American journal of clinical pathology最新文献_第9页

Clinicopathologic correlation of dermatologic diseases in patients with darker pigmentation. 深色色素沉着患者皮肤病的临床病理学相关性。

IF 2.3 4区医学

American journal of clinical pathology Pub Date : 2024-08-01 DOI: 10.1093/ajcp/aqae013

Sanjna Tripathy, Elizabeth Warbasse, Shira Ronen, Rami Al-Rohil, George F Cohen, Wei-Shen Chen, Anisha B Patel

{"title":"Clinicopathologic correlation of dermatologic diseases in patients with darker pigmentation.","authors":"Sanjna Tripathy, Elizabeth Warbasse, Shira Ronen, Rami Al-Rohil, George F Cohen, Wei-Shen Chen, Anisha B Patel","doi":"10.1093/ajcp/aqae013","DOIUrl":"10.1093/ajcp/aqae013","url":null,"abstract":"Objectives: Cutaneous diseases that disproportionately affect patients with darker pigmentation and their histologic features are historically understudied and undertreated. This review article aims to highlight the key clinical features, histopathology, and diagnostic pearls of several cutaneous diseases that commonly present in patients with darker pigmentation.Methods: A literature search was conducted, and a list of cutaneous diseases that frequently affect patients with darker pigmentation was compiled. A group of experts expounded upon those that were most common or misdiagnosed according to scientific evidence and clinical practice.Results: The diseases were divided into hypopigmented disorders, hyperpigmented disorders, scarring disorders, and alopecic disorders. Within each category, the etiology, clinical features, histopathology, and key histologic differential diagnoses are described and discussed.Conclusions: As many clinicians are taught that there are no effective treatment options or that these diseases are considered \"cosmetic\" in nature, patients often do not get a thorough medical workup or skin biopsy. This article aims to decrease the knowledge gap and serve as a resource for anyone involved in the care of patients with these cutaneous conditions.","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140183459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Kikuchi-Fujimoto disease mimicking T-cell lymphoma after COVID-19 vaccination. 接种 COVID-19 疫苗后出现模仿 T 细胞淋巴瘤的菊地-藤本氏病。

IF 2.3 4区医学

American journal of clinical pathology Pub Date : 2024-08-01 DOI: 10.1093/ajcp/aqae016

Nuttavut Sumransub, Veronika Bachanova, Michael A Linden

引用次数: 0

Correction to: Clinicopathologic Analysis of Oral and Maxillofacial Solitary Fibrous Tumor: A Systematic Review. 更正：口腔颌面部孤立性纤维瘤的临床病理分析：系统综述。

IF 2.3 4区医学

American journal of clinical pathology Pub Date : 2024-08-01 DOI: 10.1093/ajcp/aqae086

引用次数: 0

Clinical decision support to improve CBC and differential ordering. 改进全血细胞计数和鉴别诊断排序的临床决策支持。

IF 2.3 4区医学

American journal of clinical pathology Pub Date : 2024-08-01 DOI: 10.1093/ajcp/aqae024

Grace K Mahowald, Kent B Lewandrowski, Anand S Dighe

{"title":"Clinical decision support to improve CBC and differential ordering.","authors":"Grace K Mahowald, Kent B Lewandrowski, Anand S Dighe","doi":"10.1093/ajcp/aqae024","DOIUrl":"10.1093/ajcp/aqae024","url":null,"abstract":"Objectives: Complete blood count and differential (CBC diff) is a common laboratory test that may be overused or misordered, particularly in an inpatient setting. We assessed the ability of a clinical decision support (CDS) alert to decrease unnecessary orders for CBC diff and analyzed its impact in the laboratory.Methods: We designed 3 CDS alerts to provide guidance to providers ordering CBC diff on inpatients at frequencies of daily, greater than once daily, or as needed.Results: The 3 alerts were highly effective in reducing orders for CBC diff at the frequencies targeted by the alert. Overall, test volume for CBC diff decreased by 32% (mean of 5257 tests per month) after implementation of the alerts, with a corresponding decrease of 22% in manual differentials performed (mean of 898 per month). Turnaround time for manual differentials decreased by a mean of 41.5 minutes, with a mean decrease of up to 90 minutes during peak morning hours.Conclusions: The 3 CDS alerts successfully decreased inpatient orders for CBC diff and improved the quality of patient care by decreasing turnaround time for manual differentials.","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140179072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A 5-step root cause analysis model for test overutilization: A study on its application to plasma transferrin testing. 检测过度使用的五步根本原因分析模型：血浆转铁蛋白测试应用研究。

IF 2.3 4区医学

American journal of clinical pathology Pub Date : 2024-08-01 DOI: 10.1093/ajcp/aqae015

Jiracha Jittapranerat, Wimol Chinswangwatanakul

{"title":"A 5-step root cause analysis model for test overutilization: A study on its application to plasma transferrin testing.","authors":"Jiracha Jittapranerat, Wimol Chinswangwatanakul","doi":"10.1093/ajcp/aqae015","DOIUrl":"10.1093/ajcp/aqae015","url":null,"abstract":"Objectives: This study aimed to develop a root cause analysis (RCA) model for test overutilization, applying it to transferrin overordering at our institution.Methods: A comprehensive review was undertaken to establish a systematic RCA model. Upon implementation, the questionnaire identifying the root causes of transferrin overordering with infographic intervention was distributed to clinicians and nurses.Results: The RCA model comprises 5 steps: (1) problem identification, (2) causal factor determination, (3) data collection, (4) significant factor identification, and (5) corrective action development and outcome measurement. The major causes of transferrin overutilization were confusion between transferrin and transferrin saturation, as well as unfamiliarity with the laboratory handbook. An infographic reduced postintervention transferrin ordering among clinicians (84.9%, P < .001) and nurses (46.8%, P < .001).Conclusions: This study presents a 5-step RCA model that offers a customized method to identify the causes of test overutilization. Applying this model to transferrin at our institution revealed 22 leading root causes. Laboratories are encouraged to adopt this RCA model as it can contribute to optimized patient care and more efficient resource allocation.","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11291954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140048482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Four distinct ipsilateral vestibular schwannomas: A case of mosaic NF2-related schwannomatosis. 四个不同的同侧前庭分裂瘤：一例镶嵌型 NF2 相关分裂瘤病。

IF 2.3 4区医学

American journal of clinical pathology Pub Date : 2024-08-01 DOI: 10.1093/ajcp/aqae027

Alexandra E Tunkel, Emily R Youner, Hayk Barseghyan, Yulong Fu, Surajit Bhattacharya, Miriam Bornhorst, Ashkan S Monfared

{"title":"Four distinct ipsilateral vestibular schwannomas: A case of mosaic NF2-related schwannomatosis.","authors":"Alexandra E Tunkel, Emily R Youner, Hayk Barseghyan, Yulong Fu, Surajit Bhattacharya, Miriam Bornhorst, Ashkan S Monfared","doi":"10.1093/ajcp/aqae027","DOIUrl":"10.1093/ajcp/aqae027","url":null,"abstract":"Objectives: Distinguishing between sporadic and germline/mosaic NF2-related schwannomatosis is important to ensure that patients have appropriate long-term care. With this report, we describe a unique case of a patient with 4 ipsilateral schwannomas and identify a combination of sequencing modalities that can accurately diagnose mosaic NF2-related schwannomatosis.Methods: We present a 32-year-old woman with a familial history of vestibular schwannoma in her father and right-sided schwannomas involving the apical and basal turns of cochlea, lateral semicircular canal, and internal auditory canal (IAC). Genetic analysis of blood and frozen tissue from 2 tumors (intralabyrinthine and IAC tumors) was performed using next-generation sequencing (NGS), multiplex ligation-dependent probe amplification (MLPA), and optical genome mapping (OGM).Results: Germline testing for NF2, LZTR1, and SMARCB1 was negative. Tumor genetic testing revealed a shared NF2 pathogenic variant between the 2 tumors (\"first hit\") but distinct \"second hit\" NF2 variants, including mosaic loss of chromosome 22 in the IAC tumor seen only with OGM, consistent with mosaic NF2-related schwannomatosis.Conclusions: Multimodality sequencing, including NGS, MLPA, and OGM, was required to ensure appropriate diagnosis of mosaic NF2-related schwannomatosis in this patient. A similar approach can be used for other patients with multiple ipsilateral tumors and suspected tumor predisposition.","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140287982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Laboratory characterization of the pediatric B/T subtype of mixed-phenotype acute leukemia: Report of a case series. 混合表型急性白血病儿科 B/T 亚型的实验室特征：病例系列报告。

IF 2.3 4区医学

American journal of clinical pathology Pub Date : 2024-08-01 DOI: 10.1093/ajcp/aqae020

Irina Demina, Ekaterina Mikhailova, Elena Zerkalenkova, Alexandra Semchenkova, Julia Roumiantseva, Alexandra Borkovskaya, Evgeny Matveev, Dmitry Abramov, Dmitry Konovalov, Natalia Miakova, Natalia Ponomareva, Julia Belkina, Konstantin Kondratchik, Yulia Olshanskaya, Galina Novichkova, Alexander Karachunskiy, Alexander Popov

{"title":"Laboratory characterization of the pediatric B/T subtype of mixed-phenotype acute leukemia: Report of a case series.","authors":"Irina Demina, Ekaterina Mikhailova, Elena Zerkalenkova, Alexandra Semchenkova, Julia Roumiantseva, Alexandra Borkovskaya, Evgeny Matveev, Dmitry Abramov, Dmitry Konovalov, Natalia Miakova, Natalia Ponomareva, Julia Belkina, Konstantin Kondratchik, Yulia Olshanskaya, Galina Novichkova, Alexander Karachunskiy, Alexander Popov","doi":"10.1093/ajcp/aqae020","DOIUrl":"10.1093/ajcp/aqae020","url":null,"abstract":"Objectives: Mixed-phenotype acute leukemia (MPAL) is a rare disease associated with difficulties in the correct lineage assignment of leukemic cells. One of the least common subtypes within this category is characterized by the simultaneous presence of B- and T-lineage-defining antigens. Each case of suspected B/T MPAL should be considered in light of all available laboratory and clinical data to avoid misdiagnosis.Methods: In this study, we describe 6 pediatric patients who presented with leukemic blasts bearing B- and T-lineage antigens at diagnosis, including their clinical, immunophenotypic, morphologic, and cytogenetic characteristics.Results: In 3 patients, more or less distinct populations of B- and T-lymphoid origin were found; the other 3 patients had a single mixed-phenotype blast population. All cases fulfilled the World Health Organization criteria, but not all of them turned out to be bona fide cases of B/T MPAL according to the available clinical and laboratory data. Found genetic lesions were helpful for the confirmation of MPAL instead of 2 concomitant tumors, but for a general B/T MPAL diagnosis, genetic studies provided the only descriptive data.Conclusions: The accurate diagnosis of B/T MPAL requires a multidisciplinary approach combining high-tech laboratory methods and close cooperation between treating physicians and pathologists.","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140183460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Low board pass rates in Blood Banking/Transfusion Medicine. 血库/输血医学专业的考试通过率低。

IF 2.3 4区医学

American journal of clinical pathology Pub Date : 2024-08-01 DOI: 10.1093/ajcp/aqae028

Gary W Procop, Tyler Sandersfeld, Mark K Fung

引用次数: 0

Current laboratory testing practices for mismatch repair deficiency and microsatellite instability testing: A survey-based review of current laboratory practices. 错配修复缺陷和微卫星不稳定性检测的现行实验室检测方法：基于调查的实验室现行检测方法回顾。

IF 2.3 4区医学

American journal of clinical pathology Pub Date : 2024-07-30 DOI: 10.1093/ajcp/aqae094

Amy L Austin, Russell R Broaddus, Rhona J Souers, Megan E Kane, Ravindra Kolhe, Dylan V Miller, Joel T Moncur, Shakti Ramkissoon, Laura J Tafe, Dimitri G Trembath, Rondell P Graham

{"title":"Current laboratory testing practices for mismatch repair deficiency and microsatellite instability testing: A survey-based review of current laboratory practices.","authors":"Amy L Austin, Russell R Broaddus, Rhona J Souers, Megan E Kane, Ravindra Kolhe, Dylan V Miller, Joel T Moncur, Shakti Ramkissoon, Laura J Tafe, Dimitri G Trembath, Rondell P Graham","doi":"10.1093/ajcp/aqae094","DOIUrl":"https://doi.org/10.1093/ajcp/aqae094","url":null,"abstract":"Objectives: To describe mismatch repair (MMR) and microsatellite instability (MSI) testing practices in laboratories using the College of American Pathologists (CAP) MSI/MMR proficiency testing programs prior to the 2022 publication of the MSI/MMR practice guidelines copublished by CAP and the Association of Molecular Pathology (AMP).Methods: Data from supplemental questionnaires provided with the 2020-B MSI/MMR programs to 542 laboratories across different practice settings were reviewed. Questionnaires contained 21 questions regarding the type of testing performed, specimen/tumor types used for testing, and clinical practices for checkpoint blockade therapy.Results: Domestic laboratories test for MSI/MMR more often than international laboratories (P = .04) and academic hospitals/medical centers test more frequently than nonhospital sites/clinics (P = .03). The most commonly used testing modality is immunohistochemistry, followed by polymerase chain reaction, then next-generation sequencing. Most laboratories (72.6%; 347/478) reported awareness of the use of immune checkpoint inhibitor therapy for patients with high MSI or MMR-deficient results.Conclusions: The results demonstrate the state of MMR and MSI testing in laboratories prior to the publication of the CAP/AMP best practice guidelines, highlighting differences between various laboratory types. The findings indicate the importance of consensus guidelines and provide a baseline for comparison after their implementation.","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141791606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A survey analysis of the adoption of large language models among pathologists. 病理学家采用大型语言模型的调查分析。

IF 2.3 4区医学

American journal of clinical pathology Pub Date : 2024-07-27 DOI: 10.1093/ajcp/aqae093

Thiyaphat Laohawetwanit, Daniel Gomes Pinto, Andrey Bychkov

{"title":"A survey analysis of the adoption of large language models among pathologists.","authors":"Thiyaphat Laohawetwanit, Daniel Gomes Pinto, Andrey Bychkov","doi":"10.1093/ajcp/aqae093","DOIUrl":"https://doi.org/10.1093/ajcp/aqae093","url":null,"abstract":"Objectives: We sought to investigate the adoption and perception of large language model (LLM) applications among pathologists.Methods: A cross-sectional survey was conducted, gathering data from pathologists on their usage and views concerning LLM tools. The survey, distributed globally through various digital platforms, included quantitative and qualitative questions. Patterns in the respondents' adoption and perspectives on these artificial intelligence tools were analyzed.Results: Of 215 respondents, 100 (46.5%) reported using LLMs, particularly ChatGPT (OpenAI), for professional purposes, predominantly for information retrieval, proofreading, academic writing, and drafting pathology reports, highlighting a significant time-saving benefit. Academic pathologists demonstrated a better level of understanding of LLMs than their peers. Although chatbots sometimes provided incorrect general domain information, they were considered moderately proficient concerning pathology-specific knowledge. The technology was mainly used for drafting educational materials and programming tasks. The most sought-after feature in LLMs was their image analysis capabilities. Participants expressed concerns about information accuracy, privacy, and the need for regulatory approval.Conclusions: Large language model applications are gaining notable acceptance among pathologists, with nearly half of respondents indicating adoption less than a year after the tools' introduction to the market. They see the benefits but are also worried about these tools' reliability, ethical implications, and security.","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141791605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0