scholarly journals Quality improvement Initiative to eliminate silver precipitate during Periodic Acid Silver Methenamine Stain (PAMS) automated protocol of renal biopsies at McGill University Health Centre

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S152-S152
Author(s):  
M Kuk ◽  
D Chicoine ◽  
C Maedler ◽  
C Bernard
Keyword(s):  
Periodic Acid ◽  
Health Centre ◽  
Membranous Glomerulonephritis ◽  
Neutral Red ◽  
Quality Improvement Initiative ◽  
Pathology Laboratory ◽  
Preparation Temperature ◽  
Systematic Assessment ◽  
Renal Biopsies ◽  
Mcgill University

Abstract Introduction/Objective Annually, about 400 renal biopsies are processed at the McGill University Health Centre (MUHC) pathology laboratory located in Montreal, Canada. One of the stains used to visualize the glomerular basement membrane is Periodic Acid Silver Methenamine Stain (PAMS). In August 2020, a strong, granular precipitate of silver was noted during PAMS automated staining resulting in uninterpretable results and delay in the diagnosis. Based on a sample analysis, this problem affected 21 % of kidney biopsies. Methods/Case Report A cause-and-effect workflow was developed for systematic assessment of potential causes of the granular precipitate including pre-analytical and analytical factors. Some of the pre-analytical factors included length of time spent in transport before fixation and patient factors that predisposed precipitate formation. Analytical factors were categorized as fixation problems (temperature, pH, duration), embedding problems (parafilm temperature, cooling method, type of parafilm), slide preparation (temperature, water bath pH, dehydration and further processing steps), microtone parameters (microtone calibration, thickness, laboratory technologist expertise), automatic staining parameters (cartridge age, hematoxylin counterstain duration, wash-out period etc.) and coverslip placement (adhesive type, temperature, drying). Results (if a Case Study enter NA) Following our systematic approach, the cause of granular precipitate was identified as the timing of hematoxylin counterstain. A portion of renal biopsy tissue was taken from parafilm blocks of previouslly reported cases of patients with membranous glomerulonephritis to further test the hypothesis by introduction of various incubation times with the hematoxylin counterstain. Conclusion Best PAMS staining was attained when no hematoxylin counterstain was employed (instead, neutral red counterstain for 70 seconds was used). PAMS staining with hematoxylin counter stain for no more than 60 seconds was found to be acceptable for the interpretation of glomerular pathology.

scholarly journals Cannabis for Chronic Pain: Case Series and Implications for Clinicians

2002 ◽  
Vol 7 (2) ◽  
pp. 95-99 ◽  
Author(s):  
Mark A Ware ◽  
Ann Gamsa ◽  
Jan Persson ◽  
Mary-Ann Fitzcharles
Keyword(s):  
Chronic Pain ◽  
Health Centre ◽  
Case Series ◽  
Cannabis Use ◽  
Median Frequency ◽  
Median Dose ◽  
Night Time ◽  
Day Range ◽  
Frequency Of Use ◽  
Mcgill University

BACKGROUND:Chronic pain is one of the most common reasons for therapeutic cannabis use.OBJECTIVES:To describe therapeutic cannabis use among patients with chronic pain.METHODS:Patients with chronic pain who voluntarily indicated that they used cannabis therapeutically completed a questionnaire about the type of cannabis used, the mode of administration, the amount used and the frequency of use, and their perception of the effectiveness of cannabis on a set of pain-associated symptoms and side effects. The study was approved by the McGill University Health Centre Research Ethics Board.RESULTS:Fifteen patients (10 male) were interviewed (median age 49.5 years, range 24 to 68 years). All patients smoked herbal cannabis for therapeutic reasons (median duration of use six years, range two weeks to 37 years). Seven patients only smoked at night-time (median dose eight puffs, range two to eight puffs), and eight patients used cannabis mainly during the day (median dose three puffs, range two to eight puffs); the median frequency of use was four times per day (range one to 16 times per day). Twelve patients reported improvement in pain and mood, while 11 reported improvement in sleep. Eight patients reported a 'high'; six denied a 'high'. Tolerance to cannabis was not reported.CONCLUSIONS:The results of this self-selected case series must be interpreted with caution. Small doses of smoked cannabis may improve pain, mood and sleep in some patients with chronic pain. Clinical trials are warranted to test these effects. Further prospective studies should examine the patterns and prevalence of cannabis use among chronic pain populations.

scholarly journals Voice-Based Screening For SARS-CoV-2 Exposure In Cardiovascular Clinics

2021 ◽  
Author(s):  
Abhinav Sharma ◽  
Emily Oulousian ◽  
Jiayi Ni ◽  
Renato Lopes ◽  
Matthew Pellan Cheng ◽  
...  
Keyword(s):  
Healthcare Provider ◽  
Clinical Care ◽  
Health Centre ◽  
Healthcare Delivery ◽  
Signs And Symptoms ◽  
Kappa Statistic ◽  
Cohen’S Kappa ◽  
Cohen's Kappa ◽  
Mcgill University ◽  
Strongly Agree

Abstract Aims Artificial intelligence (A.I) driven voice-based assistants may facilitate data capture in clinical care and trials; however, the feasibility and accuracy of using such devices in a healthcare environment are unknown. We explored the feasibility of using the Amazon Alexa (‘Alexa’) A.I. voice-assistant to screen for risk-factors or symptoms relating to SARS-CoV-2 exposure in quaternary care cardiovascular clinics. Methods We enrolled participants to be screened for signs and symptoms of SARS-CoV-2 exposure by a healthcare provider and then subsequently by the Alexa. Our primary outcome was interrater reliability of Alexa to healthcare provider screening using Cohen’s Kappa statistic. Participants rated the Alexa in a post-study survey (scale of 1 to 5 with 5 reflecting strongly agree). This study was approved by the McGill University Health Centre ethics board. Results We prospectively enrolled 215 participants. The mean age was 46 years (17.7 years standard deviation [SD]), 55% were female, and 31% were French speakers (others were English). In total, 645 screening questions were delivered by Alexa. The Alexa mis-identified one response. The simple and weighted Cohen’s kappa statistic between Alexa and healthcare provider screening was 0.989 (95% CI: 0.982, 0.997) and 0.992 (955 CI 0.985, 0.999) respectively. The participants gave an overall mean rating of 4.4 (out of 5, 0.9 SD). Conclusion Our study demonstrates the feasibility of an A.I. driven multilingual voice-based assistant to collect data in the context of SARS-CoV-2 exposure screening. Future studies integrating such devices in cardiovascular healthcare delivery and clinical trials are warranted. Registration https://clinicaltrials.gov/ct2/show/NCT04508972

The blood leukocytes of Bufo marinus: a light, phase-contrast, and histochemical study

1987 ◽  
Vol 65 (6) ◽  
pp. 1445-1453 ◽  
Author(s):  
M. Samuel Cannon ◽  
H. W. Sampson ◽  
E. D. Kapes
Keyword(s):  
Acid Phosphatase ◽  
Phase Contrast ◽  
Periodic Acid ◽  
Hydrolytic Enzymes ◽  
Neutral Red ◽  
Bufo Marinus ◽  
Oxidative Enzymes ◽  
Blood Leukocytes ◽  
Periodic Acid Schiff ◽  
Aerobic And Anaerobic

Blood leukocytes of Bufo marinus were studied by light and phase-contrast microscopy and histochemical techniques for the localization of glycogen, lipids, several basic proteins, and a number of hydrolytic and oxidative enzymes. The hydrolytic enzymes occurred in varying amounts in neutrophils, eosinophils, lymphocytes, and monocytes; neutrophils were the only leukocytes to demonstrate alkaline phosphatase activity, while β-glucuronidase was only seen in lymphocytes, and aryl-sulfatase was not observed in any leukocytes. Periodic acid – Schiff (PAS) positive granules also occurred in varying amounts in leukocytes. Slight lipid activity was only seen in neutrophils, while arginine, and (or) lysine, and tyrosine reactivity was only observed in eosinophils. The appearance and histochemical reactivity of acid phosphatase granules in neutrophils corresponded closely with the appearance and number of specific neutrophilic granules seen in Wright–Giemsa preparations and with the PAS-positive granules. Small lymphocytes were myeloperoxidase (peroxidase) negative; β-glucuronidase, acid phosphatase, and PAS-positive granules corresponded to neutral red granules seen in supravital films. The oxidative enzymes also occurred in differing amounts in leukocytes, but strongly suggested that the leukocytes of Bufo marinus are capable of some degree of aerobic and anaerobic metabolism.

Cellular differentiation and pattern formation in the absence of morphogenesis in the cellular slime mould Polysphondylium pallidum: evidence for a biochemical tip (organizer) in submerged aggregates

1981 ◽  
Vol 27 (9) ◽  
pp. 924-936 ◽  
Author(s):  
Gary D. Paterno ◽  
Danton H. O'Day
Keyword(s):  
Cell Differentiation ◽  
Cellular Differentiation ◽  
Periodic Acid ◽  
Neutral Red ◽  
Stalk Cell ◽  
Periodic Acid Schiff ◽  
Slime Mould ◽  
Polysphondylium Pallidum ◽  
Cellular Slime ◽  
Roller Tube Culture

When amoebae of Polysphondylium pallidum WS320 are placed in nonnutrient buffer in roller tube culture they form spherical or ellipsoidal aggregates. At first the aggregates demonstrate a "loose" morphology but by 12 h, with the formation of a cellulose-containing, peripheral sheath, they become "tight" aggregates. At this time stalk differentiation begins. Using various methods for the resolution of prespore (ultrastructure, spore antigen immunofluorescence, periodic acid – Schiff staining) and prestalk (ultrastructure, alkaline phosphatase histochemistry, neutral red staining, Calcofluor fluorescence) cell localization, the pattern of cell differentiation in submerged aggregates was shown to be essentially identical to that of normal pseudoplasmodia. Furthermore, using a cAMP bioassay it was revealed that the submerged aggregates, while devoid of a morphological tip, do possess a biochemical tip which is correlated with sites of neutral red staining and stalk cell differentiation. As a result of these studies, an earlier argument that the tip of the pseudoplasmodium is not essential for the establishment of pattern or in the "organization" of cellular differentiation during slime mould development is contradicted.

scholarly journals Reasons for delay in timely administration of adjuvant chemotherapy for patients with stage III colon cancer: a multicentre cohort study from the McGill University Department of Oncology

2021 ◽  
Vol 10 (1) ◽  
pp. e000934
Author(s):  
Arielle Elkrief ◽  
Genevieve Redstone ◽  
Luca Petruccelli ◽  
Alla'a Ali ◽  
Doneal Thomas ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Clinical Practice ◽  
Adjuvant Chemotherapy ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Cox Regression ◽  
Health Centre ◽  
Stage Iii ◽  
Stage Iii Colon Cancer ◽  
Mcgill University

PurposeAdjuvant chemotherapy within 56 or 84 days following curative resection is globally accepted as the standard of care for stage III colon cancer as it has been associated with improved overall survival. Initiation of adjuvant chemotherapy within this time frame is therefore recommended by clinical practice guidelines, including the European Society for Medical Oncology. The objective of this study was to evaluate adherence to these clinical practice guidelines for patients with stage III colon cancer across the Rossy Cancer Network (RCN); a partnership of McGill University’s Faculty of Medicine, McGill University Health Centre, Jewish General Hospital and St Mary’s Hospital Center.Patients and methods187 patients who had been diagnosed with stage III colon cancer and received adjuvant chemotherapy within the RCN partner hospitals from 2012 to 2015 were included. Patient and treatment information was retrospectively determined by chart review. Χ2 and Wilcoxon rank-sum tests were used to measure associations and a multivariate Cox regression model was used to determine risk factors contributing to delays in administration of adjuvant chemotherapy.ResultsThe median turnaround time between surgery and adjuvant chemotherapy was 69 days. Importantly, only 27% of patients met the 56-day target, and 71% met the 84-day target. Increasing age, having more than one surgical complication and being diagnosed between 2013–2014 and 2014–2015 reduced the likelihood that patients met these targets. Furthermore, delays were observed at most intervals from surgery to first adjuvant chemotherapy treatment.ConclusionOur study found that within these academic hospital settings, 27% of patients met the 56-day target, and 71% met the 84-day target. Delays were associated with hospital, surgeon and patient-related factors. Initiatives in quality improvement are needed in order to improve adherence to recommended treatment guidelines for prompt administration of adjuvant chemotherapy for stage III colon cancer.

scholarly journals William Pollock Fraser (1867-1943) : Canadian pioneer plant pathologist-mycologist

2005 ◽  
Vol 73 (2) ◽  
pp. 53-59
Author(s):  
R.H. Estey
Keyword(s):  
Plant Pathology ◽  
Nova Scotia ◽  
Rust Fungi ◽  
Western Canada ◽  
Forest Pathology ◽  
Pathology Laboratory ◽  
Pioneer Plant ◽  
Mcgill University ◽  
The University ◽  
Wheat Rust

William P. Fraser, the first Canadian-born plant pathologist-mycologist to be internationally recognized as such, began as an amateur collector of fungi, with emphasis on the plant rusts, while teaching school in his home province, Nova Scotia. He then became a widely acclaimed authority on the rusts and a professional plant pathologist-mycologist. He taught plant pathology and mycology, first at McGill University and then, after an interval as head of the first plant pathology laboratory in Western Canada, at the University of Saskatchewan. Fraser was a Canadian pioneer in research on physiological races of wheat rust; in the culture of heteroecious rust fungi, in forest pathology, and in the study of root and smut diseases of grasses in Western Canada.

scholarly journals A survey of health care professionals and oncology patients at the McGill University Health Centre reveals enthusiasm for establishing a postmortem rapid tissue donation program

2019 ◽  
Vol 26 (4) ◽  
Author(s):  
M. Dankner ◽  
J. Senecal ◽  
N. S. Neubarth ◽  
N. Bertos ◽  
M. Park ◽  
...  
Keyword(s):  
Health Care ◽  
Cancer Patients ◽  
Health Care Professionals ◽  
Current Knowledge ◽  
Metastatic Cancer ◽  
Health Centre ◽  
Tissue Donation ◽  
Developmental Phase ◽  
Oncology Patients ◽  
Mcgill University

Background  In the early developmental phase of a postmortem rapid tissue donation (RTD) program for patients with metastatic cancer, we surveyed health care professionals (HCPS) and oncology patients at the McGill University Health Centre (MUHC) to assess their knowledge and attitudes pertaining to RTD from metastatic cancer patients for research purposes.Methods   A 23-item survey was developed and distributed to hcps at tumour board meetings, and a related 26-item survey was developed and distributed to oncology patients at the MUHC Cedars Cancer Centre.Results   The survey attracted participation from 73 HCPS, including 37 attending physicians, and 102 oncology patients. Despite the fact that 88% of hcps rated their knowledge of RTD as none or limited, 42% indicated that they would feel comfortable discussing RTD with their cancer patients. Of the responding hcps, 67% indicated that their current knowledge of RTD would affect their decision to discuss such a program with patients, which implies the importance of education for hcps to facilitate enrolment of patients into a RTD program. Of responding patients, 78% indicated that they would not be uncomfortable if their doctor discussed RTD with them, and 61% indicated that they would like it if their doctor were to discuss RTD with them. The hcps and patients felt that the best time for patients to be approached about consenting to a RTD program would be at the transition to palliative care when no treatment options remain.Conclusions   At the MUHC, hcps and patients are generally enthusiastic about adopting a RTD program for patients with metastatic cancer. Education of hcps and patients will be an important determinant of the program’s success.

Sclerosing Glomerulonephritis

1975 ◽  
Vol 33 ◽  
pp. 408-409
Author(s):  
A. Mandal ◽  
K. Chrysant ◽  
J. Nordquist ◽  
S. Kraikitpanitch ◽  
D. Xoung ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Renal Failure ◽  
Retrospective Study ◽  
Light Microscopy ◽  
Membranous Glomerulonephritis ◽  
Chronic Glomerulonephritis ◽  
Previous Diagnosis ◽  
Renal Biopsies ◽  
End Stage ◽  
Made In

A small but undefined percentage of adults with idiopathic proteinuria, microscopic hematuria and hypertension with partial or no response to corticosteroid or immunosuppressive therapy, progress slowly to renal failure. Histological diagnosis of membranous, membranoproliferative or chronic glomerulonephritis were made in these patients. Retrospective reevaluation of renal pathology in such patients has resulted in the emergence of a new clinicopathological entity. We are reporting a retrospective study of renal biopsies using light microscopy (LM) and electron microscopy (EM) from six patients with previous diagnosis of proliferative glomerulonephritis (2 patients), membranous glomerulonephritis (2 patients), nephrosclerosis (1 patient) and end stage kidney (1 patient). These patients were aged between l6 and 51 years, four males and two females. They had initial average 24 hour proteinuria of 1.3 gm (range 0.5-3.4 gm) and blood urea nitrogen of 24 mgm percent (range 12-32 mgm percent).

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