Journal of clinical pathology
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Vitamin K antagonists have been used for many decades and have been traditionally monitored by the measurement of the International Normalised Ratio (INR) in the laboratory. Introduction of Point of Care (POC) testing devices to measure INR has resulted in many tests being undertaken in primary care. External Quality Assessment (EQA) of these POC devices is recommended to ensure accuracy and reliability of INR results outside a laboratory setting. ⋯ Utilisation of an EQA programme for POC devices in primary care is feasible and necessary. Our data suggest for those health professionals using EQA, the reliability and accuracy of INR testing matches the quality of laboratory testing.
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High intensity focused ultrasound (HIFU) is currently offered as primary treatment for patients with clinically localised prostate cancer. Data on histopathological features of post-treatment biopsies are limited. ⋯ Post-HIFU biopsies are positive in more than 75% of patients with elevated or rising PSA. Stromal fibrosis is common but the tissue effects of this modality do not appear to impair pathologists' ability to detect and grade adenocarcinoma in follow-up biopsies.
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Neoadjuvant chemoradiation therapy (CRT) is an increasingly used therapeutic strategy for rectal cancer. Clinically, it remains a major challenge to predict therapeutic response and patient outcome after CRT. Rsf-1 (HBXAP), a novel nuclear protein with histone chaperon function, mediates ATPase-dependent chromatin remodelling and confers tumour aggressiveness and predicts therapeutic response in certain carcinomas. However, the expression of Rsf-1 has never been reported in rectal cancer. This study examined the predictive and prognostic impacts of Rsf-1 expression in patients with rectal cancer following neoadjuvant CRT. ⋯ High-expression of Rsf-1 is associated with poor therapeutic response and adverse outcome in rectal cancer patients treated with neoadjuvant CRT, which confers tumour aggressiveness and therapeutic resistance through chromatin remodelling and represents a potential prognostic biomarker in rectal cancer.
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Review
Immunohistochemistry in the distinction between primary and metastatic ovarian mucinous neoplasms.
The distinction between a primary and metastatic mucinous carcinoma within the ovary may be problematic. In most cases, the distinction can be made by careful pathological examination encompassing both the gross and microscopic findings and taking into account the distribution of the disease. ⋯ There is a significant degree of immunophenotypic overlap between primary ovarian mucinous neoplasms and metastatic mucinous carcinomas from the gastrointestinal tract, especially the upper gastrointestinal type; this is because most primary ovarian mucinous carcinomas and borderline tumours are of so-called intestinal or enteric type and exhibit some degree of positivity with enteric markers. Mullerian type primary ovarian mucinous neoplasms also exist and exhibit distinct immunohistochemical differences to the more common intestinal type.
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The medical regulator in the UK, the General Medical Council, requires curricula and assessments for postgraduate training to be blueprinted to its regulatory statement, Good Medical Practice. A similar document, Tomorrow's Doctors (2009), covers undergraduate education and training. Good Medical Practice, originally designed to regulate medical practice, is not optimally worded as an educational document. The Royal College of Physicians and Surgeons of Canada's physician competency framework known as CanMEDS is designed with education more centrally in mind. ⋯ Good Medical Practice is less suitable for an educational role and the General Medical Council should consider developing a more specific educational document around these principles.