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Extramedullary Plasmacytoma-like Posttransplantation Lymphoproliferative Disorders: Clinical and Pathologic Features
RICHENDOLLAR, Bill G;HSI, Eric D;COOK, James R
Academic Journal Academic Journal | American journal of clinical pathology. 132(4):581-588 Please log in to see more details
Most monomorphic posttransplantation lymphoproliferative disorders (PTLDs) resemble di... more
Extramedullary Plasmacytoma-like Posttransplantation Lymphoproliferative Disorders: Clinical and Pathologic Features
American journal of clinical pathology. 132(4):581-588
Most monomorphic posttransplantation lymphoproliferative disorders (PTLDs) resemble diffuse large B-cell lymphoma or Burkitt lymphoma. Rare cases of PTLD resembling extramedullary plasmacytomas have also been described This report describes the clinical, histologic, phenotypic, and genotypic findings in 4 cases of plasmacytoma-like PTLD (2 nodal, 1 adenoidal, and I cutaneous) and compares the, findings with extramedullary involvement by plasma cell neoplasms arising in immunocompetent patients. Plasmacytoma-like PTLDs characteristically arise late after transplantation (mean, 7. 0 years), show a variable association with Epstein-Barr virus (2/4 cases positive), and demonstrate histologic and phenotypic findings that overlap with immunocompetent extramedullary plasma cell neoplasms. None of the patients with plasmacytoma-like PTLD developed lytic bone lesions, and 3 of 4 patients had complete responses (>2 years) to reduction of immunosuppression, confirming the role of immunosuppression in the pathogenesis of these lesions. This report, which represents the first case series of plasmacytoma-like PTLD, clarifies the features of this rare subtype of PTLD.

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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 - Anatomopathologie - Anatomic pathology - Anatomía patológica - Extramédullaire - Extramedullary - Extramedular - Forme clinique - Clinical form - Forma clínica - Plasmocytome - Plasmacytoma - Plasmocitoma - Symptomatologie - Symptomatology - Sintomatología - Syndrome lymphoprolifératif posttransplantation - Posttransplant lymphoproliferative disorder - Síndrome linfoproliferativo postrasplante - Syndrome lymphoprolifératif - Lymphoproliferative syndrome - Linfoproliferativo síndrome - Transplantation - Trasplantación - Hémopathie lymphoïde B - B cell neoplasm - PTLD - Plasmacytoma-like - Posttransplantation lymphoproliferative disorder

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Open versus arthroscopic surgery in acromioclavicular separation
Tudor M. Gavrilă;Ștefan Cristea
Academic Journal Academic Journal | Journal of Clinical and Investigative Surgery, Vol 3, Iss 2, Pp 82-87 (2018) Please log in to see more details
Acromioclavicular separation is a very serious injury at the level of shoulder. Lesion... more
Open versus arthroscopic surgery in acromioclavicular separation
Journal of Clinical and Investigative Surgery, Vol 3, Iss 2, Pp 82-87 (2018)
Acromioclavicular separation is a very serious injury at the level of shoulder. Lesion of the acromioclavicular joint is a usual clinical condition because of its superficial situation. It is often involved in trauma of the shoulder girdle. Rockwood classification involves VI types of modifications. First three types are treated conservatively, type IV to VI surgically. Arthroscopic techniques, lead to same middle and long-term results as open surgery. Arthroscopic procedures have theoretical advantages of no deltoid disruption and may help the surgeon to diagnose and treat associated lesions such as rotator cuff ruptures. More recently, arthroscopic surgeries for fresh and/or chronic acromioclavicular disjunctions were proposed. We analyzed 13 cases of acromioclavicular separation: 7 cases were treated with open surgery and 6 arthroscopically using tightrope, or dog bone button.

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acromio-clavicular separation - arthroscopy - tight-rope - Rockwood classification - Medicine

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Clinical, Immunophenotypic, and Genetic Characterization of Small Lymphocyte-Like Plasma Cell Myeloma: A Potential Mimic of Mature B-Cell Lymphoma
HEEREMA-MCKENNEY, Amy;WALDRON, James;HUGHES, Steven;FENGHUANG ZHAN;SAWYER, ...
Academic Journal Academic Journal | American journal of clinical pathology. 133(2):265-270 Please log in to see more details
We reviewed bone marrow studies from 351 multiple myeloma (MM) cases, selecting 12 cas... more
Clinical, Immunophenotypic, and Genetic Characterization of Small Lymphocyte-Like Plasma Cell Myeloma: A Potential Mimic of Mature B-Cell Lymphoma
American journal of clinical pathology. 133(2):265-270
We reviewed bone marrow studies from 351 multiple myeloma (MM) cases, selecting 12 cases (3.4%) with predominantly small lymphocyte-like morphologic features resembling B-cell lymphoma, and correlated their genetic and clinical features. All exhibited a diffuse interstitial pattern of marrow involvement. Small lymphocyte-like plasma cells were all CD45- with bright CD38 and CD138 expression and CD20 expression in 5 cases. No case had an increase in bone marrow B lymphocytes by flow cytometry. Of 12 cases, 9 were classified as the CD-2 molecular class by gene expression profiling (GEP). The 29 CD-2 class cases with (n = 9) and without (n = 20) small lymphocyte-like features could not be discerned from one another using global GEP. Event- free, but not overall, survival was significantly better in cases with small lymphocyte-like features among those sharing the CD-2 subtype. Small lymphocyte-like MM is a rare, morphologically challenging variant distinguished from B-cell lymphoma by lack of CD45 and presence of CD138 and the clinical presentation of MM. Most cases share a common GEP signature dominated by hyperexpression of cyclin D1 or cyclin D3 genes, with increased expression of the B-cell genes CD20 and VPREB3.

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 - Immunopathologie - Immunopathology - Immunodéficits. Immunoglobulinopathies - Immunodeficiencies. Immunoglobulinopathies - Immunoglobulinopathies - 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 - Immunoglobulinopathie - Immunoglobulinopathy - Inmunoglobulinopatía - Immunopathologie - Immunopathology - Inmunopatología - Syndrome lymphoprolifératif - Lymphoproliferative syndrome - Linfoproliferativo síndrome - Anatomopathologie - Anatomic pathology - Anatomía patológica - Caractérisation - Characterization - Caracterización - Cycline D1 - Cyclin D1 - Ciclina D1 - Gène onc cellulaire - C-Onc gene - Gen onc celular - Génétique - Genetics - Genética - Immunophénotype - Immunophenotype - Inmunofenotipo - Lymphocyte B - B-Lymphocyte - Linfocito B - Lymphome - Lymphoma - Linfoma - Mime - Mimic - Mimo - Morphologie - Morphology - Morfología - Myélome - Myeloma - Mieloma - Plasmocyte - Plasmocito - Protooncogène - Protooncogene - Protooncogen - Hémopathie lymphoïde B - B cell neoplasm - Hémopathie maligne lymphoïde - Lymphoid neoplasm - Profil d'expression génique - Gene expression profile - Perfil de expresión genética - B-cell lymphoma - Gene expression profiling - Plasma cell myeloma

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Clinical relevance of myocardial bridging severity : single center experience
MOOKADAM, F;GREEN, J;HOLMES, D;MOUSTAFA, S. E;RIHAL, C
Academic Journal Academic Journal | European journal of clinical investigation. 39(2):110-115 Please log in to see more details
Background Myocardial bridging refers to intramyocardial systolic compression of a seg... more
Clinical relevance of myocardial bridging severity : single center experience
European journal of clinical investigation. 39(2):110-115
Background Myocardial bridging refers to intramyocardial systolic compression of a segment of an epicardial coronary artery. We aimed to identify the clinical significance of myocardial bridging by assessing the clinical presentation in non-obstructive coronary artery disease among a cohort of consecutive patients presenting for coronary angiography. Materials and methods A retrospective review of our institution's database between September 2002 and March 2005 was conducted to review coronary angiography reports of 14 416 patients. The study group included 226 patients (prevalence = 1.57%) with isolated myocardial bridging and < 50% stenosis in the non-bridged arteries. Cases with myocardial bridging were classified according to the percentage of systolic compression of the left anterior descending artery into group I (< 50% compression), group ∥ (50-70% compression) and group III (compression ≥ 70%). Results Mean age was 57.6 ± 15.5 years; 59% were men. The mean duration of follow-up was 12 ± 2 months. The left anterior descending was the most common site of bridging (210, 93%). There was a significant difference between groups I and III with respect to the percentage of patients who presented with non-fatal myocardial infarction (P= 0.02). Unstable angina had the highest association with myocardial bridging, but there was no significance among the level of myocardial bridging severity and the clinical presentation of angina. Conclusions Myocardial bridging is not a benign variation of coronary anatomy. It is associated with angina and myocardial infarction in patients with ≥ 70% systolic compression. The bridged segment may be a cause of enhanced atherosclerotic plaque formation.

Subject terms:

General medicine general surgery - Médecine et chirurgie générales - Sciences biologiques et medicales - Biological and medical sciences - Sciences medicales - Medical sciences - Generalites - General aspects - Techniques d'exploration et de diagnostic (generalites) - Investigative techniques, diagnostic techniques (general aspects) - Radiodiagnostic. Imagerie rmn. Spectrométrie rmn - Radiodiagnosis. Nmr imagery. Nmr spectrometry - Coeur et vaisseaux - Cardiovascular system - Radiodiagnostic - Radiodiagnosis - Radiodiagnóstico - Centre - Center - Centro - Coronarographie - Coronary arteriography - Coronarografía - Myocarde - Myocardium - Miocardio - Médecine - Medicine - Medicina - Pertinence - Relevance - Pertinencia - Sévérité - Severity - Clinical significance - coronary angiography - myocardial bridging

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Tissue Microarray for Routine Clinical Breast Biomarker Analysis: The British Columbia Cancer Agency 2008 Experience
THOMSON, Thomas A;CHEN ZHOU;CEBALLOS, Kathy;KNIGHT, Bryan
Academic Journal Academic Journal | American journal of clinical pathology. 133(6):909-914 Please log in to see more details
Clinical use of tissue microarrays for immunohistochemical analysis of breast biomarke... more
Tissue Microarray for Routine Clinical Breast Biomarker Analysis: The British Columbia Cancer Agency 2008 Experience
American journal of clinical pathology. 133(6):909-914
Clinical use of tissue microarrays for immunohistochemical analysis of breast biomarkers, namely estrogen preceptor, progesterone receptor, and HER2, was instituted in our laboratory in 2008. The method has proved reliable and cost-effective. We report the results of the initial year of testing with this method.

Subject terms:

Amérique du Nord - North America - America del norte - Amérique - America - Canada - Canadá - Colombie britannique - British Columbia - Colombia Británica - 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 - Hormone ovarienne - Ovarian hormone - Hormona ovárica - Hormone stéroïde sexuelle - Sex steroid hormone - Hormona esteroide sexual - Pathologie de la glande mammaire - Mammary gland diseases - Glándula mamaria patología - Pathologie du sein - Breast disease - Seno patología - Analyse routine - Routine analysis - Análisis rutina - Anatomopathologie - Anatomic pathology - Anatomía patológica - Cancer du sein - Breast cancer - Cáncer del pecho - Glande mammaire - Mammary gland - Glándula mamaria - Gène erbB2 - erbB2 Gene - Gen erbB2 - Gène onc cellulaire - C-Onc gene - Gen onc celular - Indicateur biologique - Biological indicator - Indicador biológico - Marqueur biologique - Biological marker - Marcador biológico - Oestrogène - Estrogen - Estrógeno - Protooncogène - Protooncogene - Protooncogen - Récepteur hormonal - Hormonal receptor - Receptor hormonal - Récepteur oestrogène - Estrogen receptor - Receptor estrógeno - Récepteur progestérone - Progesterone receptor - Receptor progesterona - Sein - Breast - Seno - Tumeur maligne - Malignant tumor - Tumor maligno - Récepteur HER2 - Human Epidermal growth factor Receptor 2 - Technique TMA - Tissue microarrays - Biomarkers - HER2 - Tissue microarray

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High-Risk HPV Testing in Women 30 Years or Older With Negative Papanicolaou Tests: Initial Clinical Experience With 18-Month Follow-up
THRALL, Michael J;RUSSELL, Donna K;FACIK, Michael S;YAO, Jorge L;WARMER, Ju...
Academic Journal Academic Journal | American journal of clinical pathology. 133(6):894-898 Please log in to see more details
Cervical screening with combined cytology and high-risk human papillomavirus (HR-HPV) ... more
High-Risk HPV Testing in Women 30 Years or Older With Negative Papanicolaou Tests: Initial Clinical Experience With 18-Month Follow-up
American journal of clinical pathology. 133(6):894-898
Cervical screening with combined cytology and high-risk human papillomavirus (HR-HPV) detection has been approved for women 30 years or older. We investigated the clinical use of cotestingfor women with negative Papanicolaou tests. Follow-up cytology, HR-HPV test, and biopsy findings were identified during an 18-month period. In 1 year, 2,719 cotests from 2, 686 women were identified; 146 were positive for HR-HPV. Among women with positive HR-HPV testing, 120 had follow-up, including 70 with repeated cotesting, and 3 had high-grade dysplasia identified (2.5% of women with follow-up). In 1,334 women with initial double-negative cotest results who had repeated cytologic testing within 18 months, 2 high-grade dysplasias were found (0.1%). The vast majority of cotest results are double-negative. Among tests that show HR-HPV positivity, the prevalence of underlying high-grade dysplasia is low. About half of all women who undergo cotesting receive follow-up that is not in accord with published guidelines.

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 - 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 - Homme - Human - Hombre - Infection - Infección - Papillomavirus - Papovaviridae - Virus - Adulte - Adult - Adulto - Age - Edad - Anatomopathologie - Anatomic pathology - Anatomía patológica - Dépistage - Medical screening - Descubrimiento - Etude longitudinale - Follow up study - Estudio longitudinal - Exploration - Exploración - Femelle - Female - Hembra - Femme - Woman - Mujer - Malignité - Malignancy - Malignidad - Néoplasie intraépithéliale - Intraepithelial neoplasia - Neoplasia intraepitelial - Papillomavirus humain - Human papillomavirus - Personne âgée - Elderly - Anciano - Risque élevé - High risk - Riesgo alto - Tumeur maligne - Malignant tumor - Tumor maligno - Virose - Viral disease - Virosis - HPV - NILM - Negative for intraepithelial lesion or malignancy - Papanicolaou test

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Doppler-guided intra-operative fluid management during major abdominal surgery : systematic review and meta-analysis
WALSH, S. R;TANG, T;BASS, S;GAUNT, M. E
Academic Journal Academic Journal | International journal of clinical practice (Esher). 62(3):466-470 Please log in to see more details
Background: Peri-operative fluid therapy is a controversial area with few randomised t... more
Doppler-guided intra-operative fluid management during major abdominal surgery : systematic review and meta-analysis
International journal of clinical practice (Esher). 62(3):466-470
Background: Peri-operative fluid therapy is a controversial area with few randomised trials to guide practice. Recently, a number of trials have suggested that intra-operative therapy guided by oesophageal Doppler acquired haemodynamic variables may improve postoperative outcome. Methods: Abstract databases and conference proceedings were searched to identify randomised controlled trials comparing Doppler-guided intra-operative fluid management to standard practice in patients undergoing major abdominal surgery. Pooled odds ratios (POR) and weighted mean differences (WMD) were calculated for categorical and continuous outcomes respectively. Results: Four trials, comprising 393 patients, were identified. Use of an oesophageal Doppler-guided fluid management algorithm resulted in fewer postoperative complications (POR 0.32; 95% Cl: 0.19-0.52; p < 0.0001) and shorter hospital stays (WMD 1.68 days; 95% Cl: 2.39-0.98; p < 0.0001). There were no significant differences in the quantities of intra-operative fluids administered although there was some evidence of heterogeneity with respect to this outcome. Conclusion: Oesophageal Doppler-guided fluid management may improve outcome following major intra-abdominal surgery. However, comparison with fluid restriction strategies, including a cost-effectiveness analysis are required.

Subject terms:

General medicine general surgery - Médecine et chirurgie générales - Sciences biologiques et medicales - Biological and medical sciences - Sciences medicales - Medical sciences - Generalites - General aspects - Techniques d'exploration et de diagnostic (generalites) - Investigative techniques, diagnostic techniques (general aspects) - Exploration par ultrasons - Ultrasonic investigative techniques - Coeur et vaisseaux - Cardiovascular system - Exploration ultrason - Sonography - Exploración ultrasonido - Pratique basée sur des preuves - Evidence-based practice - Práctica basada en la evidencia - Conduite à tenir - Clinical management - Actitud médica - Dopplérométrie - Doppler ultrasound study - Dopplerometría - Guidage - Guidance - Guiado - Médecine factuelle - Evidence-based medicine - Medicina basada en pruebas - Métaanalyse - Metaanalysis - Meta-análisis - Peropératoire - Intraoperative - Peroperatorio - Revue bibliographique - Bibliographic review - Revista bibliográfica - Revue systématique - Systematic review - Revisión sistemática - Chirurgie abdominale

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Pathologic Findings in Novel Influenza A (H1N1) Virus (Swine Flu) Infection: Contrasting Clinical Manifestations and Lung Pathology in Two Fatal Cases
MUKHOPADHYAY, Sanjay;PHILIP, Abraham T;STOPPACHER, Robert
Academic Journal Academic Journal | American journal of clinical pathology. 133(3):380-387 Please log in to see more details
Although novel influenza A (H1N1) virus infection has assumed pandemic proportions, th... more
Pathologic Findings in Novel Influenza A (H1N1) Virus (Swine Flu) Infection: Contrasting Clinical Manifestations and Lung Pathology in Two Fatal Cases
American journal of clinical pathology. 133(3):380-387
Although novel influenza A (H1N1) virus infection has assumed pandemic proportions, there are few reports of the pathologic findings. Herein we describe the pathologic findings of novel influenza A (H1N1) infection based on findings in 2 autopsy cases. The first patient, a 36-year-old man, had, flu-like symptoms; oseltamivir (Tamiflu) therapy was started 8 days after onset of symptoms, and he died on day 15 of his illness. At autopsy, the main finding was diffuse alveolar damage with extensive fresh intra-alveolar hemorrhage. The second patient, a 46-year-old woman with alcoholism, was found unresponsive in a basement and brought to the hospital intoxicated and confused. Her condition deteriorated rapidly, and she died 4 days after admission. The main autopsy finding was acute bronchopneumonia with gram-positive cocci, intermixed with diffuse alveolar damage. The pathologic findings in these contrasting cases of novel influenza A (H1N1) infection are similar to those previously described for seasonal influenza. The main pathologic abnormality in fatal cases is diffuse alveolar damage, but it may be overshadowed by an acute bacterial bronchopneumonia.

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 - Viroses humaines - Human viral diseases - Viroses respiratoires et orl - Viral diseases of the respiratory system and ent viral diseases - 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 - Artiodactyla - Influenzavirus A - Mammalia - Orthomyxoviridae - Parvoviridae - Pathologie de l'appareil respiratoire - Respiratory disease - Aparato respiratorio patología - Ungulata - Vertebrata - Virose - Viral disease - Virosis - Virus - Anatomopathologie - Anatomic pathology - Anatomía patológica - Autopsie - Autopsy - Autopsia - Bactérie - Bacteria - Bactériose - Bacteriosis - Diffus - Diffuse - Difuso - Evolution - Evolución - Infection - Infección - Lésion - Lesion - Lesión - Oséltamivir - Oseltamivir - Pathologie des poumons - Lung disease - Pulmón patología - Porcin - Swine - Porcino - Pronostic - Prognosis - Pronóstico - Symptomatologie - Symptomatology - Sintomatología - Virus H1 - H1 virus - Virus grippal A - Influenza A virus - Grippe H1N1 - H1N1 influenza - Bacterial - Bronchopneumonia - Diffuse alveolar damage - Fatal outcome - H1 N1 virus - Lung pathology - Novel influenza A virus - Oseltamivir (Tamiflu) - Swine flu

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Lupus Anticoagulant Testing: Performance and Practices by North American Clinical Laboratories
DEMBITZER, Francine R;LEDFORD KRAEMER, Marlies R;MEIJER, Piet;PEERSCHKE, El...
Academic Journal Academic Journal | American journal of clinical pathology. 134(5):764-773 Please log in to see more details
Lupus anticoagulant (LAC) testing is important for evaluating patients with antiphosph... more
Lupus Anticoagulant Testing: Performance and Practices by North American Clinical Laboratories
American journal of clinical pathology. 134(5):764-773
Lupus anticoagulant (LAC) testing is important for evaluating patients with antiphospholipid syndromes and hypercoagulable states. We reviewed results of proficiency testing challenges (n = 5) distributed by the North American Specialized Coagulation Laboratory Association to examine LAC testing performed by participating laboratories. The activated partial thromboplastin time (APTT) and dilute Russell viper venom time (dR VVT) constituted major testing methods. In screening studies, LAC-sensitive APTT methods were more sensitive to weak LAC than dR VVT-based methods but less specific. In confirmatory testing, dR VVT methods performed better, butperformance was LAC-dependent. The highest false-negative confirmatory test results were obtained for the platelet neutralization procedure. Noncompliance with recommendations for LAC testing by the International Society on Thrombosis and Haemostasis was high (8%-38%), with the majority of noncompliant laboratories failing to report results of mixing studies. These data provide new insights into LAC testing in North America and identify opportunities for standardization.

Subject terms:

Amérique du Nord - North America - America del norte - Amérique - America - Etats-Unis - United States - Estados Unidos - 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 - Maladies des thrombocytes et coagulopathies - Platelet diseases and coagulopathies - 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 - Hémopathie - Hemopathy - Hemopatía - Reptilia - Vertebrata - Américain - American - Americano - Anatomopathologie - Anatomic pathology - Anatomía patológica - Anticoagulant circulant - Circulating anticoagulant - Anticoagulante circulante - Coagulopathie - Coagulopathy - Coagulopatía - Dépistage - Medical screening - Descubrimiento - Evaluation performance - Performance evaluation - Evaluación prestación - Laboratoire - Laboratory - Laboratorio - Ophidia - Performance - Rendimiento - Pratique professionnelle - Professional practice - Práctica profesional - Temps thromboplastine partielle - Partial thromboplastin time - Tiempo tromboplastina parcial - Venin - Venom - Veneno - Activated partial thromboplastin time - Dilute Russell viper venom time - Lupus anticoagulant - Proficiency testing

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Hormone Receptor and c-ERBB2 Status in Distant Metastatic and Locally Recurrent Breast Cancer: Pathologic Correlations and Clinical Significance
IDIRISINGHE, Pushpalatha K. A;AYE AYE THIKE;POH YIAN CHEOK;TSE, Gary Man-Ki...
Academic Journal Academic Journal | American journal of clinical pathology. 133(3):416-429 Please log in to see more details
Estrogen receptor (ER), progesterone receptor (PR), and c-ERBB2 (HER2/neu) are therape... more
Hormone Receptor and c-ERBB2 Status in Distant Metastatic and Locally Recurrent Breast Cancer: Pathologic Correlations and Clinical Significance
American journal of clinical pathology. 133(3):416-429
Estrogen receptor (ER), progesterone receptor (PR), and c-ERBB2 (HER2/neu) are therapeutically and prognostically important markers in the management of breast carcinoma. They are not always analyzed in distant metastatic and locally recurrent breast cancers. We compared immunohistochemical expression in a series of primary breast carcinomas with their distant metastases (n = 72) and local recurrences (n = 45) and analyzed the impact of any changes on survival. Discordance rates between primary and metastatic and between primary and locally recurrent lesions, respectively, were 18% (13/72) and 13% (6/45) for ER, 42% (30/72) and 33% (15/45) for PR, and 7% (5/72) and 2% (1/45) for c-ERBB2. There was statistically significant discordance between primary and metastatic PR status (P = .017; κ = 0.201). Among locally recurrent tumors, 15 (33%) of 45 revealed discordance for PR (P = .006; κ = 0.366). We observed a trend for shorter survival among women with ER- metastatic and locally recurrent tumors regardless of the primary tumor ER status. Our findings suggest a benefit for routine evaluation of ER, PR, and c-ERBB2 status in distant metastatic and locally recurrent breast cancer for therapeutic and prognostic purposes.

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 - Anatomopathologie - Anatomic pathology - Anatomía patológica - Cancer du sein - Breast cancer - Cáncer del pecho - Corrélation - Correlation - Correlación - Discordance - Discordancia - Gène erbB2 - erbB2 Gene - Gen erbB2 - Gène onc cellulaire - C-Onc gene - Gen onc celular - Métastase - Metastasis - Metástasis - Métastatique - Metastatic - Metastásico - Protooncogène - Protooncogene - Protooncogen - Récepteur hormonal - Hormonal receptor - Receptor hormonal - Récidivant - Recurrent - Recidivante - Récidive - Relapse - Recaida - Stade avancé - Advanced stage - Estadio avanzado - Récepteur HER2 - Human Epidermal growth factor Receptor 2 - Hormone receptors - Local recurrence - Metastases - c-ERBB2

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Clinical and Biologic Importance of F-Actin Autoantibodies in HCV Monoinfected and HCV-HIV Coinfected Patients
HUDACKO, Rachel M;ALVAREZ, Gustavo A;TALAL, Andrew H;JACOBSON, Ira;WAN, Dav...
Academic Journal Academic Journal | American journal of clinical pathology. 134(2):228-234 Please log in to see more details
The purpose of this study was to evaluate the relationship between serum filamentous (... more
Clinical and Biologic Importance of F-Actin Autoantibodies in HCV Monoinfected and HCV-HIV Coinfected Patients
American journal of clinical pathology. 134(2):228-234
The purpose of this study was to evaluate the relationship between serum filamentous (F)-actin antibody titers and severity of hepatitis present in hepatitis C virus (HCY)-infected patients. Liver biopsy samples from 18 HCV monoinfected and 20 HCV-HIV coinfected patients were graded with respect to the degree of hepatitis activity and intensity of plasma cell infiltration using MUM-1 and CD138 immunostains. Of the 38 HCV infected patients, 6 (16%) had F-actin antibody titers in excess of 30 enzyme-linked immunosorbent assay units. We found a positive trend between serum F-actin antibody levels and the mean number of plasma cells present in the portal tracts of patients with HCV infection (r = 0.31; P = . 06) and a significant association between these factors in HCV-HIV coinfectedpatients (r = 0.64; P = .002). Our data suggest that elevated serum F-actin antibody titers are commonly encountered in HCV-infected patients and may reflect more active inflammation in liver biopsy samples, similar to autoimmune hepatitis.

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 - Viroses humaines - Human viral diseases - Viroses du tissu lymphoïde et du sang. Sida - Viral diseases of the lymphoid tissue and the blood. Aids - Hépatites virales - Viral hepatitis - 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 - Flaviviridae - Hepacivirus - Immunodéficit - Immune deficiency - Inmunodeficiencia - Immunopathologie - Immunopathology - Inmunopatología - Infection - Infección - Pathologie de l'appareil digestif - Digestive diseases - Aparato digestivo patología - Pathologie du foie - Hepatic disease - Hígado patología - Virose - Viral disease - Virosis - Virus - Anatomopathologie - Anatomic pathology - Anatomía patológica - Anticorps - Antibody - Anticuerpo - Autoanticorps - Autoantibody - Autoanticuerpo - Autoimmunité - Autoimmunity - Autoinmunidad - Hépatite virale C - Viral hepatitis C - Hepatítis virica C - Infection mixte - Mixed infection - Infección mixta - Maladie autoimmune - Autoimmune disease - Enfermedad autoinmune - Plasmocytose - Plasmacytosis - Plasmocitosis - SIDA - AIDS - Virus hépatite C - Hepatitis C virus - Actine F - Autoantibodies - Autoimmune hepatitis - F-actin - Hepatitis C

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Cataract and refractive surgery.
Academic Journal Academic Journal | Current Medical Literature: Ophthalmology. 2011, Vol. 21 Issue 3, p107-110. 4p. Please log in to see more details

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Diagnostic performance of breast technologists in reading mammograms in a clinical patient population
VAN DEN BIGGELAAR, F. J. H. M;KESSELS, A. G. H;VAN ENGELSHOVEN, J. M. A;FLO...
Academic Journal Academic Journal | International journal of clinical practice (Esher). 64(4):442-450 Please log in to see more details
Purpose: In the setting of an increasing workload for radiologists, this study focuses... more
Diagnostic performance of breast technologists in reading mammograms in a clinical patient population
International journal of clinical practice (Esher). 64(4):442-450
Purpose: In the setting of an increasing workload for radiologists, this study focuses on the feasibility of skill mixing in breast imaging in a hospital radiology department. Methods: Two radiological technologists with more than 10 years of experience in performing mammograms were trained in prereading mammograms to select the cases that require further evaluation by a radiologist. Mammograms of consecutive patients were independently evaluated by the technologists, next to the standard clinical interpretation by the radiologist on duty. Mammographic findings were recorded and a BI-RADS classification was assigned for each breast. Different prereading scenarios were analysed using clinical decision rules. Two different cut-off points of BI-RADS classifications were applied to the data. Analysis was performed for the overall clinical patient population as well as for a subgroup of patients with no immediate indication for further work-up. Results: Mammograms of 1994 patients were evaluated. In total, 93 breast cancers were found in 91 patients (prevalence 4.6%). Sensitivity and specificity in selecting mammographic findings (cut-off point between BI-RADS 1 and BI-RADS 0, 2―5 and the radiologist's diagnosis as reference standard) was 98% and 74% for technologist 1 and 98% and 78% for technologist 2. In distinguishing normal and benign mammograms from those with abnormalities that are probably benign, suspicious or highly suggestive for malignancy (cut-off point BI-RADS 1―2 and BI-RADS 0, 3―5 and pathology results as reference standard), sensitivity decreased to 89% and 91% respectively. Specificity increased to 82% for both technologists. In a subgroup of 1389 patients with no immediate indication for additional imaging with the involvement of a radiologist, technologists obtained a mean sensitivity and specificity of 98% and 77% in detecting mammographic findings, and a mean sensitivity and specificity of 78% and 88% in detecting suspicious abnormalities. Conclusions: The employment of technologists in prereading mammograms seems to be an effective working strategy in daily clinical practice. However, its position in clinical practice remains indistinct as a continuous availability of radiologists still needs to be guaranteed. Nevertheless, as a substantial proportion of mammograms could be evaluated without the attention of a radiologist, the employment of technologists in prereading mammograms seems a promising new working strategy.

Subject terms:

General medicine general surgery - Médecine et chirurgie générales - Sciences biologiques et medicales - Biological and medical sciences - Sciences medicales - Medical sciences - Generalites - General aspects - Techniques d'exploration et de diagnostic (generalites) - Investigative techniques, diagnostic techniques (general aspects) - Radiodiagnostic. Imagerie rmn. Spectrométrie rmn - Radiodiagnosis. Nmr imagery. Nmr spectrometry - Appareil génital. Glande mammaire - Genital system. Mammary gland - Radiodiagnostic - Radiodiagnosis - Radiodiagnóstico - Diagnostic - Diagnosis - Diagnóstico - Evaluation performance - Performance evaluation - Evaluación prestación - Glande mammaire - Mammary gland - Glándula mamaria - Homme - Human - Hombre - Lecture - Reading - Lectura - Malade - Patient - Enfermo - Mammographie - Mammography - Mastografía - Médecine - Medicine - Medicina - Performance - Rendimiento - Population - Población - Sein - Breast - Seno

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Decreased accuracy in interpretation of community-based screening mammography for women with multiple clinical risk factors
COOK, Andrea J;ELMORE, Joann G;MIGLIORETTI, Diana L;SICKLES, Edward A;AIELL...
Academic Journal Academic Journal | Journal of clinical epidemiology. 63(4):441-451 Please log in to see more details
Objective: To assess the impact of women's breast cancer risk factors (use of hormone ... more
Decreased accuracy in interpretation of community-based screening mammography for women with multiple clinical risk factors
Journal of clinical epidemiology. 63(4):441-451
Objective: To assess the impact of women's breast cancer risk factors (use of hormone therapy, family history of breast cancer, previous breast biopsy) on radiologists' mammographic interpretive performance and whether the influence of risk factors varies according to radiologist characteristics. Study Design and Setting: Screening mammograms (n = 638,947) performed from 1996 to 2005 by 134 radiologists from three Breast Cancer Surveillance Consortium registries was linked to cancer outcomes, radiologist surveys, and patient questionnaires. Interpretive performance measures were modeled using marginal and conditional logistic regression. Results: Having one or more clinical risk factors was associated with higher recall rates (1 vs. 0 risk factors: odds ratio [OR] = 1.17, 95% confidence interval [CI] = 1.15-1.19; ≥2 vs. 0: OR = 1.43, 95% CI = 1.40-1.47) and lower specificity (1 vs. 0: OR = 0.86 [95% CI = 0.84-0.88]; ≥2 vs. 0: OR = 0.70 [95% CI = 0.68-0.72]) without a corresponding improvement in sensitivity and only a small increase in positive predictive value (1 vs. 0: OR = 1.08 [95% CI = 0.99-1.19]; ≥2 vs. 0: OR = 1.12 [95% CI = 0.99-1.26]). There was no indication that influence of risk factors varied by radiologist characteristics. Conclusion: Women with clinical risk factors who undergo screening mammography are more likely recalled for false-positive evaluation without an associated increase in cancer detection. Radiologists and patients with risk factors should be aware of this increased risk of adverse screening events.

Subject terms:

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) - Radiodiagnostic. Imagerie rmn. Spectrométrie rmn - Radiodiagnosis. Nmr imagery. Nmr spectrometry - Appareil génital. Glande mammaire - Genital system. Mammary gland - Sante publique. Hygiene-medecine du travail - Public health. Hygiene-occupational medicine - Santé publique. Hygiène - Public health. Hygiene - Mesures de prévention et actions - Prevention and actions - Cancer - Cáncer - Pathologie de la glande mammaire - Mammary gland diseases - Glándula mamaria patología - Pathologie du sein - Breast disease - Seno patología - Radiodiagnostic - Radiodiagnosis - Radiodiagnóstico - Biopsie - Biopsy - Biopsia - Cancer du sein - Breast cancer - Cáncer del pecho - Dépistage - Medical screening - Descubrimiento - Evaluation performance - Performance evaluation - Evaluación prestación - Facteur risque - Risk factor - Factor riesgo - Femelle - Female - Hembra - Femme - Woman - Mujer - Glande mammaire - Mammary gland - Glándula mamaria - Histoire familiale - Family story - Historia familiar - Homme - Human - Hombre - Interprétation - Interpretation - Interpretación - Mammographie - Mammography - Mastografía - Milieu familial - Family environment - Medio familiar - Multiple - Múltiple - Ménopause - Menopause - Menopausia - Performance - Rendimiento - Précision - Accuracy - Precisión - Traitement hormonal substitutif - Hormone replacement therapy - Hormonoterapia sustitutiva - Traitement hormonal - Hormone therapy - Hormonoterapia - Tumeur maligne - Malignant tumor - Tumor maligno - Breast biopsy - Breast cancer screening - Family history - Hormone-replacement therapy - Radiologist performance

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Pathologic Characteristics of Solitary Small Renal Masses : Can They Be Predicted by Preoperative Clinical Parameters?
DEROCHE, Tom;WALKER, Esteban;MAGI-GALLUZZI, Cristina;MING ZHOU
Academic Journal Academic Journal | American journal of clinical pathology. 130(4):560-564 Please log in to see more details
We studied the pathologic features and whether clinical features could predict patholo... more
Pathologic Characteristics of Solitary Small Renal Masses : Can They Be Predicted by Preoperative Clinical Parameters?
American journal of clinical pathology. 130(4):560-564
We studied the pathologic features and whether clinical features could predict pathologic outcomes in small renal masses. The study included all adult patients with solitary, nonmetastatic renal masses 4 cm or smaller confirmed by nephrectomy or needle biopsy between 2004 and 2006. Tumor size, histologic type, Fuhrman nuclear grade, and stage were obtained from surgical pathology reports. Clinical variables included age, sex, tumor size, and symptomatology. The study included 290 men and 198 women (mean age, 59.3 years). Median tumor size was 2.6 cm (range, 0.5-4.0 cm). Approximately 84% of masses were incidentally detected. Nonneoplastic entities, benign neoplasms, and low- and high-grade carcinoma accounted for 1.6%, 18.0%, 49.0%, and 31.4% of masses, respectively. Women were more likely to have a benign mass (27.3% vs 14.5% of men, P <.001). Age (P =.56), tumor size (mean, 2.63 vs 2.46 cm for benign; P =.08), and symptomatology (P =.46) were not associated with malignancy. Multivariate analyses using sex, age, tumor size, and symptomatology failed to produce a model useful to predict the pathology of individual tumors. This inability may argue for an increased role for needle biopsy in their evaluation.

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 - Nephrologie. Maladies des voies urinaires - Nephrology. Urinary tract diseases - Tumeurs de l'appareil urinaire - Tumors of the urinary system - Reins - Kidneys - 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 - Appareil urinaire - Urinary system - Aparato urinario - Cancer - Cáncer - Pathologie de l'appareil urinaire - Urinary system disease - Aparato urinario patología - Pathologie du rein - Kidney disease - Riñón patología - Tumeur maligne - Malignant tumor - Tumor maligno - Anatomopathologie - Anatomic pathology - Anatomía patológica - Cancer rein - Kidney cancer - Cáncer del riñón - Carcinome - Carcinoma - Corrélation - Correlation - Correlación - Facteur prédictif - Predictive factor - Factor predictivo - Hypernéphrome - Grawitz tumor - Hipernefroma - Masse - Mass - Masa - Paramètre - Parameter - Parámetro - Prédiction - Prediction - Predicción - Préopératoire - Preoperative - Preoperatorio - Rein - Kidney - Riñón - Clinical correlation - Pathology - Renal cell carcinoma - Small renal mass

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Does histopathological examination of breast reduction specimens affect patient management and clinical follow up?
COOK, I. S;FULLER, C. E
Academic Journal Academic Journal | Journal of clinical pathology. 57(3):286-289 Please log in to see more details
Aim: To assess the value of the histopathological examination of routine breast reduct... more
Does histopathological examination of breast reduction specimens affect patient management and clinical follow up?
Journal of clinical pathology. 57(3):286-289
Aim: To assess the value of the histopathological examination of routine breast reduction specimens. Methods: All patients who underwent breast reduction surgery over a 10 year period were identified. The histopathology report for each patient was analysed. For all cases with important microscopic abnormalities, the patient's medical notes were examined to identify whether clinical follow up was arranged. Results: Histopathology reports for specimens from 1289 patients were examined. One thousand, two hundred and fifty eight of these specimens (97.6%) were reported microscopically as showing normal breast tissue or benign breast disease, 26 cases (2.0%) showed lesions of uncertain malignant potential, four cases (0.3%) showed ductal carcinoma in situ (DCIS) or microinvasive malignancy, and there was one case (0.1%) of invasive malignancy. Important diagnoses were made in 2.1% of cases with no macroscopic abnormality. Clinical follow up was arranged for all patients with a diagnosis of DCIS, microinvasive carcinoma, or invasive malignancy. There were 26 patients diagnosed with lesions of uncertain malignant potential; 11 had follow up arrangements made and 13 patients were discharged. Follow up data was not available for two patients. Conclusions: Histopathological examination of breast reduction specimens may reveal important pathological diagnoses. In some cases, patients were discharged from medical care despite histopathological examination revealing lesions associated with an increased risk of developing breast carcinoma.

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 - Chirurgie - Surgery - Cirugía - Anatomopathologie - Anatomic pathology - Anatomía patológica - Conduite à tenir - Clinical management - Actitud médica - Glande mammaire - Mammary gland - Glándula mamaria - Histopathologie - Histopathology - Histopatología - Homme - Human - Hombre - Réduction chirurgicale - Open reduction - Reducción quirúrgica - Traitement - Treatment - Tratamiento

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A 2-Year Study of Patient Safety Competency Assessment in 29 Clinical Laboratories
REED, Robyn C;KIM, Sara;FARQUHARSON, Kara;ASTION, Michael L
Academic Journal Academic Journal | American journal of clinical pathology. 129(6):959-962 Please log in to see more details
Competency assessment is critical for laboratory operations and is mandated by the Cli... more
A 2-Year Study of Patient Safety Competency Assessment in 29 Clinical Laboratories
American journal of clinical pathology. 129(6):959-962
Competency assessment is critical for laboratory operations and is mandated by the Clinical Laboratory Improvement Amendments of 1988. However, no previous reports describe methods for assessing competency in patient safety. We developed and implemented a Web-based tool to assess performance of 875 laboratory staff from 29 laboratories in patient safety. Question categories included workplace culture, categorizing error, prioritization of patient safety interventions, strength of specific interventions, and general patient safety concepts. The mean score was 85.0%, with individual scores ranging from 56% to 100% and scores by category from 81.3% to 88.6%. Of the most difficult questions (<72% correct), 6 were about intervention strength, 3 about categorizing error, 1 about workplace culture, and 1 about prioritization of interventions. Of the 13 questions about intervention strength, 6 (46%) were in the lowest quartile, suggesting that this may be a difficult topic for laboratory technologists. Computer-based competency assessments help laboratories identify topics for continuing education in patient safety.

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 - Conduite à tenir - Clinical management - Actitud médica - Erreur - Error - Homme - Human - Hombre - Laboratoire - Laboratory - Laboratorio - Toxicité - Toxicity - Toxicidad - Administration - Assessment - Competency - Errors - Management - Patient safety

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Annual Meeting of the American Society for Clinical Pathology (ASCP)
Conference Conference | American journal of clinical pathology. 128(4):681-710 Please log in to see more details
Annual Meeting of the American Society for Clinical Pathology (ASCP)
American journal of clinical pathology. 128(4):681-710

Subject terms:

Amérique du Nord - North America - America del norte - Amérique - America - Etats Unis - United States - Estados Unidos - 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 - Américain - American - Americano - Anatomopathologie - Anatomic pathology - Anatomía patológica

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Tissue Microarray for Routine Analysis of Breast Biomarkers in the Clinical Laboratory
THOMSON, Thomas A;CHEN ZHOU;CHU, Christina;KNIGHT, Bryan
Academic Journal Academic Journal | American journal of clinical pathology. 132(6):899-905 Please log in to see more details
Tissue microarray analysis (TMA) allows multiple analyses on multiple patients on sect... more
Tissue Microarray for Routine Analysis of Breast Biomarkers in the Clinical Laboratory
American journal of clinical pathology. 132(6):899-905
Tissue microarray analysis (TMA) allows multiple analyses on multiple patients on sections from a single paraffin block. Although it is widely used in research and in quality assurance settings, there are few references to its use in clinical practice. This study evaluated TMA assessment of breast biomarkers using immunohistochemical analysis in a clinical histopathology laboratory. Performance parameters, interobserver variability, and concordance between TMA and whole section results were assessed. The arrays had few lost or noninformative cores. A loss of stain intensity occurred in the arrays compared with the whole sections with some but not all antibodies, highlighting the need to validate the staining protocol for each antibody used on TMA sections. With recommended guidelines for specimen selection and reporting, TMA was found to be an economical replacement for whole section analysis for breast biomarkers.

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 - Analyse routine - Routine analysis - Análisis rutina - Anatomopathologie - Anatomic pathology - Anatomía patológica - Aspect économique - Economic aspect - Aspecto económico - Contrôle qualité - Quality control - Control de calidad - Coût - Costs - Coste - Economie santé - Health economy - Economía salud - Glande mammaire - Mammary gland - Glándula mamaria - Immunohistochimie - Immunohistochemistry - Inmunohistoquímica - Indicateur biologique - Biological indicator - Indicador biológico - Laboratoire - Laboratory - Laboratorio - Marqueur biologique - Biological marker - Marcador biológico - Sein - Breast - Seno - Technique TMA - Tissue microarrays - Tumeur sein - Breast tumor - Tumor pecho - Biomarkers - Breast tumors - Cost savings - Tissue microarray

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Validation of the Agilent 244K Oligonucleotide Array- Based Comparative Genomic Hybridization Platform for Clinical Cytogenetic Diagnosis
SHIHUI YU;BITTEL, Douglas C;KIBIRYEVA, Nataliya;ZWICK, David L;COOLEY, Lind...
Academic Journal Academic Journal | American journal of clinical pathology. 132(3):349-360 Please log in to see more details
High-resolution microarray comparative genomic hybridization (aCGH) is being adopted f... more
Validation of the Agilent 244K Oligonucleotide Array- Based Comparative Genomic Hybridization Platform for Clinical Cytogenetic Diagnosis
American journal of clinical pathology. 132(3):349-360
High-resolution microarray comparative genomic hybridization (aCGH) is being adopted for diagnostic evaluation ofgenomic disorders, but validation for clinical diagnosis has not yet been reported. We present validation data for the Agilent Human Genome Microarray Kit 244Kfor clinical application. The platform contains approximately 240, 000 distinct 60-mer oligonucleotide probes spanning the entire human genome. We studied 45 previously characterized samples (43 abnormal, 2 normal), 32 with knowledge of prior results and 13 in a blinded manner with 11 performed in a reference laboratory providing microarray testing. Array analysis confirmed known aberrations in 43 samples and a normal result in 2. The array analysis corrected 1 karyotype and clarified 2 additional cases. Array data from 6 patients with 22q11.2 deletion found an average of 2.56 megabases (Mb; range, 2.49-2.62 Mb) with a common 2.43-Mb deleted region. Approximately 7 copy number variants from 400 base pairs to 1.6 Mb were identified per sample. Results demonstrate the usefulness of the aCGH-244K platform as a powerful diagnostic tool.

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 - Aberration chromosomique - Chromosomal aberration - Aberración cromosómica - Anatomopathologie - Anatomic pathology - Anatomía patológica - Cytogénétique - Cytogenetics - Citogenética - Diagnostic - Diagnosis - Diagnóstico - Expression génique - Gene expression - Expresión genética - Génotype - Genotype - Genotipo - Hybridation génomique comparative - Comparative genomic hybridization - Hibridación genómica comparativa - Nombre copie - Copy number - Número copia - Oligonucléotide - Oligonucleotide - Oligonucleótido - Validation - Validación - Variabilité génétique - Genetic variability - Variabilidad genética - Variant - Variante - Array-based comparative genomic hybridization - Chromosome abnormality - Copy number variant

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Time Study of Clinical and Nonclinical Workload in Pathology and Laboratory Medicine
TROTTER, Martin J;LARSEN, Erik T;TAIT, Nicholas;WRIGHT, James R
Academic Journal Academic Journal | American journal of clinical pathology. 131(6):759-767 Please log in to see more details
We describe a detailed, cross-sectional, self- report time study of laboratory physici... more
Time Study of Clinical and Nonclinical Workload in Pathology and Laboratory Medicine
American journal of clinical pathology. 131(6):759-767
We describe a detailed, cross-sectional, self- report time study of laboratory physician tasks in a regionalized, multisite academic setting, using custom data collection templates programmed into personal digital assistants (PDAs). The 7-week study was completed by 56 medical and scientific staff (86% participation rate). Participants recorded 12, 781 PDA entries of specific tasks completed during the study period. The mean number of entries per worked day per participant was 8.14 (range, 1.96-14.33). Study results demonstrated that professional staff worked, on average, 53.5 hours per week. Percentage work time spent in each activity area was as follows: clinical, direct, 50.6%; administration, 18.5%; clinical, indirect, 9.5%; research, 8.2%; learning/continuing education, 5.3%; teaching, 4.9%; and quality assurance, 3.1%. These percentages varied significantly by laboratory medicine subspecialty and by type of academic appointment. The findings confirm that activities not directly involved with patient care, such as administration, quality assurance, teaching, research, and professional development, typically occupy 40% to 50% of a laboratory physician's time.

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 - Charge travail - Workload - Carga trabajo - Etude temps - Time study - Estudio tiempo - Laboratoire - Laboratory - Laboratorio - Médecine - Medicine - Medicina - Personal digital assistant

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The Clinical Reliability of Automated Cerebrospinal Fluid Cell Counts on the Beckman-Coulter LH750 and Iris iQ200
GLASSER, Lewis;MURPHY, Carole A;MACHAN, Jason T
Academic Journal Academic Journal | American journal of clinical pathology. 131(1):58-63 Please log in to see more details
Although automation has improved the accuracy and precision of blood cell counts and i... more
The Clinical Reliability of Automated Cerebrospinal Fluid Cell Counts on the Beckman-Coulter LH750 and Iris iQ200
American journal of clinical pathology. 131(1):58-63
Although automation has improved the accuracy and precision of blood cell counts and is more rapid and less labor-intensive, cerebrospinal fluid (CSF) samples are still counted manually. We compared the IRIS iQ200 Body Fluids Module (Iris Diagnostics, Chatsworth, CA) and the Beckman-Coulter LH750 (Beckman-Coulter, Brea, CA) with manual counts and evaluated the impact of automation on the laboratory if clinically acceptable performance was to be maintained. Automated counts were compared with manual counts on 313 specimens. Clinical reliability was estimated using the weighted K coefficient and the impact of errors discussed in the context of a historic census of 3,653 samples spanning 19 months. Nucleated cell counts had a reliability of 0.73 for the LH750 and 0.84 for the iQ200. However, our results showed unacceptable rates of error at counts less than 200/μL (200 × 106/L) for the LH750 and less than 50/μL (50 × 106/L) for the iQ200, representing 94% and 83% of the census specimens, respectively. If clinical reliability is to be maintained, neither the LH750 nor iQ200 would have a significant impact on improving the efficiency of the laboratory because of the high percentage of low CSF cell counts.

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 - Analyse automatique - Automatic analysis - Análisis automático - Anatomopathologie - Anatomic pathology - Anatomía patológica - Cellule - Cell - Célula - Fiabilité - Reliability - Fiabilidad - Iris (oeil) - Iris (eye) - Iris (ojo) - Liquide corporel - Body fluid - Líquido corporal - Liquide céphalorachidien - Cerebrospinal fluid - Líquido cefalorraquídeo - Numération - Numeration - Numeración - Body fluids - Iris iQ200 - LH750

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A Comparison of Estrogen Receptor SP1 and 1 D5 Monoclonal Antibodies in Routine Clinical Use Reveals Similar Staining Results
BROCK, Jane E;HORNICK, Jason L;RICHARDSON, Andrea L;DILLON, Deborah A;LESTE...
Academic Journal Academic Journal | American journal of clinical pathology. 132(3):396-401 Please log in to see more details
Clinical therapies for breast cancer are guided by estrogen receptor (ER) status deter... more
A Comparison of Estrogen Receptor SP1 and 1 D5 Monoclonal Antibodies in Routine Clinical Use Reveals Similar Staining Results
American journal of clinical pathology. 132(3):396-401
Clinical therapies for breast cancer are guided by estrogen receptor (ER) status determined by immunohistochemical analysis. A previous retrospective study comparing the recently generated rabbit SP1 monoclonal antibody (MAb) with the conventionally used mouse 1D5 MAb reported that 8% of breast carcinomas were SP1+/1D5- (correlating with good outcomes), and 2% were SP1-/1D5+ (correlating with poorer outcomes). This study on mostly previously frozen tissue implied that 1D5 fails to identify some women who may benefit from endocrine therapy. The current prospective study compared SP1 and 1D5 immunostaining on routinely processed consecutive cases of breast carcinoma. ER was classified using the same positive threshold used in the prior study (<1% negative; ≥1% positive). Of 508 carcinomas, 2 were SP1+/1D5-, and none were SP1-/1D5+. Although SP1 is our preferred antibody, with more intense nuclear staining, both MAbs give similar results in tissue from routine clinical samples with discrepant results in fewer than 0.5% of cases.

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 - Hormone ovarienne - Ovarian hormone - Hormona ovárica - Hormone stéroïde sexuelle - Sex steroid hormone - Hormona esteroide sexual - 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 routine - Routine analysis - Análisis rutina - Anatomopathologie - Anatomic pathology - Anatomía patológica - Anticorps monoclonal - Monoclonal antibody - Anticuerpo monoclonal - Cancer du sein - Breast cancer - Cáncer del pecho - Carcinome du sein - Breast carcinoma - Carcinoma pecho - Coloration échantillon - Staining - Coloración muestra - Etude comparative - Comparative study - Estudio comparativo - Oestrogène - Estrogen - Estrógeno - Récepteur hormonal - Hormonal receptor - Receptor hormonal - Récepteur oestrogène - Estrogen receptor - Receptor estrógeno - Utilisation - Use - Uso - Facteur de transcription Sp1 - Transcription factor Sp1 - 1 D5 - Monoclonal antibodies - SP1

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Clinical, pathologic, and molecular abnormalities associated with the members of the MiT transcription factor family
RAMPHAL, Raveena;PAPPO, Alberto;ZIELENSKA, Maria;GRANT, Ronald;NGAN, Bo-Yee
Academic Journal Academic Journal | American journal of clinical pathology. 126(3):349-364 Please log in to see more details
We describe the clinical features, outcome, pathology, cytogenetics, and molecular asp... more
Clinical, pathologic, and molecular abnormalities associated with the members of the MiT transcription factor family
American journal of clinical pathology. 126(3):349-364
We describe the clinical features, outcome, pathology, cytogenetics, and molecular aspects of 13 pediatric papillary renal cell carcinomas during a 19-year period. Seven cases (54%) had translocations involving Xp11.2 (TFE3). They were identified by cytogenetic, molecular, and/or immunohistochemical analyses. All Xp11.2+ translocations were TFE3+ by immunostaining. Cytogenetic and/or polymerase chain reaction analyses identified 3 cases with t(X17) and 1 case with t(1;17), and all had additional translocations. Histologic features in common in TFE3+ tumors also were present in some TFE3- tumors. One TFE3- tumor had complex cytogenetic abnormalities, 55XY,+2, del(3)(p14), +7, +8, +72, +13, +16, +17, +20[11], and 2 cases had normal karyotypes. None had t(6;11)/TFEB+ immunostaining. Five cases had focal, weak MITF tumor immunostaining. The key clinical findings were as follows: (1) The presence of an Xpll.2 (TFE3) translocation frequently is associated with advanced stage at initial examination. (2) All patients who underwent complete, partial nephrectomy with clear margins (adequate only for stage 1) and resection of metastases were alive and relapse-free at last follow-up. (3) The mean ± SD event-free survival and overall survival rates at 5 years were both 92% ± 7.4%. (4) One patient with a TFE3+ and MITF+ tumor and 66-87,XXY,der(1)t(1;8)del(4)(q?) der(11)t(11;15)derl7t(X;17) abnormalities died 9 months after diagnosis.

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 - Nephrologie. Maladies des voies urinaires - Nephrology. Urinary tract diseases - Tumeurs de l'appareil urinaire - Tumors of the urinary system - Reins - Kidneys - 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 - Aberration chromosomique - Chromosomal aberration - Aberración cromosómica - Appareil urinaire pathologie - Urinary system disease - Aparato urinario patología - Chromosome anormal - Abnormal chromosome - Cromosoma anormal - Homme - Human - Hombre - Rein pathologie - Kidney disease - Riñón patología - Tumeur maligne - Malignant tumor - Tumor maligno - Anatomopathologie - Anatomic pathology - Anatomía patológica - Anomalie - Anomaly - Anomalía - Association - Asociación - Biologie moléculaire - Molecular biology - Biología molecular - Cancer rein - Kidney cancer - Cáncer del riñón - Carcinome papillaire - Papillary carcinoma - Carcinoma papilar - Chromosome X - X-Chromosome - Cromosoma X - Cytogénétique - Cytogenetics - Citogenética - Enfant - Child - Niño - Etude familiale - Family study - Estudio familiar - Facteur transcription - Transcription factor - Factor transcripción - Forme clinique - Clinical form - Forma clínica - Hypernéphrome - Grawitz tumor - Hipernefroma - Immunopathologie - Immunopathology - Inmunopatología - Milieu familial - Family environment - Medio familiar - Pédiatrie - Pediatrics - Pediatría - Symptomatologie - Symptomatology - Sintomatología - Transduction signal - Signal transduction - Transducción señal - Translocation chromosomique - Chromosome translocation - Translocación cromosómica - Facteur transcription MITF - Transcription factor MITF - Clinical features - MITF - Molecular diagnostics - Pediatric papillary renal cell carcinoma - TFE3 - Xp11.2 translocation

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Strict Adherence to a Blood Bank Specimen Labeling Policy by All Clinical Laboratories Significantly Reduces the Incidence of Wrong Blood in Tube
O'NEILL, Edward;RICHARDSON-WEBER, Leslie;MCCORMACK, Gina;UHL, Lynne;HASPEL,...
Academic Journal Academic Journal | American journal of clinical pathology. 132(2):164-168 Please log in to see more details
Phlebotomy errors leading to incompatible transfusions are a leading cause of transfus... more
Strict Adherence to a Blood Bank Specimen Labeling Policy by All Clinical Laboratories Significantly Reduces the Incidence of Wrong Blood in Tube
American journal of clinical pathology. 132(2):164-168
Phlebotomy errors leading to incompatible transfusions are a leading cause of transfusion-related morbidity and mortality. Our institution's specimen-labeling policy requires the collection date, 2 unique patient identifiers, and the ability to identify the phlebotomist. This policy, however, was initially strictly enforced only by the blood bank. In fiscal year 2005, following an educational campaign on proper specimen labeling, all clinical laboratories began strictly adhering to the specimen-labeling policy. Compared with the preceding 4 years, in the 3 years following policy implementation, the incidence of wrong blood in tube (WBIT) and mislabeled specimens detected by the blood bank decreased by 73.5% (0.034% to 0.009%; P ≤. 0001) and by 84.6% (0.026% to 0.004%; P ≤ .0001), respectively. During a short period, a simple, low-cost educational initiative and policy change can lead to statistically significant decreases in WBIT and mislabeled specimens received by the blood bank.

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 - Anesthesie. Reanimation. Transfusion. Therapie cellulaire et therapie genique - Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy - Transfusions. Complications. Accidents transfusionnels. Thérapie cellulaire et thérapie génique - Transfusions. Complications. Transfusion reactions. Cell and gene therapy - Sang. Succédanés du sang et du plasma. Constituants du sang. Cellules sanguines. Groupage sanguin. Plasmaphérèse. Aphérèse - Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis - Anatomopathologie - Anatomic pathology - Anatomía patológica - Banque sang - Blood bank - Banco sangre - Erreur - Error - Etiquetage - Labelling - Etiquetaje - Homme - Human - Hombre - Laboratoire - Laboratory - Laboratorio - Phlébotomie - Phlebotomy - Flebotomía - Sang - Blood - Sangre - Transfusion - Transfusión - Tube - Tubo - Mistransfusion - Specimen labeling - Wrong blood in tube

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