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Pathology Consultation

Alexi Baidoshvili, Anca Bucur, Jasper van Leeuwen, Jeroen van der Laak, Philip Kluin, Paul J van Diest
BACKGROUND: The benefits of digital pathology for workflow improvement and thereby cost savings in pathology, at least partly outweighing investment costs, are increasingly recognized. Successful implementations in a variety of scenarios start to demonstrate cost benefits of digital pathology for both research and routine diagnostics, contributing to a sound business case encouraging further adoption. To further support new adopters, there is still a need for detailed assessment of the impact this technology has on the relevant pathology workflows with emphasis on time saving...
June 20, 2018: Histopathology
De-Jian Chen, Qi Lai, Jianghao Zhu, Zongmiao Wan, Hucheng Liu, Min Dai, Runsheng Guo, Bin Zhang
RATIONALE: Osteosarcoma is a rare neoplasm in the lumbar spine. Although osteosarcoma can arise in any portion of the skeleton, it very rarely arises in the spinal canal, which accounts for <0.1% of all cases of adult sarcomas. Here, we describe a case of osteosarcoma arising in the L4-5 spinal canal. PATIENT CONCERNS: The present report describes the case of a 55-year-old female patient with osteosarcoma of the L4-5 spinal canal. DIAGNOSES: The patient was initially diagnosed with lumbar spinal stenosis and underwent lumbar fusion at a local hospital...
June 2018: Medicine (Baltimore)
Jeanne-Marie Perotin, Claire Launois, Maxime Dewolf, Antoine Dumazet, Sandra Dury, François Lebargy, Valérian Dormoy, Gaëtan Deslee
Chronic cough is a common complaint and a frequent cause of medical consultation. Its management can be difficult. We present here an overview of the current guidelines for the management of chronic cough. Different steps are detailed, including the initial research of an obvious etiology and alert signs that should lead to further investigation of underlying condition. The diagnosis of the most frequent causes: asthma, non-asthmatic eosinophilic bronchitis, gastroesophageal reflux disease and upper airway cough syndrome should be considered, assessed and treated accordingly...
2018: Therapeutics and Clinical Risk Management
Eric Z Herring, Matthew R Peck, Caroline E Vonck, Gabriel A Smith, Thomas E Mroz, Michael P Steinmetz
OBJECTIVE Spine surgeons in the United States continue to be overwhelmed by an aging population, and patients are waiting weeks to months for appointments. With a finite number of clinic visits per surgeon, analysis of referral sources needs to be explored. In this study, the authors evaluated patient referrals and their yield for surgical volume at a tertiary care center. METHODS This is a retrospective study of new patient visits by the spine surgery group at the Cleveland Clinic Center for Spine Health from 2011 to 2016...
June 15, 2018: Journal of Neurosurgery. Spine
Armen Khararjian, Prakash Mathew, Ajuni Choudhary, Alexander Baras
CONTEXT: - Intraoperative pathology consultation is an important tool for many surgical procedures and is deemed appropriate when the pathology result immediately alters surgical management. OBJECTIVE: - To evaluate the utility of intraoperative gross examinations of colorectal resections and to better understand the associated costs. DESIGN: - The pathology database of our institution was searched for colorectal resections for primary disease, and those cases were separated into 3 categories: frozen section performed, intraoperative gross examination performed, and no intraoperative consultation...
June 14, 2018: Archives of Pathology & Laboratory Medicine
Aline C Tregnago, Jonathan I Epstein
Skene's (periurethral) gland adenocarcinoma is very rare, with only 7 cases reported in the literature. This is the first series of cases on this entity. We describe the histologic, immunohistochemical, and clinical findings of 4 patients with Skene's gland adenocarcinoma retrieved from the Johns Hopkins Urologic Pathology Consult Service from 1984 to 2017. The average age at diagnosis of the 4 women was 74.5 years (range, 61 to 87 y). Tumors were treated by limited resections with negative margins. Tumor size ranged from 1...
June 12, 2018: American Journal of Surgical Pathology
Sophie Goettmann, Isabelle Moulonguet, Inès Zaraa
BACKGROUND: Nail unit melanoma (NUM) is a rare melanoma variant, usually associated with a poor prognosis because of a delayed diagnosis. Few data are available concerning the management and long-term outcome of in situ NUM. OBJECTIVE: To use a large cohort to provide comprehensive patient data and long-term follow-up information. This will serve to investigate distinctive epidemiological, clinical, and histological features of in situ NUM. to report treatment modalities, assess conservative surgery and evaluate its long-term safety...
June 12, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
Alexi Baidoshvili, Nikolas Stathonikos, Gerard Freling, Jos Bart, Nils 't Hart, Jeroen van der Laak, Jan Doff, Bert van der Vegt, Philip Kluin, Paul J van Diest
BACKGROUND: Most validation studies on digital pathology diagnostics have been performed in single institutes. Since rapid consultation of extramural experts is one of the most important use cases for digital pathology laboratory networks, the aim of this study was to validate a whole slide image-based teleconsultation network between three independent laboratories. METHODS: Each laboratory contributed 30 biopsies and / or excisions, adding up to 90 specimens (776 slides) of varying difficulty and covering a wide variety of organs and subspecialties...
June 12, 2018: Histopathology
Marie-Pierrette Ntyonga-Pono
Chronic adrenal insufficiency is regarded as a rare disease in its primary stage. However, secondary adrenal insufficiency, which essentially occurs after stopping corticosteroids, is more frequent, ranging from 4.2% to 60%, depending on the pathology treated, but it is often unrecognized. We report the case of a 66 year old female patient with a history of chronic fatigue for more than 2 years. The patient consulted several clinicians but symptoms were wrongly attributed to a depressive disorder rather than to adrenal corticotropic adrenal insufficiency...
2018: Pan African Medical Journal
Carlos Varela, Sven Young, Reinou Groen, Leonard Banza, Nyengo C Mkandawire, Asgaut Viste
Background: Noncommunicable diseases, such as surgical conditions have received little attention from public health planners in low income countries (LIC) like Malawi. Though increasingly recognised as a growing global health problem, the burden of surgical pathologies and access to surgical care has not been adequately identified in many LIC. Information on the spectrum and burden of surgical disease in Malawi is important to uncover the unmet need for surgery and for planning of the National Health Service...
September 2017: Malawi Medical Journal: the Journal of Medical Association of Malawi
Nuno Rui Paulino Pereira, Paul T Ogink, Olivier Q Groot, Marco L Ferrone, Francis J Hornicek, C N van Dijk, J A M Bramer, Joseph H Schwab
BACKGROUND CONTEXT: Postoperative morbidity may offset the potential benefits of surgical treatment for spine metastatic disease; hence, risk factors for postoperative complications and reoperations should be taken into considerations during surgical decision-making. In addition, it remains unknown whether complications and reoperations shorten these patients' survival. PURPOSE: We aimed to describe and identify factors associated with having a complication within 30 days of index surgery as well as factors associated with having a subsequent reoperation...
June 1, 2018: Spine Journal: Official Journal of the North American Spine Society
Matthew Johnson, Angela Mary Tod, Stephen Brummell, Karen Collins
Patients with lung cancer who undergo surgery may potentially be cured. The resulting pathological staging gives an indication of 5-year survival and whether further treatment is recommended. To date, there is little research evidence regarding the way potential recurrence is communicated to patients by staff. This qualitative research used case studies to explore how information disclosure about possible recurrence was managed following lung cancer surgery and aimed to identify practice implications for clinical teams...
June 4, 2018: European Journal of Cancer Care
Attila Zalatnai, Eszter Galambos, Eszter Perjési
The long-acting somatostatin analogs represent important weapons in treatment protocols of patients with neuroendocrine tumors. Because these peptides preferentially bind to the specific somatostatin receptors, the targeted therapy requires detection of them. As one of the national consulting centers, here we present the results of the immunohistochemically positive neuroendocrine neoplasms diagnosed between 2010 and 2014. Twenty-four paraffin-embedded cases (14 females 10 men, 21-79 years) from different localizations were found to express somatostatin-receptor type 2 (SSTR2)...
June 3, 2018: Pathology Oncology Research: POR
Xian-Rui Wu, Hua-Shan Liu, Xue-Ying Shi, Wei-Xun Zhou, Zhi-Nong Jiang, Yan Huang, Dipti M Karamchandani, John R Goldblum, Shu-Yuan Xiao, Hong-Fa Zhu, Michael M Feely, Amy L Collinsworth, Ashwini Esnakula, Hao Xie, Bo Shen, Ping Lan, Xiu-Li Liu
Background: The aim of this study was to evaluate the interobserver variability in diagnosing inflammatory bowel disease (IBD)-associated neoplasia among practicing pathologists from China using telepathology, a practice of remote diagnostic consultation increasingly used nationally and internationally, and its comparison with the interpretation of subspecialized gastrointestinal (GI) pathologists from the United States (US). Methods: Eight GI pathologists from the US and 4 pathologists from China with an interest in GI pathology participated in this study...
2018: Gastroenterology Research and Practice
Joseph M Armstrong, Sorena Keihani, James M Hotaling
PURPOSE OF REVIEW: Male factor infertility is a complex and multifaceted problem facing the modern urologist and is identified in 30-40% of infertile couples. This review focuses on the use of ultrasound, as an adjunct screening tool, in the initial evaluation of male infertility. RECENT FINDINGS: Access to male reproductive urologist for assessment of male infertility is limited and about a quarter of infertile couples do not complete the male component in their infertility assessment...
May 28, 2018: Current Urology Reports
Barry Kevane, Seamus Allen, Kevin Walsh, Karl Egan, Patricia B Maguire, Marie C Galligan, Damien Kenny, Rhona Savage, Esther Doran, Áine Lennon, E Laine Neary, Fionnuala Ní Áinle
AIMS: The mechanisms underlying the competing thrombotic and hemorrhagic risks in Eisenmenger syndrome are poorly understood. We aimed to characterise derangements of blood coagulation and to assess the effect of dual endothelin-1 receptor antagonism in modulating hemostasis in this rare disorder. METHODS: In a 10 month recruitment period at a tertiary cardiology referral centre during which time there were over 14,000 out-patient consultations, consecutive subjects with Eisenmenger syndrome being considered for macitentan therapy (n=9) and healthy volunteers (n=9) were recruited...
May 26, 2018: Journal of Thrombosis and Haemostasis: JTH
Helen L Ord, Michael J Griksaitis
Point of care ultrasound (POCUS) is well established in adult emergency medicine and critical care. It is used for immediate diagnosis and evaluation of the impact of bedside interventions in the acutely unwell child. This article highlights how ultrasound can be helpful in paediatric practice when dealing with the neonate, infant or older child with undifferentiated respiratory distress, respiratory failure or ventilation problems. It highlights indications for use, key diagnostic features of common pathology and outlines the benefits of POCUS in everyday practice...
May 25, 2018: Archives of Disease in Childhood. Education and Practice Edition
Chelsea Horwood, Jonathan Wisler, Sara Byrd, Karina Woodling, Eric B Schneider, Amy Rushing
BACKGROUND: Little is reported in the literature on management strategies and outcomes in patients with an active cancer diagnosis who undergo emergent general surgery. The purpose of this study is to evaluate preoperative risk factors in both operative and non-operative management, as well as to describe the outcomes of colonic emergencies within a cancer patient population. METHODS: A single institution cancer database was reviewed retrospectively to identify patients with an active cancer diagnosis who had an emergency general surgery consult placed for an acute colonic pathology...
May 22, 2018: Surgery
O Rees-Stoner, A Jenkinson, K Shah, M Kittur
Oral and maxillofacial surgeons carry out the diagnosis and treatment of diseases affecting the mouth, jaws, face and neck. They provide a critical referral service for dentists in general practice, with the most suspicious of these being sent as 'urgent suspected cancer', or 'USC'. According to national guidelines, such cases must be seen within 14 days. In January and February 2017, the oral and maxillofacial team in Morriston hospital received two such referrals from separate GDPs in the locality. Both were prioritised and seen within the two week window on consultant clinics...
May 25, 2018: British Dental Journal
Kelly J Butnor, Justin Rueckert, Elizabeth N Pavlisko, Thomas A Sporn, Victor L Roggli
AIMS: Florid mesothelial hyperplasia is known to result from endometriosis. Well-differentiated papillary mesothelioma and multiloculated peritoneal inclusion cysts have also been described in women with endometriosis. To our knowledge, peritoneal diffuse malignant mesothelioma (MM) arising in the setting of endometriosis has not been reported. The purpose of this study is to report the clinicopathological characteristics of women with MM and endometriosis. METHODS: The surgical pathology files of a tertiary academic medical centre and the consultation files of one of the study authors were reviewed for cases of MM in females with and without endometriosis...
May 23, 2018: Journal of Clinical Pathology
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