Answer to Case 413
Answer:Giardia duodenalis,akaG. lamblia, G. intestinalisThis uncommon preparation of a common parasite nicely demonstrates how the morphologic features remain apparent despite the unfamiliar stain. As you can see from the images,Giardiatrophozoites are mostly Gram negative, with visible nuclei and flagella. (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - September 12, 2016 Category: Parasitology Source Type: blogs
Jobs with the Highest Suicide Rates: Farming, Fishing, and Forestry
A recent article addressed suicide rates by occupation (see:Jobs With Highest Suicide Rates Identified). Suicides are a major public health problem in various types of jobs as well as in the military (see:U.S. military suicides remain high for 7th year). Below is an excerpt from the article:Individuals with jobs in farming, fishing, and forestry have the highest suicide rates, followed by those working in construction, according to an analysis by the US Centers for Disease Control and Prevention (CDC). In 2012, suicide was the 10th leading cause of death in the United States, with roughly 40,000 dea...
Source: Lab Soft News - September 9, 2016 Category: Laboratory Medicine Authors: Bruce Friedman Tags: General Healthcare Healthcare Delivery Medical Education Medical Research Preventive Medicine Public Health Informatics Source Type: blogs
Introduction of the Term " Webside " to Refer to Telemedicine Interactions
I am a great fan of telemedicine. There are many kinks that need to be worked out in the deployment of large-scale telemedicine systems. However, this will be the most important response to the need to deliver quality healthcare on a much larger scale. One aspect of this shift in healthcare is the development of a new vocabulary to describe various aspects of patient-provider interactions on the web. A recent article addressed one of these jargon issues (see:At the'webside'):When Kaiser Permanente's emergency room wait times began rising three years ag...
Source: Lab Soft News - September 6, 2016 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Business Healthcare Delivery Healthcare Information Technology Hospital Executive Management Medical Consumerism Medical Education Quality of Care Source Type: blogs
Featured Neuropathologist: Karra A. Jones, MD, PhD
Karra Jones, MD, PhDFrom time to time on Neuropathology Blog, we profile a prominent neuropathologist. In the past, we ' ve featured the likes ofCraig Horbinski,Roger McLendon, andJan Leestma. Today, we feature a rising star in the field: Karra A. Jones, MD, PhD. Having just moved to theUniversity of Iowa fromUCSD, Dr. Jones is poised to do great work at her new institution. Here ' s a short bio followed by a Q&A with the inimitable Dr. Jones:Karra Jones grew up in Kansas City where she completed her M.D. and Ph.D. at the University of Kansas School of Medicine. Karra ’s graduate work focused on the evaluation of mus...
Source: neuropathology blog - September 6, 2016 Category: Radiology Tags: neuropathologists Source Type: blogs
Case of the Week 412
The week ' s case was generously donated by Dr. Audrey Schuetz from Mayo Clinic and Dr. Roy King of Dermatopathology Partners.The patient is a 70 year old woman with a painful lesion on the side of her foot. She also had a similar lesion on the tip of one of her toes. She had recently returned from Brazil, where she had been for 1 month. The lesions appeared approximately 2.5 weeks into her visit and were preceded by pruritus. She reports walking barefoot on the beaches while in Brazil. Below are H&E-stained sections of the curetted lesions:Diagnosis? (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - September 6, 2016 Category: Parasitology Source Type: blogs
Steps to Help Ensure a Successful Surgical Procedure
Here's a scenario for your consideration. Let's hypothesize that you are scheduled for elective surgery shortly. You have sought a second opinion and the surgery has been deemed necessary and appropriate (see:Cleveland Clinic TV Advertisement: Get a Second Opinion in Cardiology). You have made inquiries and your surgeon is well trained and has performed your procedure numerous times with the same team. You are in relatively good health, have a normal weight, and are a non-smoker so you do not anticipate any significant post-operative complications. You have heal...
Source: Lab Soft News - September 4, 2016 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Delivery Hospital Executive Management Medical Consumerism Quality of Care Source Type: blogs
Answer to Case 412
Answer: tungiasis, due to the " chigoe " flea,Tunga penetransArthur V gave us a great description, pointing out the trachae (T), eggs, and striated muscle (M). A portion of the stratum corneum of the epidermis (E) can also be seen. The cuticle of the flea lies right below this.Tunga penetrans female fleas embed in the epidemis where they feed and produce eggs. The posterior of the flea sticks out from the skin, allowing the eggs to be released (if you squeeze the lesion, you may be able to express the eggs). Humans usually become infected by walking barefoot on the beach in tropical and subtropical areas. Therefore, t...
Source: Creepy Dreadful Wonderful Parasites - September 4, 2016 Category: Parasitology Source Type: blogs
Cleveland Clinic TV Advertisement: Get a Second Opinion in Cardiology
I recently viewed a TV commercial for the Cleveland Clinic on MSNBC. One of the major themes of it was: Get a second opinion if you have a diagnosis of a cardiology condition. There is nothing surprising about a tertiary care center like Cleveland Clinic promoting second opinions. I have been a strong advocate for this in selected cases and have blogged about the idea many times (see:Seeking A Second Opinion as a Partial Solution to the DCIS Controversy;Fourteen Ways to Avoid Getting Screwed by the U.S. Healthcare System;Some Tips for Selecting a"...
Source: Lab Soft News - August 30, 2016 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Health Insurance Healthcare Business Healthcare Delivery Medical Consumerism Medical Ethics Quality of Care Source Type: blogs
Why Is It So Hard to Promote Meaningful Changes in EHRs?
A recent article in the JAMA network discussed what the authors termed "evolutionary pressures" being placed on EHRs and provided a critique of some of the shortcomings of these systems in the delivery of healthcare (see:Evolutionary Pressures on the Electronic Health Record). For me, the key quote from the article was the following: Bloated records, devoid of meaning and full of cut-and-paste content, are leading some to call for adopting a “less is more” strategy that prioritizes relevant information.The authors of the article then went on to make the following point:...
Source: Lab Soft News - August 29, 2016 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Electronic Health Record (EHR) Healthcare Delivery Healthcare Information Technology Hospital Executive Management Hospital Finance Pathology Informatics Quality of Care Source Type: blogs
Case of the Week 411
This week ' s case was generously donated by Florida Fan. The patient is a young African adult male. Shown are Giemsa-stained thick and thin blood films.Identification? (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - August 29, 2016 Category: Parasitology Source Type: blogs
Best Post of July 2016 -- The signature feature of sparsely granulated growth hormone pituitary adenoma: the fibrous body
The next in our " Best of the Month " series is from July 19, 2016:The patient is a middle-aged female with subtle signs of acromegaly.Arrows point to the pale balls in this pituitary adenoma which correspond tofibrous bodies on CAM 5.2 immunohistochemistryThe signature feature of sparsely granulated GH adenomas is the finding of widespread, ball-like, cytoplasmic ‘fibrous bodies’ on CAM5.2 in>70% of cells.CAM 5.2 immunohistochemistry (Source: neuropathology blog)
Source: neuropathology blog - August 29, 2016 Category: Radiology Tags: Best of the Month series pituitary Source Type: blogs
Answer to Case 411
Answer: Malaria due to Plasmodium falciparum This case generated a lot of great discussion! As nicely described by Arthur V, there are " multiple infected RBCs containing 1 or more ring forms. " Also, " the RBCs don ' t seem to be enlarged " , " there are no amoeboid ring forms " and " the parasitaemia appears to be moderate judging by the number of ring forms present on the thick smear. " These features, along with the absence of late-stage trophozoites and other intermediate forms are all consistent withP. falciparuminfection. The following annotated images demonstrate some of the characteristic features s...
Source: Creepy Dreadful Wonderful Parasites - August 28, 2016 Category: Parasitology Source Type: blogs
Crooke cells in a touch preparation of a corticotroph pituitary adenoma
(Source: neuropathology blog)
Source: neuropathology blog - August 25, 2016 Category: Radiology Tags: pituitary Source Type: blogs
Capturing Value from Remnant Serum and Tissue Specimens by the Delaware HIE
Health information exchange (HIEs) have been struggling since their inception to stay afloat. At the regional or state level, they serve the function of integrating health information generated for patients across the various providers in an area. One of the major problems that bedevils them is developing a successful financial model. Although their mission is critical and despite the fact that vast amount of money are spent on healthcare in the U.S, clinical data integration is not a high priority for many hospitals. The Delaware HIE has come up with a new source of revenue (see:Delaware HIE Teamin...
Source: Lab Soft News - August 24, 2016 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Electronic Health Record (EHR) Healthcare Business Healthcare Information Technology Medical Education Medical Ethics Medical Research Pharmaceutical Industry Source Type: blogs
Case of the Week 410
This week ' s case is in honor of thethird annual Contact Lens Health Week (August 22-26). Contact lenses were received from a young adult male with bilateral conjunctivitis, photophobia and eye pain. These symptoms began shortly after he had been swimming in a freshwater lake while wearing his contact lenses. The contact lenses were plated for bacterial, mycobacterial, fungal and free-living amebic cultures, and fluid from the contact cases was sent to the cytology lab where it was made into a cell block. Here are photographs from the H&E-stained cell block specimen.Identification? (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - August 22, 2016 Category: Parasitology Source Type: blogs
