Archives of pathology & laboratory medicine
-
Arch. Pathol. Lab. Med. · May 2015
Comparative StudyImpact of a rapid respiratory panel test on patient outcomes.
Evolution of polymerase chain reaction testing for infectious pathogens has occurred concurrent with a focus on value-based medicine. ⋯ The RRP decreases the duration of antibiotic use, the length of inpatient stay, and the time in isolation.
-
Arch. Pathol. Lab. Med. · May 2015
Use of Thromboelastography (TEG) for Detection of New Oral Anticoagulants.
The clinical introduction of new oral anticoagulants (NOACs) has stimulated the development of tests to quantify the effects of these drugs and manage complications associated with their use. Until recently, the only treatment choices for the prevention of venous thromboembolism in orthopedic surgical patients, as well as for stroke and systemic embolism in patients with atrial fibrillation, were vitamin K antagonists, antiplatelet drugs, and unfractionated and low-molecular-weight heparins. With the approval of NOACs, treatment options and consequent diagnostic challenges have expanded. ⋯ The RapidTEG activated clotting time test and the kaolin test appear to be capable of detecting and monitoring NOACs. The ecarin test may be used to differentiate between Xa inhibitors and direct thrombin inhibitors. Therefore, TEG may be a valuable tool to investigate hemostasis and the effectiveness of reversal strategies for patients receiving NOACs.
-
Arch. Pathol. Lab. Med. · May 2015
Interinstitutional whole slide imaging teleconsultation service development: assessment using internal training and clinical consultation cases.
Assessment of accuracy and feasibility of whole slide imaging (WSI) for interinstitutional consultation in surgical pathology. ⋯ A significant learning curve was observed in the transition from the training set to clinical consultation cases associated both with WSI interpretation and adjustments to the digital analogs of routine GS workflow. Results from second-opinion consultations indicated that WSI interpretation was as accurate as GS interpretation among properly trained and experienced users. Overall, WSI-based practice appears feasible for second-opinion consultations.
-
Arch. Pathol. Lab. Med. · May 2015
Genomic profiling of advanced-stage, metaplastic breast carcinoma by next-generation sequencing reveals frequent, targetable genomic abnormalities and potential new treatment options.
Metastatic metaplastic breast carcinoma (MPBC) is an uncommon, but aggressive, tumor resistant to conventional chemotherapy. ⋯ Our results indicate that genomic profiling using next-generation sequencing can identify clinically meaningful alterations that have the potential to guide targeted treatment decisions in most patients with metastatic MPBC.