DNA Ploidy Analysis and Cell Block Immunohistochemistry in the Diagnosis of Malignant Effusions

2019 ◽  
Vol 64 (3) ◽  
pp. 256-264
Author(s):  
Megha Puri ◽  
Rajeev Sen ◽  
Monika Gupta ◽  
Rajnish Kalra ◽  
Shilpi Bhargava ◽  
...  
Keyword(s):  
Final Diagnosis ◽  
Grey Zone ◽  
Cell Block ◽  
Tissue Biopsy ◽  
Conventional Cytology ◽  
Ploidy Analysis ◽  
Atypical Cells ◽  
Initiation Of Therapy ◽  
Time Required ◽  
A Prospective Study

Background: Effusion cytology is a major diagnostic tool in medicine and has both therapeutic and prognostic implications. One of the dilemmas encountered is the differentiation between atypical cells and reactive mesothelial cells. The use of ancillary tools can reduce this grey zone and help to achieve a definitive diagnosis. Objectives: The main objective of this study was to evaluate the role of flow cytometry (FCM) and cell block with immunohistochemistry (IHC), along with the clinicoradiological investigations, to achieve a final diagnosis in effusion cytology to the maximum extent possible. Method: A prospective study was conducted. Effusion fluids, showing adequate amount and cellularity, were processed for conventional cytology, ploidy analysis by FCM, and cell block analysis, followed by IHC wherever required. Conventional cytological analysis was done by 2 independent pathologists, to look for interobserver variation, if any. The final result was achieved on the basis of integration of the results of the aforementioned studies, cytological details, clinicoradiological information, tissue biopsy findings, and follow-up. Result: A total of 90 samples were analyzed. On cytological examination, observer I categorized 60% samples as benign and 18.8% (n = 17) as malignant versus 58% categorized as benign and 23.3% (n = 21) as malignant by observer II. Observer I reported 19 (21.1%) equivocal cases and observer II reported 16 (17.7%). When both pathologists were considered together, the number of equivocal cases increased to 20. Sensitivity and specificity of FCM were 96.67 and 100%, respectively, and 100% for the cell block. On combining all techniques, the equivocal cases were resolved and a total of 33 cases were reported as malignant. However, 3 cases could still not be categorized and were labeled inconclusive. Conclusion: Conventional cytology combined with cell block IHC and FCM has the potential to minimize the requirement of tissue biopsy for confirmation. If the first sample is used judiciously for all the techniques, this may reduce the requirement for a second sample and possibly also the time required for a definite diagnosis and the initiation of therapy.

Negative Pressure Therapy in Wounds Surgical Treatment

2017 ◽  
Vol 68 (11) ◽  
pp. 2687-2690 ◽  
Author(s):  
Bogdan Mihnea Ciuntu ◽  
Stefan Octavian Georgescu ◽  
Ciprian Cirdeiu ◽  
Daniel Timofte ◽  
Doina Azoicai ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Healing Time ◽  
Negative Pressure Therapy ◽  
Simultaneous Application ◽  
Average Hospital ◽  
Pressure Therapy ◽  
Days Of Therapy ◽  
Functional Consequences ◽  
Time Required ◽  
A Prospective Study

The study aims to assess the significance of negative pressure therapy in the treatment of 1 January 2014 - 31 June 2017. The objectives intend to evaluate the healing time required after applying the method and the functional consequences for the patient. A prospective study was conducted on a sample of 31 patients with various tipe of wounds which were monitored their clinical course between September 2014 - February 2017, following negative pressure therapy. There were used vacuum assisted closure devices (VAC � -Hartman) in order to apply negative pressure to the wound, while complying with specified settings in accordance with patients� outcome. Healing was obtained in all cases, to an average hospital stay of 30 days and 12 days of therapy application.The negative result of microbial cultures was obtained after an average of 7.55 days by simultaneous application of negative pressure and antibiotic treatment according to the antibiogram. After basic treatment of the wound, auxiliary methods such as negative pressure contribute to the healing. Evolution was favorable with wound granulation in 95% cases, which allowed surgery under local anesthesia, and defect was covered with skin graft. VAC therapy falls into the last group of treatments by eliminating healing inhibitors. This regenerates the wound in a damp environment and essentially turns an open wound into a closed system.

Usefulness of point-of-care ultrasound in military medical emergencies performed by young military medicine residents

2019 ◽  
pp. jramc-2018-001132
Author(s):  
Pierre Perrier ◽  
J Leyral ◽  
O Thabouillot ◽  
D Papeix ◽  
G Comat ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Clinical Examination ◽  
Point Of Care ◽  
Military Medicine ◽  
Final Diagnosis ◽  
Absolute Difference ◽  
Point Of Care Ultrasound ◽  
Medical Emergencies ◽  
The Mean ◽  
A Prospective Study

IntroductionTo evaluate the usefulness of point-of-care ultrasound (POCUS) performed by young military medicine residents after short training in the diagnosis of medical emergencies.MethodsA prospective study was performed in the emergency department of a French army teaching hospital. Two young military medicine residents received ultrasound training focused on gall bladder, kidneys and lower limb veins. After clinical examination, they assigned a ‘clinicaldiagnostic probability’ (CP) on a visual analogue scale from 0 (definitely not diagnosis) to 10 (definitive diagnosis). The same student performed ultrasound examination and assigned an ‘ultrasounddiagnostic probability’ (UP) in the same way. The absolute difference between CP and UP was calculated. This result corresponded to the Ultrasound Diagnostic Index (UDI), which was positive if UP was closer to the final diagnosis than CP (POCUS improved the diagnostic accuracy), and negative conversely (POCUS decreased the diagnostic accuracy).ResultsForty-eight patients were included and 48 ultrasound examinations were performed. The present pathologies were found in 14 patients (29%). The mean UDI value was +3 (0–5). UDI was positive in 35 exams (73%), zero in 12 exams (25%) and negative in only one exam (2%).ConclusionPOCUS performed after clinical examination increases the diagnostic accuracy of young military medicine residents.

EVALUATION OF CELL BLOCK TECHNIQUE VERSUS CONVENTIONAL CYTOLOGY ON BRONCHOSCOPY GUIDED NEEDLE ASPIRATION/ BRUSH CYTOLOGY FOR DIAGNOSIS OF LUNG CANCER

2021 ◽  
pp. 64-66
Author(s):  
Manveer kour Raina ◽  
Neena Gupta ◽  
Sanjeev Kumar ◽  
Anuradha Kusum
Keyword(s):  
Gold Standard ◽  
Diagnostic Yield ◽  
Needle Aspiration ◽  
Cell Block ◽  
Brush Cytology ◽  
Conventional Cytology ◽  
Cytological Preparation ◽  
True Conclusion ◽  
Diagnosis Of Lung Cancer ◽  
Cytology Study

INTRODUCTION: Bronchoscopy is a safe and effective method for diagnosing lung carcinomas with a variation in the diagnostic yield with different bronchoscopy guided procedures. Cell block technique has shown an addition cases positivity in diagnosing carcinomas as compared to the conventional method. AIM: The present study was aimed to evaluate the diagnostic utility of cell block technique on Bronchoscopy guided needle aspiration/ Brush and also to compare cytological preparation with cell block. MATERIAL AND METHODS: A total of 50 cases were included in the study that was suspected to be having lung carcinoma. These patients went under bronchoscope guided aspirations (TBNA, EBNA, and Brush). Smears were immediately made for conventional cytology study and well as in another aliquot samples were collected to prepare cell blocks following which H&E staining was done. RESULTS: Out of 50 cases, 8 cases came out to be negative on conventional smears and when compared with cell block technique 4 additional cases came out to be positive who were negative on conventional smears. The diagnosis were compared with histopathology biopsies keeping it as a gold standard and results on cell block techniques were conrmed to be true. CONCLUSION: Out of 50 cases, an additional 4 more cases were diagnosed malignant by using the cell blocks technique but there were few drawbacks with cell block technique. In few of the cases on cell block, cellularity was very less, cells morphology was also not very clear and some showed cells entrapped in a clusters. The conclusion made out of this study is that cell block technique is more accurate than the cytological smears and when used in combination diagnostic efcacy will be improved.

scholarly journals A prospective study on appendicular mass

2021 ◽  
Vol 8 (4) ◽  
pp. 1114
Author(s):  
K. Ravichandran ◽  
R. Jayaraman ◽  
K. Nithya
Keyword(s):  
Prospective Study ◽  
Conservative Management ◽  
Enterocutaneous Fistula ◽  
Wound Dehiscence ◽  
Final Diagnosis ◽  
College Hospital ◽  
Duration Of Surgery ◽  
Interval Appendicectomy ◽  
A Prospective Study ◽  
Appendicular Mass

Background: The immediate management of appendicular mass have always been controversial. Early appendicectomy (within 72 hours of presentation) is preferred in some cases, while in others non operative conservative management is advocated. Usually successful conservative management (Ochsner Sherren regimen) is followed by interval appendicectomy (6-8 weeks later). This study determines the outcome of different modalities of intervention in patients with appendicular mass.Methods: A prospective study was conducted in Rajah Muthiah medical college hospital in department of general surgery from June 2018 to December 2020, in cases diagnosed to have appendicular mass. A total of 116 patients were included. After taking detailed history and clinical examination, relevant blood and radiological investigations, were done to achieve the final diagnosis. Presentation, examination findings, investigations, type of surgery, duration of surgery, post-operative complications and duration of hospital stay were studied. Data was collected, compiled, tabulated and analysed.Results: Conservative management followed by interval appendicectomy had lesser incidence of complications like Intraoperative adhesions, surgical site infection, wound dehiscence and enterocutaneous fistula. It also had relatively lesser operative time and lesser period of hospital stay.Conclusions: On comparing the different modalities of intervention, conservative management followed by interval appendicectomy is quite effective and safe method of treatment, with less operative difficulties and better outcome.

Concordance Between Rapid On-Site Evaluation and Final Cytologic Diagnosis in Patients Undergoing Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration for Non-Small Cell Lung Cancer Staging

2019 ◽  
Author(s):  
Cristina Caupena ◽  
Lluis Esteban ◽  
Angels Jaen ◽  
Bienvenido Barreiro ◽  
Raquel Albero ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Staging ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Concordance Rate ◽  
Endobronchial Ultrasound ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration ◽  
Site Evaluation ◽  
A Prospective Study

Abstract Objectives In patients with lung cancer undergoing mediastinal staging through endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), decisions are based on rapid on-site evaluation (ROSE) findings. We aimed to analyze the concordance rate between ROSE diagnosis and final diagnosis. Methods A prospective study was carried out in patients undergoing EBUS-TBNA for lung cancer staging. Diagnosis concordance was defined as cases where lymph nodes (LNs) presented the same diagnosis in ROSE and final diagnosis. Determinants of concordance were analyzed. Results Sixty-four patients were included and 637 LNs sampled. ROSE diagnosis was concordant with final diagnosis in 612 (96.1%) LNs and nonconcordant in 25 (3.9%). Differences in the concordance rate were found between pathologists, ROSE diagnoses, presence of cell block, number of passes, and number of slides. The staging status was changed between ROSE and the final diagnosis in three (4.6%) patients. Conclusions ROSE diagnosis has a high concordance with the final diagnosis.

From (Psycho) Pathology to Diagnosis: Psychiatry Nosology Beyond Dichotomy

2017 ◽  
Vol 41 (S1) ◽  
pp. S45-S45
Author(s):  
A. Erfurth ◽  
G. Sachs
Keyword(s):  
Final Diagnosis ◽  
Classification Systems ◽  
Careful Examination ◽  
Potential Consequence ◽  
Additional Information ◽  
Diagnostic Categories ◽  
Competing Interest ◽  
Initiation Of Therapy ◽  
Medical Disciplines ◽  
System 1

As in all medical disciplines, diagnosis in clinical psychiatry should be reached in a step-wise approach: after assessing the chief complaint of the patient, a careful examination of the psychopathology follows e.g. by using the AMDP system [1] to preliminarily conclude the process with a syndromal classification [2]. This syndromal classification is of great importance as it guides the initiation of therapy in daily life practice. After gaining additional information (e.g. investigation in the course of the disease, brain imaging, thorough assessment of cognitive function, exclusion of organic causes) a final diagnosis is possible. Unfortunately, a premature jumping to diagnosis is not uncommon (with the potential consequence of incorrect therapies).In addition to these difficulties, recent neurobiological research has shown that nosologic assignments through conventional diagnostic classifications are far less specific than assumed, revealing a large overlap between diagnostic categories [3,4], e.g. between Schizophrenia and affective disorders. Consequences of this finding are discussed both for the construction of future classification systems and for therapy.Disclosure of interestThe authors declare that they have no competing interest.

Incidence of Venous Air Embolism during Craniectomy for Craniosynostosis Repair

2000 ◽  
Vol 92 (1) ◽  
pp. 20-20 ◽  
Author(s):  
Lisa W. Faberowski ◽  
Susan Black ◽  
J. Parker Mickle
Keyword(s):  
Air Embolism ◽  
Hemodynamic Instability ◽  
Mortality Rates ◽  
Cardiovascular Collapse ◽  
Ultrasonic Probe ◽  
Safe Method ◽  
Venous Air Embolism ◽  
Doppler Probe ◽  
Initiation Of Therapy ◽  
A Prospective Study

Background Investigations to determine the incidence of venous air embolism in children undergoing craniectomy for craniosynostosis repair have been limited, although venous air embolism has been suspected as the cause of hemodynamic instability and sometimes death. A precordial Doppler ultrasonic probe is an accepted method for detection of venous air embolism and is readily available at most institutions. Methods A prospective study was conducted using a precordial Doppler ultrasonic probe in children undergoing craniectomy for craniosynostosis repair. The Doppler signal was continuously monitored intraoperatively for characteristic changes of venous air embolism. A recording was made of the precordial Doppler probe pulses, which was later reviewed by a neuroanesthesiologist, blinded to the intraoperative events. This information was correlated with the intraoperative events and episodes of venous air embolism were graded. Results Twenty-three patients were enrolled in the study during the 2-yr study period. Nineteen patients (82.6%) demonstrated 64 episodes of venous air embolism; six patients (31.6%) had hypotension associated with venous air embolism. Thirty-two episodes of hypotension were demonstrated in eight patients (34.7%). None of the patients developed cardiovascular collapse. Conclusion The incidence of venous air embolism in our study of 23 children undergoing craniectomy for craniosynostosis was 82.6%. Though most episodes of venous air embolism during craniosynostosis repair are without hemodynamic consequences, the preemptive placement of a precordial Doppler ultrasonic probe is a noninvasive, economic, and safe method for the detection of venous air embolism. Prompt recognition may allow for the early initiation of therapy, thereby decreasing morbidity and mortality rates related to venous air embolism.

Use of cell block preparation for morphological, immunocytochemistry, and ploidy analysis in ThinPrep® monolayer preparations

2001 ◽  
Vol 25 (6) ◽  
pp. 415-416 ◽  
Author(s):  
Cristina Freitas ◽  
Fernanda Milanezi ◽  
Aureliano Jorge Dias ◽  
Maria José Bento ◽  
Fernando Carlos Schmitt
Keyword(s):  
Cell Block ◽  
Ploidy Analysis

scholarly journals A comparative study of conventional cytology and cell block method with immunohistochemistry in the diagnosis of serous effusions

2020 ◽  
Vol 6 (2) ◽  
pp. 146-154
Author(s):  
Dr Rama Saha ◽  
◽  
Dr. Pratyush Datta ◽  
Dr. Jayati Chakraborty ◽  
◽  
...  
Keyword(s):  
Comparative Study ◽  
Cell Block ◽  
Block Method ◽  
Conventional Cytology
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