Validation Study of Algorithms to Identify Malignant Tumors and Serious Infections in a Japanese Administrative Healthcare Database

Abstract Background Rises in the incidence of bacterial infections, such as infective endocarditis (IE), have been reported in conjunction with the opioid crisis. However, recent trends for IE and other serious infections among persons with substance use disorders (SUDs) are unknown. Methods Using the Premier Healthcare Database, we identified hospitalizations from 2012 through 2017 among adults with primary discharge diagnoses of bacterial infections and secondary SUD diagnoses, using International Classification of Diseases, Clinical Modification Ninth and Tenth Revision codes. We calculated annual rates of infections with SUD diagnoses and evaluated temporal trends. Blood and cardiac tissue specimens were identified from IE hospitalizations to describe the microbiology distribution and temporal trends among hospitalizations with and without SUDs. Results Among 72 481 weighted IE admissions recorded, SUD diagnoses increased from 19.9% in 2012 to 39.4% in 2017 (P < .0001). Hospitalizations with SUDs increased from 1.1 to 2.1 per 100 000 persons for IE, 1.4 to 2.4 per 100 000 persons for osteomyelitis, 0.5 to 0.9 per 100 000 persons for central nervous system abscesses, and 24.4 to 32.9 per 100 000 persons for skin and soft tissue infections. For adults aged 18–44 years, IE-SUD hospitalizations more than doubled, from 1.6 in 2012 to 3.6 in 2017 per 100 000 persons. Among all IE-SUD hospitalizations, 50.3% had a Staphylococcus aureus infection, compared with 19.4% of IE hospitalizations without SUDs. Conclusions Rates of hospitalization for serious infections among persons with SUDs are increasing, driven primarily by younger age groups. The differences in the microbiology of IE hospitalizations suggest that SUDs are changing the epidemiology of these infections.

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The application of electron microscopy to diagnosis in gynecologic neoplasms and tumor-like conditions

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100110787 ◽

1984 ◽

Vol 42 ◽

pp. 102-105

Author(s):

Lawrence M. Roth

Keyword(s):

Electron Microscopy ◽

Reproductive Tract ◽

Malignant Tumors ◽

Frozen Section ◽

Cost Effective ◽

Female Reproductive Tract ◽

Ultrastructural Examination ◽

Specific Diagnosis ◽

Potential Value ◽

Gynecologic Neoplasms

The female reproductive tract may be the site of a wide variety of benign and malignant tumors, as well as non-neoplastic tumor-like conditions, most of which can be diagnosed by light microscopic examination including special stains and more recently immunoperoxidase techniques. Nevertheless there are situations where ultrastructural examination can contribute substantially to an accurate and specific diagnosis. It is my opinion that electron microscopy can be of greatest benefit and is most cost effective when applied in conjunction with other methodologies. Thus, I have developed an approach which has proved useful for me and may have benefit for others. In cases where it is deemed of potential value, glutaraldehyde-fixed material is obtained at the time of frozen section or otherwise at operation. Coordination with the gynecologic oncologist is required in the latter situation. This material is processed and blocked and is available if a future need arises.

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Ultrastructure of Cryptorchidism and Seminoma

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100099143 ◽

1981 ◽

Vol 39 ◽

pp. 540-541

Author(s):

Shirley Siew ◽

Susan C. James

Keyword(s):

Malignant Tumors ◽

Frozen Section ◽

Malignant Potential ◽

Genetic Influences ◽

Endocrine Gland ◽

Medial Aspect ◽

Left Testis ◽

Bilateral Orchiectomy

Testicular maldescent is the most common endocrine gland abnormality, as 2.7% of mature neonates are cryptorchid. The significant complications are that there is a disturbance of normal maturation which results in diminished fertility and there is an increase in the malignant potential which is 35 times greater in the undescended than the descended testis. It is considered that genetic influences may be of etiological importance and recurrence has been described in some families. It is of interest, that the case reported here has 2 siblings who have also presented with cryptorchidism and malignant tumors.The propositus is 14 years old. He is well developed (described by some as obese) and shows normal secondary male characteristics except for an immature scrotum. Laparotomy showed both testes to be intraabdominal. A hard nodule (0.5cm) was palpated on the medial aspect of the left testis. Frozen section showed the presence of seminoma and bilateral orchiectomy was performed.

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Hepatocyte ultrastructural alterations in perimetastatic areas

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100166300 ◽

1996 ◽

Vol 54 ◽

pp. 768-769

Author(s):

H. J. Finol ◽

M. E. Correa ◽

L.A. Sosa ◽

A. Márquez ◽

N.L. Díaz

Keyword(s):

Malignant Tumor ◽

Malignant Tumors ◽

Surrounding Tissue ◽

Ultrastructural Changes ◽

Pancreas Carcinoma ◽

Duct Carcinoma ◽

Tissue Samples ◽

Primary Malignant Tumor ◽

Transmission Electron ◽

Remote Sites

In classical oncological literature two mechanisms for tissue aggression in patients with cancer have been described. The first is the progressive invasion, infiltration and destruction of tissues surrounding primary malignant tumor or their metastases; the other includes alterations produced in remote sites that are not directly affected by any focus of disease, the so called paraneoplastic phenomenon. The non-invaded tissue which surrounds a primary malignant tumor or its metastases has been usually considered a normal tissue . In this work we describe the ultrastructural changes observed in hepatocytes located next to metastases from diverse malignant tumors.Hepatic biopsies were obtained surgically in patients with different malignant tumors which metatastized in liver. Biopsies included tumor mass, the zone of macroscopic contact between the tumor and the surrounding tissue, and the tissue adjacent to the tumor but outside the macroscopic area of infiltration. The patients (n = 5), 36–75 years old, presented different tumors including rhabdomyosarcoma, leiomyosarcoma, pancreas carcinoma, biliar duct carcinoma and colon carcinoma. Tissue samples were processed with routine techniques for transmission electron microscopy and observed in a Hitachi H-500 electron microscope.

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