Evaluation of HbA1c on the Roche COBAS Integra 800 closed tube system

OBJECTIVES: Evaluate a new whole blood (WB) HbA1c immunoassay and system with closed tube sampling (CTS) capability. DESIGN AND METHODS: Compare the Tina-quant Haemoglobin A1c Gen.2 (A1C-2) application on the COBAS INTEGRA 800 (I800) and new I800 dedicated system with CTS capability to current Integra applications and a HbA1c method accurate with common haemoglobin (Hb) variants. RESULTS: CVs were < or =1.7%. Mean bias against National Glycohaemoglobin Standardization Program (NGSP) samples was 0.3 HbA1c %. Compared to the Hitachi Tina-quant(R) [a] HbA1c II (HbA1c II) assay (accurate with common Hb variants), mean bias was 0.04% and 0.21% HbA1c at 6% and 9%, respectively, with Hb AS variants; and -0.01% and 0.26% HbA1c at 6% and 9%, respectively, with Hb AC variants. CONCLUSIONS: The Integra A1C-2 application is precise, accurate against NGSP-assigned samples and the Hb variants tested; and, the I800 dedicated system with CTS capability offers increased throughput and reduced sample handling.     

通过参加美国临床实验室室间质评提高寄生虫检查质量

目的 通过参加美国病理家学会（CAP）组织的寄生虫检查能力验证（PT）来评估实验室能力，为进一步提高实验室寄生虫检查的质量奠定基础。方法 将CAP发放的寄生虫能力验证标本于10个工作日内按要求与常规病人标本一起进行检查并通过网络将结果直接提交给CAP。结果 全年共检测CAP质控标本15份，所有回报结果正确率为100％。结论 通过参加CAP能力验证将该实验室的寄生虫检查标准化，并提高了实验室全体成员识别寄生虫的能力。     

Disfranchisement,expulsion and persecution of pathologists in the Third Reich – A sociodemographic study

This sociodemographic study focuses on the disenfranchisement, expulsion and persecution of pathologists in the Third Reich – a group that has, until now, received little systematic attention in scholarly research. The paper attempts to determine the number of pathologists who suffered persecution, the characteristics they shared, and the effects the repression had on their lives – both in the period from 1933 to 1945 and in the post-war period.The study is based on primary sources from numerous archives as well as on a systematic re-analysis of published secondary literature on the history of Nazi medicine. A total of 89 disenfranchised pathologists were identified and have been included. The vast majority of these pathologists (90%) were persecuted due to their Jewish ancestry or their relation to Jews. A good two-thirds of these pathologists were employed at a university until their disenfranchisement.For two-thirds of these pathologists (n = 62; 70%), documentation of emigration was found. Twenty-four pathologists remained in their home country; of these, five died in concentration camps and two others committed suicide.The preferred country for direct immigration was the United States (n = 19), followed by Great Britain (n = 13). Most of these pathologists were able to establish themselves professionally in their destination country, and little inclination to return to Germany after 1945 was shown. The reasons for this were a lack of career options in their home country, the lack of a welcoming culture among colleagues and universities, and the stigmatizing experiences of individual pathologists had during academic appointments and reparations proceedings in Germany. However, especially in recent decades and in part posthumously, these pathologists are being granted honorary, intangible recognition in Germany and Austria. Even though this recognition can no longer provide tangible reparations, it is nevertheless a sign of a gradual change in consciousness.     

Adjuvant endocrine therapy in patients with estrogen receptor-low positive breast cancer: A prospective cohort study

BackgroundLittle is known about the benefits of adjuvant endocrine therapy (ET) in low ER-positive breast cancer (1%–10%) patients. We analyzed the association between ET and breast cancer-specific survival (BCSS) in these patients with respect to the regimen and the duration of ET.MethodsPatients were classified into three groups based on the regimen and duration of ET. The regimens included aromatase inhibitor (AI) monotherapy or sequential tamoxifen followed by an AI (AI/T + AI), or only tamoxifen and no ET. The duration of ET included 2–3 years and >3 years. Multivariate Cox regression analysis was employed to calculate the hazard ratios (HRs) with 95% confidence intervals (CIs).ResultsOf the 10,696 patients diagnosed with breast cancer between 2010 and 2020, 407 women were identified with ER-low positive disease and met the inclusion criteria. During a median follow-up of 5.2 years, patients who received ET improved BCSS. Of them, those with AI/T + AI had increased BCSS compared to patients without ET, after adjusting for demographics and tumor characteristics, especially in ER-low/HER-2-positive breast cancer. After additional adjustment for treatment mode, the association maintained a similar trend. Patients who received >3 years of ET was associated with a better DFS. There was no significant difference in BCSS between patients with 2–3 years and >3 years of ET.ConclusionFor ER-low patients, findings suggest that ET with AI/T + AI may be a reasonable treatment alternative. This effect should be assessed in randomized studies.     

Interobserver Variation in Evaluating Perineural Invasion for Oral Squamous Cell Carcinoma: Phase 2 Survey Study

In a previous study, we found interobserver agreement among 88 board-certified pathologists evaluating perineural invasion (PNI) in oral squamous cell carcinoma (OSCC) was fair, and participants most often used the following criteria: (1) tumor invading the perineurium, (2) tumor surrounding a nerve. In this study, we aimed to determine whether application of these most commonly used criteria may improve interobserver agreement. 512 pathologists were invited to participate in a web-based survey. Participants were asked to assess the presence/absence of PNI in a set of OSCC photomicrographs by applying each of the two criteria above. The survey was completed by 84 board-certified pathologists [mean age: 52 years (range 31–81), mean years in practice: 19 (range 1–56)]. Interobserver agreement was moderate (k = 0.46, 95% CI 0.45–0.46) when using definition #1 (tumor invading the perineurium) and fair (k = 0.24, 95% CI 0.23–0.25) when using definition #2 (tumor surrounding a nerve). By comparison, interobserver agreement was fair (k = 0.36, 95% CI 0.35–0.37) among phase 1 participants asked to evaluate these photomicrographs as they would in their pathology practice. Differences in kappa between definition #1 and phase 1, definition #2 and phase 2, and definition #1 and #2 were statistically significant (p < 0.001). Compared to our prior study based on pathologists’ personal views, the current study shows improved interobserver agreement with application of the criterion, “tumor invading the perineurium.” However, further work is needed to delineate concise, objective, and more reproducible criteria for histopathologic assessment of PNI.     

Improving the performance of virtual crossmatch results by correlating with nationally-performed physical crossmatches: Obtaining additional value from proficiency testing activities

Purpose

When donor specific HLA antibodies (DSA) are identified, the predictive value of whether a certain strength of reactivity (mean fluorescence intensity, MFI) leads to a positive crossmatch is uncertain. To determine this, we compared the DSA MFI results we generated locally for nationally distributed proficiency samples against the percentage of other laboratories reporting a positive crossmatch.

参加美国病理学家协会血小板功能能力比对试验之体会

目的总结参加美国病理学家协会血小板功能能力比对试验的经验。方法使用美国病理学家协会(CAP)提供的样本,按常规操作进行检测。结果我室检测结果在美国病理学家协会的标准结果范围内,成绩合格。结论标准化操作,严格的训练是保证能力比对结果成功的关键。     

Post-mortem examination after stillbirth: views of UK-based practitioners

Objectives

Worldwide, around four million stillbirths occur annually. The UK was recently ranked as 33rd out of 35 developed nations for stillbirth rates. The reasons for many stillbirths remain unexplained. Post-mortem examination (PME) can provide information for grieving families, and for future pregnancies. Rates of consent for PME are decreasing in the UK. The views of professionals may influence their approach to bereaved families, and, therefore, rates of consent. Arguably, obtaining qualitative insights into emotive areas such as PME from large numbers of practitioners is increasingly possible as electronic surveys become more sophisticated. Therefore we aimed to describe, using electronic media, the views of UK obstetricians, midwives and perinatal pathologists about PME for stillbirth.

Study design

10,000 UK midwives, 1136 UK obstetricians and all 40 UK perinatal pathologists received a link to an Internet survey via their professional organizations. A box was included for free-text responses. Iterative thematic analysis generated five themes and a ‘line of argument’ synthesis.

Results

683 midwives, 98 obstetricians, and 11 perinatal pathologists provided open comments, generating five themes and the following line of argument: both professional views and family decision-making about postmortem after stillbirth are affected by the education and training of staff, local resources, and the quality of information available. All of these structural issues are interpreted by individual staff, women and families through personal beliefs and emotions, and professional and social discourses.

Conclusions

Internet-based surveys can generate valuable qualitative data. Effective decision-making for post-mortem after stillbirth may be improved by the introduction of user-friendly information and consent procedures, and staff training that takes account of existing innovations, and of the emotions and prior experiences of both staff and parents.