Kidney glomerular pathology in various forms of acute and chronic hepatitis.

Kidney tissue from 99 unselected necropsy cases of various forms of hepatitis and liver cirrhosis was examined by histology and direct immunofluorescence. Glomerular deposits of hepatitis B surface antigen (HBsAg), IgG, IgM, and complement were found in nine of 59 cases (15%) of acute and subacute hepatitis and in seven of 40 cases (17%) of chronic aggressive hepatitis and liver cirrhosis. Different amounts of granular hepatitis B surface antigen immune deposits were distributed along glomerular capillary walls and/or in mesangial areas. Glomerular lesions found in these cases consisted of thickening of glomerular capillary walls, a slight increase in glomerular cellularity, and an increase of mesangial matrix. These glomerular lesions are considered to result from the humoral immune elimination of circulating viral surface antigen immune complexes.     

Statistics in the pathology laboratory: characteristics of diagnostic tests

Sensitivity, specificity and receiver operating characteristic (ROC) curves all provide information about the ability of a diagnostic test to provide useful information in the assessment of disease. They are discussed in this review along with the importance of estimates of precision.     

Pathologico-anatomic diagnosis of placental insufficiency in various forms of maternal pathology

Placental insufficiency is considered as a disorder of compensatory-adaptative reactions on subcellular, cellular and tissue levels. In cases of relative insufficiency diagnosed on subcellular and cellular levels, homeostasis of the mother-placenta-fetus system is maintained by the tissue reactions, mainly hemodynamic ones. Among morphological features of compensatory mechanisms the most informative is the index of chorionic villi vascularization. Rapid decrease of the index indicates the development of the absolute placental insufficiency. Among the factors which limit compensatory-adaptative reactions it is necessary to distinguish, besides involutional-dystrophic, circulatory, inflammatory processes, a disorder in the chorion maturation which proceeds in different versions depending on the character and duration of the maternal pathology influence.     

Use of multichannel discrete analyser to reduce unnecessary biochemical tests.

AIM--To investigate the waste of laboratory reagents which resulted from the process of ordering biochemistry profiles. METHODS--The frequency of measurement of 15 analytes was recorded during the six months before the introduction of a system of discretionary requesting and analysis of samples (high capacity multichannel discrete analyser), and also during the same six month period one year and two years after its introduction. RESULTS--The frequency of measurement of 10 of the 15 analytes decreased during the six month period one year after the change to discretionary testing. The remaining five analytes were measured up to 22% more frequently. There was an overall decrease in the measurement of biochemical tests by 31,359. This created an annual cost saving of 7124 pounds. In the second year five analytes still continued to be measured less frequently than originally but the remaining 10 analytes were measured more frequently. This resulted in an overall increase in the measurement of biochemical tests by 53,678 compared with the six month period before discretionary analysis. The pattern of requests was similar during both periods of discretionary requesting studied and as a result, a small annual cost saving of 1672 pounds was again made. CONCLUSION--Discretionary requesting and analysis of tests may eliminate the measurement of clinically unnecessary test which had previously resulted from the processes of ordering tests. These cost savings may be rapidly eroded by an increase in the laboratory workload.     

Perceptions of stress among pathology residents: survey results and some strategies to reduce them

We conducted a survey to attempt to identify stressors perceived by pathology residents. A comparison of survey results from pathology residents with stressors perceived by residents in other specialties was done to evaluate whether the stressors in pathology are unique. A confidential e-mail survey of residency programs in the United States generated a response rate from program directors of 23.3% and a resident response rate of 6.4%. Although the study is limited by response rates and the data are primarily from university-based residency programs, the concordance between the identifiable risk factors for stress by the resident and program director groups validates the importance of this issue among pathology residency programs. Both groups identified variability in faculty expectations and work overload that inhibits optimal learning as the top 2 stressors for residents. We discuss various factors that contribute to stress and some strategies that pathology residency programs can implement to address the stressors.     

Mite avoidance can reduce air trapping and airway inflammation in allergic asthmatic children

BACKGROUND: We investigated the effects of prolonged allergen avoidance in 18 house dust mite-sensitized asthmatic children during a prolonged residential period at a high altitude, allergen-free environment. METHODS: Evaluations of residual volume (RV) and exhaled nitric oxide (eNO) were performed (i) at admission to the residential house in September, (ii) in December after 3 months of stay, (iii) in January after 15 days at home, exposed to allergens, and (iv) in June after 9 months of stay. RESULTS: During the study period RV showed a significant decrease in December (from 117.5 +/- 7.7% to 96.5 +/- 3.2%) (P < 0.02) and a following increase in January (126.2 +/- 17.2%), after allergen re-exposure (P < 0.03). RV decreased again in June at the end of the study period (91.1 +/- 6.0%) (P = 0.001). FEV(1), FEF(25-75) and VC values did not present significant variations. ENO showed a significant decrease in December after 3 months at high altitude (from 21.3 +/- 3.9 p.p.b. to 11.9 +/- 1.7 p.p.b.) (P = 0.03), but no further significant change. No correlation was found between lung volumes and eNO, probably reflecting different aspects of asthma. CONCLUSIONS: Results suggest that RV may be more sensitive than other respiratory function parameters in identifying children with air trapping, being influenced significantly as the inflammatory indices by effective allergen avoidance/exposure regimen.     

Cellular sensitivity to the effect of interferon during different forms of viral pathology

A new approach to evaluation of interferon (IFN) status of patients with acute respiratory viral infections, herpes, and urogenital infections has been developed. It consists in measurement of IFN-alpha and IFN-gamma production by leukocytes primed with IFN-alpha and IFN-gamma, respectively, and subsequent identification of groups of patients whose lymphocytes differ by their in vitro response to IFN priming: sensitive to IFN-alpha and IFN-gamma; sensitive to IFN-alpha but not to IFN-gamma; sensitive to IFN-gamma but not to IFN-alpha; not sensitive to IFN-alpha and IFN-gamma. Such analysis helps understand the mechanisms of IFN system deficiency in infectious diseases and promotes more effective IFN therapy due to selection of patients whose cells retain in vitro sensitivity to a certain IFN type.     

Participating in a virtual reality balance exercise program can reduce risk and fear of falls

Objective

The objective of this study was to quantify the effectiveness of virtual reality balance games (VRBG) to decrease risk and fear of falls among women.

Methods

Thirty six community dwelling women aged 56 and above were randomly divided into experimental (exercises using VRBG focus on improving balance) and control (conventional balance exercises) groups. Both groups attended a twice 6 weekly exercise session for an hour. Risk and fear of falls were measured with Physiological Profile Approach (PPA) and Activity Specific Balance Scale (ABC-6). Pre and post intervention differences between the groups were examined using two way repeated measures ANOVA.

Results

Both VRBG and conventional balance exercise groups had significant decrease in PPA (p < 0.001) and ABC-6 (p < 0.01) after the interventions. However, no significant effects were demonstrated between the groups in PPA (p = 0.18) and ABC-6 (p = 0.25) post intervention. Time and group interaction effect were not significant for PPA (p = 0.18) and ABC-6 (p = 0.45).

Conclusions

Practising VRBG can increase balance confidence and decrease risk of falls among community dwelling women.