-
Archives of Pathology & Laboratory... Apr 2008Examination of the bone marrow poses several unique challenges to the pathologist: it is a semisolid organ without helpful gross correlation, it exists in a dynamic... (Review)
Review
Examination of the bone marrow poses several unique challenges to the pathologist: it is a semisolid organ without helpful gross correlation, it exists in a dynamic state with the peripheral blood and other organs of the lymphohemopoietic system, and the diagnosis of diseases affecting bone marrow often depends heavily on ancillary special studies. The bone marrow examination ideally encompasses review of the bone marrow biopsy histology (with or without additional nondecalcified clot preparation material), bone marrow aspirate smear cytology, and the peripheral blood smear; optimal procurement and processing of these samples is critical in ensuring that a maximal level of diagnostic information can be extracted. The pathologist must be aware of the clinical context of the bone marrow and the results of ancillary tests, whether these are ordered by the pathologist or the clinician. A combination of excellent diagnostic samples, appropriate ancillary tests, and knowledge of the clinical context provides the best background to distinguish between the common reactive and neoplastic processes that involve the bone marrow and to avoid diagnostic pitfalls in making these distinctions.
Topics: Biopsy; Bone Marrow; Bone Marrow Diseases; Bone Marrow Examination; Bone Marrow Neoplasms; Diagnosis, Differential; Humans; Pathology
PubMed: 18384210
DOI: 10.5858/2008-132-587-RVNBMP -
Journal of Clinical Pathology Mar 2003The incidence of malignant and premalignant endocervical glandular lesions is increasing. This review covers controversial and difficult aspects regarding the... (Review)
Review
The incidence of malignant and premalignant endocervical glandular lesions is increasing. This review covers controversial and difficult aspects regarding the categorisation and diagnosis of these lesions. The terminology of premalignant endocervical glandular lesions is discussed because of the differences between the UK terminology and the widely used World Health Organisation classification. The morphology and histological subtypes of premalignant endocervical glandular lesions are described. Early invasive adenocarcinoma and difficulties in the diagnosis and recognition of this entity are covered, as is the measurement of early invasion within cervical adenocarcinoma. Several benign endocervical glandular lesions can mimic malignant and premalignant endocervical glandular lesions, and the distinction of these benign mimics from premalignant and malignant lesions using ancillary immunohistochemical studies is also covered. Antibodies used to distinguish between endometrial and endocervical adenocarcinoma, in the diagnosis of cervical minimal deviation adenocarcinoma of mucinous type (adenoma malignum), and in the diagnosis of cervical mesonephric lesions are also reviewed.
Topics: Adenocarcinoma; Diagnosis, Differential; Female; Humans; Neoplasm Invasiveness; Precancerous Conditions; Terminology as Topic; Uterine Cervical Neoplasms; Uterine Cervical Dysplasia
PubMed: 12610091
DOI: 10.1136/jcp.56.3.164 -
Frontiers in Psychology 2023The Padlet interactive platform constitutes a virtual online board on which users can post various types of multimedia content, such as documents, questions, comments,...
INTRODUCTION
The Padlet interactive platform constitutes a virtual online board on which users can post various types of multimedia content, such as documents, questions, comments, images, video clips, and audio clips. This platform has gained popularity in higher education yet remains ancillary in the fields of medical education and medical management.
METHODS
This case study sought to initially design an intervention program that employs online collaborative learning enabled by Padlet and to assess how Health Management students perceived the activity and its ramifications for their learning. 85 students' reflective journals were content analyzed.
RESULTS
five main categories stood out: (1) user experience of the platform; (2) visuality and visibility of the platform; (3) collaborative learning and OCL; (4) active online learning and student engagement; and (5) cognitive flexibility.
DISCUSSION
This study emphasizes the importance of incorporating digital tools in education, particularly the use of the Padlet platform to facilitate collaborative learning and improve the quality of teaching and learning. It demonstrates that Padlet-mediated online collaborative learning can be an effective digital learning tool because of its ease of use and ability to accommodate both pedagogical and technological challenges.
PubMed: 37063539
DOI: 10.3389/fpsyg.2023.1157621 -
Acta Cytologica 2014Fine-needle aspiration (FNA) is a safe and cost-effective technique for the diagnosis of breast lesions, especially when correlated with clinical and imaging studies.... (Review)
Review
OBJECTIVE
Fine-needle aspiration (FNA) is a safe and cost-effective technique for the diagnosis of breast lesions, especially when correlated with clinical and imaging studies. However, the success of breast FNA is highly dependent on the adequate preparation of cytological conventional smears (CS). The liquid-based cytology (LBC) technique consists of an automated method for preparing thin-layer cytological samples from cell suspensions collected in alcohol-based preservative. LBC is designed to improve CS by avoiding limiting factors such as obscuring material, air-drying and smearing artifacts.
STUDY DESIGN
We performed a review of the published literature about LBC applied to breast FNA.
RESULTS
LBC preparations of breast aspirates demonstrated better cellular preservation, less cell overlapping and elimination of blood and excessive inflammation compared to CS. Conversely, alterations in architecture and cell morphology as well as loss of myoepithelial cells and stromal elements have been described in LBC specimens, requiring training before applying this technique for diagnosis. Studies have shown a similar accuracy between LBC and CS for the diagnosis of breast lesions. LBC also permits the use of residual material for ancillary tests, which is an important advantage compared to CS.
CONCLUSIONS
LBC can be safely applied to breast FNA, showing a similar diagnostic accuracy to CS.
Topics: Biopsy, Fine-Needle; Breast; Breast Neoplasms; Female; Humans; Papanicolaou Test; Predictive Value of Tests; Prognosis; Reproducibility of Results; Staining and Labeling
PubMed: 25115652
DOI: 10.1159/000362805 -
Polish Journal of Radiology 2022The liver imaging reporting and data system (LI-RADS) is a structured reporting system that categorizes hepatic observations according to major imaging features and...
PURPOSE
The liver imaging reporting and data system (LI-RADS) is a structured reporting system that categorizes hepatic observations according to major imaging features and lesion size, with an optional ancillary features contribution. This study aimed to evaluate inter-reader agreement of dynamic magnetic resonance imaging (MRI) using LI-RADS v2018 lexicon.
MATERIAL AND METHODS
Forty-nine patients with 69 hepatic observations were included in our study. The major and ancillary features of each hepatic observation were evaluated by 2 radiologists using LI-RADS v2018, and the interreader agreement was allocated.
RESULTS
The inter-reader agreement of major LI-RADS features was substantial; κ of non-rim arterial hyperenhancement, non-peripheral washout appearance, and enhancing capsule was 0.796, 0.799, and 0.772 ( < 0.001), respectively. The agreement of the final LI-RADS category was substantial with κ = 0.651 ( < 0.001), and weighted κ = 0.786 ( < 0.001). The inter-reader agreement of the ancillary features was substantial to almost perfect (k range from 0.718 to 1; < 0.001). An almost perfect correlation was noted for the hepatic lesion size measurement with ICC = 0.977 ( < 0.001).
CONCLUSIONS
The major and ancillary features of the LI-RADS v2018, as well as the final category and lesions size, have substantial to almost perfect inter-reader agreement.
PubMed: 35892071
DOI: 10.5114/pjr.2022.117590 -
Modern Pathology : An Official Journal... Jan 2019Metastatic malignancies of unknown primary site (MUP) is the eighth most common form of malignancy, with an estimated 10-15% of oncology patients having a MUP. Fine... (Review)
Review
Metastatic malignancies of unknown primary site (MUP) is the eighth most common form of malignancy, with an estimated 10-15% of oncology patients having a MUP. Fine needle aspiration cytology (FNA) and core needle biopsy (CNB) are often the first procedures utilized in the work-up of these cases and have a pivotal role for the diagnosis of metastases. There is an increasing emphasis on the precise classification of malignancy and determination of primary site of origin, utilizing smaller specimens. Recent available data suggest that there is a management benefit in identifying the primary site and/or specific cell lineage of MUP. In addition, the pathologists are asked to preserve the limited diagnostic material for potential molecular testing, as selected patients may benefit from targeted therapy. However, these tasks can become extremely challenging, especially if there is no previous history of malignancy, prior pathology is not available for review, or there is an unpredictable pattern of metastasis. In this review, we present a contemporary clinicopathologic approach to the work-up of MUP that includes cytomorphology, ancillary studies, and clinicopathologic correlation. The cytohistologic subclassification of malignancies into specific cell lineages and/or morphologic categories is presented. Knowledge of the various patterns of metastasis to common and unusual sites can help narrow down the location of a primary site. The use of ancillary studies with particular emphasis on IHC utilizing an algorithmic approach and the role of molecular analysis as a diagnostic and theranotic test are also discussed. When the cell block and/or CNB lacks sufficient material for ancillary testing, the cell transfer technique may be utilized.
Topics: Biopsy, Fine-Needle; Biopsy, Large-Core Needle; Humans; Neoplasms, Unknown Primary
PubMed: 30600317
DOI: 10.1038/s41379-018-0149-9 -
AJNR. American Journal of Neuroradiology Mar 2016Transcranial Doppler is a useful ancillary test for brain death confirmation because it is safe, noninvasive, and done at the bedside. Transcranial Doppler confirms... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND PURPOSE
Transcranial Doppler is a useful ancillary test for brain death confirmation because it is safe, noninvasive, and done at the bedside. Transcranial Doppler confirms brain death by evaluating cerebral circulatory arrest. Case series studies have generally reported good correlations between transcranial Doppler confirmation of cerebral circulatory arrest and clinical confirmation of brain death. The purpose of this study is to evaluate the utility of transcranial Doppler as an ancillary test in brain death confirmation.
MATERIALS AND METHODS
We conducted a systematic review of the literature and a diagnostic test accuracy meta-analysis to compare the sensitivity and specificity of transcranial Doppler confirmation of cerebral circulatory arrest, by using clinical confirmation of brain death as the criterion standard.
RESULTS
We identified 22 eligible studies (1671 patients total), dating from 1987 to 2014. Pooled sensitivity and specificity estimates from 12 study protocols that reported data for the calculation of both values were 0.90 (95% CI, 0.87-0.92) and 0.98 (95% CI, 0.96-0.99), respectively. Between-study differences in the diagnostic performance of transcranial Doppler were found for both sensitivity (I(2) = 76%; P < .001) and specificity (I(2) = 74.3%; P < .001). The threshold effect was not significant (Spearman r = -0.173; P = .612). The area under the curve with the corresponding standard error (SE) was 0.964 ± 0.018, while index Q test ± SE was estimated at 0.910 ± 0.028.
CONCLUSIONS
The results of this meta-analysis suggest that transcranial Doppler is a highly accurate ancillary test for brain death confirmation. However, transcranial Doppler evaluates cerebral circulatory arrest rather than brain stem function, and this limitation needs to be taken into account when interpreting the results of this meta-analysis.
Topics: Brain Death; Female; Humans; Sensitivity and Specificity; Ultrasonography, Doppler, Transcranial
PubMed: 26514611
DOI: 10.3174/ajnr.A4548 -
Philosophical Transactions of the Royal... Jun 2017Extreme climatic events (ECEs) have a disproportionate effect on ecosystems. Yet much of what we know about the ecological impact of ECEs is based on observing the... (Review)
Review
Extreme climatic events (ECEs) have a disproportionate effect on ecosystems. Yet much of what we know about the ecological impact of ECEs is based on observing the effects of single extreme events. We examined what characteristics affect the strength of inference that can be drawn from single-event studies, which broadly fell into three categories: opportunistic observational studies initiated after an ECE, long-term observational studies with data before and after an ECE and experiments. Because extreme events occur rarely, inference from such single-event studies cannot easily be made under the usual statistical paradigm that relies on replication and control. However, single-event studies can yield important information for theory development and can contribute to meta-analyses. Adaptive management approaches can be used to learn from single, or a few, extreme events. We identify a number of factors that can make observations of single events more informative. These include providing robust estimates of the magnitude of ecological responses and some measure of climatic extremeness, collecting ancillary data that can inform on mechanisms, continuing to observe the biological system after the ECE and combining observational data with experiments and models. Well-designed single-event studies are an important contribution to our understanding of biological effects of ECEs.This article is part of the themed issue 'Behavioural, ecological and evolutionary responses to extreme climatic events'.
Topics: Animals; Climate Change; Ecosystem; Life History Traits; Plant Physiological Phenomena
PubMed: 28483871
DOI: 10.1098/rstb.2016.0141 -
JAMA Ophthalmology Jul 2021Intimate partner violence (IPV) is a substantial cause of morbidity and mortality in the US. Previous studies indicate gaps in identifying and referring female patients...
Detection and Referral of Orbital and Ocular Injuries Associated With Intimate Partner Violence Following an Educational and Screening Initiative in an Emergency Department.
IMPORTANCE
Intimate partner violence (IPV) is a substantial cause of morbidity and mortality in the US. Previous studies indicate gaps in identifying and referring female patients with IPV-associated orbital and ocular injuries to ancillary services.
OBJECTIVE
To determine the number of IPV-associated orbital floor fractures, zygomaticomaxillary complex (ZMC) fractures, and ruptured globes referred to ancillary services in adult female patients following an educational and screening intervention to health care professionals.
DESIGN, SETTING, AND PARTICIPANTS
This single-center retrospective quality improvement analysis examined electronic medical records of adult female patients seen in a single level 1 trauma center emergency department and ophthalmology clinic between January 2015 and February 2019, after the initiative began. Female adults who sustained orbital floor fractures, ZMC fractures, or ruptured globes were included. Preinitiative data were previously collected between January 1995 and January 2015 on adult female patients and published. Data analysis for this study occurred from May 2020 to September 2020.
INTERVENTIONS
A 2-part, ongoing initiative began January 2015. First, enhancement of IPV screening protocols in the emergency department was conducted. Second, an educational campaign on IPV injury patterns was presented to residents and faculty in ophthalmology, emergency, otolaryngology, and trauma departments.
MAIN OUTCOMES AND MEASURES
Comparison of ancillary service involvement preinitiative (January 1995 to January 2015) and postinitiative (January 2015 to February 2019).
RESULTS
A total of 216 adult female patients (mean [SD] age, 55.0 [22.7] years; age range, 18-99 years) sustained orbital floor or ZMC fractures postinitiative. A total of 22 of 216 (10.2%) sustained fractures from IPV compared with 31 of 405 (7.6%) preinitiative (95% CI, -2.2% to 7.3%; P = .28). Documented social work referrals (11 of 31 preinitiative vs 20 of 22 postinitiative; difference, 55% [95% CI, 35%-76%]; P < .001), homegoing safety assessments (1 of 31 preinitiative vs 18 of 22 postinitiative; difference, 79% [95% CI, 61%-96%]; P < .001), and law enforcement involvement (7 of 21 preinitiative vs 16 of 22 postinitiative; difference, 50% [95% CI, 26%-74%]; P < .001) were higher in patients who presented after the initiative with orbital floor and ZMC fractures. A total of 51 adult female patients (mean [SD] age, 57.7 [20.8] years; age range 20-93 years) sustained ruptured globes postinitiative. A total of 5 of 51 patients (9.8%) sustained injury due to IPV postinitiative, compared with 5 of 141 (3.5%) preinitiative (95% patients, -2.5% to 15.0%; P = .08).
CONCLUSIONS AND RELEVANCE
Following the start of the initiative, referral patterns of adult female patients with IPV-associated orbital fractures improved. Targeted IPV screening of patients with orbital and ocular injuries is essential for effective intervention.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Emergency Service, Hospital; Eye Injuries; Female; Humans; Intimate Partner Violence; Middle Aged; Orbital Fractures; Referral and Consultation; Retrospective Studies; Young Adult
PubMed: 34042949
DOI: 10.1001/jamaophthalmol.2021.1546 -
PloS One 2021Testosterone and alendronate have been identified as two bone healing compounds which, when combined, synergistically stimulate bone regeneration. This study describes...
Testosterone and alendronate have been identified as two bone healing compounds which, when combined, synergistically stimulate bone regeneration. This study describes the development of a novel ultrasonic spray coating for sustained release of ancillary amounts of testosterone and alendronate encapsulated in PLGA 5004A as a carrier. Due to the low amounts of testosterone and alendronate used, sensitive in vitro assays were developed to determine in vitro release. The ultrasonic spray coating technology was optimized for coating titanium screws and pericardial collagen membranes, with the aim to improve osseo-integration and (guided) bone regeneration, respectively, without interfering with their primary mode of action. In vitro release analysis of collagen membranes and screws showed up to 21 days sustained release of the compounds without a burst release. Subsequent preclinical studies in rat and rabbit models indicated that testosterone and alendronate coated membranes and screws significantly improved bone regeneration in vivo. Coated membranes significantly improved the formation of new bone in a critical size calvarial defect model in rats (by 160% compared to controls). Coated screws implanted in rabbit femoral condyles significantly improved bone implant contact (69% vs 54% in controls), bone mineral density (121%) and bone volume (119%) up to 1.3 mm from the implant. Based on the results obtained, we suggest that implants or membranes enabled with local sustained delivery of ancillary amounts of testosterone and alendronate can be a promising system to stimulate local bone regeneration resulting in improved osseo-integration of implants and improved healing of bone defects and fractures.
Topics: Alendronate; Animals; Bone Density; Bone Density Conservation Agents; Bone Regeneration; Coated Materials, Biocompatible; Delayed-Action Preparations; Disease Models, Animal; Femur; Humans; Male; Osseointegration; Polylactic Acid-Polyglycolic Acid Copolymer; Prostheses and Implants; Rabbits; Rats; Testosterone; Titanium
PubMed: 33999955
DOI: 10.1371/journal.pone.0251864