Academic Pathology最新文献_第9页

An open-access laboratory medicine course for medical students 一门开放存取的医学生检验医学课程

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Academic Pathology Pub Date : 2023-01-01 DOI: 10.1016/j.acpath.2022.100066

Sofia A. Haile MD , William N. Rose MD

引用次数: 0

Educational Case: Gout 教育案例:痛风

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Academic Pathology Pub Date : 2023-01-01 DOI: 10.1016/j.acpath.2022.100065

Jonathan Light MS , Laurie L. Wellman PhD , Richard M. Conran MD, PhD, JD

引用次数: 1

Utilizing digital pathology and immunohistochemistry of p53 as an adjunct to molecular testing in myeloid disorders 利用数字病理和免疫组织化学p53作为辅助髓系疾病的分子检测

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Academic Pathology Pub Date : 2023-01-01 DOI: 10.1016/j.acpath.2022.100064

Kai J. Rogers MD, PhD , Ibrahim M. Abukhiran MD , Sergei Syrbu MD, PhD , Michael Tomasson MD , Melissa Bates PhD , Prajwal Dhakal MD , Sharathkumar Bhagavathi MD

{"title":"Utilizing digital pathology and immunohistochemistry of p53 as an adjunct to molecular testing in myeloid disorders","authors":"Kai J. Rogers MD, PhD , Ibrahim M. Abukhiran MD , Sergei Syrbu MD, PhD , Michael Tomasson MD , Melissa Bates PhD , Prajwal Dhakal MD , Sharathkumar Bhagavathi MD","doi":"10.1016/j.acpath.2022.100064","DOIUrl":"10.1016/j.acpath.2022.100064","url":null,"abstract":"<div><p><em>TP53</em> mutation status guides early therapeutic decisions in the treatment of clonal myeloid disorders and serves as a simple means of monitoring response to treatment. We aim here to develop a standardized protocol for evaluating <em>TP</em>53 mutation status in myeloid disorders using immunohistochemistry assisted by digital image analysis and further compare this approach to manual interpretation alone. To accomplish this, we obtained 118 bone marrow biopsies from patients with hematologic malignancy and molecular testing for mutations associated with acute myeloid leukemia was performed. Clot or core biopsy slides were stained for p53 and digitally scanned. Overall mutation burden was assessed digitally using two different metrics to determine positivity, compared to the results of manual review, and correlated with molecular results. Using this approach, we found that digital analysis of immunohistochemistry stained slides performed worse than manual categorization alone in predicting <em>TP53</em> mutation status in our cohort (PPV 91%, NPV 100% vs. PPV 100%, NPV 98%). While digital analysis reduced inter- and intraobserver variability when assessing mutation burden, there was poor correlation between the quantity and intensity of p53 staining and molecular analysis (R<sup>2</sup> = 0.204). Therefore, digital image analysis of p53 immunohistochemistry accurately predicts <em>TP53</em> mutation status as confirmed by molecular testing but does not offer a significant advantage over manual categorization alone. However, this approach offers a highly standardized methodology for monitoring disease status or response to treatment once a diagnosis has been made.</p></div>","PeriodicalId":44927,"journal":{"name":"Academic Pathology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10031312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9194090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diagnostic yield and repeat biopsies in rectal and nonrectal colorectal adenocarcinoma: Are we hedging on rectal biopsies? 直肠和非直肠结直肠腺癌的诊断率和重复活检:我们是否要对直肠活检进行回避?

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Academic Pathology Pub Date : 2023-01-01 DOI: 10.1016/j.acpath.2022.100063

Michel Kmeid MD , Rupinder Brar MD , Luz Sullivan MD , Mustafa Erdem Arslan MD , Neharika Shrestha MD , Edward C. Lee MD , Anne Chen MD , Timothy A. Jennings MD , Hwajeong Lee MD

{"title":"Diagnostic yield and repeat biopsies in rectal and nonrectal colorectal adenocarcinoma: Are we hedging on rectal biopsies?","authors":"Michel Kmeid MD , Rupinder Brar MD , Luz Sullivan MD , Mustafa Erdem Arslan MD , Neharika Shrestha MD , Edward C. Lee MD , Anne Chen MD , Timothy A. Jennings MD , Hwajeong Lee MD","doi":"10.1016/j.acpath.2022.100063","DOIUrl":"10.1016/j.acpath.2022.100063","url":null,"abstract":"<div><p>Patients with rectal cancer undergo more repeat biopsies compared to those with nonrectal colon cancer prior to management. We investigated the factors driving the higher frequency of repeat biopsies in patients with rectal cancer. We compared clinicopathologic features of diagnostic and nondiagnostic (in regard to invasion) rectal (n = 64) and colonic (n = 57) biopsies from colorectal cancer patients and characterized corresponding resections. Despite similar diagnostic yield, repeat biopsy was more common in rectal carcinoma, especially in patients receiving neoadjuvant therapy (p < 0.05). The presence of desmoplasia (odds ratio 12.9, p < 0.05) was a strong predictor of making a diagnosis of invasion in both rectal and nonrectal colon cancer biopsies. Diagnostic biopsies had more desmoplasia, intramucosal carcinoma component and marked inflammation, and less low-grade dysplasia component (p < 0.05). Diagnostic yield of biopsy was higher for tumors with high-grade tumor budding, mucosal involvement by high-grade dysplasia/intramucosal carcinoma without low-grade dysplasia and diffuse surface desmoplasia irrespective of tumor location. Sample size, amount of benign tissue, appearance, and T stage did not affect diagnostic yield. Repeat biopsy of rectal cancer is primarily driven by management implications. Diagnostic yield in colorectal cancer biopsies is multifactorial and is not due to differing pathologists’ diagnostic approach per tumor site. For rectal tumors, a multidisciplinary strategic approach is warranted to avoid repeat biopsy when unnecessary.</p></div>","PeriodicalId":44927,"journal":{"name":"Academic Pathology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10031322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9198895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Supporting a culture of patient safety: Resident-led patient safety event reviews in a pathology residency training program 支持患者安全文化：病理住院医师培训项目中住院医师领导的患者安全事件审查

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Academic Pathology Pub Date : 2023-01-01 DOI: 10.1016/j.acpath.2023.100069

Catherine M. Tucker MD , Rebecca Jaffe MD , Allison Goldberg MD

{"title":"Supporting a culture of patient safety: Resident-led patient safety event reviews in a pathology residency training program","authors":"Catherine M. Tucker MD , Rebecca Jaffe MD , Allison Goldberg MD","doi":"10.1016/j.acpath.2023.100069","DOIUrl":"10.1016/j.acpath.2023.100069","url":null,"abstract":"<div><p>Patient safety is a critical component of quality patient care at any healthcare institution. In order to support a culture of patient safety, and in the context of a hospital-wide patient safety initiative at our institution, we have created and implemented a new patient safety curriculum within our training program. The curriculum is embedded in an introductory course for first-year residents, in which residents gain an understanding of the multifaceted role of the pathologist in patient care. The patient safety curriculum is a resident-centered event review process and includes 1) identification and reporting of a patient safety event, 2) event investigation and review, and 3) presentation of findings to the residency program including core faculty and safety champions for the consideration of implementation of the identified systems solution. Here we discuss the development of our patient safety curriculum, which was trialed over a series of seven event reviews conducted between January 2021 and June 2022. Resident involvement in patient safety event reporting and patient safety event review outcomes were measured. All event reviews conducted thus far have resulted in the implementation of the solutions discussed during event review presentations based on cause analysis and identification of strong action items. Ultimately this pilot will serve as the basis by which we implement a sustainable curriculum in our pathology residency training program centered on supporting a culture of patient safety, and in line with ACGME requirements.</p></div>","PeriodicalId":44927,"journal":{"name":"Academic Pathology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9982285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10844500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Undergraduate medical student perspectives on the role of autopsy in medical education 本科医学生对尸检在医学教育中的作用的看法

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Academic Pathology Pub Date : 2023-01-01 DOI: 10.1016/j.acpath.2022.100068

Patrick Hearle , Wing Fei Wong AB , Joanna Chan MD

{"title":"Undergraduate medical student perspectives on the role of autopsy in medical education","authors":"Patrick Hearle , Wing Fei Wong AB , Joanna Chan MD","doi":"10.1016/j.acpath.2022.100068","DOIUrl":"10.1016/j.acpath.2022.100068","url":null,"abstract":"<div><p>Medical autopsy has historically been considered a valued experience in undergraduate medical education; however, student participation has declined in recent years. Medical education literature from the educator point of view supports autopsy as an educational tool, but more data are needed on undergraduate medical students’ (UMS) perspectives on autopsy. This study aims to assess UMS opinions on the role of autopsy in undergraduate medical education. A 5-point Likert scale survey concerning autopsy and medical education was offered to all UMS at Sidney Kimmel Medical College. In addition, 28 senior students were assigned a 500 word essay on hospital autopsy and its role in medical education. Senior students were given the opportunity to view an autopsy prior to completing their essays. UMS (n = 87) reported that witnessing an autopsy can improve anatomic knowledge (μ = 4.3), observational skills (μ = 4.1), and clinicopathologic correlation (μ = 4.3) but were neutral in their perceived importance of viewing an autopsy in their pathology education (μ = 3.7). Senior students (n = 27) responding to the essay prompt reported that autopsy is essential in medical education (85.2%) and increases clinical and anatomical understanding (63.0%). This study suggests that many UMS acknowledge the importance and applicability of autopsy in their education. This concurrence of UMS opinion with the medical education literature supports making autopsy participation a widely available component of undergraduate medical education.</p></div>","PeriodicalId":44927,"journal":{"name":"Academic Pathology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9926072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9306894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Educational Case: Transfusion reactions: Transfusion associated circulatory overload vs transfusion-related acute lung injury 教育案例:输血反应:输血相关循环负荷vs输血相关急性肺损伤

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Academic Pathology Pub Date : 2022-01-01 DOI: 10.1016/j.acpath.2022.100022

Diana S. Desai MD, MBA , Kinjal S. Shah MD , Sejal A. Shah MD

引用次数: 0

Educational Case: Renal allograft rejection 教育案例:肾移植排斥反应

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Academic Pathology Pub Date : 2022-01-01 DOI: 10.1016/j.acpath.2022.100013

Harrison Dai BS , Shirui Chen MD , Jolanta Kowalewska MD, PhD

引用次数: 0

Educational Case: Evaluating a patient with cirrhosis 教育案例:评价一个肝硬化患者