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Archives of Pathology & Laboratory... Jul 2021Both the incidence of cancer and cancer-related mortality rates are high in sub-Saharan Africa, while resources for diagnosis and management are inadequate. In Benin,...
CONTEXT.—
Both the incidence of cancer and cancer-related mortality rates are high in sub-Saharan Africa, while resources for diagnosis and management are inadequate. In Benin, there is an extreme shortage of pathology services. Because of this shortage we built a histopathology laboratory equipped with an automated immunohistochemistry and a whole-slide imaging and telepathology system.
OBJECTIVE.—
To report our experience of telepathology practice in the improvement of cancer diagnosis.
DESIGN.—
The study was performed in our histopathology laboratory from January 1, 2016, to December 31, 2018. Resident laboratory technicians were trained in the preparation of microscopic and virtual slides by European pathologists. Virtual slides were stored on a Web-accessible server area for reading by 21 telepathologists in Benin and Europe. All patients with a histologic diagnosis of cancer were included in this study. Demographic data of patients, anatomic site of cancer, its histologic type, and its histologic grade were recorded.
RESULTS.—
We registered 399 patients diagnosed with cancer of 1593 patients whose surgical specimens had been analyzed. There were 349 adults including 160 males and 189 females, and 50 children (both sexes) with a mean age of 53.40 years, 46.92 years, and 9.72 years, respectively. Eighty-three of 211 females (39.34%) had infiltrating breast carcinoma, and 34 of 188 males (18.09%) had prostatic carcinoma. Infiltrating carcinoma of no special type represented 51 (91.07%) of all infiltrating breast carcinomas. Prostatic carcinoma and infiltrating breast carcinoma were of high grade in 13 of 23 males (56.52%) and 34 of 56 females (60.71%), respectively.
CONCLUSIONS.—
Telepathology is enabling a great improvement in cancer diagnosis in our hospital.
Topics: Adolescent; Adult; Aged; Automation, Laboratory; Benin; Biomarkers, Tumor; Child; Child, Preschool; Female; Humans; Image Interpretation, Computer-Assisted; Immunohistochemistry; Infant; Male; Middle Aged; Neoplasms; Predictive Value of Tests; Program Evaluation; Remote Consultation; Reproducibility of Results; Retrospective Studies; Telepathology; Young Adult
PubMed: 33091927
DOI: 10.5858/arpa.2019-0437-OA -
Archives of Pathology & Laboratory... Oct 2020The measurement of cytokines in clinical laboratories is becoming an increasingly routine part of immune monitoring when administering biologic and cell-based...
CONTEXT.—
The measurement of cytokines in clinical laboratories is becoming an increasingly routine part of immune monitoring when administering biologic and cell-based immunotherapies and also for clinical assessment of inflammatory conditions. While a number of commercial assays and platforms are available for cytokine measurement, there is currently little standardization among these analytical methods.
OBJECTIVE.—
To characterize the variability and comparability among cytokine testing platforms that are commonly used in clinical laboratories.
DESIGN.—
We analyzed data for 4 cytokines (interleukin [IL]-1, IL-6, IL-8, and tumor necrosis factor-alpha [TNF-α]) from 6 College of American Pathologists cytokine surveys administered from 2015 to 2018. Analyses interrogated variability between testing methods and variability within each laboratory across the mailings.
RESULTS.—
Significant variability was noted across methods with analysis of IL-1 showing the least variability and IL-6, IL-8, and TNF-α varying between methods to a greater extent. Intralab variability was also significant with TNF-α measurements again showing the greatest variability.
CONCLUSIONS.—
This retrospective analysis of College of American Pathologists proficiency testing data for cytokine measurement is the largest method comparison to date, and this study provides a description of the variation of cytokine measurement across methods, across laboratories, and within laboratories. Serial monitoring of cytokines should preferentially be performed by the same method within the same laboratory.
Topics: Cytokines; Humans; Laboratories; Laboratory Proficiency Testing; Pathology, Clinical; Quality Improvement; Retrospective Studies
PubMed: 32401053
DOI: 10.5858/arpa.2019-0519-CP -
European Journal of Clinical... Jan 2020Infection by Toxoplasma gondii is prevalent worldwide. The parasite can infect a broad spectrum of vertebrate hosts, but infection of fetuses and immunocompromised... (Review)
Review
Infection by Toxoplasma gondii is prevalent worldwide. The parasite can infect a broad spectrum of vertebrate hosts, but infection of fetuses and immunocompromised patients is of particular concern. Easy-to-perform, robust, and highly sensitive and specific methods to detect Toxoplasma infection are important for the treatment and management of patients. Rapid diagnostic methods that do not sacrifice the accuracy of the assay and give reproducible results in a short time are highly desirable. In this context, rapid diagnostic tests (RDTs), especially with point-of-care (POC) features, are promising diagnostic methods in clinical microbiology laboratories, especially in areas with minimal laboratory facilities. More advanced methods using microfluidics and sensor technology will be the future trend. In this review, we discuss serological and molecular-based rapid diagnostic tests for detecting Toxoplasma infection in humans as well as animals.
Topics: Animals; Humans; Pathology, Molecular; Point-of-Care Testing; Serologic Tests; Toxoplasma; Toxoplasmosis; Toxoplasmosis, Animal
PubMed: 31428897
DOI: 10.1007/s10096-019-03680-2 -
Current Oncology (Toronto, Ont.) Feb 2022: Biomarker data are critical to the delivery of precision cancer care. The average turnaround of next-generation sequencing (NGS) reports is over 2 weeks, and in-house...
: Biomarker data are critical to the delivery of precision cancer care. The average turnaround of next-generation sequencing (NGS) reports is over 2 weeks, and in-house availability is typically limited to academic centers. Lengthy turnaround times for biomarkers can adversely affect outcomes. Traditional workflows involve moving specimens through multiple facilities. This study evaluates the feasibility of rapid comprehensive NGS using the Genexus integrated sequencer and a novel streamlined workflow in a community setting. : A retrospective chart review was performed to assess the early experience and performance characteristics of a novel approach to biomarker testing at a large community center. This approach to NGS included an automated workflow utilizing the Genexus integrated sequencer, validated for clinical use. NGS testing was further integrated within a routine immunohistochemistry (IHC) service, utilizing histotechnologists to perform technical aspects of NGS, with results reported directly by anatomic pathologists. : Between October 2020 and October 2021, 578 solid tumor samples underwent genomic profiling. (IQR: 2-5). Four hundred eighty-one (83%) of the cases were resulted in fewer than 5 business days, and 66 (11%) of the cases were resulted simultaneously with diagnosis. Tumor types included lung cancer (310), melanoma (97), and colorectal carcinoma (68), among others. NGS testing detected key driver alterations at expected prevalence rates: lung (16%), (3%), (1%), melanoma (43%), colorectal / (67%), among others. : This is the first study demonstrating clinical implementation of rapid NGS. This supports the feasibility of automated comprehensive NGS performed and interpreted in parallel with diagnostic histopathology and immunohistochemistry. This novel approach to biomarker testing offers considerable advantages to clinical cancer care.
Topics: Biomarkers, Tumor; High-Throughput Nucleotide Sequencing; Humans; Lung Neoplasms; Melanoma; Mutation; Point-of-Care Systems; Retrospective Studies
PubMed: 35323313
DOI: 10.3390/curroncol29030113 -
Fa Yi Xue Za Zhi Apr 2020Autopsy of patients who died of infectious diseases is of significance for public health management. Few forensic autopsies have been performed since the outbreak of the... (Review)
Review
Autopsy of patients who died of infectious diseases is of significance for public health management. Few forensic autopsies have been performed since the outbreak of the corona virus disease 2019 (COVID-19) due to some limitations, thus forensic pathological examination failed to contribute to the prevention and treatment of infectious diseases. Virtual autopsy has unique advantages in the forensic examination of patients who died of infectious diseases. Accumulated virtual autopsy image data are of great value to the study of the pathological mechanism and diagnosis of COVID-19. This article reviews the relationship between imaging changes and pathology of the COVID-19 as well as the application of virtual autopsy in autopsy of patients who died of infectious diseases, in order to provide reference for performing virtual autopsy in the outbreak of COVID-19.
Topics: Autopsy; Betacoronavirus; COVID-19; Coronavirus Infections; Forensic Pathology; Humans; Pandemics; Pneumonia, Viral; SARS-CoV-2
PubMed: 32212513
DOI: 10.12116/j.issn.1004-5619.2020.02.001 -
JSLS : Journal of the Society of... 2023Hysteroscopy is the gold standard for evaluating intrauterine pathology. The majority of physicians currently perform hysteroscopy in the operating room. Lack of...
BACKGROUND
Hysteroscopy is the gold standard for evaluating intrauterine pathology. The majority of physicians currently perform hysteroscopy in the operating room. Lack of training has been cited as a barrier to performing office hysteroscopy; however, resident training in office hysteroscopy has not yet been evaluated.
METHODS
A prospective cross-sectional survey was performed. A validated 17 question survey tool was sent to 297 program directors of Accreditation Council for Graduate Medical Education accredited obstetrics and gynecology residency programs for distribution to their residents. The survey utilized a Likert scale to assess resident interest in learning office hysteroscopy, satisfaction in training, and perceived self-efficacy to perform office hysteroscopy independently upon graduation.
RESULTS
Two hundred and ninety-three obstetrics and gynecology residents responded. Of the respondents, 26.3% reported receiving training in office hysteroscopy. There was no statistically significant difference in training among postgraduate years or program regions. A greater proportion of male residents received training when compared to female residents (42.9% vs. 24.2%, =0.019). Ninety-four percent of residents reported interest in learning office hysteroscopy. Satisfaction with hysteroscopy training in the operating room versus the office was 91.1% vs. 11.3% respectively. Of the fourth-year residents, 17.4% felt they could perform office hysteroscopy independently upon graduation and 14.5% reported feeling comfortable performing the procedure.
CONCLUSIONS
Residency training in office hysteroscopy is lacking and residents are unprepared to perform the procedure after graduation. Enhanced residency training in office hysteroscopy would likely improve resident comfort and ability to perform office hysteroscopy in practice.
Topics: Humans; Female; Male; Pregnancy; United States; Gynecology; Hysteroscopy; Cross-Sectional Studies; Prospective Studies; Clinical Competence; Internship and Residency; Obstetrics; Surveys and Questionnaires
PubMed: 37522105
DOI: 10.4293/JSLS.2023.00009 -
Journal of Veterinary Diagnostic... Jul 2024Telepathology, as a subset of teleconsulting, is pathology interpretation performed at a distance. Telepathology is not a new phenomenon, but since ~2015, significant... (Review)
Review
Telepathology, as a subset of teleconsulting, is pathology interpretation performed at a distance. Telepathology is not a new phenomenon, but since ~2015, significant advances in information technology and telecommunications coupled with the pandemic have led to unprecedented sophistication, accessibility, and use of telepathology in human and veterinary medicine. Furthermore, telepathology can connect veterinary practices to distant laboratories and provide support for underserved animals and communities. Through our scoping review, we provide an overview of how telepathology is being used in veterinary medicine, identify gaps in the literature, and highlight future areas of research and service development. We searched MEDLINE, CAB Abstracts, and the gray literature, and included all relevant literature. Despite the widespread use of digital microscopy in large veterinary diagnostic laboratories, we identified a paucity of literature describing the use of telepathology in veterinary medicine, with a significant gap in studies addressing the validation of whole-slide imaging for primary diagnosis. Underutilization of telepathology to support postmortem examinations conducted in the field was also identified, which indicates a potential area for service development. The use of telepathology is increasing in veterinary medicine, and pathologists must keep pace with the changing technology, ensure the validation of innovative technologies, and identify novel uses to advance the profession.
Topics: Animals; Veterinary Medicine; Telepathology; Pathology, Veterinary
PubMed: 38742388
DOI: 10.1177/10406387241241270 -
Journal of Endocrinological... Dec 2021Due to relevant repercussions on reproductive medicine, we aimed to evaluate feasibility of RT-PCR as a detection method of SARS-CoV-2 RNA in seminal fluid.
PURPOSE
Due to relevant repercussions on reproductive medicine, we aimed to evaluate feasibility of RT-PCR as a detection method of SARS-CoV-2 RNA in seminal fluid.
METHODS
A qualitative determination of the RT-PCR assays in semen was performed through different approaches: (1) efficiency of RNA extraction from sperm and seminal plasma was determined using PRM1 and PRM2 mRNA and a heterologous system as control; (2) samples obtained by diluting viral preparation from a SARS-CoV-2 panel (virus cultured in Vero E6 cell lines) were tested; (3) viral presence in different fractions of seminal fluid (whole sample, seminal plasma and post-centrifugation pellet) was evaluated. Semen samples from mild and recovered COVID-19 subjects were collected by patients referring to the Infectious Disease Department of the Policlinico Umberto I Hospital - "Sapienza" University of Rome. Control subjects were recruited at the Laboratory of Seminology-Sperm Bank "Loredana Gandini'' of the same hospital.
RESULTS
The control panel using viral preparations diluted in saline and seminal fluid showed the capability to detect viral RNA presence with C values depending on the initial viral concentration. All tested semen samples were negative for SARS-CoV-2, regardless of the nasopharyngeal swab result or seminal fluid fraction.
CONCLUSION
These preliminary data show that RT-PCR for SARS-CoV-2 RNA testing appears to be a feasible method for the molecular diagnosis of SARS-CoV-2 in seminal fluid, supported by results of the control panel. The ability to detect SARS-CoV-2 in semen is extremely important for reproductive medicine, especially in assisted reproductive technology and sperm cryopreservation.
Topics: Adult; Animals; COVID-19; Chlorocebus aethiops; Feasibility Studies; Humans; Male; Pathology, Molecular; RNA, Messenger; RNA, Viral; Real-Time Polymerase Chain Reaction; Reproductive Techniques; Semen; Vero Cells
PubMed: 33929709
DOI: 10.1007/s40618-021-01580-x -
Diagnostic Pathology Mar 2021The role of Artificial intelligence (AI) which is defined as the ability of computers to perform tasks that normally require human intelligence is constantly expanding.... (Review)
Review
Artificial intelligence (AI) in medicine, current applications and future role with special emphasis on its potential and promise in pathology: present and future impact, obstacles including costs and acceptance among pathologists, practical and philosophical considerations. A comprehensive review.
BACKGROUND
The role of Artificial intelligence (AI) which is defined as the ability of computers to perform tasks that normally require human intelligence is constantly expanding. Medicine was slow to embrace AI. However, the role of AI in medicine is rapidly expanding and promises to revolutionize patient care in the coming years. In addition, it has the ability to democratize high level medical care and make it accessible to all parts of the world.
MAIN TEXT
Among specialties of medicine, some like radiology were relatively quick to adopt AI whereas others especially pathology (and surgical pathology in particular) are only just beginning to utilize AI. AI promises to play a major role in accurate diagnosis, prognosis and treatment of cancers. In this paper, the general principles of AI are defined first followed by a detailed discussion of its current role in medicine. In the second half of this comprehensive review, the current and future role of AI in surgical pathology is discussed in detail including an account of the practical difficulties involved and the fear of pathologists of being replaced by computer algorithms. A number of recent studies which demonstrate the usefulness of AI in the practice of surgical pathology are highlighted.
CONCLUSION
AI has the potential to transform the practice of surgical pathology by ensuring rapid and accurate results and enabling pathologists to focus on higher level diagnostic and consultative tasks such as integrating molecular, morphologic and clinical information to make accurate diagnosis in difficult cases, determine prognosis objectively and in this way contribute to personalized care.
Topics: Artificial Intelligence; Attitude of Health Personnel; Attitude to Computers; Cost-Benefit Analysis; Health Care Costs; Health Knowledge, Attitudes, Practice; Humans; Image Interpretation, Computer-Assisted; Microscopy; Pathologists; Pathology; Practice Patterns, Physicians'; Predictive Value of Tests; Reproducibility of Results
PubMed: 33731170
DOI: 10.1186/s13000-021-01085-4 -
Cancer Medicine Aug 2023Endoscopic ultrasonography-guided fine-needle aspiration/biopsy (EUS-FNA/B) is considered to be a first-line procedure for the pathological diagnosis of pancreatic...
BACKGROUND AND AIMS
Endoscopic ultrasonography-guided fine-needle aspiration/biopsy (EUS-FNA/B) is considered to be a first-line procedure for the pathological diagnosis of pancreatic cancer owing to its high accuracy and low complication rate. The number of new cases of pancreatic ductal adenocarcinoma (PDAC) is increasing, and its accurate pathological diagnosis poses a challenge for cytopathologists. Our aim was to develop a hyperspectral imaging (HSI)-based convolution neural network (CNN) algorithm to aid in the diagnosis of pancreatic EUS-FNA cytology specimens.
METHODS
HSI images were captured of pancreatic EUS-FNA cytological specimens from benign pancreatic tissues (n = 33) and PDAC (n = 39) prepared using a liquid-based cytology method. A CNN was established to test the diagnostic performance, and Attribution Guided Factorization Visualization (AGF-Visualization) was used to visualize the regions of important classification features identified by the model.
RESULTS
A total of 1913 HSI images were obtained. Our ResNet18-SimSiam model achieved an accuracy of 0.9204, sensitivity of 0.9310 and specificity of 0.9123 (area under the curve of 0.9625) when trained on HSI images for the differentiation of PDAC cytological specimens from benign pancreatic cells. AGF-Visualization confirmed that the diagnoses were based on the features of tumor cell nuclei.
CONCLUSIONS
An HSI-based model was developed to diagnose cytological PDAC specimens obtained using EUS-guided sampling. Under the supervision of experienced cytopathologists, we performed multi-staged consecutive in-depth learning of the model. Its superior diagnostic performance could be of value for cytologists when diagnosing PDAC.
Topics: Humans; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Cytology; Deep Learning; Pancreatic Neoplasms; Carcinoma, Pancreatic Ductal
PubMed: 37455599
DOI: 10.1002/cam4.6335