BULLETIN

In the past, Lab Bulletins from MDS Metro have been sent to physicians on an "as needed" basis. Commencing with this edition, we will be sending bulletins most months (with the exception of the summer). We will aim to be light but informative and we do encourage feedback. We will also include specific inserts for new utilization protocols and medical subjects of interest.

MDS METRO ON THE INFORMATION SUPERHIGHWAY

For those who are "connected", answers to laboratory clinical and service questions can be sent by email to ASKDOC  where an answer from an expert will be returned as soon as possible. Give us a try! MDS Laboratory Division also has a website at www.mdsdx.com which may be of interest to "surfers".

PSA AFTER DRE

We are frequently asked if the PSA becomes elevated following a digital rectal examination. The Internal Medicine Research Consortium has stated that following a rectal examination, patients who are free of carcinoma may increase their PSA up to 4 m g/L over their usual level (the increase is roughly correlated with prostate size). However, only 3% of patients who have a normal baseline PSA are rendered abnormal after DRE. Return to baseline values occurs in three days. Cancer patients may have a more significant increase. (Arch Int Med 1995;155: 389-392). Increases may also occur after ejaculation and occasionally following exercise (notably cycling).

NEW THYROID UTILIZATION PROTOCOL

The BCMA and MSC have announced a new Thyroid Utilization Protocol for adults 17 years of age and older. This will go into effect at MDS Metro on October 27, 1997. The essence of the protocol is that a single test (TSH usually preferred) is recommended in most clinical situations for diagnosis and monitoring thyroid replacement. A second test should be reserved for situations where there is a discrepancy between the patient’s clinical findings and the result of the initial test, or for "special cases" when medically required (these must be stated on the requisition). The Protocol is briefly reviewed and the requisition conditions are outlined in the accompanying pages.

PROFESSIONAL STAFF CHANGES

After a 20 year career with Metro, Dr. William Ibbott has retired. Bill’s previous career as a Clinical Hematologist and the wisdom he gained as BCMA President and with the BC College, served Metro well. We all wish Bill a happy and prosperous next career.

Joining our 11 member Medical Staff is Dr. Mukesh Chhanabhai, a laboratory hematologist who practiced clinical medicine in Zimbabwe and Newfoundland for ten years before taking his specialty training. He qualified in General Pathology (FRCPC and American Boards) and recently completed a two year fellowship at the BC Cancer Agency. He will be based in our Burnaby Reference Laboratory and has accepted additional responsibilities for some of our BC regional labs. Mukesh can be contacted for consultations at

604-431-5005 or 1-800-431-7206.

REMEMBER - Laboratory Medicine consultations are available at any time by calling our Burnaby Reference Laboratory at (604) 431-5005 or

1-800-431-7206 or our Victoria Reference Laboratory at 250-881-3100 or 1-800-304-4011. Or, send an email to ASKDOC .