scholarly journals Changing Trends in Dermatopathology Case Complexity: A 9-Year Academic Center Experience

2020 ◽  
Author(s):  
Anna M. Stagner ◽  
Steven R. Tahan ◽  
Rosalynn M. Nazarian
Keyword(s):  
Retrospective Review ◽  
Tertiary Care ◽  
Clinical Service ◽  
Case Volume ◽  
Academic Setting ◽  
Case Complexity ◽  
Changing Trends ◽  
Academic Center ◽  
Explanatory Note ◽  
Increasing Trend

Context.— Pathology case volume and complexity impact clinical service burden, staffing, and reimbursement, particularly in an academic setting. Objective.— To investigate dermatopathology case complexity by using indicators of challenging cases, which require increased clinical service effort. Design.— A retrospective review was performed of dermatopathology cases during a 9-year period at a tertiary care academic center. A subset of cases was analyzed for which extractable data were available. Cases requiring the following metrics of complexity were identified: rush processing, consensus agreement, performance of immunohistochemistry, use of special histochemical stains, use of immunofluorescence, examination of additional tissue levels, review of a prior case, addition of an explanatory note, presence of multiple specimen parts, and use of intradepartmental consultation. Results.— A total of 8173 cases were reviewed. During the same 3-month period of the year, there was a statistically significant increase in use of rush processing/interpretation, consensus review, number of cases requiring immunostains, special stains, levels, and an explanatory note, and cases reviewed by other subspecialists in the department from 2010 to 2019. Conclusions.— This study shows an increasing trend in dermatopathology case complexity, suggesting that overall clinical service efforts have increased. These findings may inform clinical service staffing and reimbursement.

Endogenous Bacterial Endophthalmitis: A Five-Year Retrospective Review at a Tertiary Care Academic Center

2019 ◽  
Vol 28 (6) ◽  
pp. 975-983 ◽  
Author(s):  
Thomas L. Jenkins ◽  
Katherine E. Talcott ◽  
Douglas R. Matsunaga ◽  
Martha E. Ryan ◽  
Anthony Obeid ◽  
...  
Keyword(s):  
Retrospective Review ◽  
Tertiary Care ◽  
Bacterial Endophthalmitis ◽  
Academic Center ◽  
Endogenous Bacterial Endophthalmitis

scholarly journals Audit of caesarean deliveries in a tertiary care hospital of northern Andhra Pradesh using modified Robson criteria

2018 ◽  
Vol 7 (7) ◽  
pp. 2796
Author(s):  
Prabhavathi V. ◽  
Krishnamma B. ◽  
Prasad D. K. V. ◽  
Bhavya K. ◽  
Satyavathi R.
Keyword(s):  
Andhra Pradesh ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Care Hospital ◽  
Changing Trends ◽  
Increasing Trend ◽  
Common Group ◽  
Failed Induction ◽  
Group 1

Background: Today, there is an increased trend in the incidence of caesarean section (CS) rate worldwide particularly in India, even with the lack of evidence supporting considerable maternal and perinatal benefits with higher CS rates. The main objective of our study was to find the incidence of CS rate, auditing the data on the basis of modified Robson criteria, factors responsible for the most common group, to know the changing trends of CS and finally put forth the strategies to reduce CS rate.Methods: This is a retrospective study of 472 CS cases carried out in a tertiary care hospital during the year 2016. All the cases were grouped according to the modified Robson criteria and the data was analyzed. The data were grouped into 3 different slots of 4 months each (FF = first four months; MF = middle four months and LF = last four months of the year 2016).Results: A significant increasing trend was observed in the groups of 2B and 5C where as a significant decreasing trend was noticed in 6C and 7C. The most common indications for caesarean delivery were cephalo-pelvic disproportion (CPD) (28%) and fetal distress (22%) in group 1 whereas in group 2A CPD, fetal distress and failed induction were found to be 12%, 24% and 30% respectively.Conclusions: The change in trend has been noticed in the last few months particularly in 2B and 5C groups suggesting that there is a change in the attitude of obstetricians in conducting caesarean deliveries before the onset of labour rather than performing CS after the onset of labour. Targeting 2B along with 5C would help our efforts in reducing the CS rate.

Changing trends in bacteriology of peritonsillar abscess

2007 ◽  
Vol 122 (9) ◽  
pp. 928-930 ◽  
Author(s):  
S B Megalamani ◽  
G Suria ◽  
U Manickam ◽  
D Balasubramanian ◽  
S Jothimahalingam
Keyword(s):  
Tertiary Care ◽  
Peritonsillar Abscess ◽  
Aerobic Bacteria ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Increasing Trend ◽  
Changing Patterns ◽  
Sensitivity Studies ◽  
Resistance To Penicillin ◽  
Empirical Antibiotics

AbstractObjectives:To evaluate the type of aerobic bacteria commonly isolated from peritonsillar abscesses.Study design:A retrospective study involving 60 patients presenting with peritonsillar abscess treated between 2003 and 2006.Setting:The patients were treated in a tertiary care, teaching hospital. The records of the patients were reviewed and analysed.Results:Gram-positive organisms were commonly isolated from the abscesses. However, an increasing trend towards Gram-negative bacterial isolates was noted. The antibiogram showed changing patterns of sensitivity, with a resistance to penicillin.Conclusion:There is an increasing incidence of Gram-negative aerobic bacteria causing peritonsillar abscess. Appropriate antibiotics for Gram-negative bacteria should be included in the regimen if such bacteria are isolated in culture and sensitivity studies.Significance:Empirical antibiotics with Gram-negative cover will be appropriate as adjunctive therapy.

scholarly journals Surgical Pathology Resident Rotation Restructuring at a Tertiary Care Academic Center

2017 ◽  
Vol 4 ◽  
pp. 237428951773634
Author(s):  
Chelsea R. Mehr ◽  
Amrom E. Obstfeld ◽  
Amanda C. Barrett ◽  
Kathleen T. Montone ◽  
Lauren E. Schwartz
Keyword(s):  
Resident Education ◽  
Tertiary Care ◽  
Turnaround Time ◽  
Surgical Pathology ◽  
Primary Sources ◽  
Road Map ◽  
Academic Center ◽  
Organ Systems ◽  
Before And After ◽  
Time Required

Changes in the field of pathology and resident education necessitate ongoing evaluation of residency training. Evolutionary change is particularly important for surgical pathology rotations, which form the core of anatomic pathology training programs. In the past, we organized this rotation based on subjective insight. When faced with the recent need to restructure the rotation, we strove for a more evidence-based process. Our approach involved 2 primary sources of data. We quantified the number of cases and blocks submitted per case type to estimate workload and surveyed residents about the time required to gross specimens in all organ systems. A multidisciplinary committee including faculty, residents, and staff evaluated the results and used the data to model how various changes to the rotation would affect resident workload, turnaround time, and other variables. Finally, we identified rotation structures that equally distributed work and created a point-based system that capped grossing time for residents of different experience. Following implementation, we retrospectively compared turnaround time and duty hour violations before and after these changes and surveyed residents about their experiences with both systems. We evaluated the accuracy of the point-based system by examining grossing times and comparing them to the assigned point values. We found overall improvement in the rotation following the implementation. As there is essentially no literature on the subject of surgical pathology rotation organization, we hope that our experience will provide a road map to improve pathology resident education at other institutions.

scholarly journals Impact of changing trends of treatment on outcome of cerebral gliosarcoma: A tertiary care centre experience

2015 ◽  
Vol 04 (01) ◽  
pp. 015-017 ◽  
Author(s):  
Kumar Narendra ◽  
Tapesh Bhattacharyya ◽  
Chanchalani Karan ◽  
Praveen Shalunke ◽  
B D Radotra ◽  
...  
Keyword(s):  
Overall Survival ◽  
Median Overall Survival ◽  
External Beam Radiotherapy ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
Female Ratio ◽  
Changing Trends ◽  
Common Location ◽  
Male Preponderance ◽  
Radiotherapy Alone

Abstract Aim: To assess clinicopathological features and outcomes in patients of primary gliosarcoma with changing trends of treatment. Materials and Methods: Medical records were reviewed and data collected on primary gliosarcoma over a 5-year period (2009–2013) from the departmental case files. Results: A total 27 patients were included in this study. The median age of presentation was 54 years. There was a slight male preponderance, with male to female ratio of 1.25:1. The most common location of the tumor was temporal lobe (44.4%). Gross total resection was possible in 19 cases, near total excision was done in five cases, and only partial excision with decompression in three cases. Of the 27 patients, 80.8% patients received post-operative radical external beam radiotherapy of 60 Gy/30#/6 weeks. Concurrent and adjuvant temozolomide was used in 42.3% cases, depending on affordability and tolerance. Median overall survival was 9 months. On subgroup analysis, median overall survival in the radiotherapy plus temozolomide group was 10 months as compared to 9 months in the radiotherapy alone group; however, this was not statistically significant.(P = 0.244). Conclusion: Treating Gliosarcoma is a major therapeutic challenge for a clinician because of its poor prognosis, aggressive clinical behavior, rarity, and limited clinical experience. With surgery and concurrent chemoradiation, we were able to achieve a median overall survival of 9 months. Addition of temozolomide has shown a better trend in survival though it is not statistically significant.

scholarly journals Awareness about cigarettes and other tobacco products act and impact of health warnings on smokers in a North Indian city

2019 ◽  
Vol 7 (11) ◽  
pp. 4356
Author(s):  
Riya Gupta ◽  
Mudasir Majeed ◽  
Bhavna Langer ◽  
Rashmi Kumari ◽  
Rajiv Kumar Gupta ◽  
...  
Keyword(s):  
Tobacco Use ◽  
Tertiary Care ◽  
Care Hospital ◽  
Health Warnings ◽  
Outpatient Services ◽  
Tobacco Products ◽  
Medical College ◽  
Pictorial Warnings ◽  
Increasing Trend ◽  
Indian City

Background: Tobacco use is a major preventable cause of morbidity as well as mortality worldwide. To combat the increasing trend of this problem, Government of India formulated the COTPA (Cigarettes and Other Tobacco Products Act) in 2003. The study aimed to assess the awareness about COTPA and impact of pictorial warnings among smokers attending outpatient services in a tertiary care hospital in Jammu.Method: The present study was conducted among 320 patients attending the outpatient department of Internal Medicine, Government Medical College, Jammu who happened to be cigarette smokers. The questionnaire was developed by authors with the help of literature review and pilot tested before its final use. Information was elicited about demographic details, awareness about COTPA and impact of pictorial warnings on quitting of smoking.Results: More than half of the respondents were in 30-50-year age group and were urban residents. Awareness about COTPA was good on some parameters but was relatively low on other parameters. Despite all, the respondents noticing pictorial warnings on tobacco packages, only 69.37% of them were contemplating to quit. About half of them were of the view that warning statements preferably be written in local languages.Conclusion: Health and pictorial warnings on tobacco packages remain an important pillar in filling the gap of knowledge and communicating the health risks of tobacco use to the consumers. Only 69.3% of the respondents were planning to quit and awareness levels about COTPA were mixed. 

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