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Journal of Clinical and Investigative Surgery
Academic Journal Academic Journal | 01/01/2017 Please log in to see more details
Journal of Clinical and Investigative Surgery
01/01/2017

Subject terms:

clinical surgery - investigative surgery - surgery - Medicine

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BASE

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Journal of Clinical and Investigative Surgery
Academic Journal Academic Journal | 26/11/2017 Please log in to see more details
Journal of Clinical and Investigative Surgery
26/11/2017

Subject terms:

clinical surgery - investigative surgery - surgery - Medicine

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Directory of Open Access Journals

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The Impact of a Surgical Unit's Structure and Operative Technique on Quality in Two Swedish Rural Hospitals
Odelberg, Nina, Author;Cengiz, Yucel, Author;Jänes, Arthur, Author;Hennings...
Academic Journal Academic Journal | Journal of investigative surgery. Please log in to see more details
Introduction: Laparoscopic cholecystectomy (LC) is a commonly performed surgical proce... more
The Impact of a Surgical Unit's Structure and Operative Technique on Quality in Two Swedish Rural Hospitals
Journal of investigative surgery.
Introduction: Laparoscopic cholecystectomy (LC) is a commonly performed surgical procedure with a low complication rate. It is performed either as an acute or as an elective procedure. Most elective LCs are performed on nonlethal diseases and this is why good quality is important. Our study compared the quality of LC in two surgical units in northern Sweden (Sundsvall and ostersund) which use different clinical structures (subspecialised vs. general surgery) and surgical techniques (ultrasound fundus first vs. conventional diathermy). The study aimed to investigate whether these differences affected the quality of outcomes after LC.Materials and methods: This is a registry-based study which included 607 elective LCs from January 2014 to May 2016. There were 286 from Sundsvall and 321 from ostersund. Primary outcomes were operative time and the percentage of day surgeries. The secondary outcome was the presence of postoperative complications within the first 30 days in terms of bile duct injury, bleeding that necessitated reoperation, bile leakage and abscesses treated with drainage and mortality.Results: The time length of surgery was shorter in Sundsvall (mean 48.3 min) compared to ostersund (mean 108.6 min, p < 0.001. The percentage of day care surgeries was 94% in Sundsvall and 23% in ostersund, p < 0.001. Six patients (2.1%) had a complication in Sundsvall compared to seven patients (2.2%) in ostersund, p = 1.00.Conclusion: There is a significant difference between the two hospitals regarding operative time and the percentage of day surgeries. Complication rates in both units were equal and low.

Subject terms:

Medical and Health Sciences - Clinical Medicine - Surgery - Medicin och hälsovetenskap - Klinisk medicin - Kirurgi - laparoscopic cholecystectomy - operative technique - day surgery - complications - quality

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SwePub

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Indocyanine green enhanced surgery; principle, clinical applications and future research directions
Catalin Alius;Sorin Oprescu;Cristian Balalau;Adriana Elena Nica
Academic Journal Academic Journal | Journal of Clinical and Investigative Surgery, Vol 3, Iss 1, Pp 1-8 (2018) Please log in to see more details
Over the past decade a new emergent technology has become very popular in all fields o... more
Indocyanine green enhanced surgery; principle, clinical applications and future research directions
Journal of Clinical and Investigative Surgery, Vol 3, Iss 1, Pp 1-8 (2018)
Over the past decade a new emergent technology has become very popular in all fields of surgery using Indocyanine green and near infrared fluorescent optical systems. This revolutionary approach overlaps conventional and near infrared images to produce highly informative intraoperative images on the anatomy and physiology of various tissues. Near infrared fluorescence is employed for perioperative angiography in vascular mapping, assessment of anastomoses, location of sentinel lymph nodes and delineation of biliary tree anatomy, highlighting tumours and metastatic deposits, improving surgical techniques and for many other uses. A lot of researchers have reported better surgical outcomes and technique innovations facilitated by this novel technology which although in its early stages, it lights up great interest worldwide. This article reviews the principle of the method, the properties of the fluorescent dye, the main clinical applications and discusses future research directions.

Subject terms:

indocyanine green - surgery - near infrared fluorescence - Medicine

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Directory of Open Access Journals

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Comparison of gingival blood flow during healing of simplified papilla preservation and modified widman flap surgery : a clinical trial using laser dopplerflowmetry
RETZEPI, M;TONETTI, M;DONOS, N
Academic Journal Academic Journal | Journal of clinical periodontology. 34(10):903-911 Please log in to see more details
Aim: This prospective randomized-controlled clinical trial compared the gingival blood... more
Comparison of gingival blood flow during healing of simplified papilla preservation and modified widman flap surgery : a clinical trial using laser dopplerflowmetry
Journal of clinical periodontology. 34(10):903-911
Aim: This prospective randomized-controlled clinical trial compared the gingival blood flow responses following simplified papilla preservation (test) versus modified Widman flap (control). Materials and Methods: Twenty contra-lateral upper sites with pocket depth ≥ 5 mm after initial treatment in 10 chronic periodontitis patients were randomly assigned to either test or control treatment, using a split-mouth design. Laser Doppler flowmetry recordings were performed pre-operatively, following anaesthesia, immediately post-operatively and on days 1, 2, 3, 4, 7, 15, 30 and 60, at nine selected sites per flap. Results: Significant ischaemia was observed at all sites following anaesthesia and immediately post-operatively. At the mucosal flap basis, a peak hyperaemic response was observed on day 1, which tended to resolve by day 4 at the test sites, but persisted until day 7 at the control sites. The buccal and palatal papillae blood perfusion presented the maximum increase on day 7 in both groups and returned to baseline by day 15. Both surgical modalities yielded significant pocket depth reduction, recession increase and clinical attachment gain. Conclusions: Periodontal access flaps represent an ischaemia-reperfusion flap model. The simplified papilla preservation flap may be associated with faster recovery of the gingival blood flow post-operatively compared with the modified Widman flap.

Subject terms:

Otorhinolaryngology, stomatology, dentistry - Otorhinolaryngologie, stomatologie, dentisterie - Sciences biologiques et medicales - Biological and medical sciences - Sciences medicales - Medical sciences - Techniques d'exploration et de diagnostic (generalites) - Investigative techniques, diagnostic techniques (general aspects) - Exploration par ultrasons - Ultrasonic investigative techniques - Coeur et vaisseaux - Cardiovascular system - Chirurgie - Surgery - Cirugía - Accessibilité - Accessibility - Accesibilidad - Cicatrisant - Healing agent - Cicatrizante - Cicatrisation - Cicatrization - Cicatrización - Conservation - Conservación - Dentisterie - Dentistry - Odontología - Dopplérométrie laser - Laser dopplerometry - Dopplerometría laser - Débit sanguin - Blood flow - Flujo sanguíneo - Débitmétrie - Flowmetry - Caudalimetría - Essai clinique - Clinical trial - Ensayo clínico - Etude comparative - Comparative study - Estudio comparativo - Gencive - Gingiva - Encía - Lambeau - Flap (surgery) - Colgajo - Laser - Láser - Plaie - Wound - Herida - Préservation - Preservation - Preservación - Traitement - Treatment - Tratamiento - blood flow - laser Doppler flowmetry - periodontal access flap - wound healing

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PASCAL Archive

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An Examination of the Usefulness of Repeat Testing Practices in a Large Hospital Clinical Chemistry Laboratory
DEETZ, Carl O;NOLAN, Debra K;SCOTT, Mitchell G
Academic Journal Academic Journal | American journal of clinical pathology. 137(1):20-25 Please log in to see more details
A long-standing practice in clinical laboratories has been to automatically repeat lab... more
An Examination of the Usefulness of Repeat Testing Practices in a Large Hospital Clinical Chemistry Laboratory
American journal of clinical pathology. 137(1):20-25
A long-standing practice in clinical laboratories has been to automatically repeat laboratory tests when values trigger automated repeat rules in the laboratory information system such as a critical test result. We examined 25,553 repeated laboratory values for 30 common chemistry tests from December 1, 2010, to February 28, 2011, to determine whether this practice is necessary and whether it may be possible to reduce repeat testing to improve efficiency and turnaround time for reporting critical values. An error was defined to occur when the difference between the initial and verified values exceeded the College of American Pathologists/Clinical Laboratory Improvement Amendments allowable error limit. The initial values from 2.6% of all repeated tests (668) were errors. Of these 668 errors, only 102 occurred for values within the analytic measurement range. Median delays in reporting critical values owing to repeated testing ranged from 5 (blood gases) to 17 (glucose) minutes.

Subject terms:

Medical oncology - Cancérologie - Medical laboratory techniques - Techniques de laboratoire médical - General medicine general surgery - Médecine et chirurgie générales - Sciences biologiques et medicales - Biological and medical sciences - Sciences medicales - Medical sciences - Techniques d'exploration et de diagnostic (generalites) - Investigative techniques, diagnostic techniques (general aspects) - Anatomopathologie. Exploration cytologique. Biochimie. Spectrométries. Méthodes cliniques et paracliniques diverses - Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques - Anatomopathologie - Anatomic pathology - Anatomía patológica - Biologie clinique - Clinical biology - Biología clínica - Conduite à tenir - Clinical management - Actitud médica - Dépistage - Medical screening - Descubrimiento - Erreur - Error - Hôpital - Hospital - Laboratoire - Laboratory - Laboratorio - Pratique professionnelle - Professional practice - Práctica profesional - Valeur critique - Critical value - Valor crítico - Laboratory error - Laboratory management

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PASCAL Archive

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Clinical significance of ESR1 gene copy number changes in breast cancer as measured by fluorescence in situ hybridisation
LIN, Ching-Hung;LIU, Jacqueline M;LU, Yen-Shen;LAN, Chieh;LEE, Wei-Chung;KU...
Academic Journal Academic Journal | Journal of clinical pathology. 66(2):142-147 Please log in to see more details
Aims The ESR1 gene encodes for oestrogen receptor (ER) α, which plays a crucial role i... more
Clinical significance of ESR1 gene copy number changes in breast cancer as measured by fluorescence in situ hybridisation
Journal of clinical pathology. 66(2):142-147
Aims The ESR1 gene encodes for oestrogen receptor (ER) α, which plays a crucial role in mammary carcinogenesis and clinical outcome in patients with breast cancer. However, the clinical significance of the ESR1 gene copy number change for breast cancer has not been clarified. Methods ESR1 gene copy number was determined by fluorescence in situ hybridisation (FISH) on tissue sections. A minimum of 20 tumour cells were counted per section, and a FISH ratio of ESR1 gene to CEP6 ≥2.0 was considered ESR1 amplification. A ratio >1.2 but <2.0 was considered ESR1 gain. The ESR1 copy number was further measured by quantitative real-time PCR (Q-PCR) with ASXL2 as a reference. Results FISH revealed ESR1 amplification in six cases (4.0%) and ESR1 gain in 13 cases (8.7%) from a total of 150 cases. ESR1 gain and amplification were more common in older patients (p<0.001), and correlated well with ER protein expression (p=0.03) measured by immunohistochemistry, and ESR1 copy number (p<0.001) measured by Q-PCR. Furthermore, the multivariate analysis revealed that ESR1 amplification was associated with a shorter disease-free survival (HR=5.56, p=0.03) and a shorter overall survival (HR=5.11, p=0.04). Conclusions In general, the frequency of ESR1 amplification in breast cancer is low when measured by FISH in large sections. ESR1 gain and amplification in breast cancer may be associated with older age and poorer outcomes.

Subject terms:

Medical oncology - Cancérologie - Medical laboratory techniques - Techniques de laboratoire médical - General medicine general surgery - Médecine et chirurgie générales - Sciences biologiques et medicales - Biological and medical sciences - Sciences medicales - Medical sciences - Gynecologie. Andrologie. Obstetrique - Gynecology. Andrology. Obstetrics - Pathologie de la glande mammaire - Mammary gland diseases - Tumeurs - Tumors - Techniques d'exploration et de diagnostic (generalites) - Investigative techniques, diagnostic techniques (general aspects) - Anatomopathologie. Exploration cytologique. Biochimie. Spectrométries. Méthodes cliniques et paracliniques diverses - Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques - Cancer - Cáncer - Pathologie de la glande mammaire - Mammary gland diseases - Glándula mamaria patología - Pathologie du sein - Breast disease - Seno patología - Tumeur maligne - Malignant tumor - Tumor maligno - Analyse quantitative - Quantitative analysis - Análisis cuantitativo - Anatomopathologie - Anatomic pathology - Anatomía patológica - Cancer du sein - Breast cancer - Cáncer del pecho - Gène - Gene - Gen - Génétique - Genetics - Genética - Hybridation in situ fluorescence - Fluorescence in situ hybridization - Hibridación in situ fluorescencia - Nombre copie - Copy number - Número copia

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PASCAL Archive

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Stuck Between a Scalpel and a Rock, or Molecular Pathology and Legal-Ethical Issues in Use of Tissues for Clinical Care and Research: What Must a Pathologist Know?
DRY, Sarah;GRODY, Wayne W;PAPAGNI, Paul
Academic Journal Academic Journal | American journal of clinical pathology. 137(3):346-355 Please log in to see more details
Personalized medicine and health care reform offer the opportunity for pathologists to... more
Stuck Between a Scalpel and a Rock, or Molecular Pathology and Legal-Ethical Issues in Use of Tissues for Clinical Care and Research: What Must a Pathologist Know?
American journal of clinical pathology. 137(3):346-355
Personalized medicine and health care reform offer the opportunity for pathologists to have a more central and visible role in patient care. Pathologists face new and more complicated requests for clinical and research testing on tissue specimens, including testing for somatic and inherited mutations. Pathologists must comprehend the applications and requirements for molecular testing and their legal and ethical responsibilities in handling tissue requests for clinical and research purposes to best serve the needs of patients and clinicians and to comply with federal and state laws. This article reviews these rapidly evolving and complex areas.

Subject terms:

Medical oncology - Cancérologie - Medical laboratory techniques - Techniques de laboratoire médical - General medicine general surgery - Médecine et chirurgie générales - Sciences biologiques et medicales - Biological and medical sciences - Sciences medicales - Medical sciences - Techniques d'exploration et de diagnostic (generalites) - Investigative techniques, diagnostic techniques (general aspects) - Anatomopathologie. Exploration cytologique. Biochimie. Spectrométries. Méthodes cliniques et paracliniques diverses - Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques - Anatomopathologie - Anatomic pathology - Anatomía patológica - Aspect juridique - Legal aspect - Aspecto jurídico - Ethique - Ethics - Etica - Génétique - Genetics - Genética - Recherche clinique - Clinical research - Investigación clínica - Scalpel - Escalpelo - Soin - Care - Cuidado - Tissu - Tissue - Tejido - Utilisation - Use - Uso - Rho kinase - Ethical - Legal - Molecular pathology - Pathologist - Research - Tissues

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PASCAL Archive

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Human monocyte responses to lipopolysaccharide and 9-cis retinoic acid after laparoscopic surgery for colon cancer
KOLSETH, Ingrid B. M;FØRLAND, Dag T;RISØE, Petter K;FLOOD-KJELDSEN, Signe;A...
Academic Journal Academic Journal | Scandinavian journal of clinical & laboratory investigation. 72(8):593-601 Please log in to see more details
Surgery, even modern minimal invasive laparoscopic surgery, induces an initial inflamm... more
Human monocyte responses to lipopolysaccharide and 9-cis retinoic acid after laparoscopic surgery for colon cancer
Scandinavian journal of clinical & laboratory investigation. 72(8):593-601
Surgery, even modern minimal invasive laparoscopic surgery, induces an initial inflammatory and acute phase response which is followed by a period of immunosuppression rendering surgical patients more susceptible to infection. Here, we aimed to study changes in monocyte inflammatory responses and inflammatory modulation mechanisms following laparoscopic colorectal surgery for colon cancer. Blood samples were collected from 19 colon cancer patients before, directly after and daily for 3 days following surgery. Blood cells were exposed ex vivo to bacterial lipopolysaccharide (LPS) or the inflammatory modulator 9-cis retinoic acid (9cisRA). In blood samples taken prior to surgery, we found significant pro-inflammatory responses to LPS, indicating classical monocyte activation. Directly after surgery, LPS induced significantly less early pro-inflammatory cytokines and monocyte/granulocyte-attracting chemokines.The LPS-mediated release of interleukin (IL)-1β was still significantly attenuated 3 days after surgery. In patient monocytes collected after surgery, we found increased levels of suppressors of cytokine signaling (SOCS) 1 and SOCS3 mRNA, reported to be associated with polarization towards resolving macrophages. The retinoic acid isomer 9cisRA, reported to attenuate LPS-mediated inflammatory responses and alter chemokine responses in cultured monocytes, had a similar effect in patient blood. Three days after surgery, 9cisRA still attenuated pro-inflammatory responses, but the induction of monocyte chemoattractive protein (MCP)-1/CCL2 mRNA in monocytes was reduced. This study indicates changes in monocyte responses that last for at least 3 days after laparoscopic surgery.

Subject terms:

Medical laboratory techniques - Techniques de laboratoire médical - Sciences biologiques et medicales - Biological and medical sciences - Sciences medicales - Medical sciences - Gastroenterologie. Foie. Pancreas. Abdomen - Gastroenterology. Liver. Pancreas. Abdomen - Estomac. Duodénum. Intestin grêle. Côlon. Rectum. Anus - Stomach. Duodenum. Small intestine. Colon. Rectum. Anus - Tumeurs - Tumors - Techniques d'exploration et de diagnostic (generalites) - Investigative techniques, diagnostic techniques (general aspects) - Chirurgie (generalites). Transplantations, greffes d'organes et de tissus. Pathologie des greffons - Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases - Chirurgie de l'appareil digestif - Surgery of the digestive system - Cancer - Cáncer - Pathologie de l'appareil digestif - Digestive diseases - Aparato digestivo patología - Pathologie de l'estomac - Gastric disease - Estómago patología - Pathologie de l'intestin - Intestinal disease - Intestino patología - Pathologie du côlon - Colonic disease - Colón patología - Tumeur maligne - Malignant tumor - Tumor maligno - Alitrétinoïne - Alitretinoin - Alitretinoína - Anticancéreux - Antineoplastic agent - Anticanceroso - Biologie clinique - Clinical biology - Biología clínica - Cancer du côlon - Colon cancer - Cáncer del colon - Chimiokine - Chemokine - Quimioquina - Chirurgie endoscopique - Endoscopic surgery - Cirugía endoscópica - Coeliochirurgie - Laparoscopic surgery - Cirugía laparoscopica - Cytokine - Citoquina - Homme - Human - Hombre - Lipopolyoside - Lipopolysaccharide - Lipopoliósido - Monocyte - Monocito - Protéine SOCS - Suppressor of cytokine signalling - proteínas supresoras de la señalización por citocinas - Traitement - Treatment - Tratamiento - Cancer gastrointestinal - Gastrointestinal cancer - Cáncer gastrointestinal - Chirurgie digestive - Cytokines - chemokines - gastrointestinal cancer surgery - monocytes - suppressor of cytokine signaling

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PASCAL Archive

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Progastrin-Releasing Peptide Is a Candidate Marker for Quality Control in Clinical Sample Processing and Storage
KIM, Shine-Young;KIM, Ji-Su;HWANG, Sang-Hyun;PARK, Hye-Kyung;LEE, Jin-Hyeon...
Academic Journal Academic Journal | American journal of clinical pathology. 137(2):277-282 Please log in to see more details
For clinical epidemiologic and proteomic studies, the control of preanalytic variation... more
Progastrin-Releasing Peptide Is a Candidate Marker for Quality Control in Clinical Sample Processing and Storage
American journal of clinical pathology. 137(2):277-282
For clinical epidemiologic and proteomic studies, the control of preanalytic variation, including sample processing and storage, is important. We evaluated the stability of progastrin-releasing peptide (ProGRP) as a marker for the quality control of stored serum and plasma samples. The ProGRP from 23 healthy volunteers was measured serially for 8 hours at room temperature, and the results were validated with clinical samples from the biobank. A significant difference in ΔProGRP was also noted between good-quality (time delay <4 hours before storage) and poor-quality (time delay ≥4 hours before storage) specimens (mean ± SD, 0.17 ± 0. 08 vs 0.36 ± 0.14; P < .001; Wilcoxon signed-rank test). With a ΔProGRP cutoff of 0.22, the sensitivity and specificity of detection of the poor-quality samples were 85. 7% and 75.0%, respectively, in clinical validations. We demonstrated that ΔProGRP could be used as a marker for quality control in sample processing and storage in biobanks.

Subject terms:

Medical oncology - Cancérologie - Medical laboratory techniques - Techniques de laboratoire médical - General medicine general surgery - Médecine et chirurgie générales - Sciences biologiques et medicales - Biological and medical sciences - Sciences medicales - Medical sciences - Techniques d'exploration et de diagnostic (generalites) - Investigative techniques, diagnostic techniques (general aspects) - Anatomopathologie. Exploration cytologique. Biochimie. Spectrométries. Méthodes cliniques et paracliniques diverses - Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques - Anatomopathologie - Anatomic pathology - Anatomía patológica - Conservation - Conservación - Contrôle qualité - Quality control - Control de calidad - Dégradation - Degradation - Degradación - Indicateur biologique - Biological indicator - Indicador biológico - Isolat clinique - Clinical isolate - Aislado clinico - Marqueur biologique - Biological marker - Marcador biológico - Peptide - Peptides - Péptido - Protéomique - Proteomics - Proteómica - Stabilité - Stability - Estabilidad - Stockage - Storage - Almacenamiento - Biobank - Biomarker - ProGRP - Progastrin-releasing peptide - Rapid degradation - Sample stability

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PASCAL Archive

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Increased plasma and salivary cortisol levels in patients with oral cancer and their association with clinical stage
GALERA BERNABE, Daniel;CAIRES TAMAE, Adriano;ISSAMU MIYAHARA, Glauco;MARCAL...
Academic Journal Academic Journal | Journal of clinical pathology. 65(10):934-939 Please log in to see more details
Objectives Dysregulation of the hypothalamus—pituitary—adrenal axis has been observed ... more
Increased plasma and salivary cortisol levels in patients with oral cancer and their association with clinical stage
Journal of clinical pathology. 65(10):934-939
Objectives Dysregulation of the hypothalamus—pituitary—adrenal axis has been observed in patients with cancer. This cross-sectional study investigated whether patients with oral and oropharyngeal squamous cell carcinoma (SCC) show changes in cortisol levels in saliva and plasma compared with three control groups, and evaluated its correlation with clinicopathological data. Methods Salivary and plasma cortisol levels of 34 patients with oral SCC were compared with hormonal levels of 17 oropharyngeal SCC patients, 17 oral leukoplakia patients, 27 smokers and/or drinkers and 25 healthy volunteers. Multivariate analysis was used to evaluate the impact of clinical variables on the cortisol levels. Results The plasma (p<0.05) and salivary (p<0.01) cortisol levels were significantly higher in patients with oral SCC compared with all groups. Patients with oropharyngeal SCC had higher levels of salivary cortisol compared with smokers and/or drinkers (p<0.05) and patients with leukoplakia (p<0.01). Patients with advanced-stage oral SCC showed significantly higher levels of cortisol than those in an initial clinical stage. Men with oral SCC had higher salivary cortisol levels than women (p<0.05). Age, smoking, alcohol consumption, presence of teeth and awareness of cancer diagnosis had no significant effect on cortisol levels. Conclusions These results indicate a dysregulation of cortisol secretion in patients with oral cancer and suggest that this hormone can be a biomarker associated with the disease's clinical status.

Subject terms:

Medical oncology - Cancérologie - Medical laboratory techniques - Techniques de laboratoire médical - General medicine general surgery - Médecine et chirurgie générales - Sciences biologiques et medicales - Biological and medical sciences - Sciences medicales - Medical sciences - Otorhinolaryngologie. Stomatologie - Otorhinolaryngology. Stomatology - Voies aérodigestives supérieures, sinus de la face, glandes salivaires: maladies, sémiologie - Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology - Tumeurs - Tumors - Techniques d'exploration et de diagnostic (generalites) - Investigative techniques, diagnostic techniques (general aspects) - Anatomopathologie. Exploration cytologique. Biochimie. Spectrométries. Méthodes cliniques et paracliniques diverses - Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques - Cancer - Cáncer - Pathologie de la cavité buccale - Oral cavity disease - Cavidad bucal patología - Stomatologie - Stomatology - Estomatología - Tumeur maligne - Malignant tumor - Tumor maligno - Anatomopathologie - Anatomic pathology - Anatomía patológica - Association - Asociación - Cancer de la cavité buccale - Oral cancer - Cáncer de cavidad bucal - Cortisol - Homme - Human - Hombre - Plasma sanguin - Blood plasma - Plasma sanguíneo - Salive - Saliva - Stade clinique - Clinical stage - Estadio clínico

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PASCAL Archive

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Clinical and Pathologic Features of Secondary Acute Promyelocytic Leukemia
DUFFIELD, Amy S;AOKI, Joseph;LEVIS, Mark;COWAN, Kathleen;GOCKE, Christopher...
Academic Journal Academic Journal | American journal of clinical pathology. 137(3):395-402 Please log in to see more details
Acute promyelocytic leukemia (APL) is a relatively common form of acute myeloid leukem... more
Clinical and Pathologic Features of Secondary Acute Promyelocytic Leukemia
American journal of clinical pathology. 137(3):395-402
Acute promyelocytic leukemia (APL) is a relatively common form of acute myeloid leukemia (AML) that has an excellent prognosis. In contrast, secondary acute myeloid leukemias, including therapy-related AML and AML, with myelodysplasia-related changes, have a relatively poor prognosis. We identified 9 cases ofAPL at our institution in which there was a history of chemotherapy, radiotherapy, chronic immunosuppression, or antecedent myelodysplastic syndrome. The clinical and pathologic findings in these cases of secondary APL were compared with the clinical and pathologic findings in cases of de novo APL. We found that secondary and de novo APL had abnormal promyelocytes with similar morphologic and immunophenotypic features, comparable cytogenetic findings, comparable rates of FMS-like tyrosine kinase mutations, and similar rates of recurrent disease and death. These data suggest that secondary APL is similar to de novo APL and, thus, should be considered distinct from other secondary acute myeloid neoplasms.

Subject terms:

Medical oncology - Cancérologie - Medical laboratory techniques - Techniques de laboratoire médical - General medicine general surgery - Médecine et chirurgie générales - Sciences biologiques et medicales - Biological and medical sciences - Sciences medicales - Medical sciences - Hemopathies - Hematologic and hematopoietic diseases - Leucémies. Lymphomes malins. Réticuloses malignes. Hématodermies. Splénomégalie myéloïde - Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis - Techniques d'exploration et de diagnostic (generalites) - Investigative techniques, diagnostic techniques (general aspects) - Anatomopathologie. Exploration cytologique. Biochimie. Spectrométries. Méthodes cliniques et paracliniques diverses - Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques - Cancer - Cáncer - Hémopathie maligne - Malignant hemopathy - Hemopatía maligna - Aigu - Acute - Agudo - Anatomopathologie - Anatomic pathology - Anatomía patológica - Cytométrie flux - Flow cytometry - Citometría flujo - Forme clinique - Clinical form - Forma clínica - Leucémie aiguë myéloblastique - Acute myelogenous leukemia - Leucemia aguda mieloblástica - Leucémie myéloblastique M3 - M3 acute myelocytic leukemia - Leucemia mieloblástica M3 - Leucémie promyélocytaire - Promyelocytic leukemia - Leucemia promielocítica - Secondaire - Secondary - Secundario - Symptomatologie - Symptomatology - Sintomatología - Syndrome myélodysplasique - Myelodysplastic syndrome - Mielodisplastico síndrome - Syndrome myéloprolifératif - Myeloproliferative syndrome - Mieloproliferativo síndrome - Traitement - Treatment - Tratamiento - Hémopathie maligne myéloïde - Myeloid neoplasm - APL - Acute myeloid leukemia with myelodysplasia-related changes - Acute promyelocytic leukemia - Therapy-related acute myeloid leukemia - Therapy-related myeloid neoplasm

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External Quality Assurance Performance of Clinical Research Laboratories in Sub-Saharan Africa
AMUKELE, Timothy K;MICHAEL, Kurt;HANES, Mary;MILLER, Robert E;BROOKS JACKSO...
Academic Journal Academic Journal | American journal of clinical pathology. 138(5):720-723 Please log in to see more details
Patient Safety Monitoring in International Laboratories (JHU-SMILE) is a resource at J... more
External Quality Assurance Performance of Clinical Research Laboratories in Sub-Saharan Africa
American journal of clinical pathology. 138(5):720-723
Patient Safety Monitoring in International Laboratories (JHU-SMILE) is a resource at Johns Hopkins University that supports and monitors laboratories in National Institutes of Health―funded international clinical trials. To determine the impact of the JHU-SMILE quality assurance scheme in sub-Saharan African laboratories, we reviewed 40 to 60 months of external quality assurance (EQA) results of the College of American Pathologists (CAP) in these laboratories. We reviewed the performance of 8 analytes: albumin, alanine aminotransferase, creatinine, sodium, WBC, hemoglobin, hematocrit, and the human immunodeficiency virus antibody rapid test. Over the 40- to 60-month observation period, the sub-Saharan laboratories had a 1.63% failure rate, which was 40% lower than the 2011 CAP-wide rate of 2.8%. Seventy-six percent of the observed EQA failures occurred in 4 of the 21 laboratories. These results demonstrate that a system of remote monitoring, feedback, and audits can support quality in low-resource settings, even in places without strong regulatory support for laboratory quality.

Subject terms:

Afrique - Africa - Afrique subsaharienne - Sub-Saharan Africa - Africa subsahariana - Medical oncology - Cancérologie - Medical laboratory techniques - Techniques de laboratoire médical - General medicine general surgery - Médecine et chirurgie générales - Sciences biologiques et medicales - Biological and medical sciences - Sciences medicales - Medical sciences - Pathologie infectieuse - Infectious diseases - Viroses - Viral diseases - Viroses humaines - Human viral diseases - Viroses du tissu lymphoïde et du sang. Sida - Viral diseases of the lymphoid tissue and the blood. Aids - Immunopathologie - Immunopathology - Immunodéficits. Immunoglobulinopathies - Immunodeficiencies. Immunoglobulinopathies - Immunodéficits - Immunodeficiencies - Techniques d'exploration et de diagnostic (generalites) - Investigative techniques, diagnostic techniques (general aspects) - Anatomopathologie. Exploration cytologique. Biochimie. Spectrométries. Méthodes cliniques et paracliniques diverses - Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques - Immunodéficit - Immune deficiency - Inmunodeficiencia - Immunopathologie - Immunopathology - Inmunopatología - Infection - Infección - Lentivirus - Retroviridae - Virose - Viral disease - Virosis - Virus - Anatomopathologie - Anatomic pathology - Anatomía patológica - Assurance qualité - Quality assurance - Aseguración calidad - Evaluation performance - Performance evaluation - Evaluación prestación - Externe - External - Externo - Laboratoire - Laboratory - Laboratorio - Performance - Rendimiento - Recherche clinique - Clinical research - Investigación clínica - SIDA - AIDS - Virus immunodéficience humaine - Human immunodeficiency virus - CAP - HIV - PEPFAR - Sub-Saharan Africa

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Epidemiology of Escherichia coli, Klebsiella Species, and Proteus mirabilis Strains Producing Extended-Spectrum β-Lactamases From Clinical Samples in the Kinki Region of Japan
NAKAMURA, Tatsuya;KOMATSU, Masaru;SATOH, Kaori;TODA, Hirofumi;TOYOKAWA, Mas...
Academic Journal Academic Journal | American journal of clinical pathology. 137(4):620-626 Please log in to see more details
In the present study, nonduplicate, clinical isolates of extended-spectrum β-lactamase... more
Epidemiology of Escherichia coli, Klebsiella Species, and Proteus mirabilis Strains Producing Extended-Spectrum β-Lactamases From Clinical Samples in the Kinki Region of Japan
American journal of clinical pathology. 137(4):620-626
In the present study, nonduplicate, clinical isolates of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli, Klebsiella spp, and Proteus mirabilis were collected during a 10-year period from 2000 to 2009 at several hospitals in the Kinki region, Japan. The detection rate ofE coli markedly increased from 0.24% to 7.25%. The detection rate of Klebsiella pneumoniae increased from 0% to 2.44% and that of P mirabilisfrom 6.97% to 12.85%. The most frequently detected genotypes were the CTX-M9 group for E coli, the CTX-M2 group for K pneumoniae, and the CTX-M2 group for P mirabilis. E coli clone o25: H4-ST131 producing CTX-M-15, which is spreading worldwide, was first detected in 2007. The most common replicon type ofE coli was the IncF type, particularly FIB, detected in 466 strains (69. 7%). Of the K pneumoniae strains, 47 (55.3%) were of the IncN type; 77 P mirabilis strains (96.3%) were of the IncT type. In the future, the surveillance of various resistant bacteria, mainly ESBL-producing Enterobacteriaceae, should be expanded to prevent their spread.

Subject terms:

Asie - Asia - Japon - Japan - Japón - Medical oncology - Cancérologie - Medical laboratory techniques - Techniques de laboratoire médical - General medicine general surgery - Médecine et chirurgie générales - Sciences biologiques et medicales - Biological and medical sciences - Sciences medicales - Medical sciences - Techniques d'exploration et de diagnostic (generalites) - Investigative techniques, diagnostic techniques (general aspects) - Anatomopathologie. Exploration cytologique. Biochimie. Spectrométries. Méthodes cliniques et paracliniques diverses - Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques - Bactérie - Bacteria - Enterobacteriaceae - Anatomopathologie - Anatomic pathology - Anatomía patológica - Epidémiologie - Epidemiology - Epidemiología - Escherichia coli - Espèce - Species - Especie - Isolat clinique - Clinical isolate - Aislado clinico - Klebsiella - Proteus mirabilis - Réaction chaîne polymérase - Polymerase chain reaction - Reacción cadena polimerasa - Réplicon - Replicon - Replicón - Souche - Strain - Cepa - Surveillance - Vigilancia - β-Lactamase à spectre étendu - Extended-spectrum β-lactamase - β-lactamasa de espectro extendido - Extended-spectrum β-lactamases - Replicon type

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Determination of Turnaround Time in the Clinical Laboratory: Accessioning-to-Result Time Does Not Always Accurately Reflect Laboratory Performance
STOTLER, Brie A;KRATZ, Alexander
Academic Journal Academic Journal | American journal of clinical pathology. 138(5):724-729 Please log in to see more details
Laboratories often focus on computer-generated components of turnaround time (TAT) rep... more
Determination of Turnaround Time in the Clinical Laboratory: Accessioning-to-Result Time Does Not Always Accurately Reflect Laboratory Performance
American journal of clinical pathology. 138(5):724-729
Laboratories often focus on computer-generated components of turnaround time (TAT) reports that capture time from sample accessioning to reporting of results, and use this indicator to determine performance. This study assesses limitations of accessioning-to-results times and details ways in which to evaluate laboratory-controlled TAT. Samples were sent via pneumatic tube and times from arrival to accessioning were determined. Staffing was increased and the delay between sample arrival and accessioning was measured again. Significant delays were seen between specimen arrival and accessioning, which were not captured with computer-generated TAT reports. When TAT was calculated to include these delays, the TAT goal was not achieved. Increasing the number of employees significantly decreased delays. Laboratories must ensure that TAT reports encompass all laboratory-controlled parts of the testing processes. Analysis of causes for discrepancies between computer reports and clinician perceptions, combined with targeted measurements and well-designed interventions, can decrease TAT and improve service.

Subject terms:

Medical oncology - Cancérologie - Medical laboratory techniques - Techniques de laboratoire médical - General medicine general surgery - Médecine et chirurgie générales - Sciences biologiques et medicales - Biological and medical sciences - Sciences medicales - Medical sciences - Techniques d'exploration et de diagnostic (generalites) - Investigative techniques, diagnostic techniques (general aspects) - Anatomopathologie. Exploration cytologique. Biochimie. Spectrométries. Méthodes cliniques et paracliniques diverses - Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques - Anatomopathologie - Anatomic pathology - Anatomía patológica - Assurance qualité - Quality assurance - Aseguración calidad - Evaluation performance - Performance evaluation - Evaluación prestación - Laboratoire - Laboratory - Laboratorio - Performance - Rendimiento - Qualité - Quality - Calidad - Accessioning time - Clinical laboratory - Quality improvement - Turnaround time

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Historical perspectives in diagnostic clinical pathology: development of the pregnancy test
HAARBURGER, David;PILLAY, Tahir S
Academic Journal Academic Journal | Journal of clinical pathology. 64(6):546-548 Please log in to see more details
This is the first in a series of articles dealing with developments in the history of ... more
Historical perspectives in diagnostic clinical pathology: development of the pregnancy test
Journal of clinical pathology. 64(6):546-548
This is the first in a series of articles dealing with developments in the history of diagnostic pathology and laboratory medicine for the Journal of Clinical Pathology. The pregnancy test kits of today can give an accurate result within 2 min and are as easily available in the laboratory as they are for over-the-counter purchase. Such kits also find a use in the emergency room when dealing with the diagnosis of sudden abdominal pain in a woman of childbearing age. It is not immediately obvious that the simple urine dipstick tests of today reflect the cumulative knowledge of almost a century of reproductive biology, immunology and clinical chemistry.

Subject terms:

Medical oncology - Cancérologie - Medical laboratory techniques - Techniques de laboratoire médical - General medicine general surgery - Médecine et chirurgie générales - Sciences biologiques et medicales - Biological and medical sciences - Sciences medicales - Medical sciences - Techniques d'exploration et de diagnostic (generalites) - Investigative techniques, diagnostic techniques (general aspects) - Anatomopathologie. Exploration cytologique. Biochimie. Spectrométries. Méthodes cliniques et paracliniques diverses - Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques - Anatomopathologie - Anatomic pathology - Anatomía patológica - Diagnostic - Diagnosis - Diagnóstico - Développement - Development - Desarrollo - Exploration - Exploración - Femelle - Female - Hembra - Gestation - Pregnancy - Gestación - Historique - Case history - Estudio histórico

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Predicting clinical behaviour of breast phyllodes tumours: a nomogram based on histological criteria and surgical margins
PUAY HOON TAN;AYE AYE THIKE;WAI JIN TAN;MINN MINN MYINT THU;BUSRNANIS, Inny...
Academic Journal Academic Journal | Journal of clinical pathology. 65(1):69-76 Please log in to see more details
Aim To define a predictive model for clinical behaviour of breast phyllodes tumours (P... more
Predicting clinical behaviour of breast phyllodes tumours: a nomogram based on histological criteria and surgical margins
Journal of clinical pathology. 65(1):69-76
Aim To define a predictive model for clinical behaviour of breast phyllodes tumours (PT) using histological parameters and surgical margin status. Methods Cases of breast PT diagnosed in the Department of Pathology Singapore General Hospital between January 1992 and December 2010 were stratified into benign, borderline and malignant grades based on a combination of histological parameters (stromal atypia, hypercellularity, mitoses, overgrowth and nature of tumour borders). Surgical margin status was assessed. Clinical follow-up and biostatistical modelling were accomplished. Results Of 605 PT, 440 (72.7%) were benign, 111 (18.4%) borderline and 54 (8.9%) malignant. Recurrences, which were predominantly local, were documented in 80 (13.2%) women. Deaths from PT occurred in 12 (2%) women. Multivariate analysis revealed stromal atypia, overgrowth and surgical margins to be independently predictive of clinical behaviour, with mitoses achieving near significance. Stromal hypercellularity and tumour borders were not independently useful. A nomogram developed based on atypia, mitoses, overgrowth and surgical margins (AMOS criteria) could predict recurrence-free survival at 1, 3, 5 and 10 years. This nomogram was superior to a total histological score derived from adding values assigned to each of five histological parameters. Conclusion A predictive nomogram based on three histological criteria and surgical margin status can be used to calculate recurrence-free survival of an individual woman diagnosed with PT. This can be applied for patient counselling and clinical management.

Subject terms:

Medical oncology - Cancérologie - Medical laboratory techniques - Techniques de laboratoire médical - General medicine general surgery - Médecine et chirurgie générales - Sciences biologiques et medicales - Biological and medical sciences - Sciences medicales - Medical sciences - Gynecologie. Andrologie. Obstetrique - Gynecology. Andrology. Obstetrics - Pathologie de la glande mammaire - Mammary gland diseases - Tumeurs - Tumors - Techniques d'exploration et de diagnostic (generalites) - Investigative techniques, diagnostic techniques (general aspects) - Anatomopathologie. Exploration cytologique. Biochimie. Spectrométries. Méthodes cliniques et paracliniques diverses - Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques - Pathologie de la glande mammaire - Mammary gland diseases - Glándula mamaria patología - Pathologie du sein - Breast disease - Seno patología - Anatomopathologie - Anatomic pathology - Anatomía patológica - Chirurgie - Surgery - Cirugía - Comportement - Behavior - Conducta - Critère - Criterion - Criterio - Histologie - Histology - Histología - Marge chirurgicale - Surgical margin - Margen quirúrgica - Nomogramme - Nomogram - Nomograma - Tumeur phyllode - Phyllode tumor - Tumor filoides - Tumeur sein - Breast tumor - Tumor pecho

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Pathological grading of regression following neoadjuvant chemoradiation therapy: the clinical need is now
MACGREGOR, Tom P;MAUGHAN, Tim S;SHARMA, Ricky A
Academic Journal Academic Journal | Journal of clinical pathology. 65(10):867-871 Please log in to see more details
Neoadjuvant chemoradiotherapy for locally advanced rectal cancer has been shown to dec... more
Pathological grading of regression following neoadjuvant chemoradiation therapy: the clinical need is now
Journal of clinical pathology. 65(10):867-871
Neoadjuvant chemoradiotherapy for locally advanced rectal cancer has been shown to decrease rates of local recurrence and more than double the rate of sphincter-preserving surgery. There is now compelling evidence that pathological complete response is an independent predictor of likelihood of local recurrence, distal metastases, disease-free and overall survival in locally advanced rectal cancer following neoadjuvant chemoradiotherapy. Pathological regression grading can therefore guide clinical decisions about salvage surgical strategies, adjuvant therapy and long-term surveillance. No universally recognised regression grading system currently exists for pathologists presented with resected tumour specimens following neoadjuvant chemoradiotherapy. The purpose of this review is to highlight the relevance of accurate tumour regression grading in achieving optimal clinical care for patients with rectal cancer.

Subject terms:

Medical oncology - Cancérologie - Medical laboratory techniques - Techniques de laboratoire médical - General medicine general surgery - Médecine et chirurgie générales - Sciences biologiques et medicales - Biological and medical sciences - Sciences medicales - Medical sciences - Techniques d'exploration et de diagnostic (generalites) - Investigative techniques, diagnostic techniques (general aspects) - Anatomopathologie. Exploration cytologique. Biochimie. Spectrométries. Méthodes cliniques et paracliniques diverses - Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques - Anatomopathologie - Anatomic pathology - Anatomía patológica - Besoin - Need - Necesidad - Chimioradiothérapie - Chemoradiotherapy - Quimioradioterapia - Grade histologique - Histological grading - Grado histológico - Régression - Regression - Regresión - Traitement néoadjuvant - Neoadjuvant treatment - Neocoadyuvante tratamiento

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Clinical, Morphologic, Immunophenotypic, and Molecular Cytogenetic Assessment of CD4-/CD8- γδ T-Cell Large Granular Lymphocytic Leukemia
CHEN, Yi-Hua;CHADBURN, Amy;EVENS, Andrew M;WINTER, Jane N;GORDON, Leo I;CHE...
Academic Journal Academic Journal | American journal of clinical pathology. 136(2):289-299 Please log in to see more details
γδ T-cell large granular lymphocytic (T-LGL) leukemia of the CD4-/CD8- subtype is rare... more
Clinical, Morphologic, Immunophenotypic, and Molecular Cytogenetic Assessment of CD4-/CD8- γδ T-Cell Large Granular Lymphocytic Leukemia
American journal of clinical pathology. 136(2):289-299
γδ T-cell large granular lymphocytic (T-LGL) leukemia of the CD4-/CD8- subtype is rare, and data are limited in the literature. This study evaluated the clinical, morphologic, immunophenotypic, and molecular cytogenetic features of 7 cases of CD4-/ CD8- γδ T-LGL leukemia. Although this variant shares several clinical and morphologic features with the more common T-LGL leukemias, the incidences of autoimmune hemolytic anemia and pure red cell aplasia are higher. Another striking feature observed in our study was the lack of increased large granular lymphocytes in the peripheral blood in the majority of cases despite prominent bone marrow or splenic involvement. CD4-/CD8- γδ T-LGL leukemia also displays an immunophenotype and pattern of splenic involvement overlapping with hepatosplenic T-cell lymphoma. Clinically, this variant of T-LGL leukemia shows an overall indolent course, but treatment is often required in the initial stages of the disease. Awareness of these features is important for early recognition and accurate diagnosis of patients with CD4-/CD8- γδ T-LGL leukemia.

Subject terms:

Medical oncology - Cancérologie - Medical laboratory techniques - Techniques de laboratoire médical - General medicine general surgery - Médecine et chirurgie générales - Sciences biologiques et medicales - Biological and medical sciences - Sciences medicales - Medical sciences - Techniques d'exploration et de diagnostic (generalites) - Investigative techniques, diagnostic techniques (general aspects) - Anatomopathologie. Exploration cytologique. Biochimie. Spectrométries. Méthodes cliniques et paracliniques diverses - Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques - Anatomopathologie - Anatomic pathology - Anatomía patológica - Cytogénétique - Cytogenetics - Citogenética - Forme clinique - Clinical form - Forma clínica - Immunophénotype - Immunophenotype - Inmunofenotipo - Lymphocyte T CD4 - CD4 T lymphocyte - Linfocito T CD4 - Lymphocyte T CD8 - CD8 T lymphocyte - Linfocito T CD8 - Lymphocyte T - T-Lymphocyte - Linfocito T - Moelle osseuse - Bone marrow - Médula ósea - Morphologie - Morphology - Morfología - Rate - Spleen - Bazo - Récepteur cellule T γ/δ - γ/δ T cell receptor - Receptor célula T γ/δ - Symptomatologie - Symptomatology - Sintomatología - Hémopathie maligne lymphoïde - Lymphoid neoplasm - Clinical features - Morphologic features - γδ T-cell large granular lymphocytic leukemia

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Bulls and bears: the stock market and clinical pathology research
KHONG, T. Y
Academic Journal Academic Journal | Journal of clinical pathology. 62(9):834-836 Please log in to see more details
Aims: To analyse the level of funded research in clinical pathology in a recent bear a... more
Bulls and bears: the stock market and clinical pathology research
Journal of clinical pathology. 62(9):834-836
Aims: To analyse the level of funded research in clinical pathology in a recent bear and bull market to act as a predictor for future funding during the current global financial crisis. Methods: The level of funding for research published in three clinical pathology journals in 2005 and 2008 to coincide with the bear market of March 2000 to October 2002 and with the subsequent bull market to October 2007 was determined using a Medline query. Other parameters examined were the type of article, affiliation of the first author and the pathology subspecialty. Results: Approximately 30% of publications were funded and did not differ between the 2 years studied. Original research papers were more likely to be funded than case reports or reviews. Research from university departments of pathology was more likely to be funded than from hospital pathology departments but there were more publications from hospital pathology departments. The proportion of research in the different subspecialties that was funded did not differ significantly between each other and between 2005 and 2008. Conclusions: Based on data from the previous bear market, which was the longest and deepest of the post 1950 era, and the subsequent bull market, which led to the all-time high in the Dow Jones Industrial Index, funding for clinical pathology research does not seem to be affected by bull or bear markets.

Subject terms:

Medical oncology - Cancérologie - Medical laboratory techniques - Techniques de laboratoire médical - General medicine general surgery - Médecine et chirurgie générales - Sciences biologiques et medicales - Biological and medical sciences - Sciences medicales - Medical sciences - Techniques d'exploration et de diagnostic (generalites) - Investigative techniques, diagnostic techniques (general aspects) - Anatomopathologie. Exploration cytologique. Biochimie. Spectrométries. Méthodes cliniques et paracliniques diverses - Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques - Anatomopathologie - Anatomic pathology - Anatomía patológica - Recherche clinique - Clinical research - Investigación clínica

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What Proportion of Vancomycin Trough Levels Are Drawn Too Early?: Frequency and Impact on Clinical Actions
MORRISON, Aileen P;MELANSON, Stacy E. F;CARTY, Marcy G;BATES, David W;SZUMI...
Academic Journal Academic Journal | American journal of clinical pathology. 137(3):472-478 Please log in to see more details
Vancomycin trough levels are recommended to predict vancomycin efficacy, and inaccurat... more
What Proportion of Vancomycin Trough Levels Are Drawn Too Early?: Frequency and Impact on Clinical Actions
American journal of clinical pathology. 137(3):472-478
Vancomycin trough levels are recommended to predict vancomycin efficacy, and inaccurate levels may lead to inappropriate clinical actions. However, the frequency of timing errors and associated clinical impact is unknown. We retrospectively analyzed vancomycin levels (n = 2,597) measured during 13 months at a large academic medical center. Of the specimens, 41.3% were drawn too early. These samples yielded significantly higher average ± SD vancomycin concentrations than correctly timed samples (22.1 ± 11.7 mg/L vs 15.5 mg/L ± 8.6 mg/L; P < .001), and, consequently, clinicians were more likely to decrease, discontinue, or hold a patient's vancomycin dose (25.6% vs 21.4%; P < .02) or repeat the vancomycin level (29.2% vs 20.0%; P < .001). A substantial proportion of specimens collected to assess vancomycin efficacy were drawn too early, leading to overestimation ofpatients' true trough level and possible underdosing of vancomycin or a high rate of repeat tests for vancomycin.

Subject terms:

Medical oncology - Cancérologie - Medical laboratory techniques - Techniques de laboratoire médical - General medicine general surgery - Médecine et chirurgie générales - Sciences biologiques et medicales - Biological and medical sciences - Sciences medicales - Medical sciences - Techniques d'exploration et de diagnostic (generalites) - Investigative techniques, diagnostic techniques (general aspects) - Anatomopathologie. Exploration cytologique. Biochimie. Spectrométries. Méthodes cliniques et paracliniques diverses - Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques - Anatomopathologie - Anatomic pathology - Anatomía patológica - Fréquence - Frequency - Frecuencia - Homme - Human - Hombre - Proportion - Proporción - Précoce - Early - Precoz - Prélèvement - Samplings - Toma de muestra - Qualité - Quality - Calidad - Suivi thérapeutique pharmacologique - Therapeutic drug monitoring - Monitorización farmacoterapéutica - Toxicité - Toxicity - Toxicidad - Vancomycine - Vancomycin - Vancomicina - Patient safety - Specimen collection

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A review of the clinical presentation, natural history and inheritance of variegate porphyria: its implausibility as the source of the 'Royal Malady'
HIFT, Richard J;PETERS, Timothy J;MEISSNER, Peter N
Academic Journal Academic Journal | Journal of clinical pathology. 65(3):200-205 Please log in to see more details
It has been suggested that King George III of Great Britain suffered from the haem bio... more
A review of the clinical presentation, natural history and inheritance of variegate porphyria: its implausibility as the source of the 'Royal Malady'
Journal of clinical pathology. 65(3):200-205
It has been suggested that King George III of Great Britain suffered from the haem biosynthetic disorder, variegate porphyria. This diagnosis is pervasive throughout the scientific and popular literature, and is often referred to as the 'Royal Malady.' The authors believe it inappropriate to view the case for porphyria purely in terms of symptoms, as has generally been the case in his presumptive acute porphyria diagnosis. Accordingly, this review provides a current description of the natural history and clinical presentation of the porphyrias, against which we measure the case for porphyria in George III and his relatives. The authors have critically assessed the prevalence of porphyria in a population, the expected patterns and frequency of inheritance, its penetrance and its expected natural history in affected individuals, and conclude that neither George nor his relatives had porphyria, based on four principal reasons. First, the rarity of the disease mandates a very low prior probability, and therefore implies a vanishingly low positive predictive value for any diagnostic indicator of low specificity, such as a historical reading of the symptoms. Second, penetrance of this autosomal dominant disorder is approximately 40%, and one may expect to have identified characteristic clinical features of porphyria in a large number of descendants without difficulty. Third, the symptoms of both George III and his relatives are highly atypical for porphyria and are more appropriately explained by other much commoner conditions. Finally, the natural history of the illnesses reported in this family is as atypical for variegate porphyria as are their symptoms.

Subject terms:

Medical oncology - Cancérologie - Medical laboratory techniques - Techniques de laboratoire médical - General medicine general surgery - Médecine et chirurgie générales - Sciences biologiques et medicales - Biological and medical sciences - Sciences medicales - Medical sciences - Dermatologie - Dermatology - Dermatoses diverses. Peau et pathologie générale. Généralités - Skin involvement in other diseases. Miscellaneous. General aspects - Maladies metaboliques - Metabolic diseases - Autres maladies métaboliques - Other metabolic disorders - Pigments (porphyries, hyperbilirubinémies...) - Pigments (porphyrias, hyperbilirubinemias...) - Techniques d'exploration et de diagnostic (generalites) - Investigative techniques, diagnostic techniques (general aspects) - Anatomopathologie. Exploration cytologique. Biochimie. Spectrométries. Méthodes cliniques et paracliniques diverses - Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques - Enzymopathie - Enzymopathy - Enzimopatía - Maladie héréditaire - Genetic disease - Enfermedad hereditaria - Maladie métabolique - Metabolic diseases - Metabolismo patología - Pathologie de la peau - Skin disease - Piel patología - Photosensibilité - Photosensitivity - Fotosensibilidad - Anatomopathologie - Anatomic pathology - Anatomía patológica - Article synthèse - Review - Artículo síntesis - Hérédité - Inheritance(genetics) - Herencia(genética) - Pathogénie - Pathogenesis - Patogenia - Pigment - Pigments - Pigmento - Porphyrie - Porphyria - Porfiria - Porphyrine - Porphyrin - Porfirina - Revue bibliographique - Bibliographic review - Revista bibliográfica - Symptomatologie - Symptomatology - Sintomatología

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LBP and sCD14 patterns in total hip replacement surgery performed during combined spinal/epidural anaesthesia
BASTIAN, Daniel;TAMBURSTUEN, Margareth V;LYNGSTADAAS, Stale P;REIKERAS, Ola...
Academic Journal Academic Journal | Scandinavian journal of clinical & laboratory investigation. 71(6):486-491 Please log in to see more details
Background. Danger patterns and pattern recognition receptors have been targets in the... more
LBP and sCD14 patterns in total hip replacement surgery performed during combined spinal/epidural anaesthesia
Scandinavian journal of clinical & laboratory investigation. 71(6):486-491
Background. Danger patterns and pattern recognition receptors have been targets in the investigation and treatment of systemic inflammatory response syndrome and sepsis. Lipopolysaccharide (LPS)-binding protein (LBP) presents LPS and gram-positive bacterial cell wall products to the receptors TLR4/MD-2 andTLR2, respectively. Low concentrations of LBP stimulate responses to LPS and peptidoglycan, whereas higher concentrations inhibit these responses. Soluble CD14 (sCD14) presents the LBP-LPS complex to CD14-negative cells, and it modulates the biological activity of circulating LPS. In this study, we aimed to elucidate the physiological reactions to LBP and sCD14 after total hip replacement surgery during spinal/epidural anaesthesia. Methods. Seven patients with coxarthrosis were operated upon with a total hip replacement, which is a defined trauma to bone and muscles in conjunction with a certain amount of blood loss. Venous blood samples were taken before the operation and at 1 h, 3 days and 6 days after surgery. LBP and sCD14 were measured by conventional ELISA. To correct for hemodilution, each parameter was adjusted for hematocrit. A panel of cytokines was measured using Luminex technology to evaluate the trauma reaction. Results. IL-6 levels peaked 24 h after the operation, whereas IL-1β and IL-10 levels remained unchanged. Systemic levels of LBP were increased 24 h after surgery, whereas sCD14 remained steady. However, the dilution-corrected sCD14 values increased significantly, and the levels of both LBP and sCD14 peaked at day 3 after surgery. Conclusion. Aseptic trauma primes the innate immune system for the posttraumatic release of LBP and sCD14.

Subject terms:

Medical laboratory techniques - Techniques de laboratoire médical - Sciences biologiques et medicales - Biological and medical sciences - Sciences medicales - Medical sciences - Techniques d'exploration et de diagnostic (generalites) - Investigative techniques, diagnostic techniques (general aspects) - Chirurgie (generalites). Transplantations, greffes d'organes et de tissus. Pathologie des greffons - Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases - Chirurgie orthopédique - Orthopedic surgery - Biologie clinique - Clinical biology - Biología clínica - Chirurgie orthopédique - Orthopedic surgery - Cirugía ortopédica - Extradural - Forme soluble - Soluble form - Forma soluble - Lipopolyoside - Lipopolysaccharide - Lipopoliósido - Protéine liaison - Binding protein - Proteína enlace - Traitement - Treatment - Tratamiento - Traumatisme - Trauma - Traumatismo - Antigène CD14 - Prothèse de hanche - Hip prosthesis - Prótesis de cadera - Lipopolysaccharide-binding protein - hip prosthesis - soluble CD14 - surgery - trauma

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A New PCR-Based Mass Spectrometry System for High-Risk HPV, Part II: Clinical Trial
HUI DU;JI YI;RUIFANG WU;BELINSON, Suzanne E;XINFENG QU;BIN YANG;CHUN WANG;X...
Academic Journal Academic Journal | American journal of clinical pathology. 136(6):920-923 Please log in to see more details
This was a population-based clinical trial of a polymerase chain reaction―based multip... more
A New PCR-Based Mass Spectrometry System for High-Risk HPV, Part II: Clinical Trial
American journal of clinical pathology. 136(6):920-923
This was a population-based clinical trial of a polymerase chain reaction―based multiplex high-risk human papillomavirus (HR-HPV) assay using mass spectrometry (MassARRAY [Sequenom, San Diego, CA] matrix-assisted laser desorption/ionization time-of-flight mass spectrometry system [MALDI-TOF]). Participants were 10, 000 women between the ages of 25 and 59 years in Guangdong Province, China (SHENCCAST II Study). All women collected a self-sample (tested with Cervista [Hologic, Marlborough, MA] and MALDI-TOF) followed by a clinician-collected cervical sample (for cytology, Hybrid Capture 2 [HC2; Qiagen, Gaithersburg, MD], Cervista, and MALDI-TOF). Patients with any abnormal result were asked to return for colposcopy and biopsies. This analysis included the data for 8,556 women. The sensitivity values for cervical intraepithelial neoplasia (CIN) 3 or worse for a direct cervical sample were 97.9%, 95.1%, and 94.3 for HC2, Cervista, and MALDI-TOF, respectively (P > .05). The sensitivity for CIN 3 or worse for a self-collected sample tested with MALDI-TOF was also 94.3%, which was similar to a clinician-obtained endocervical sample assayed with the 3 HR-HPTI assays. MALDI-TOF combined with a self-collected sample provides a highly sensitive, high-throughput, low-cost-per-case assay for mass screening.

Subject terms:

Medical oncology - Cancérologie - Medical laboratory techniques - Techniques de laboratoire médical - General medicine general surgery - Médecine et chirurgie générales - Sciences biologiques et medicales - Biological and medical sciences - Sciences medicales - Medical sciences - Pathologie infectieuse - Infectious diseases - Viroses - Viral diseases - Gynecologie. Andrologie. Obstetrique - Gynecology. Andrology. Obstetrics - Pathologie de l'appareil génital femelle - Female genital diseases - Tumeurs - Tumors - Techniques d'exploration et de diagnostic (generalites) - Investigative techniques, diagnostic techniques (general aspects) - Anatomopathologie. Exploration cytologique. Biochimie. Spectrométries. Méthodes cliniques et paracliniques diverses - Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques - Cancer - Cáncer - Infection - Infección - Papillomavirus - Papovaviridae - Pathologie de l'appareil génital femelle - Female genital diseases - Aparato genital hembra patología - Pathologie du col de l'utérus - Uterine cervix diseases - Cuello útero patología - Tumeur maligne - Malignant tumor - Tumor maligno - Virus - Anatomopathologie - Anatomic pathology - Anatomía patológica - Cancer du col de l'utérus - Cervical cancer - Cáncer de cuello del útero - Dépistage - Medical screening - Descubrimiento - Désorption laser - Laser desorption - Desorción láser - Essai clinique - Clinical trial - Ensayo clínico - Ionisation - Ionization - Ionización - Méthode temps vol - Time of flight method - Método tiempo vuelo - Papillomavirus humain - Human papillomavirus - Risque élevé - High risk - Riesgo alto - Réaction chaîne polymérase - Polymerase chain reaction - Reacción cadena polimerasa - Spectrométrie masse - Mass spectrometry - Espectrometría masa - Virose - Viral disease - Virosis - HPV - MALDI-TOF - Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry system - Screening

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