Exome Sequencing in Individuals with Isolated Biliary Atresia.

Biliary atresia (BA) is a severe pediatric liver disease resulting in necroinflammatory obliteration of the extrahepatic biliary tree. BA presents within the first few months of life as either an isolated finding or with additional syndromic features. The etiology of isolated BA is unknown, with evidence for infectious, environmental, and genetic risk factors described.

Methods to Improve Sustainability of a Large Academic Biorepository.

This article discusses the evolution of the University of Pittsburgh (UPitt) Health Sciences Tissue Bank (HSTB) operation and how it has successfully positioned itself, manages to sustain its value, and remains viable in today's research landscape. We describe the various components of our biobanking operation, which are valued by our researchers, thus leading to sustainability for our biorepository. Operating within the infrastructure of a large academic university, we have access to the most cutting-edge database resources for collecting, tracking, and annotating thousands of specimens.

Tissue adequacy for ancillary studies beyond frozen section: a potential method for improving diagnostic and therapeutic results.

The evolving nature of medicine has created new challenges in numerous aspects of the practice of pathology. The development of less invasive procedures, the generation of better diagnostic tools, and the recognition of prognostic markers have contributed to these challenges. Between 42.

Frozen section diagnosis: is there discordance between what pathologists say and what surgeons hear?

Objectives: Communication in various medical settings is subject to misinterpretation. The frozen section (FS) diagnosis in patient care is dependent on successful communication between pathologists and surgeons. However, very few studies looking at FS errors analyzed postanalytic communication issues.

Use of a laboratory information system driven tool for pre-signout quality assurance of random cytopathology reports.

Background: Quality assurance (QA) programs in cytopathology laboratories in the USA currently primarily involve the review of Pap tests per clinical laboratory improvement amendments of 1988 federal regulations. A pre-signout quality assurance tool (PQAT) at our institution allows the laboratory information system (LIS) to also automatically and randomly select an adjustable percentage of non-gynecological cytopathology cases for review before release of the final report. The aim of this study was to review our experience and the effectiveness of this novel PQAT tool in cytology.

Initial experience with a novel pre-sign-out quality assurance tool for review of random surgical pathology diagnoses in a subspecialty-based university practice.

We recently implemented a novel pre-sign-out quality assurance tool in our subspecialty-based surgical pathology practice at the University of Pittsburgh Medical Center. It randomly selects an adjustable percentage of cases for review by a second pathologist at the time the originating pathologist's electronic signature is entered and requires that the review be completed within 24 hours, before release of the final report. The tool replaced a retrospective audit system and it has been in successful use since January 2009.

The development and testing of a laboratory information system-driven tool for pre-sign-out quality assurance of random surgical pathology reports.

We describe the development and testing of a novel pre-sign-out quality assurance tool for case diagnoses that allows for the random review of a percentage of cases by a second pathologist before case verification and release of the final report. The tool incorporates the ability to record and report levels of diagnostic disagreement, reviewers' comments, and steps taken to resolve any discrepancies identified. It is expandable to allow for the review of any percentage of cases in any number of subspecialty or general pathology "benches" and provides a prospective instrument for preventing some serious errors from occurring, thereby potentially affecting patient care in addition to identifying and documenting more general process issues.

The value of physical tests for subacromial impingement syndrome: a study of diagnostic accuracy.

Objective: To determine the diagnostic accuracy of commonly used physical tests for subacromial impingement syndrome, using ultrasound as the reference standard.

Design: A cross-sectional study of 59 participants with chronic shoulder pain of more than four months duration with a referral for diagnostic ultrasound scanning were invited to participate in the study.

Main Measures: Thirty-four participants met the inclusion criteria and had an ultrasound scan followed immediately by application of the following tests: Neer's sign, Hawkins and Kennedy test, painful arc of abduction, empty and full can tests, resisted isometric shoulder abduction and resisted isometric shoulder external rotation.

Clinical outcomes of exercise in the management of subacromial impingement syndrome: a systematic review.

Objective: To assess the clinical outcomes of types of exercise in the management of subacromial impingement syndrome.

Design: Systematic review of randomized controlled trials.

Methods: Studies were identified from databases searched to May 2009: MEDLINE, EMBASE, CINAHL, Sports Discus, PEDro, AMED, Cochrane Library, National Research Register, Index Chiropractic Literature.

Effect of macronutrient composition on postprandial peptide YY levels.

Background: Peptide YY (PYY) is released from the distal small intestine and colon after meals and reduces appetite by increasing satiety. The amount of PYY released is proportional to calories ingested. Fat ingestion has also been reported to stimulate PYY release.

A pilot study for a randomised controlled trial of waterbirth versus land birth.

Objectives: To assess the feasibility of undertaking an adequately powered multicentre study comparing waterbirth with land birth. To assess whether women are willing to participate in such a trial and whether participation has a negative effect on their birthing experience.

Design: A randomised controlled trial (RCT) with 'preference arm'.