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  1. Article ; Online: Mounting a Regional Response to the COVID-19 Pandemic: Another Reason to "Keep" Your Lab.

    Paczos, Tamera A

    Archives of pathology & laboratory medicine

    2020  Volume 144, Issue 11, Page(s) 1321–1324

    Abstract: Context.—: Declining reimbursement shifts hospital laboratories from system assets to cost centers. This has resulted in increased outsourcing of laboratory services, which can jeopardize a hospital systems' ability to respond to a health care crisis.!## ...

    Abstract Context.—: Declining reimbursement shifts hospital laboratories from system assets to cost centers. This has resulted in increased outsourcing of laboratory services, which can jeopardize a hospital systems' ability to respond to a health care crisis.
    Objectives.—: To demonstrate that investment in a core laboratory serving an academic medical center equipped a regional health system to respond to the Coronavirus disease 2019 (COVID-19) pandemic.
    Design.—: COVID-19 diagnostic testing data were analyzed. Volumes were evaluated by result date (March 16, 2020-May 6, 2020), and the average of received-to-verified turnaround time was calculated and compared for in-house and send-out testing, and different in-house testing methodologies.
    Results.—: Daily viral diagnostic testing capacity increased by greater than 3000% (from 21 tests per day to 658 tests per day). Total viral diagnostic testing reported by the core laboratory increased by 128 times during 22 days of test method validation and 826 times during the analysis period, while average turnaround time per day for send-out testing increased from 3.7 days to 21 days. Decreased overall average turnaround time was observed at the core laboratory (0.45 days) versus send-out testing (7.63 days) (P < .001).
    Conclusions.—: Investment in a core laboratory provided the health system with the necessary expertise and resources to mount a robust response to the pandemic. Local access to testing allowed rapid triage of patients and conservation of scarce personal protective equipment (PPE). In addition, the core laboratory was able to support regional health departments and several hospitals outside of the system.
    MeSH term(s) Academic Medical Centers/standards ; Academic Medical Centers/statistics & numerical data ; Betacoronavirus/isolation & purification ; Betacoronavirus/physiology ; COVID-19 ; COVID-19 Testing ; Clinical Laboratory Services/standards ; Clinical Laboratory Services/statistics & numerical data ; Clinical Laboratory Techniques/methods ; Coronavirus Infections/diagnosis ; Coronavirus Infections/prevention & control ; Coronavirus Infections/virology ; Delivery of Health Care/standards ; Delivery of Health Care/statistics & numerical data ; Humans ; Laboratories, Hospital ; Pandemics/prevention & control ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/prevention & control ; Pneumonia, Viral/virology ; Reproducibility of Results ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-07-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 194119-7
    ISSN 1543-2165 ; 0363-0153 ; 0096-8528 ; 0003-9985
    ISSN (online) 1543-2165
    ISSN 0363-0153 ; 0096-8528 ; 0003-9985
    DOI 10.5858/arpa.2020-0397-SA
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Mounting a Regional Response to the COVID-19 Pandemic: Another Reason to "Keep" Your Lab

    Paczos, Tamera A

    Arch Pathol Lab Med

    Abstract: CONTEXT.­: Declining reimbursement shifts hospital laboratories from system assets to cost centers. This has resulted in increased outsourcing of laboratory services, which can jeopardize a hospital systems' ability to respond to a health care crisis. ... ...

    Abstract CONTEXT.­: Declining reimbursement shifts hospital laboratories from system assets to cost centers. This has resulted in increased outsourcing of laboratory services, which can jeopardize a hospital systems' ability to respond to a health care crisis. OBJECTIVES.­: To demonstrate that investment in a core laboratory serving an academic medical center equipped a regional health system to respond to the Coronavirus disease 2019 (COVID-19) pandemic. DESIGN.­: COVID-19 diagnostic testing data were analyzed. Volumes were evaluated by result date (March 16, 2020-May 6, 2020), and the average of received-to-verified turnaround time was calculated and compared for in-house and send-out testing, and different in-house testing methodologies. RESULTS.­: Daily viral diagnostic testing capacity increased by greater than 3000% (from 21 tests per day to 658 tests per day). Total viral diagnostic testing reported by the core laboratory increased by 128 times during 22 days of test method validation and 826 times during the analysis period, while average turnaround time per day for send-out testing increased from 3.7 days to 21 days. Decreased overall average turnaround time was observed at the core laboratory (0.45 days) versus send-out testing (7.63 days) (P < .001). CONCLUSIONS.­: Investment in a core laboratory provided the health system with the necessary expertise and resources to mount a robust response to the pandemic. Local access to testing allowed rapid triage of patients and conservation of scarce personal protective equipment (PPE). In addition, the core laboratory was able to support regional health departments and several hospitals outside of the system.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #639712
    Database COVID19

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  3. Article ; Online: Acantholytic Squamous Cell Carcinoma Arising From Lichen Sclerosus: A Rare Case Affecting Vulvar Skin.

    Barron, Cynthia R / Paczos, Tamera A / Varghese, Sharlin / Smoller, Bruce R

    International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists

    2021  Volume 41, Issue 2, Page(s) 122–125

    Abstract: We present the case of an 82-year-old female with acantholytic squamous cell carcinoma affecting vulvar skin. The patient had a history of perineal lichen sclerosus for 5 years before presentation. She was referred to a dermatologist for intractable ... ...

    Abstract We present the case of an 82-year-old female with acantholytic squamous cell carcinoma affecting vulvar skin. The patient had a history of perineal lichen sclerosus for 5 years before presentation. She was referred to a dermatologist for intractable severe pain associated with the lesions. Biopsies showed an infiltrative squamous cell carcinoma with histology consistent with the acantholytic subtype. Acantholytic squamous cell carcinoma is a rare histologic variant characterized by dyscohesive keratinocytes with pseudoglandular formation and dyskeratosis. It is associated with sun-damaged skin and most commonly occurs in the head and neck of elderly men. Few cases have been reported at nondermal sites and non-sun-exposed dermis. The patient underwent a radical vulvectomy and bilateral inguinal node dissection. The 1.6 cm tumor was diffusely acantholytic and pseudoglands were present. The tumor cells were diffusely positive for p63 immunohistochemical stain. As expected at this site, there was no solar elastosis identified histologically. However, vulvar intraepithelial neoplasia and chronic lichen sclerosus were apparent. This case represents a rare histologic subtype of squamous cell carcinoma in an unusual site associated with lichen sclerosus instead of solar elastosis.
    MeSH term(s) Aged ; Aged, 80 and over ; Carcinoma in Situ/pathology ; Carcinoma, Squamous Cell/complications ; Carcinoma, Squamous Cell/pathology ; Female ; Humans ; Lichen Sclerosus et Atrophicus/complications ; Male ; Vulva/pathology ; Vulvar Lichen Sclerosus/complications ; Vulvar Lichen Sclerosus/pathology ; Vulvar Neoplasms/complications ; Vulvar Neoplasms/pathology
    Language English
    Publishing date 2021-05-13
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 604859-6
    ISSN 1538-7151 ; 0277-1691
    ISSN (online) 1538-7151
    ISSN 0277-1691
    DOI 10.1097/PGP.0000000000000794
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1814: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)

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  4. Article ; Online: Near-Histologic Resolution Images of Cervical Dysplasia Obtained With Gabor Domain Optical Coherence Microscopy.

    Paczos, Tamera / Bonham, Adrienne / Canavesi, Cristina / Rolland, Jannick P / O'Connell, Rachel

    Journal of lower genital tract disease

    2021  Volume 25, Issue 2, Page(s) 137–141

    Abstract: Objective: Histopathology is the criterion standard for evaluating cervical squamous intraepithelial neoplasia (dysplasia). In this pilot feasibility study, we examined whether a novel 3-dimensional imaging device using Gabor-domain optical coherence ... ...

    Abstract Objective: Histopathology is the criterion standard for evaluating cervical squamous intraepithelial neoplasia (dysplasia). In this pilot feasibility study, we examined whether a novel 3-dimensional imaging device using Gabor-domain optical coherence microscopy (GDOCM) could distinguish features of cervical dysplasia comparable with histopathology.
    Methods: A prospective observational pilot study enrolled a small sample of women undergoing loop electrosurgical excision procedure for cervical squamous intraepithelial neoplasia. Fresh ex vivo specimens were imaged with the GDOCM device. Digital images were reviewed by a pathologist who was blinded to the histopathology results. Histopathologic features were then compared with the digital observations.
    Results: Standard histologic features of cervical squamous epithelium and of squamous intraepithelial neoplasia could be observed in GDOCM images. Cervical epithelium, stroma, basement membrane, and squamous papilla could all be identified. Human papillomavirus effects, such as vacuolization and cellular density, were also observed.
    Conclusions: A GDOCM imaging system has the potential to obtain histologic resolution images of the cervix in the evaluation of squamous intraepithelial neoplasia. This pilot study allowed for optimizing the imaging system and paved the way for a future diagnostic accuracy study. The development of this technology could streamline the evaluation of patients at risk for cervical neoplasia.
    MeSH term(s) Adult ; Female ; Humans ; Microscopy/methods ; Middle Aged ; Neoplasm Staging ; New York ; Pilot Projects ; Prospective Studies ; Squamous Intraepithelial Lesions of the Cervix/pathology ; Uterine Cervical Neoplasms/pathology ; Uterine Cervical Dysplasia/pathology
    Language English
    Publishing date 2021-02-09
    Publishing country United States
    Document type Journal Article ; Observational Study
    ZDB-ID 2041332-4
    ISSN 1526-0976 ; 1089-2591
    ISSN (online) 1526-0976
    ISSN 1089-2591
    DOI 10.1097/LGT.0000000000000590
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 5466: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
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  5. Article ; Online: Incidental finding of placental choriocarcinoma after an uncomplicated term pregnancy: a case report with review of the literature.

    Ganapathi, Karthik A / Paczos, Tamera / George, Mary D / Goodloe, Samuel / Balos, Lucia L / Chen, Frank

    International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists

    2010  Volume 29, Issue 5, Page(s) 476–478

    Abstract: Choriocarcinoma is frequently preceded by a complete mole, ectopic pregnancy, nonmolar intrauterine abortion, and uncommonly by a partial mole. Choriocarcinoma coexisting with or after an otherwise "normal" pregnancy is extremely rare, with an estimated ... ...

    Abstract Choriocarcinoma is frequently preceded by a complete mole, ectopic pregnancy, nonmolar intrauterine abortion, and uncommonly by a partial mole. Choriocarcinoma coexisting with or after an otherwise "normal" pregnancy is extremely rare, with an estimated occurrence of 1 per 160,000 pregnancies. We here report a case of a placental choriocarcinoma with no metastases in a full-term intrauterine pregnancy. The patient is a 29-year-old gravida 2 para 1 female, who had an uncomplicated full-term vaginal delivery of a healthy 3030 g female infant. Her current pregnancy was uneventful, and past medical history was significant for an elective termination of pregnancy 2 years ago at 8 weeks of gestation. Routine examination of the placenta showed a gray-tan nodule, measuring 2 cm in the largest dimension, with a papillary cut surface. Microscopically, this nodule was composed of highly atypical cytotrophoblastic cells and multinucleated atypical syncytiotrophoblastic cells, which were positive for beta-human chorionic gonadotrophin by immunostaining. Extensive necrosis and multiple foci of hemorrhage were present. The overall morphologic and immunohistochemical features were diagnostic for choriocarcinoma. Further investigations, including a full body computed tomography scan, showed no lesions suspicious for metastases. The patient is currently asymptomatic and being followed-up with monthly beta-human chorionic gonadotrophin levels, the most recent one being negative. By reporting this case and reviewing the literature, we support the opinion of a recent similar case report that the incidence of placental choriocarcinoma may actually be higher than expected, as placental examination after a normal spontaneous delivery is not routinely performed at most of the institutions.
    MeSH term(s) Adult ; Choriocarcinoma/metabolism ; Choriocarcinoma/pathology ; Female ; Humans ; Immunohistochemistry ; Incidental Findings ; Pregnancy ; Term Birth ; Uterine Neoplasms/metabolism ; Uterine Neoplasms/pathology
    Language English
    Publishing date 2010-09
    Publishing country United States
    Document type Case Reports ; Journal Article ; Review
    ZDB-ID 604859-6
    ISSN 1538-7151 ; 0277-1691
    ISSN (online) 1538-7151
    ISSN 0277-1691
    DOI 10.1097/PGP.0b013e3181d81cc2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1814: Show issues Location:
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  6. Article ; Online: Primary vaginal adenocarcinoma arising in vaginal adenosis after CO2 laser vaporization and 5-fluorouracil therapy.

    Paczos, Tamera A / Ackers, Stacey / Odunsi, Kunle / Lele, Shashikant / Mhawech-Fauceglia, Paulette

    International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists

    2010  Volume 29, Issue 2, Page(s) 193–196

    Abstract: We present a case of a 45-year-old woman with a long-standing history of persistent cervical dysplasia that resulted in a hysterectomy. Subsequent vaginal smears revealed high-grade vaginal intraepithelial neoplasia (VAIN III) on Pap smear with positive ... ...

    Abstract We present a case of a 45-year-old woman with a long-standing history of persistent cervical dysplasia that resulted in a hysterectomy. Subsequent vaginal smears revealed high-grade vaginal intraepithelial neoplasia (VAIN III) on Pap smear with positive human papilloma virus (HPV) testing. Over the course of 2 years, the patient underwent 2 CO(2) laser vaporization procedures of the upper vagina and intermittent 5-fluorouracil therapy. A biopsy performed at the time of the second laser procedure revealed endocervical-type well-differentiated adenocarcinoma, associated with VAIN III. HPV in situ hybridization for HPV types 16 and 18 was positive in both the glandular and squamous mucosa. The patient has no known history of intrauterine diethylstilbestrol exposure or mullerian developmental abnormalities. Subsequently, the patient underwent a radical upper vaginetcomy with bilateral pelvic lymph nodes dissection and bilateral salpingo-oophorectomy. The vaginectomy specimen showed residual adenocarcinoma associated with VAIN-III and extensive vaginal adenosis with free resection margins. This is the second reported case in the literature of adenocarcinoma arising in vaginal adenosis after 5-fluorouracil. Herein, we highlight these important findings and shed some light on the pathogenesis of vaginal adenosis and the subsequent development of vaginal adenocarcinoma.
    MeSH term(s) Adenocarcinoma/pathology ; Adenocarcinoma/therapy ; Adenocarcinoma/virology ; Biopsy ; Carcinoma in Situ/therapy ; DNA, Viral/chemistry ; DNA, Viral/genetics ; Female ; Fluorouracil/administration & dosage ; Fluorouracil/adverse effects ; Histocytochemistry ; Human papillomavirus 16/genetics ; Human papillomavirus 18/genetics ; Humans ; In Situ Hybridization ; Laser Therapy/adverse effects ; Laser Therapy/methods ; Middle Aged ; Papillomavirus Infections/pathology ; Papillomavirus Infections/virology ; Vaginal Neoplasms/pathology ; Vaginal Neoplasms/therapy ; Vaginal Neoplasms/virology
    Chemical Substances DNA, Viral ; Fluorouracil (U3P01618RT)
    Language English
    Publishing date 2010-02-23
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 604859-6
    ISSN 1538-7151 ; 0277-1691
    ISSN (online) 1538-7151
    ISSN 0277-1691
    DOI 10.1097/PGP.0b013e3181b6a7d7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

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