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American Journal of Clinical Pathology

Jeannette Guarner, Lee F Schroeder, Timothy K Amukele
No abstract text is available yet for this article.
December 15, 2018: American Journal of Clinical Pathology
Char Loo Tan, Yin Huei Pang, Keith Hsiu Chin Lim, Lwin Sein, Patrick J Codd, Roger E McLendon
Objectives: The list of tumors involving the pituitary gland has been expanded to include a variety of neuronal and paraneuronal tumors in the 2017 World Health Organization tumor classification of endocrine organs. All the entities included in this category are distinctly rare, with limited case reports in the literature. Methods: We illustrate two extraordinary sellar tumors with neuronal differentiation: a sellar paraganglioma and a sellar neurocytoma, with thorough literature review and comparison of the clinicopathologic features of these entities...
December 14, 2018: American Journal of Clinical Pathology
Elena Nedelcu, Martha Frances Wright, Seth Karp, Makenzie Cook, Otilia Barbu, Quentin Eichbaum
Objectives: Orthotopic liver transplantation (OLT) can require substantial usage of blood products. Higher rates of transfusion have been associated with increased length of hospital stay, higher rates of infection, graft failure, and mortality. This study was a retrospective analysis to assess the impact of quality improvement interventions in OLT. Methods: Data collection included demographics, preoperative and intraoperative data, blood utilization, and cost data...
December 8, 2018: American Journal of Clinical Pathology
Sohail Qayyum, Grant C Bullock, Steven H Swerdlow, Raven Brower, Marina Nikiforova, Nidhi Aggarwal
Objectives: T-cell receptor (TCR) gene rearrangement studies are widely used for assessing T-cell clonality. The frequency and significance of clonal peaks restricted to TCR β (TCRB) tube C are uncertain. We retrospectively reviewed 80 TCR studies performed on bone marrow/peripheral blood. Methods: TCRB and TCR γ (TCRG) analyses were performed using BIOMED-2 primers. A peak was considered clonal or atypical if it was reproducible and 5× or more or 3× to 5× polyclonal background, respectively...
December 8, 2018: American Journal of Clinical Pathology
Susan Horton, Kenneth A Fleming, Modupe Kuti, Lai-Meng Looi, Sanjay A Pai, Shahin Sayed, Michael L Wilson
Objectives: To compare the most common diagnostic/laboratory tests across five different referral hospitals by volume and revenue. Methods: The authors obtained data on volumes and reimbursement rates for the most common 25 tests at the five hospitals with which they are affiliated and organized them to be as comparable as possible. Simple descriptive statistics were used to make cross-country comparisons. Results: There are strong similarities across all five hospitals in the top five tests by both volume and revenue...
December 6, 2018: American Journal of Clinical Pathology
Andrea Hernandez, Tamar C Brandler, Fang Zhou, Andre L Moreira, Nina Schatz-Siemers, Aylin Simsir
Objectives: To evaluate whether non-small cell lung carcinoma (NSCLC) cytology specimens are reliable for programmed death-ligand 1 (PD-L1) immunohistochemical (IHC) testing. Methods: Fifty-two cell blocks (CBs) with corresponding surgical pathology PD-L1 IHC testing were stained with a Dako PD-L1 pharmDX antibody (clone-22C3). Tumor cellularity was recorded as <100 or ≥100 cells. PD-L1 IHC was scored by percentage of tumor cells staining (<1%, ≥1%-49%, ≥50%) and compared between matched cases...
December 6, 2018: American Journal of Clinical Pathology
Martín Yago, Herminio López-Escribano
No abstract text is available yet for this article.
December 5, 2018: American Journal of Clinical Pathology
James O Westgard, Sten A Westgard
Objectives: To establish an objective, scientific, evidence-based process for planning statistical quality control (SQC) procedures based on quality required for a test, precision and bias observed for a measurement procedure, probabilities of error detection and false rejection for different control rules and numbers of control measurements, and frequency of QC events (or run size) to minimize patient risk. Methods: A Sigma-Metric Run Size Nomogram and Power Function Graphs have been used to guide the selection of control rules, numbers of control measurements, and frequency of QC events (or patient run size)...
December 5, 2018: American Journal of Clinical Pathology
Maxwell Akonde, Benedict Boateng Antuamwine, Lawrence Quaye, Zakiya Abdul-Mumin
No abstract text is available yet for this article.
November 29, 2018: American Journal of Clinical Pathology
Daniel T Holmes, Kevin A Buhr
Objectives: The Hoffmann method is a procedure for reference interval estimation using routine clinical results. Many authors incorrectly prepare Hoffmann plots on a linear rather than normal probability scale. We explore the consequences. Methods: This was investigated algebraically, by random number simulations (45 simulations, n = 100,000 each) and using clinical data sets. Strategies compared were: Hoffmann's method as originally and incorrectly implemented, Bhattacharya's method, and maximum likelihood (ML)...
November 26, 2018: American Journal of Clinical Pathology
Jenna Khan, Wayne L Chandler
Objectives: To determine the relationship between baseline variations in the partial thromboplastin time (PTT) and the discordance between the PTT and anti-Xa heparin activity (anti-Xa) during heparin therapy. Methods: The baseline PTT on heparin was determined using automated heparin neutralization with protamine (prPTT). The prPTT was used to calculate a baseline-corrected PTT on heparin to reduce discordance with anti-Xa measurements. Results: The prPTT removed up to 1 U/mL of heparin, returning baseline values for normal, factor-deficient, and lupus inhibitor plasmas...
November 25, 2018: American Journal of Clinical Pathology
Colin H Murphy, Daniel E Sabath
Objectives: To compare the accuracy and reliability of phenotypic activated protein C resistance (aPC-R) assays with a genotypic assay for the factor V Leiden F5 p.R506Q (FVL) mutation. Methods: Data were obtained from an electronic data warehouse for FVL testing performed at an academic institution with a large referral laboratory service. In total, 1,596 patients were identified who had undergone both phenotypic aPC-R and genotypic FVL mutation testing. Results: Phenotypic testing showed a high level of sensitivity, specificity, and other biostatistical values compared with genotypic testing...
November 13, 2018: American Journal of Clinical Pathology
Denise L Uettwiller-Geiger, Marvin Lessig, Jie An, Tara Barsch, Susan Smith, Sharan Walker, Alexander Riedel, Yi Hao, Amin A Mohammad
Objectives: We evaluated the performance of the Elecsys HIV combi PT assay on the cobas e 602 analyzer for diagnosing human immunodeficiency virus (HIV; part of the US Food and Drug Administration [FDA] submission). Methods: The HIV combi PT and reference (ARCHITECT HIV Ag/Ab Combo) assays were assessed at four independent clinical laboratories/one reference laboratory (United States; July 2014 to November 2015). Clinical performance was evaluated using four reagent lots...
November 13, 2018: American Journal of Clinical Pathology
Kathryn C Behling, Charlene Bierl
Objectives: Traditional laboratory utilization measures are unable to detect the results of small-scale utilization improvement efforts in a background of rising patient volumes and acuity. However, accurate assessment is necessary to document effectiveness of these efforts. Methods: Test menu changes, physician education, and laboratory utilization feedback were used to address costs and overused tests. Effectiveness was evaluated using cost/case mix index (CMI)-adjusted hospital day and inpatient tests/CMI-adjusted discharge...
November 13, 2018: American Journal of Clinical Pathology
Brian D Adkins, Shaun Lawicki, Mary Johnson, Quentin Eichbaum
Objectives: Transfusions are often needlessly aborted after occurrence of a mild allergic transfusion reaction (ATR), leading to wastage and reexposure of recipients to additional blood products (with potential alloimmunization). We aimed to determine the symptoms associated with such reactions (along with other parameters) as a possible reason of concern for transfusionists aborting such transfusions. Methods: We reviewed the symptomology of all mild ATRs (as well as the associated wastage and costs of aborted transfusions) at an academic medical center that occurred over a period of 1 year...
November 13, 2018: American Journal of Clinical Pathology
Lisa Senzel, Tahmeena Ahmed, Eric D Spitzer
Objectives: To review the use of laboratory tests for antiplatelet agents to determine escalation of antiplatelet therapy and for emergent reversal of P2Y12 inhibitors. Methods: A case scenario and review of cardiovascular and neurointerventional literature are described. Results: In cardiovascular disease patients, large randomized trials failed to demonstrate superiority of tailored antiplatelet regimens using the VerifyNow P2Y12 assay, where earlier studies had shown promise...
November 3, 2018: American Journal of Clinical Pathology
Rohit Bhargava, Beth Z Clark, David J Dabbs
Objectives: To investigate use of Magee equations (MEs) to determine which breast cancer cases can be excluded from Oncotype DX testing. Methods: A prospective value study was carried out using data from pathology reports. Results: If all three MEs scores were less than 18 or 31 or higher, the cases were labeled do not send for testing. If any or all scores were 18 to 25, cases were labeled do not send if mitosis score was 1. Of the total 205 cases, 146 (71%) were labeled do not send; of these, the correct call was made in 143 (98%) cases...
November 2, 2018: American Journal of Clinical Pathology
Marion Magierowicz, Nicolas Lechevalier, Nicolas Freynet, Cedric Pastoret, Bouchra Badaoui, Beatrice Ly-Sunnaram, Thierry Fest, Francis Lacombe, Orianne Wagner-Ballon, Mikael Roussel
Objectives: WBC differentials performed using flow cytometry with monoclonal antibodies have been developed in the last decade and are nowadays integrated into the routine workflow of some laboratories. Definition of reference values for each population is required in order to achieve an automatic validation of the results by laboratory software. Methods: We analyzed 584 samples from three hospitals using the Hematoflow solution to define the reference values. Results: Reference values are presented for five groups according to age (0-5, 6-11, 12-19, 20-69, and >69 years)...
October 31, 2018: American Journal of Clinical Pathology
Seon Young Kim, Jeong Su Park, Yun Ji Hong, Taek Soo Kim, Kiho Hong, Kyoung-Ho Song, Hyunju Lee, Eu Suk Kim, Hong Bin Kim, Kyoung Un Park, Junghan Song, Sun Hoe Koo, Eui-Chong Kim
Objectives: To compare a microarray-based identification and resistance determination system (blood culture gram-negative [BC-GN]; Nanosphere, Northbrook, IL) with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) for direct blood cultures (BCs). Methods: BC-GN and MALDI-TOF MS assay results from direct BCs were compared with conventional test results after pure culture. Results: Among 124 BCs, 130 gram-negative rods (GNRs), including six cultures with mixed GNRs (117 bacteria were covered by the BC-GN panel), were detected...
October 31, 2018: American Journal of Clinical Pathology
Dhruv Jain, Chandrashekhar Dravid, Abha Singla, Smita Kumari, Rajesh Kumar Grover
Objectives: We retrospectively compared the seventh and eighth editions of American Joint Committee on Cancer (AJCC) TNM frameworks as disease-free survival (DFS) and overall survival (OS) predictors in oral squamous carcinomas (OSCCs). Methods: We restaged the 342 patients with the revised pT and pN criteria and performed survival analyses. Results: The 3-year DFS (mean follow-up, 364 days; recurrences, 99) was 50%, and the 5-year OS (mean follow-up, 615 days; deaths, 69) was 42%...
October 31, 2018: American Journal of Clinical Pathology
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