Pathology Commons^™

Reference Intervals For Prothrombin Time And Activated Partial Thromboplastin Time Derived From Black African Blood Donors At A University Teaching Hospital In Nairobi, Kenya, Abubakar Abdillah

Master of Medicine in Clinical Pathology

Introduction: Prothrombin time (PT) and activated partial thromboplastin time (APTT) are important coagulation screening tests that give an insight into how well the extrinsic and intrinsic arms of the coagulation cascade are performing. For correct interpretation of laboratory results and avoidance of errors and misdiagnosis, population specific RIs are most appropriate. In a healthcare setting, it is up to the laboratory to establish RIs for use for the particular analytes that they run, or at least verify the RIs availed by the manufacturer of the reagents for a particular analyte. Objectives: This study aimed to establish reference intervals (RIs) for …

Comparison Of Xpert Mtb/Rif With Histology For The Detection Of Mycobacterium Tuberculosis In Formalin Fixed Paraffin Embedded Tissues At Aga Khan University Hospital, Nairobi, Njau Allan Njoroge

Master of Medicine in Anatomic Pathology

Background: Diagnosis of extrapulmonary tuberculosis (EPTB) continues to be a challenge due to the complexity of the causative organism and the wide array of pathologic features seen in this infection. A number of studies have shown polymerase chain reaction (PCR) for EPTB to be a feasible, sensitive and specific test for diagnosis of tuberculosis (TB) of which, the World Health Organisation (WHO) has given recommendations. As pertains EPTB, Xpert MTB/RIF may be used in place of conventional tests such as microscopy, histopathology and culture in lymph nodes and other tissues from patients suspected to have EPTB. It has been demonstrated …

Osteoporosis And Its Perspective In Pakistan: A Review Of Evidence And Issues For Addressing Fragility Fractures, Aysha Habib Khan, Lena Jafri, Sibtain Ahmed, Shahryar Noordin

Department of Pathology and Laboratory Medicine

Despite major advances in osteoporosis diagnosis and treatment, low rates of investigating and treating osteoporosis in patients with fragility fracture are reported in Pakistan. Cost of therapies, time and cost of resources for diagnosis, concerns about medications and lack of clarity regarding the onus of responsibility to undertake this care, are some of the barriers to osteoporosis identification and treatment. Data from our part of the world on osteoporosis as well as on fragility fractures is sparse. This review addresses the current screening and diagnostic strategies for osteoporosis and reviews the existing literature to highlight the issues prevalent in our …

Antimicrobial Peptide Ll-37 And Recombinant Human Mannose-Binding Lectin Express Distinct Age- And Pathogen-Specific Antimicrobial Activity In Human Newborn Cord Blood In Vitro, Annette Scheid, Ning Li, Carleen Jeffers, Francesco Borriello, Sweta Joshi, Al Ozonoff, Matthew Pettengill, Ofer Levy

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Background: There is a need to prevent and treat infection in newborns. One approach is administration of antimicrobial proteins and peptides (APPs) such as LL-37, a membrane-active cathelicidin antimicrobial peptide, and mannose-binding lectin (MBL), a pattern-recognition protein that binds to microbial surface polysaccharides resulting in opsonization and complement activation. Low plasma/serum levels of LL-37 and of MBL have been correlated with infection and exogenous administration of these agents may enhance host defense. Methods: The antimicrobial activity of LL-37 (15 µg/ml) or rMBL (0.5, 2 and 10 µg/ml) was tested in hirudin-anticoagulated preterm and term human cord blood (N = 12-14) …

Recurrent Hotspot Mutations In Hras Q61 And Pi3k-Akt Pathway Genes As Drivers Of Breast Adenomyoepitheliomas., Felipe C. Geyer, Anqi Li, Anastasios D. Papanastasiou, Alison Smith, Pier Selenica, Kathleen A. Burke, Marcia Edelweiss, Huei-Chi Wen, Salvatore Piscuoglio, Anne M. Schultheis, Luciano G. Martelotto, Fresia Pareja, Rahul Kumar, Alissa Brandes, Dan Fan, Thais Basili, Arnaud Da Cruz Paula, John R. Lozada, Pedro Blecua, Simone Muenst, Achim A. Jungbluth, Maria P. Foschini, Hannah Y. Wen, Edi Brogi, Juan P. Palazzo, Brian P. Rubin, Charlotte K.Y. Ng, Larry Norton, Zsuzsanna Varga, Ian O. Ellis, Emad A. Rakha, Sarat Chandarlapaty, Britta Weigelt, Jorge S. Reis-Filho

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Adenomyoepithelioma of the breast is a rare tumor characterized by epithelial-myoepithelial differentiation, whose genetic underpinning is largely unknown. Here we show through whole-exome and targeted massively parallel sequencing analysis that whilst estrogen receptor (ER)-positive adenomyoepitheliomas display PIK3CA or AKT1 activating mutations, ER-negative adenomyoepitheliomas harbor highly recurrent codon Q61 HRAS hotspot mutations, which co-occur with PIK3CA or PIK3R1 mutations. In two- and three-dimensional cell culture models, forced expression of HRAS

Expression Of Androgen Receptor And Cancer Stem Cell Markers (Cd44 +/Cd24 - And Aldh1 +): Prognostic Implications In Invasive Breast Cancer, Nazia Riaz, Romana Idress, Sadia Habib, Iqbal Azam Syed, El Nasir Lalani

Section of General Surgery

Background: Androgen receptor (AR) has emerged as a significant prognostic marker in early breast cancer (BCa). Association of AR with cancer stem cell (CSC) markers in BCa is unknown. Aim of the present study was to evaluate the immunohistochemical expression of AR, CD44, CD24 and ALDH1 in a cohort of Pakistani patients diagnosed with invasive BCa and to correlate the expression with 5- year disease free survival.
Patients and methods: We evaluated immunohistochemical expression AR, CD44, CD24 and ALDH1 in formalin fixed paraffin embedded archival blocks of 166 cases of primary invasive BCa (stage I-III) and correlated the expression with …

Gastric Hibernoma: A Novel Location And Presentation Of A Rare Tumor., Shane P Smith, Andrew F Feczko, Matias Mihura, Jey-Hsin Chen, Alexander S Farivar

Articles, Abstracts, and Reports

We present a case of gastric hibernoma, an unusual tumor with a location novel to the literature. A 39-year-old female presented with one year of upper gastrointestinal bleeding and dysphagia. Gastroenterology performed an esophagogastroduodenoscopy with ultrasound and identified a 6 cm mass within the muscularis propria of the antrum. Computed tomography demonstrated a 9.7 × 7.8 × 4.8 cm

Implementing Daily Management System Huddle Boards To Improve Communication Across Satellite Laboratories, Sean Tucker

Posters

Background

In a laboratory setting with fast-paced changes and heavy demands on staff, day-to-day communication across departments is challenging, yet paramount to resource sharing and real-time problem solving. Children’s Mercy Hospital Kansas City (CMH) has implemented system-wide lean practices focused on clinical and operational excellence. Our laboratory mission, or True North, is to produce clinically relevant laboratory results and information to assist in the diagnosis, treatment and prognosis of patients in a timely manner, by: �� Reducing Errors – Pre-analytical, Analytical & Post-analytical �� Making encounters with the laboratory extraordinary �� Reducing turnaround times �� Maximizing employee engagement and productivity …

No Risk Reduction For Plasmodium Vivax Malaria In Sickle Cell Disease, Bushra Moiz, Ayesha Majeed Memon

Department of Pathology and Laboratory Medicine

Hemoglobin S is known to protect against uncomplicated Plasmodium falciparum malaria. However, there is paucity of the literature regarding interaction of HbS and other malaria species. Usually, P. vivax malaria is a relapsing condition, and without radical cure with primaquine, recurrence may be observed even with hemoglobin S.

Extending The Phenotypic Spectrum Of Sengers Syndrome: Congenital Lactic Acidosis With Synthetic Liver Dysfunction., David B Beck, Kristina Cusmano-Ozog, Nickie Andescavage, Eyby Leon

Pathology Faculty Publications

Sengers syndrome is a rare autosomal recessive mitochondrial disease characterized by lactic acidosis, hypertrophic cardiomyopathy and bilateral cataracts. We present here a case of neonatal demise, within the first day of life, who initially presented with severe lactic acidosis, with evidence of both chorioamnionitis and cardiogenic shock. Initial metabolic labs demonstrated a severe lactic acidosis prompting genetic testing which revealed a homozygous pathogenic variant for Sengers syndrome in

Bilateral Carotid Artery Stenosis Causes Unexpected Early Changes In Brain Extracellular Matrix And Blood-Brain Barrier Integrity In Mice, Jill M. Roberts, Michael E. Maniskas, Gregory J. Bix

Neuroscience Faculty Publications

Bilateral carotid artery stenosis (BCAS) is one experimental model of vascular dementia thought to preferentially impact brain white matter. Indeed, few studies report hippocampal and cortical pathology prior to 30 days post-stenosis; though it is unclear whether those studies examined regions outside the white matter. Since changes in the blood-brain barrier (BBB) permeability precede more overt brain pathology in various diseases, we hypothesized that changes within the BBB and/or BBB-associated extracellular matrix (ECM) could occur earlier after BCAS in the hippocampus, cortex and striatum and be a precursor of longer term pathology. Here, C57Bl/6 mice underwent BCAS or sham surgeries …

Dealing With Deans And Academic Medical Center Leadership: Advice From Leaders., Fred Sanfilippo, Deborah Powell, Robert Folberg, Mark Tykocinski

Department of Medicine Faculty Papers

The 2017 Association of Pathology Chairs Annual Meeting included a session for department chairs and other department leaders on "how to deal with deans and academic medical center leadership." The session was focused on discussing ways to foster positive relationships with university, medical school, and health system leaders, and productively address issues and opportunities with them. Presentations and a panel discussion were provided by 4 former pathology chairs who subsequently have served as medical deans and in other leadership positions including university provost, medical center CEO, and health system board chair. There was a strong consensus among the participants on …

Diversity Unsupported Is Diversity Derailed, Kauser Jabeen, Kulsoom Ghias

Department of Pathology and Laboratory Medicine

In this view point challenges of a diverse student body and its impact on quality of education and student’ social interactions are discussed. Enhanced institutional responsibility and ownership of all institutional members to provide adequate support for all individuals that make up the student body has been discussed as a major strategy to overcome these challenges.

The Path Report Volume 1 Issue 4, Pathology Department, New York Medical College

The Path Report

No abstract provided.

Onyx Use In Extracranial Pathologies - A Retrospective Case Review, Faezeh Razjouyan, Rishi Sood, Alex Cho, Anthony Venbrux, Shawn Sarin

GW Research Days 2016 - 2020

Purpose:

Onyx is an embolic agent currently FDA approved for neurointerventional procedures such as in the treatment of aneurysms and arteriovenous malformations. Despite its limited indications, the agent's off-label use in the treatment of extracranial pathologies continues to increase. To date, there has not been a single-center study demonstrating a large number of cases demonstrating safe and effective peripheral embolization with Onyx.

Materials:

We performed a retrospective review of all cases that used Onyx between October 2010 and July 2016 at a single tertiary care academic university urban hospital. Institutional review board approval was appropriately obtained. Initial case selection was …

Non O1, Non O139 Vibrio Cholerae Bacteraemia In An Infant; Case Report And Literature Review, Mirza Zain Baig, Umme Hani Abdullah, Yusra Shafquat, Khadija Nuzhat Humayun, Afia Zafar

Medical College Documents

Non 01, Non O139 Vibrio cholerae bacteraemia is a rare but potentially fatal occurrence. There have been very few incidents of this infection from around the world. The treatment regimen of antibiotics also varies in literature. We present a case of bacteraemia caused by Non O1, Non O139 Vibrio cholerae along with associated risk factors, disease manifestations, laboratory diagnosis and treatment regimen. This serves to add additional information regarding symptoms and signs of this infection along with management of patient. Knowledge regarding this topic shall be highly useful to professionals if further cases are detected. In the discussion section, a …

Torsion Of Ovarian Dysgerminoma In A Child: Role Of Computed Tomography., Kumail Khandwala, Jehanzeb Shahid, Naila Nadeem, Muhammad Usman Tariq

Department of Radiology

Dysgerminomas are malignant germ cell tumors of the ovary that most commonly occur in the adolescent population. Ovarian dysgerminomapresenting with complications like torsion is a rare entity in the pediatric age group. Cross-sectional imaging plays a crucial role in diagnosis, tumor staging before surgical resection, and for planning adjuvant chemotherapy. We report a case of a nine-year-old female who presented to the emergency room (ER) with abdominal distention and abdominal pain. Computed tomography scan revealed a large right-sided pelvic mass with areas of low attenuation, speckled calcification, peritumoral free fluid, and a twisted vascular pedicle that was likely originating from …

Adequacy Of Platelet Counting By Automated Haematology Analyzers: An Insight On Current Methodologies, Muhammad Shariq Shaikh, Noor Rahman Khan, Zeeshan Ansar Ahmed

Department of Pathology and Laboratory Medicine

No abstract provided.

Diagnostic Dilemma Of Patients With Methylmalonic Aciduria: Experience From A Tertiary Care Centre In Pakistan, Hafsa Majid, Aysha Habib Khan, Lena Jafri, Azeema Jamil, Nasir Yousufzai, Midhat Fatima, Zeba Zulfiqar Ali, Bushra Afroze

Department of Pathology and Laboratory Medicine

Objective: To determine the frequency of disorders leading to methylmalonic acidurias.
Methods: This cross-sectional study was conducted from January 2013 to April 2016 at the Aga Khan University Hospital, Karachi, and comprised patients diagnosed with methylmalonic acidurias based on urine organic acid analysis. Clinical history and biochemical data was collected from the biochemical genetics laboratory requisition forms. Organic acid chromatograms of all the subjects were critically reviewed by a biochemical pathologist and a metabolic physician. For assessing the clinical outcome, medical charts of the patients were reviewed. SPSS 19 was used for data analysis.
Results: Of the 1,778 patients 50(2.81%) …

The Role Of Reactive Astrocitose In The Chronological Evolution Of Traumatic Brain Injury, Roxana M. Duncea-Borca, Vladimir Belis, Mihnea Costescu, Relu G. Calota, Reka Kutasi, Cosmin A. Moldovan

Journal of Mind and Medical Sciences

Introduction and objectives. This study aims to investigate whether the cerebral modifications of posttraumatic reactive astrocitose can be considered an objective criterion for determining the age of traumatic cranio-cerebral lesions.

Materials and methods. The present study consists of a series of 23 medico-legal cases that underwent autopsy inTeleormanCounty(Romania) Department of Forensic Medicine during 2007–2016, with full immune-histochemical microscopic examination using GFAP staining. The study consists of two groups, a series of 13 cases with cranio-cerebral trauma with different posttraumatic survival periods and 9 cases as a control group.

Results and discussions. We discovered GFAP+ reactive astrocytes even when death occurred …