Archives of pathology & laboratory medicine
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Arch. Pathol. Lab. Med. · Jan 1996
Review Case ReportsCoexistence of Hodgkin's disease and giant lymph node hyperplasia of the plasma-cell type (Castleman's disease).
Coexistence of Hodgkin's disease and giant lymph node hyperplasia (Castleman's disease) is well documented in the literature. We present a unique case in which the original lymph node biopsy revealed interfollicular Hodgkin's disease (CD15+, CD30+, CD45-, Reed-Sternberg cells) with coexistent histologic features of the plasma-cell variant of Castleman's disease. The patient experienced a long-term remission following combined chemotherapy and radiation therapy. ⋯ This unique case report further strengthens the association of Castleman's disease and Hodgkin's lymphoma. Two pathogenetic mechanisms for this association have been suggested: (1) secretion of interleukin-6 by Hodgkin's Reed-Sternberg cells and histiocytes, and (2) manifestation of an abnormal immune state associated with Hodgkin's disease. These two mechanisms may, indeed, be related.
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This report describes the quality control and quality assurance programs for bedside glucometry at our institution. From our 3-year experience, a regular schedule of inspections is necessary for maintenance of high-quality bedside glucose testing. ⋯ Regarding the cost analysis for bedside glucometry, we conclude that bedside glucose testing is not inherently more expensive than testing performed within the clinical laboratory. The increased cost of bedside glucometry over laboratory testing can be significantly minimized by involvement of a limited number of health care workers and performance of bedside glucometry only on clinical units where testing is required more than five times per day.
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Arch. Pathol. Lab. Med. · Oct 1995
Successful alternatives to alternate site testing. Use of a pneumatic tube system to the central laboratory.
We evaluated the use of several modes of alternate site versus central laboratory testing in our hospital to provide improved processing of stat specimens from the Emergency Department and the Operating Room. Using the principle of parallel processing for sample analysis, coupled with installation of a computerized pneumatic tube specimen delivery system, we provided improved turnaround time, a larger test menu, and 24-hour-a-day service from the central laboratory. ⋯ A separate tube zone was established for the Operating Room, and a critical care whole-blood test unit was established in the central laboratory, providing 7-minute turnaround time for blood gases, electrolytes, and glucose. Testing in the Operating Room by nonlaboratory personnel was discontinued.
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Arch. Pathol. Lab. Med. · Jul 1995
Kaiser Permanente. An insider's view of the practice of pathology in an HMO hospital-based multispecialty group.
The practice of pathology in a physician-driven health maintenance organization can be professionally and personally satisfying. Much of what The Permanente Medical Group has learned is applicable, comforting, and helpful to other pathologists. The organization of Kaiser Permanente, the largest health maintenance organization in the United States, is presented, as are some of the pertinent practice parameters of its pathologists.
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Arch. Pathol. Lab. Med. · Jun 1995
Continuous improvement, quality control, and cost containment in clinical laboratory testing. Effects of establishing and implementing guidelines for preoperative tests.
To develop guidelines for laboratory tests ordered before admission for elective surgery. ⋯ We have described an approach that involves a sustained educational effort and collaboration of nurses and physicians and have presented specific guidelines for preoperative testing. A major decrease in the number of tests ordered, an increase in their appropriateness, and marked fiscal savings were documented.