Solitary fibrous tumor of the central nervous system with epithelioid neuroendocrine "Transdedifferentiation": A case report and review of the literatures.

Solitary fibrous tumors (SFTs) of the central nervous system (CNS) are rare mesenchymal tumors characterized by a fusion of the NGFI-A-binding protein 2 (NAB2) gene and the signal transducer and activator of transcription 6 (STAT6) gene, immunohistochemically resulting in nuclear expression of STAT6 - an immunohistochemical hallmark essential for diagnosis, as outlined in the fifth edition of the World Health Organization Classification of Tumors. Dedifferentiation, where low-grade tumors transform into high-grade forms, has been observed in SFTs, with documented cases involving sarcomatous or rarely epithelial transformations. We report the first case of a CNS SFT exhibiting "transdedifferentiation" into epithelioid neuroendocrine differentiation.

The Impact of Pathologist Review on Peripheral Blood Smears: A College of American Pathologists Q-Probes Study of 22 Laboratories.

Context.—: The aim of the study was to determine the impact of peripheral blood (PB) smear review by a pathologist when requested by a technologist or provider to measure the rate of pathologist-detected clinically relevant findings.

Objective.

Minimally invasive anterior cervical foraminotomy for unilateral radiculopathy.

Anterior cervical foraminotomy (ACF) is an alternative surgical option for the treatment of refractory unilateral radiculopathy due to disc herniation or spondylosis. The efficacy and adverse event rate in experienced practitioners are comparable to those of anterior cervical discectomy and fusion, total disc arthroplasty, and posterior foraminotomy. However, this technique has not been widely adopted, likely because of the proximity of the working zone and the vertebral artery.

ICU Delirium in Cardiac Patients.

Delirium is a prevalent complication in critically ill medical and surgical cardiac patients. It is associated with increased morbidity and mortality, prolonged hospitalizations, cognitive impairments, functional decline, and hospital costs. The incidence of delirium in cardiac patients varies based on the criteria used for the diagnosis, the population studied, and the type of surgery (cardiac or not cardiac).

Common and contrast determinants of peripheral artery disease and diabetic peripheral neuropathy in North Central Nigeria.

Background: Peripheral artery disease (PAD) and diabetic peripheral neuropathy (DPN) are two of the leading causes of non-traumatic amputation worldwide with tremendous negative effects on the quality of life, psychosocial well-being of persons with diabetes mellitus; and a great burden on health care expenditure. It is therefore imperative, to identify the common and contrast determinants of PAD and DPN in order to ease adoption of common and specific strategies for their early prevention.

Methods: This was a multi-center cross-sectional study which involved the consecutive enrolment of one thousand and forty (1040) participants following consent and waiver of ethical approval.

Validating Whole Slide Imaging Systems for Diagnostic Purposes in Pathology.

Context.—: The original guideline, "Validating Whole Slide Imaging for Diagnostic Purposes in Pathology," was published in 2013 and included 12 guideline statements. The College of American Pathologists convened an expert panel to update the guideline following standards established by the National Academies of Medicine for developing trustworthy clinical practice guidelines.

Tocilizumab for the Critically Ill With Severe COVID-19: A Community Hospital Case Series.

Objective: To evaluate the use of tocilizumab in a community hospital setting for critically ill patients with severe COVID-19.

Design: A retrospective case series.

Setting: Five community hospitals within 1 urban health system.

Use of path modeling to inform a clinical decision support application to encourage osteoporosis medication use.

Background: Osteoporosis medication use is suboptimal. Simple interventions personalized to a patients' stage of readiness are needed to encourage osteoporosis medication use.

Objectives: To estimate interrelationships of sociodemographic factors, perceived fracture risk, health literacy, receipt of medication information, medication trust and readiness to use osteoporosis medication; and apply observed relationships to inform design specifications for a clinical decision support application that can be used for personalized patient counseling.

Complete AV Block Induced by Right Coronary Artery Spasm Following Radiofrequency Ablation for Atrial Fibrillation.

Coronary artery spasm during catheter ablation for arrhythmias is a rare but previously reported complication. Timing of presentation, manifestations of vasospasm, and purported mechanisms vary somewhat in the prior literature. We present a case of chest pain, inferior lead ST elevation, and complete AV block with angiographically confirmed right coronary artery (RCA) vasospasm that occurred immediately after catheter ablation for atrial fibrillation.

Identification and management of cough-induced laryngotracheitis.

Chronic cough is associated with repetitive injury to the upper airway and trachea, which can lead to an underdiagnosed pathology known as "cough-induced" laryngotracheitis (CILT). In this report, we describe a case of CILT that responded well to dual therapy.

Breast Specimen Processing and Reporting With an Emphasis on Margin Evaluation: A College of American Pathologists Survey of 866 Laboratories.

Context: - The College of American Pathologists (CAP) developed protocols for reporting pathologic characteristics of breast cancer specimens, including margin status. The Society of Surgical Oncology (SSO) and the American Society for Radiation Oncology (ASTRO) published treatment guidelines regarding margins in patients with invasive cancer; and SSO, ASTRO, and the American Society of Clinical Oncology (ASCO) recently published guidelines for patients with ductal carcinoma in situ.

Objective: - To assess current practices among pathologists with regard to the processing/reporting of breast specimens, assess compliance with CAP cancer protocols, and assess alignment with SSO/ASTRO and SSO/ASTRO/ASCO guidelines.

Admission Temperature and Associated Mortality and Morbidity among Moderately and Extremely Preterm Infants.

Objective: To evaluate the temperature distribution among moderately preterm (MPT, 29-33 weeks) and extremely preterm (EPT, <29 weeks) infants upon neonatal intensive care unit (NICU) admission in 2012-2013, the change in admission temperature distribution for EPT infants between 2002-2003 and 2012-2013, and associations between admission temperature and mortality and morbidity for both MPT and EPT infants.

Study Design: Prospectively collected data from 18 centers in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network were used to examine NICU admission temperature of inborn MPT and EPT infants. Associations between admission temperature and mortality and morbidity were determined by multivariable logistic regression.

Uniform Labeling of Blocks and Slides in Surgical Pathology: Guideline From the College of American Pathologists Pathology and Laboratory Quality Center and the National Society for Histotechnology.

Context: The labeling of paraffin blocks and microscopic glass slides in the practice of surgical pathology varies from institution to institution and introduces potential risk of preanalytic error. Currently there are no evidence-based guidelines regarding the uniform labeling of these materials.

Objective: To develop recommendations that will address the need for adequate patient identification and provide a consistent method of identifying slides originating from a particular block.

The Mirror Program: Preparing Women for the Postoperative Mastectomy Mirror-Viewing Experience.

Problem: Preparing women for the experiences they will endure during the breast cancer trajectory improves psychological outcomes and quality of life. Women have found that it may be difficult to view themselves in a mirror after having a mastectomy. Supporting women who have had a mastectomy in mirror-viewing and body image is a relatively new yet important intervention in oncology nursing.

Bubble nasal CPAP, early surfactant treatment, and rapid extubation are associated with decreased incidence of bronchopulmonary dysplasia in very-low-birth-weight newborns: efficacy and safety considerations.

Background: Current literature has been inconsistent in demonstrating that minimizing the duration of mechanical ventilation in very-low-birth-weight (VLBW) newborns reduces lung damage.

Objective: To determine if introduction of bubble nasal CPAP (bnCPAP), early surfactant treatment, and rapid extubation (combined bnCPAP strategy) in our community-based neonatal ICU reduced bronchopulmonary dysplasia (BPD).

Methods: This was a 7-year retrospective,single-institution review of respiratory outcomes in 633 VLBW babies before and after introduction of the combined bnCPAP strategy.

Controlling blood glucose levels to reduce infection.

Achieving and maintaining tight glucose control in the critically ill patient is becoming the standard of care across the country. It is well established that hyperglycemia is common in critically ill patients, and recent studies have shown a possible connection between hyperglycemia and the ability to fight infection. Healthcare providers face many challenges when choosing to implement this evidence-based practice into their standard of patient care.

A primer for understanding diagnosis-related groups and inpatient hospital reimbursement with nursing implications.

This study describes diagnosis-related groups (DRGs) as set forth by the Centers for Medicare and Medicaid (CMS). Factors that impact a DRGs length of stay and reimbursement, including the case mix index, blended rates, and medical coding guidelines, are discussed. Nurses can play roles that greatly impact the final DRG for each inpatient medical record.

Understanding diagnostic related groups (DRGs) and inpatient hospital reimbursement.

Knowing insurance plan regulations and complying precisely with requirements is critical for hospital reimbursement of care provided. Diagnostic related groups provide guidelines widely used in the United States to determine hospital reimbursement by Medicare, Medicaid, and many insurance providers. Because hospitals are the largest employers of nurses, nurses have a responsibility and interest in contributing to the stability of their hospital's financial status to protect incomes and job security.

From hysterectomy to historicity.

In this paper we describe recovery after hysterectomy. Study participants identified four common elements of recovery--physical symptoms, emotional well-being, activity levels, and decision-making--within the four phases of recovery after hysterectomy: measuring health, comparing past to present, renewal, and growth through healing. Each element changed within each phase over time to provide a description of recovery after hysterectomy.

The role of cholesterol and statins in Alzheimer's disease.

Objective: To briefly discuss the impact of elevated total and low-density-lipoprotein cholesterol levels, as well as the potential relationship of hydroxymethylglutaryl coenzyme A reductase inhibitor (statin) use, on the development of Alzheimer's disease (AD).

Data Sources: Biomedical literature was accessed through MEDLINE and International Pharmaceutical Abstracts (1966-June 2003). The authors independently reviewed literature for possible inclusion in this article.

Serotonergic agents in the treatment of fibromyalgia syndrome.

Objective: To evaluate literature that discusses the treatment of fibromyalgia syndrome (FMS) with agents that involve the neurotransmitter serotonin.

Data Sources: Biomedical literature accessed through MEDLINE (1966-August 2001) and International Pharmaceutical Abstracts.

Data Synthesis: The cause and pathophysiology of FMS remain elusive, although abnormalities in the serotonin pathway have been implicated.