to service Emergency at Strong, and in inclement weather, that need is often greater than ever.
The fast pace is something Nathan Giles, a senior tech at Strong SMS, has grown accustomed to. Explaining the work of “the lab” to others can sometimes be difficult, he says, largely due to misconceptions about what happens to patient specimens.
When you see fictional doctors running their own lab tests on TV shows, it can seem like lab technologists are obsolete. The opposite is true. For doctors and nurses to start with the best information possible, it all starts in the lab.
“It’s not often that patients think about this part,” said Giles. “If I’d want them to know anything, it’s that we exist and that we’re a huge part of their treatment every day.”
In photos
Top: A technician prepares to place blood samples onto the modular pre-analytics system, or MPA, which spins the samples at high speed to separate them into serum and plasma.
Middle: Specimens arrive at the SMS lab at Strong Memorial Hospital via courier. Each sample is scanned by barcode into an electronic database so it can be tracked.
5/23/2016
We are pleased to announce that two Pathology faculty from URMC have been named to the American Society of Clinical Pathology (ASCP) 2016 40 Under Forty List.
Drs. Jennifer Findeis-Hosey and Raul Gonzalez have been chosen from a pool of national candidates.
“I think it’s outstanding that two of our faculty are paving the way for others in the field of pathology,” said Dr. Bruce Smoller, Pathology Department Chair.
About the award:
Each year, the ASCP chooses 40 members under the age of 40 whose achievements and leadership qualities are making a significant impact on the fields of pathology and laboratory medicine. This year’s number of applicants was the largest and most competitive yet.
About the honorees:
Dr. Jennifer Findeis-Hosey, 36, joined the University as an assistant professor in 2012. She is a gastrointestinal and hepatobiliary pathologist with a research focus on Lynch syndrome.
Her research at URMC extends from immunohistochemical markers of Lynch syndrome to the development of a multidisciplinary high risk colorectal carcinoma program. She serves as the director of pathology curriculum for the UR School of Medicine and oversees high school and undergraduate students in the Pathology Information Technology program.
She earned her B.S. from Bucknell University and M.D. from the Pennsylvania State University College of Medicine. She completed her residency at URMC and Surgical Pathology fellowship at the University of Michigan. A native of State College, Pa., she and her husband Dan live in Pittsford with their children, Emily, 7, and William, 2.
Dr. Raul Gonzalez, 34, joined the University in 2014 as an assistant professor. He specializes in gastrointestinal (GI) pathology. He has done much collaborative research in the field, with a focus on subtypes of colorectal carcinoma; he has published findings on adenoma-like adenocarcinoma and micropapillary carcinoma.
He trained at Emory University for residency, where he also earned his B.S. He completed fellowships in surgical and GI pathology at Vanderbilt University, where he was also an instructor. His M.D. is from the Medical College of Georgia, in his home state.
This year, he co-authored a textbook on non-neoplastic liver disease scheduled to be released in June. He was recently named the co-director of the GI pathology fellowship and teaches pathology residents and graduate students. He and his wife Lindsey live in Rochester.
5/11/2016
UR Medicine Central Labs and UR Medicine Labs have been providing essential, behind-the-scenes services for sites across the U.S. participating in a clinical trial for cancer immunotherapy.
An Elmira man was featured in the local news because he was the first person enrolled at the Wilmot Cancer Institute to participate in the national clinical study of CAR T-cell therapy, which uses a patient’s own immune system to fight cancer. The trial is limited to people with certain types of lymphoma who have not responded to conventional treatment, and who meet strict eligibility criteria.
UR Medicine labs first partnered with a pharmaceutical company in 2015 to adapt and validate as assay for the presence and quantity of CAR19 T-cells in a patient’s blood, based on an a model developed by the National Cancer Institute. Since then the UR labs team has worked to refine and validate the assay for large-scale implementation.
The immunotherapy trial is designed to manipulate the body’s built-in defense mechanisms to fight cancer. Regular antibodies can be effective in fighting infection but are not so useful in killing tumor cells. Research has shown that a certain type of lymphocytes (a disease-fighting category of white blood cells) called T lymphocytes can target and kill lymphoma cells.
These "T-cells" must first receive permission from the body to fight, however. The patient's T-cells are introduced to DNA that first incorporates itself into their genome to produce a new protein – a chimeric antigen receptor (CAR) – that activates each cell, giving it the ability to detect and bind to a lymphoma cell.
"You're bypassing a lot of the regulatory checks and balances that have prevented previous attempts to generate tumor-killing T-cells," said Dr. Dan Ryan, director of Central Labs. "If (the cells) don't become activated, they die off."
Bill Crowe and Paul Rothberg from the Molecular Diagnostics Laboratory are leaders of the group that expanded the NCI test. Central Labs closely monitors test results from participating patient treatment sites across the U.S., and a vast network of lab professionals completes a series of time-sensitive steps.
Staff at Ridgeland Road assembles and sends out testing kits to each treatment site. The blood samples are then received via mail by Specimen Logistics staff six days a week. Technologists at the Tissue Typing Lab at Strong Memorial Hospital, Lymphoma/Leukemia Tissue Bank (SMH), Hematology Lab and Microarray Lab (Ridgeland) are responsible for processing and freezing all of the peripheral blood mononuclear cell blood tubes (PBMCs) for storage.
Phil Rock is a lab technician at SMH whose duties include tracking frozen samples for the CAR T-cell trial. He says the number of samples has skyrocketed since the trial began, which is a positive sign for immunotherapy.
"I think this trial, and the fact that (Central Labs) is growing is great for the department," said Rock. "I enjoy it immensely because having a hand in it allows me to use things that I went to school for and I've been trained to do that previously had no application."
In photos:
Top: Clinical tech specialist, Jonathan Hoffmann, treats PBMC samples in the Human Leukocyte Antigen (HLA) Laboratory at URMC. Middle: Dr. Dan Ryan, director of UR Medicine Central Labs, which coordinates participation in clinical trials. Bottom: UR Medicine Central Labs kit production coordinator Deidra Davis, left, and Morgan Devaney.
4/29/2016
Mary Ann Rutkowski remembers the day she chose her future career – at the mall.
As a high-schooler, she was at a career day event when someone handed her a flier about the field of cytology. Intrigued, she read about microscopes and cancer detection, picturing herself behind a 'scope someday.
A native of the Utica region, she graduated from Upstate Medical Center and went on to complete a clinical semester at URMC to become a certified cytotechnologist.
It was the summer of 1978, and she was 20 years old when she was offered a job in the URMC Department of Pathology and Lab Medicine. She hasn't looked back since and on May 6, Rutkowski will retire from that same position after 38 years.
Here, she shares some reflections on her long and successful career.
Do you remember your teachers from your clinical semester at URMC?
Dr. Stanley F. Patten, Jr. wrote the textbooks. He laid the groundwork for how you not only diagnose cancer but the pre-cancerous conditions, which are so important. I have had so many wonderful mentors throughout my tenure here. Many were really pioneers in the field. Drs. Bonfiglio, Wilbur, Stoler are just a few that come to mind. Florence Patten also had a major influence on my formative years as a cytotech.
I still find it kind of frustrating when we get a case of cervical cancer which should be 100 percent preventable. It’s usually in people who may not have insurance, or something prevents them from getting annual screenings.
How has microscope technology changed since you started?
We used to look at a lot of conventional slides where you smear the material onto the slide, and it was very difficult to see. It was thick, not well stained, and air dried, so there were a lot of technical problems. It was challenging in a fun kind of way to decipher what was going on in these conventional smears.
Probably in the early 1990s, liquid-based technology really revolutionized cervical cancer screening and took that element of poor quality out of the picture. It was definitely a much needed advancement. That’s where we are today placing a pap sample in a solution and removing error the doctor may make in making the slides.
What has been your favorite part of the job overall?
The part I enjoy most is when we go out on our aspiration biopsy procedures because we get to see the patients and we’re reminded that it’s not just a piece of glass that we have on a microscope. We may see their family, friends – their support personnel – with them. Even though we can never get to know them personally because then you lose your objectivity, I’ve always enjoyed going out and playing an “active” role in obtaining diagnostic material. The first step for our patients towards treatment is getting the answer; that is the role we play.
Do you think some people choose this profession because it’s not patient-facing?
Perhaps. That’s what attracted me to it – it has some patient contact but not an extreme amount. I admire people who take care of people who are quite sick. It’s a tough job. We are the people who are behind the scenes.
In addition to patients, what has it been like to work with partnering agencies?
We have had some wonderful clinicians who get referrals from all over this part of the state. I think we take it for granted because we’ve worked with them for so long, but these people come from Buffalo and the Southern Tier because they don’t have access to people with the expertise to do endoscopies or the various invasive procedures. For me it’s rewarding that we’re on the same team. They’re trying to stick a needle in a target and we’re trying to interpret that material accurately to the best of our ability.
How do you plan to spend retirement?
Life’s a gift and when you’re around people who have a lot of health problems you’re reminded that if you have your health, you should enjoy it and not complain. I hope to travel and I enjoy photography (an amateur shutterbug). My husband and I have a little cabin on 30 acres in the middle of nowhere on the top of a mountain in Naples that we’ve nicknamed “the bungalow.” I suspect I will be there more often.
Rochester has been our home for 30 years … When you’re here this long, this becomes your home and we have friends here. We live right in the Highland Park area and love city living, being close to things, and that park is so unique. That was my goal: to be retired before the Lilac Festival (laughs).
It’s rare these days to hear about someone sticking with the same job for 38 years. What has kept you around so long?
I never really wanted to leave, (and) even now it’s bittersweet. I feel like I have friends here, not just coworkers. We’ve always worked as a team and that’s what has allowed us to survive, helping each other out. That’s what I think has kept me here as long as I have. It can be stressful some days but we help each other out. The days go by fast and the weeks go by even faster. And the years! I blinked and here I am 38 years later. I truly have had the time of my life here at the U of R.
Do you have any advice for young people starting their careers?
Make sure you set your goals and do something you enjoy doing. You may not stay as long in one place, but no matter what, make sure you enjoy it and appreciate what you have instead of looking at the glass as half-empty.
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