bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of Sampling Time and Ultrafiltration Coefficient of the Dialysis Membrane on Cardiac Troponin I and T
Authors: Lippi Giuseppe , Tessitore Nicola , Montagnana Martina , Salvagno Gian Luca , Lupo Antonio , Guidi Gian Cesare
Published: February 2021

Context.—The measurement of cardiac troponin I (TnI) and T (TnT) is essential to diagnose, guide therapy, and predict outcomes of the acute coronary syndrome. Increased levels of troponins, especially TnT, are frequently observed in patients on chronic hemodialysis (HD), reflecting ongoing and subclinical myocardial damage.

Objective.—Because these markers are increasingly used for stratification of cardiac risk in these patients, their behavior during HD should be acknowledged to optimize their clinical usefulness.

Design.—TnI and TnT were measured in 34 patients pre-HD and post-HD by either high- or low-flux membranes. The post-HD concentrations were corrected for hemoconcentration.

Results.—Pre-HD levels above the 99th percentile reference limits of the general population of TnI (>0.06 ng/ mL) and TnT (>0.01 ng/mL) were observed in 9% (13% high-flux, 6% low-flux membranes) and 88% (94% high-flux; 83% low-flux membranes) of the patients, respectively. No significant difference was observed in mean pre-HD values between patients dialyzed by low- and high-flux membranes. The overall decrease post-HD of both troponins (−21% and −17% for TnI and TnT, respectively) only reached statistical significance in patients dialyzed by low-flux membranes (−27% and −37% for TnI and TnT, respectively). A significant correlation was observed between absolute variations of TnI and TnT pre-HD to post-HD.

Conclusions.—Results of our investigation attest that high-flux membranes clear both troponins more efficiently from circulation than low-flux membranes. Therefore, sampling time and ultrafiltration coefficient of the HD membrane should be regarded as potential sources of variability in the clinical interpretation of troponin measurement in HD patients.
Pediatric Pituitary Adenomas
Authors: Webb Christopher , Prayson Richard A.
Published: February 2021

Context.—Pituitary adenomas are relatively rare occurrences in the pediatric population, and there are few studies documenting the profile of these tumors in this age group.

Objective.—To study the clinical and pathologic features of pediatric pituitary adenomas in conjunction with a review of the available literature.

Design.—A retrospective clinicopathologic review of 20 pediatric patients (younger than 20 years of age) with pituitary adenomas resected during a 24.5-year period (1981–2005).

Results.—A total of 20 patients, including 12 females and 8 males, comprise the study group. Mean age at onset of symptoms was 14.0 years (range, 5–18 years). Four patients had onset of symptoms before the age of 12 years. The majority of patients presented with headaches (n = 12), visual disturbances (n = 12) or, in females, menstrual dysfunction (n = 9/12). Tumor size based on radiographic data was known for 19 tumors; 12 adenomas were greater than 1 cm in greatest dimension, and 7 were less than 1 cm. On follow-up, 2 patients with total gross tumor resections had recurrent adenomas; time to recurrence was 5 months and 17 months, respectively. Nine adenomas stained solely for prolactin, 5 for adrenocorticotropic hormone, and 3 for growth hormone. Two stained for growth hormone and prolactin. One did not stain with hormone antibodies.

Conclusions.—Most pediatric pituitary adenomas present after the onset of puberty and present with frequent headaches, changes in visual acuity and, in females, menstrual dysfunction. Most (19/20) were secretory, with prolactinomas being the most common type.
Frequent Detection of Androgen Receptors in Spindle Cell Lipomas: An Explanation for This Lesion's Male Predominance?
Authors: Syed Sajjad , Martin Anne-Marie , Haupt Helen , Podolski Victoria , Brooks John J.
Published: February 2021

Context.—Spindle cell lipoma (SCL) is a tumor with marked male predilection. We discovered one SCL that exhibited strong immunoreactivity for androgen receptors (ARs) in the spindle cells.

Objective.—The hypothesis was that ARs in SCLs would not be rare and that all or nearly all SCLs would be AR positive, perhaps explaining its male predominance.

Design.—Twenty-eight cases of SCL (22 men, 6 women) and a control group of 20 conventional lipomas (10 men, 10 women) were stained with monoclonal AR antibody (1: 150; Dako, Carpinteria, Calif) using the Ventana Discovery. Only nuclear reactivity was considered positive, as noted in prostate controls. Cell types (fat, spindle cells) and extent of staining were recorded as rare, considered negative, focal (1+), or diffuse (2+/3+).

Results.—All 22 cases of SCL in men were positive for ARs. Twenty showed diffuse (2+/3+) reactivity mainly in the spindle cells. Of the 6 SCLs in women, 1 was AR negative, 1 showed a 3+ reaction in the spindle cells, and 4 had weak (1+) staining of spindle cells. Overall, 96% of SCLs were AR positive, including 83% of SCLs in women. Seventy percent of conventional lipomas showed positive staining in fat, but only 2 showed 2+ staining. In the rest, staining was rare or weak (1+).

Conclusions.—Nearly all SCLs exhibited AR reactivity. However, the presence of ARs in a substantial percentage of ordinary lipomas and in SCLs in females mitigates against the hypothesis that AR reactivity alone can explain the marked male predominance of SCL.
Use of Digital Video for Documentation of Microscopic Features of Tissue Samples
Authors: Melín-Aldana Héctor , Gasilionis Valdas , Kapur Umesh
Published: February 2021

Context.—Digital photography is commonly used to document microscopic features of tissue samples, but it relies on the capture of arbitrarily selected representative areas. Current technologic advances permit the review of an entire sample, some even replicating the use of a microscope.

Objective.—To demonstrate the applicability of digital video to the documentation of histologic samples.

Design.—A Canon Elura MC40 digital camcorder was mounted on a microscope, glass slide–mounted tissue sections were filmed, and the unedited movies were transferred to a Apple Mac Pro computer. Movies were edited using the software iMovie HD, including placement of a time counter and a voice recording.

Results.—The finished movies can be viewed in computers, incorporated onto DVDs, or placed on a Web site after compression with Flash software. The final movies range, on average, between 2 and 8 minutes, depending on the size of the sample, and between 50 MB and 1.6 GB, depending on the intended means of distribution, with DVDs providing the best image quality.

Conclusions.—Digital video is a practical methodology for documentation of entire tissue samples. We propose an affordable method that uses easily available hardware and software and does not require significant computer knowledge. Pathology education can be enhanced by the implementation of digital video technology.
Metastatic Patterns of Cancers: Results From a Large Autopsy Study
Authors: diSibio Guy , French Samuel W.
Published: February 2021

Context.—Many studies have addressed metastatic patterns seen among various cancers. No recent studies, however, provide quantitative analyses of such patterns arising from a broad range of cancers based primarily on postmortem tissue analyses.

Objective.—To provide a quantitative description of metastatic patterns among different primary cancers based on data obtained from a large, focused autopsy study.

Design.—Review of data from 3827 autopsies, performed between 1914 and 1943 on patients from 5 affiliated medical centers, comprising 41 different primary cancers and 30 different metastatic sites.

Results.—Testicular cancers were most likely to metastasize (5.8 metastases per primary cancer), whereas duodenal cancers were least likely to do so (0.6 metastases per primary cancer). Preferred metastatic sites varied among the primary cancers analyzed. Overall, regional lymph nodes were the most common metastatic target (20.6% of total), whereas testes were the least common (0.1% of total).

Conclusions.—Not surprisingly, different primary cancers tended to metastasize, with differing frequencies, to different sites. These varying metastatic patterns might be helpful in deducing the origins of cancers whose primary sites are unclear at presentation.
A Novel Polymorphism in the FMR1 Gene: Implications for Clinical Testing of Fragile X Syndrome
Authors: Thyagarajan Bharat , Bower Matthew , Berger Michael , Jones Sidney , Dolan Michelle , Wang Xinjing
Published: February 2021

Fragile X syndrome is the most common cause of inherited mental retardation among males. In most cases, the molecular basis of fragile X syndrome is the expansion and subsequent methylation of a CGG trinucleotide repeat in the 5′ untranslated region of the fragile X mental retardation 1 (FMR1) gene. Laboratory diagnosis usually relies on a combination of Southern blot and polymerase chain reaction analyses. In this case report we describe an unusual Southern blot result in a patient who presented with developmental delay and had a normal CGG repeat number by polymerase chain reaction analysis. Further investigation revealed a novel G3310C transversion in the FMR1 gene resulting in a new recognition site for the BssHII restriction enzyme. This novel restriction site could potentially mimic a partial deletion of the FMR1 gene on Southern blot analysis and thus represents a possible pitfall in the diagnosis of fragile X syndrome.
Is Surgical Excision Necessary for the Management of Atypical Lobular Hyperplasia and Lobular Carcinoma In Situ Diagnosed on Core Needle Biopsy?: A Report of 38 Cases and Review of the Literature
Authors: Cangiarella Joan , Guth Amber , Axelrod Deborah , Darvishian Farbod , Singh Baljit , Simsir Aylin , Roses Daniel , Mercado Cecilia
Published: February 2021

Context.—Both atypical lobular hyperplasia (ALH) and lobular carcinoma in situ (LCIS) have traditionally been considered to be risk factors for the development of invasive carcinoma and are followed by close observation. Recent studies have suggested that these lesions may represent true precursors with progression to invasive carcinoma. Due to the debate over the significance of these lesions and the small number of cases reported in the literature, the treatment for lobular neoplasia diagnosed by percutaneous core biopsy (PCB) remains controversial.

Objective.—To review our experience with pure LCIS or ALH diagnosed by PCB and correlate the radiologic findings and surgical excision diagnoses to develop management guidelines for lobular neoplasia diagnosed by PCB.

Design.—We searched the pathology database for patients who underwent PCB with a diagnosis of either pure LCIS or ALH and had subsequent surgical excision. We compared the core diagnoses with the surgical excision diagnoses and the radiologic findings.

Results.—Thirty-eight PCBs with a diagnosis of ALH (18 cases) or LCIS (20 cases) were identified. Carcinoma was present at excision in 1 (6%) of the ALH cases and in 2 (10%) of the LCIS cases. In summary, 8% (3/38) of PCBs diagnosed as lobular neoplasia (ALH or LCIS) were upgraded to carcinoma (invasive carcinoma or ductal carcinoma in situ) at excision.

Conclusions.—Surgical excision is indicated for all PCBs diagnosed as ALH or LCIS, as a significant percentage will show carcinoma at excision.
A New Study of Intraosseous Blood for Laboratory Analysis
Authors: Miller Larry J. , Philbeck Thomas E. , Montez Diana , Spadaccini Cathy J.
Published: February 2021

Context.—Intraosseous (IO) blood is frequently used to establish a blood chemistry profile in critically ill patients. Questions remain regarding the reliability of IO blood for laboratory analysis and established criteria regarding the amount of marrow/blood to waste before taking an IO sample are not available.

Objectives.—To evaluate IO-derived blood for routine laboratory blood tests needed in the care of critically ill patients and to determine the amount of marrow/blood to waste before drawing blood from the IO space for laboratory analysis.

Design.—Blood samples were drawn from peripheral veins of 10 volunteers. Within 5 minutes, 2 IO blood samples were obtained; one following 2 mL of waste and another following 6 mL of waste. Samples were analyzed for complete blood count and chemistry profile. Values were analyzed using Pearson correlation coefficients. Levels of significance were determined using the t distribution. Mean values for the draws were calculated and compared, with the intravenous blood sample serving as a control for the IO samples.

Results.—There was a significant correlation between intravenous and IO samples for red blood cell counts and hemoglobin and hematocrit levels but not for white blood cell counts and platelet counts. There was a significant correlation between intravenous and IO samples for glucose, blood urea nitrogen, creatinine, chloride, total protein, and albumin concentrations but not for sodium, potassium, CO2, and calcium levels.

Conclusions.—When venous blood cannot be accessed, IO blood aspirate may serve as a reliable alternate, especially for hemoglobin and hematocrit levels and most analytes in a basic blood chemistry profile. Exceptions are CO2 levels and platelet counts, which may be lower, and white blood cell counts, which may appear elevated.
Accuracy of Burkitt Lymphoma Diagnosis in Constrained Pathology Settings: Importance to Epidemiology
Authors: Ogwang Martin D , Zhao Weiqiang , Ayers Leona W , Mbulaiteye Sam M
Published: February 2021

Context.—Burkitt lymphoma (BL) is endemic in Uganda and because of the high incidence, diagnosis is often presumed during clinical care and epidemiologic studies.

Objectives.—To assess the accuracy of the clinical and the local pathology diagnosis of BL as assessed by an outside pathology review diagnosis and to understand the limitations on histopathology practice in a resource-constrained setting at 1 hospital in Uganda.

Design.—Clinically presumed pediatric (<15 years) BL cases with biopsies and pathology reports, from 1993 to 2007, were identified at St Mary's Hospital, Lacor (Gulu, Uganda). Local histopathology procedures, hematoxylin-eosin–stained tissue sections, and formalin-fixed paraffin-embedded blocks were reviewed onsite by an outside pathologist, followed by outside study that included tissue microarray immunohistochemistry and in situ hybridization.

Results.—Local pathology laboratory procedures were inconsistent and suboptimal, especially for tissue fixation. There were 88 clinically presumed BL cases. Sixty-three could be reviewed by outside pathology (25 cases of lost blocks or no remaining tumor) and showed a clinical diagnostic accuracy of 75% (47 confirmed of 63), with a possible range of 62% to 85%, depending on the actual diagnosis of the 25 nonevaluable cases. There were 64 BL cases diagnosed by local pathology. Forty-five could be reviewed by outside pathology (19 cases of lost blocks or no remaining tumor) and showed a local pathology diagnostic accuracy of 82% (37 confirmed of 45), with a possible range of 58% to 88%, depending on the actual diagnosis of the 19 nonevaluable cases. Non-BL diagnoses included other non-Hodgkin lymphomas, Hodgkin lymphoma, and benign infectious lymphadenopathy.

Conclusions.—Accuracy of clinical diagnosis of BL was reduced by inclusion of other diseases with similar clinical presentations. Local pathology, using morphology alone, only marginally improved clinical accuracy and often could not support outside pathology review due to inadequate laboratory procedures. There is an urgent need to improve pathology services in Uganda before conducting high-quality clinical and epidemiologic studies.
Solid Variant of Papillary Renal Cell Carcinoma With Spindle Cell and Tubular Components
Authors: Cantley Richard , Gattuso Paolo , Cimbaluk David
Published: February 2021

The solid variant of papillary renal cell carcinoma, when strictly defined as a tumor in which no true papillae can be identified, is extremely rare, with only a few cases reported in the literature. This tumor is characterized histologically by solid sheets of cells without true papillae; nevertheless, immunohistochemical and genetic analysis supports the classification of this tumor as a variant of papillary renal cell carcinoma. We report a case of solid variant of papillary renal cell carcinoma affecting a young man and provide histologic and clinical follow-up data, adding an additional case of this extremely rare pathology to the literature. In addition, we describe the first case, to our knowledge, of a solid variant of papillary renal cell carcinoma to contain a high-grade (sarcomatoid) spindle cell component.
A Cribriform Urothelial Neoplasm of the Renal Pelvis: An Adenoid Cysticlike Variant of Inverted Urothelial Papilloma or Florid Ureteritis Cystica?
Authors: Talmon Geoffrey A. , Khan Ansar , Koerber Rodney , Lele Subodh , Johansson Sonny
Published: February 2021

Tumors with cribriform appearance, similar to that of salivary gland adenoid cystic carcinoma, have been described at various anatomic sites. We present an unusual polypoid tumor, discovered incidentally, in the renal pelvis of an elderly man. The mass displayed a prominent cribriform architecture, akin to adenoid cystic carcinoma with an immunophenotype that supported a urothelial origin. Because of its lack of significant invasive growth and other adverse morphologic features, this lesion will likely behave in a banal fashion. This cribriform urothelial neoplasm of the renal pelvis may, in fact, represent a variant of an inverted urothelial neoplasm with a prominent cystic component or florid ureteritis cystica. It is important for pathologists to recognize this growth pattern as a possible variant of urothelial tumors.
Adenoid Cystic Carcinoma
Authors: Jaso Jesse , Malhotra Reenu
Published: February 2021

Adenoid cystic carcinoma is a malignant tumor with a deceptively benign histologic appearance characterized by indolent, locally invasive growth with high propensity for local recurrence and distant metastasis. The tumor is composed of basaloid cells with small, angulated, and hyperchromatic nuclei and scant cytoplasm arranged into 3 prognostically significant patterns: cribriform, tubular, and solid. Some tumors undergo dedifferentiation into a high-grade form. Numerous studies have attempted to elucidate accurate histologic prognostic features but have often yielded conflicting results. Microarray analysis and gene expression profiling have provided new potential diagnostic and prognostic markers. However, tumor grade, stage, lymph node metastasis, invasion of major nerves, and margin status remain the most consistent predictors of prognosis. The combination of surgery and postoperative radiation therapy has improved locoregional control of the disease. Despite this achievement, late local recurrence and distant metastasis rates remain high and may occur decades after initial diagnosis.
Pseudohyponatremia Revisited: A Modern-Day Pitfall
Authors: Fortgens Philip , Pillay Tahir S
Published: February 2021

Factitiously low sodium estimations are a hazard in most modern clinical laboratories. Most modern high-throughput analyzers use indirect ion-selective electrodes to estimate electrolyte concentrations in serum samples. This analysis is preceded by a dilution step of the sample. If the water concentration is altered by the presence of increased lipid or protein, the dilution step and the subsequent calculation of concentration by the analyzer results in a falsely low sodium value. This places patients at risk, particularly if the factitious result is acted upon by the physician. In this short review, we highlight this problem and review the methodology and situations where this artifact can occur and discuss strategies to circumvent this problem. When factitious results are suspected, whole blood sodium can be assessed using a direct ion-selective electrode, by measurement of osmolality, or by calculation of the serum water fraction and applying a correction to the reported value.
Concomitant Occurrence of Sinus Histiocytosis With Massive Lymphadenopathy and Nodal Marginal Zone Lymphoma
Authors: Pang Changlee S , Grier David D , Beaty Michael W
Published: February 2021

Sinus histiocytosis with massive lymphadenopathy (SHML), also known as Rosai-Dorfman disease, is a rare self-limiting disorder of histiocytes with unknown etiology. Sinus histiocytosis with massive lymphadenopathy is most common in children and young adults and is characterized by painless lymphadenopathy. Histologically there is a proliferation of sinus histiocytes with lymphophagocytosis or emperipolesis. On rare occasions, SHML has been associated with lymphoma, usually involving different anatomic sites and developing at different times. We report a case of concomitant SHML and nodal marginal zone lymphoma involving the same lymph node without involvement of other nodal or extranodal sites. The presence of concomitant SHML within the lymph node involved by nodal marginal zone lymphoma may represent the responsiveness of SHML histiocytes to B-cell–derived cytokines in lymphoproliferative disorders. To our knowledge, this is the first description of concomitant occurrence of SHML and nodal marginal zone lymphoma.
Adrenal Perivascular Epithelioid Cell Tumor: A Case Report With Discussion of Differential Diagnoses
Authors: Zarineh Alireza , Silverman Jan F
Published: February 2021

A 50-year-old man presented with nausea and abdominal bloating sensation of a few months' duration and was found to have a large adrenal mass that was resected after computed tomography scan evaluation. The histopathologic examination showed epithelioid and spindle cells having clear to granular eosinophilic cytoplasm, and small, central, round to oval nuclei with small nucleoli. The tumor cells demonstrated reactivity for smooth muscle actin, HMB-45, Melan-A, and vimentin, with focal positivity for desmin and S100 protein and negative staining for inhibin, synaptophysin, and chromogranin. A diagnosis of perivascular epithelioid cell tumor was made. Perivascular epithelioid cell tumors can arise in a variety of locations, including omentum/mesentery, female genital tract, pelvic soft tissues, skin, and falciform ligament, but an adrenal primary tumor has not been previously reported, to the best of our knowledge. The differential diagnosis is broad and site-dependant and in our case includes several neoplasms with clear cells that can involve the adrenal gland, including a primary adrenocortical neoplasm. A review of the related literature and discussion of the differential diagnoses are presented.
Age-Dependent Reference Ranges for Automated Assessment of Immature Granulocytes and Clinical Significance in an Outpatient Setting
Authors: Roehrl Michael H. A , Lantz Donald , Sylvester Crystal , Wang Julia Y
Published: February 2021

Context.—New generations of hematology analyzers have made the routine automated quantification of immature granulocytes (IGs) in peripheral blood samples accessible as a powerful clinical parameter.

Objective.—The use of IGs has previously been studied mostly in hospitalized patients with sepsis. We investigated the use of IGs in the outpatient setting. Establishment of precise normal outpatient IG reference ranges is a prerequisite for clinically meaningful interpretation of the parameter.

Design.—We analyzed a large outpatient population comprising more than 2400 samples to determine age-stratified normal reference ranges for IGs.

Results.—Using nonparametric statistical approaches, we show that 1-tailed 95th percentile estimates for relative and absolute IG concentrations up to the age of 10 years are 0.30% and 30.0 µL−1, respectively. For individuals above the age of 10 years, the respective 95th percentile estimates are approximately twice as large at 0.74% and 60.0 µL−1. No differences were seen between male and female reference ranges. Taking nonparametric 90% confidence intervals for each estimate into account, we recommend the following IG upper reference range limits for routine outpatient use: 0.30%/40.0 µL−1 (≤10 years) and 0.90%/70.0 µL−1 (>10 years). Up to the age of 10 years, the most common pathologies associated with elevated IG counts in outpatients were infections, in particular, otitis media, upper and lower respiratory infections, and gastroenteritis. By contrast, above the age of 10 years, the most common causes were hematologic malignancies, drug therapy (glucocorticoids, chemotherapy), severe infections, and pregnancy (young females).

Conclusions.—The use of appropriate reference ranges makes IGs a powerful hematologic parameter for outpatient care that is associated with differential diagnoses that are distinctly characteristic of that setting.
p63 Expression in Giant Cell–Containing Lesions of Bone and Soft Tissue
Authors: de la Roza Gustavo
Published: February 2021

Context.—Previous studies have demonstrated p63 overexpression in giant cell tumors of bone and advocate its use as a potential diagnostic marker. Although routine histology is often all that is required to diagnose giant cell tumor of bone, immunohistochemistry could prove useful to distinguish it from other benign and malignant giant cell–containing lesions of bone and soft tissue on needle biopsies and unusual clinical settings.

Objective.—To assess p63 expression in giant cell–containing lesions of bone and soft tissue.

Design.—p63 immunohistochemistry was performed in 23 giant cell tumors of bone, 8 primary aneurysmal bone cysts, 12 chondroblastomas, 4 giant cell reparative granulomas, 4 osteosarcomas, 15 tenosynovial giant cell tumors, 6 nonossifying fibromas, and 4 pigmented villonodular synovitides.

Results.—p63 overexpression was identified in 20 of 23 giant cell tumors of bone (86.9%), 5 of 8 primary aneurysmal bone cysts (62.5%), 10 of 12 chondroblastomas (83.3%), 4 of 4 giant cell reparative granulomas (100%), 2 of 4 osteosarcomas (50%), 1 of 15 tenosynovial giant cell tumors (6.6%), 1 of 6 nonossifying fibromas (16.6%), and 1 of 4 pigmented villonodular synovitides (25%). The sensitivity, specificity, positive predictive value, and negative predictive value of p63 immunohistochemistry for the diagnosis of giant cell tumor of bone were 86.95%, 53.36%, 45.45%, and 91.17%, respectively.

Conclusions.—This study shows that although p63 is expressed by most giant cell tumors of bone, its lack of specificity limits its use as an immunohistochemical marker in the differential diagnosis of giant cell–containing lesions of bone and soft tissue.
Modern Concepts on the Role of Inflammation in Pulmonary Fibrosis
Authors: Homer Robert J. , Elias Jack A. , Lee Chun Gun , Herzog Erica
Published: February 2021

Context.—Idiopathic pulmonary fibrosis is a uniformly lethal disease with limited biomarkers and no proven therapeutic intervention short of lung transplantation. Pulmonary fibrosis at one time was thought to be a result of inflammation in the lung. Although some forms of pulmonary fibrosis may result from inflammation, idiopathic pulmonary fibrosis is currently thought to result from cell death primarily and inflammation secondarily.

Objective.—To determine the role of inflammation in pulmonary fibrosis in light of our laboratory's published and unpublished research and published literature.

Data Sources.—Review based on our laboratory's published and unpublished experimental data with relevant background and clinical context provided.

Conclusions.—Although cell death is central to pulmonary fibrosis, the proper cytokine environment leading to macrophage polarization is also critical. Evaluation of this environment is promising both for the development of disease biomarkers and for targets for therapeutic intervention.
Effects of Preanalytical Variables on the Detection of Proteins by Immunohistochemistry in Formalin-Fixed, Paraffin-Embedded Tissue
Authors: Engel Kelly B. , Moore Helen M.
Published: February 2021

Context.—While formalin fixation and paraffin embedding has become a universal mechanism of tissue preservation and a gold standard for immunohistochemistry, fixation and processing variables that may confound assay effectiveness have received little attention from the scientific community.

Objective.—To identify discrete steps in specimen fixation and processing that may impact immunostaining, assess the magnitude of reported effects in the literature, and highlight preanalytical variables that require further investigation.

Data Sources.—Thirty-nine primary research articles that investigated immunohistochemical effects of 1 or more preanalytical variables were identified by our literature survey. Thresholds identified in the literature were then compared with published immunohistochemistry guidelines for formalin-fixed, paraffin-embedded specimens.

Conclusions.—Of the 62 preanalytical variables identified, 27 were examined in published research. Meta-analysis revealed 15 preanalytical variables that were capable of impacting immunohistochemistry (including fixation delay; fixative type; time in fixative; reagents and conditions of dehydration, clearing, and paraffin impregnation; and conditions of slide drying and storage) and 12 variables with no reported influence (including the type of processor used; the number and position of specimens during dehydration, clearing, and paraffin impregnation; and the duration of paraffin block storage). Variables with antigen-dependent or inconsistent effects were highlighted. Comparison of literature-supported thresholds with published recommendations revealed (1) strong agreement among preanalytical variables for optimal immunostaining, (2) discrepancies among thresholds for adequate immunostaining, and (3) the continued need for rigorous research and comprehensive guidelines on specimen fixation, processing, and storage.
Unite to predict
Authors: Kothari Meeraj , Belsky Daniel W
Published: February 2021

Integrating the analysis of molecular data from different sources may improve our understanding of the effects of biological aging.
Effects of Kinesiotaping on the Improvement of Sensorimotor Function along with Disability in Chronic Mechanical Neck Pain
Authors: Zeeshan Mohammad , Sen Siddhartha , Dhawan Pooja Bhardwaj
Published: February 2021

Introduction: Mechanical neck pain is a significant societal burden and may include symptoms in the neck and upper extremity. It has been reported that the lifetime and point prevalence of neck pain are almost as high as those of low back pain. It appears to run a chronic episodic course, which is characterised by episodes of persistent, recurrent, or fluctuating pain and disability. It has been found that an altered muscle activity in the Trapezius and the Serratus anterior muscles can be associated with the presence of pain in the neck during functional activities. Aim: To find out the effects of Kinesiotaping on the improvement of sensorimotor function and neck disability in patients with chronic neck pain. Materials and Methods: This was a pre-test, post-test control group design with 30 subjects randomly selected and divided into two groups, an experimental group (Group A) and a control group (Group B) with 15 subjects in each. Experimental group received Kinesio Tape (KT) for 1 week whereas control group received Sham tape. Measurements were taken on the first day and 1 week after the intervention for Cervical Joint Position Sense (CJPE), range of motion and neck disability using an inclinometer instrument, universal goniometer, Neck Disability Index (NDI) questionnaire, respectively. The data was analysed using SPSS 17 software package. Independent t-test was done to find effect between the groups and paired t-test was done to find out the effect within the group. Results: The study clearly demonstrated a significant improvement in CJPE, Cervical Range of Motion (CROM) and NDI within group A (p<0.05) whereas improvement showed significance in CROM and NDI for group B. While comparing both the groups, significant improvement in proprioception and NDI was shown but not in CROM. Conclusion: The study concludes that patients with chronic mechanical neck pain can be benefitted by the use of Kinesiotaping with improvement of sensorimotor function.
Public Knowledge and Awareness Regarding the Use of Dental Implants for Replacing Missing Teeth: A Questionnaire-based Survey in Riyadh, Saudi Arabia
Authors: Al-Shibani Nouf , Al-Kattan Reem , Labban Nawaf , Alnuwaiser Mazen Khalid , Eldesouky Malek Hammam
Published: February 2021

Introduction: In recent years, dental implants have become a viable option for replacement of missing teeth in completely or partially edentulous patients. However, due to inadequate knowledge or information many patients do not prefer implant therapy. Aim: The main study objective was to evaluate the knowledge and awareness regarding dental implants as an option of treatment among dental patients according to their level of education in Riyadh, Saudi Arabia. Materials and Methods: The knowledge and awareness of patients regarding the use of dental implants for substituting missing teeth were assessed with the help of a cross-sectional study from January 2018 to June 2018 utilising standardised self-explanatory questionnaire that were circulated at two places in Riyadh: dental patients visiting the college of dentistry, King Saud University and outpatients visiting King Khalid University Hospital. Patients were provided with the questionnaires during their routine visits to the dental clinics. A total of 1471 subjects participated in this study. Chi-square test was performed to find association between education level of study subjects and their knowledge on various aspects of dental implants, and a p-value <0.05 was considered as statistically significant. The statistical analysis was performed using IBM’s Statistical Package for Social Sciences (SPSS) software, version 20. Results: This study results revealed that 67% of the patients were aware regarding the dental implants and 467 (31.7%) hadn’t heard of dental implants. Among the participants who were aware of dental implants, 555 (37.7%) had college level education and this association was statistically significant (χ2=64.18; p<0.001). The main information source regarding dental implants was dentists and friends. There was a significant association between source of information and education (χ2=122.53; p<0.001). Among the subjects, 386 (26.2%) subjects were aware that oral surgeons are the most qualified to place dental implants followed by periodontist-314 (21.3%) and prosthodontist-174 (11.8%). High expenses (53%) and fear of surgery (21%) was the main reasons for not availing implants among the study subjects. Our data depicted that deficits in knowledge are distributed widely across education. Conclusion: A significant education level influenced knowledge deficit in almost all the aspects of dental implants. There is a need for awareness programmes from dental care experts and specialists to raise the knowledge and awareness level of the public regarding the use of dental implant as a replacement option for missing tooth.
Ileosigmoid Knotting Causing Double Lumen Acute Intestinal Obstruction and Gangrene: Review and A Case Report
Authors: Gupta Arun Kumar , Ansari Md Abu Masud , Jayant Sneh , Goel Shubham , Bansal Lalit Kumar
Published: February 2021

Ileosigmoid Knotting is a rare cause of intestinal obstruction. It is also called as compound volvulus or double volvulus. It is caused by the wrapping of the ileum around the sigmoid colon and its mesentery or vice-versa. It is a rapidly progressive condition, leads to acute intestinal obstruction and gangrene in ileum as well as in the sigmoid colon. Early diagnosis and intervention is the key to a better outcome. Due to the rarity and unfamiliarity of this entity, diagnosis is usually made intraoperatively. Surgical removal of the gangrenous segment with either stoma formation or anastomosis is the only hope.An additional systemic search of the literature was done in PubMed, MEDLINE, ISIS, Embase, and CAS searches with the following free text keywords: ileosigmoid knotting, intestinal knotting, compound volvulus and double volvulus in English literature. Around 64 studies were identified, out of which 38 studies were selected for this article after the removal of duplicates and unrelated articles. These case series and reports were reviewed for aetiopathogenesis, presentation, diagnostic modalities, surgical interventions, and outcome.Along with this review article, there was a case report of ileosigmoid knotting in a 38-year-old male patient that presented in the surgical Emergency Department; with complaints of generalised pain and distention of abdomen for two days. Also, he had complained of not passing flatus and motion for two days. On examination, patient had generalised tenderness and bowel sounds were absent. X-ray abdomen showed dilated small and large bowel with multiple air-fluid levels. After resuscitation, an emergency exploratory laparotomy was done, and the diagnosis of ileosigmoid knotting with gangrene of both ileum and sigmoid colon was made intraoperatively. After resection of both gangrenous segment, colocolic anastomosis and double barrel ileostomy was performed. The postoperative course was uneventful, and patient was discharged on 7th postoperative day.
Severe Pulmonary Air Leak Complicating Neonatal Resuscitation
Authors: Supriya . , Deepthi Perumalla Bhavani , Giridhar S
Published: February 2021

Air leaks are an important respiratory morbidity in neonates and can result from positive pressure breaths administered at birth. The presentations can vary from being asymptomatic to severe respiratory distress and hypoxaemia. This report is about a term boy who presented with respiratory distress immediately after birth, following resuscitation. He also had a diffuse swelling in the nape of the neck and interscapular region with crepitus on palpation. Serial chest radiographs initially revealed a pneumomediastinum and a subcutaneous emphysema, followed later by a right-sided pneumothorax. After chest drain insertion and supportive care, the air leaks resolved, with no residual complications. Severe air leaks with multi-site air tracking can rarely complicate positive pressure administration at birth, requiring timely intervention to optimise outcomes.
Comparison between Intra-abdominal and Extra-abdominal Repair of the Uterus with Relation to Intraoperative Haemodynamic Changes in Patients Undergoing LSCS under Spinal Anaesthesia: A Cohort Study
Authors: Rai Arati , Bhutia Meyong Pincho , Pradhan Anup
Published: February 2021

Introduction: Exteriorisation of the uterus during caesarean section offers the benefit of faster repair of uterine incision, reduced blood loss and shorter Duration of Surgery (DOS). However, this technique has been associated with haemodynamic disturbances in the intraoperative period particularly while repositioning the uterus into the abdominal cavit y af ter repairing it. This could prove detrimental for the patient, if not corrected promptly. Aim: To assess whether exteriorisation of the uterus for the repair of uterine incision has an effect on the haemodynamic changes and comparing the same with the intra-abdominal repair technique of uterine incision. Materials and Methods: ASA I and II pregnant females undergoing elective/emergency caesarean section under spinal anaesthesia for various obstetric indications were enrolled in this cohort study. The duration of study was 6 months after getting approval from IEC (September 2019 to February 2020). As per the discretion of the operating surgeon, the uterus of the patients undergoing caesarean section was repaired either intra-abdominally (Group I) or after exteriorisation of the uterus (Group E) and the patients were grouped accordingly. Haemodynamic monitoring was done every 5 minutes after giving spinal anaesthesia until the completion of the caesarean section using a standard automated multi-parameter monitor. Data was recorded and the two groups were compared with regard to the haemodynamic changes during intraoperative period, DOS, the incidence of any adverse events namely nausea and vomiting and Time To First Rescue Analgesia (TTFRA) in the postoperative period. Unpaired t-test was used to compare and analyse the data between the two groups, where ever applicable. A p-value of less than 0.05 was considered statistically significant. Chi-square test was used for qualitative data analysis. Results: Analysis of data between the two groups showed a significant fall in Systolic and Diastolic Blood Pressure (SBP and DBP) in Group E compared to Group I at 10 minutes [p=0.046 (SBP) and p=0.039 (DBP)], 30 minutes [p=0.047 (SBP) and p=0.002 (DBP)] and 35 minutes [p=0.046 (SBP) and p=0.006 (DBP)] time interval after giving spinal anaesthesia which was attributed to uterine exteriorisation to repair the uterine incision in Group E. The incidence of nausea, hypotension and pelvic discomfort was also significantly higher in Group E compared to Group I. Owing to less uterine handling, patients in Group I secured analgesia for a significantly longer time (TTFRA=244 min) in the postoperative period compared to patients in Group E (TTFRA=217 min) (p≤0.001). Conclusion: Extra-abdominal repair of the uterine incision carries the risk of haemodynamic disturbances associated with nausea and vomiting.
A Review on the Use of Honey in the Treatment of Wound Infection
Authors: Adamu Hassana Ibrahim , Rabi’u Isma’il , Inah Mabeh Blessing
Published: February 2021

Honey is a sweet substance made by bees using nectar from flowers. Honey is of different types, but the Apis mellifera is the one most commonly used, consumed by people and collected by bee keepers. The flower from which bees gather nectar, determines the colour, chemical composition, flavour and aroma of the honey. The use of honey in folk medicine has been practiced since ancient times and has more recently been rediscovered by medical researchers for its use in dressing acute and chronic wounds, particularly where conventional modern therapeutic agents have failed. The wound healing property of honey is due to its antibacterial activity; the ability to maintain a moist wound condition, the high sugar content which hinders microbial growth, the high viscosity which help in providing a protective barrier to prevent infection, the immunomodulatory property which helps in wound repair, the enzymatic production of hydrogen peroxide and the high osmolarity which draws fluid out of the wound bed to enable an outflow of lymph, as occurs with negative pressure wound therapy. Different scientists reported honey, as having one of the most powerful inhibitory effect with regard to sixty species of bacteria. Although the inhibitory activity of honey has been established against wide spectrum of bacteria, it differs depending on the type of honey. Under different concentrations, honey has been reported to be active against a number of bacterial pathogens such as (Escherichia coli, Pseudomonas aeruginosa, Klebsiella, Salmonella, Shigella, Enterobacter and Coagulase positive/ negative Staphylococcus etc.) isolated from wounds.
Comparison of Length and Weight Characteristics of O. niloticus and O. aureus from Garmat Ali River, Iraq
Authors: Mohamed Abdul-Razak M. , Salman Ayat N.
Published: February 2021

Cichlid species invaded the Iraqi waters in the mid-2000s and are now dominant fish species. The present study was carried out to investigate the age and growth of two cichlid species, Oreochromis niloticus and O. aureus in Garmat Ali River, Iraq from October 2019 to September 2020. A total of 2707 specimens of O. niloticus ranging from 7.0 to 25.5 cm and 1664 of O. aureus varying from 7.0 to 26.3 cm were examined which were captured by various fishing gears. The length-frequency distributions revealed that fish lengths (13.0-18.0 cm) formed 64.1% of the total catch of O. niloticus and 67.2% of O. aureus. The length-weight relationships were W=0.012*L3.109 for O. niloticusand W=0.015*L3.075 for O. aureus, and both species indicated positive allometric growth. The highest values of the relative condition factor were obtained during spring and the values decrease when length of two species increase. Seven age groups were determined for O. niloticus: 9.9, 12.9, 15.6, 17.9, 19.4, 20.4 and 22.2 cm, and for O. aureus: 9.3, 12.5, 15.2, 18.0, 19.4, 21.3 and 22.2 cm. The theoretical maximum length (L∞) was 29.2 cm for O. niloticus and 28.6 cmfor O. aureus. These results can assist in fisheries management and conservation of the fish species in Iraqi waters.
Transfer of Technology through Social Media in Pandemic Perspective
Authors: Srikar Katiki , Chowdary K. Raghavendra , Tejaswini M.
Published: February 2021

Currently the entire world is passing through a crisis situation caused by corona virus disease 2019 (COVID-19). All activities are shuttered during lockdown but not the primitive activity i.e. Agriculture. Due to Pandemic, the extension professional contact is more digital than physical contact. In recent past extension professionals are using social media as an effective tool for transfer technology due to the enormous penetration of the internet and Smartphone’s among the majority of rural India. The present study was conducted with an objective to focus on the change in usage of social media during pandemic by extension professionals. A structured questionnaire was developed to interview the Krishi Vigyan Kendra (KVK) extension professionals under ATARI, Kolkata (zone- 5) through Google forms. The usage of social media was studied with few indicators viz., time spent on social media, the purpose of using social media and individual trend of using social media in comparison with general and pandemic conditions. The result from the study revealed that extension professionals had a significant positive change in the time spent on social media during the pandemic situation. A drastic change was observed in the time spent categories of 4-6 hours and more than 6 hours (increased by 11.21%) due to lockdown situation. Extension professionals started to reach more participants during pandemic through social media platforms. The majority of the respondents (increased by 15.88%) justified that they could reach 100-500 farmers during pandemic with the help of social media. Positive improvement was observed in the purpose of using social media like sharing knowledge to farming community, using social media for discussion, and to promote new technological advances with the overall raise of 26 percent. More than fifty per cent (60.74%) of total respondents felt that their trend in using social media was at a medium level and only 18.69 percent of respondents felt a high trend in social media usage. From the study we can justify that the extension professionals had a positive change in the usage of social media platforms in a productive way to transfer the technology to the farming community.