The impact of clinically significant discrepancies from primary pathological review of transurethral bladder resection specimens upon repeat review at a tertiary care center.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 4552-4552
Author(s):  
Lamont J. Barlow ◽  
Edan Shapiro ◽  
Jennifer Ahn ◽  
Mitchell C. Benson ◽  
James M. McKiernan
Keyword(s):  
Clinical Care ◽  
Care Center ◽  
Tertiary Care ◽  
Tumor Stage ◽  
Tertiary Care Center ◽  
Urologic Oncology ◽  
Internal Review ◽  
Clinically Significant ◽  
Muscle Invasion ◽  
The Impact

4552 Background: Internal review of outside pathology slides is a common practice among urologic oncologists at tertiary care facilities, and discrepancies have a potential to directly affect the choice of treatment. While repeat prostate biopsy review has been extensively studied, there is little data available on the impact of repeat reviews of bladder biopsies. The purpose of the current study is to perform a standardized comparison of original and internal pathology reviews of identical bladder specimens to characterize the impact of repeat review on treatment decisions. Methods: Using the Columbia Urologic Oncology Database, a retrospective analysis of 91 consecutive patients who underwent bladder resections at outside institutions from 2008-2012 with secondary referral to a single urologist and internal review at our institution was conducted. Characteristics of both original pathology reports and internal reviews were collected and compared by blinded reviewers. A discrepancy in one of the following characteristics was considered treatment-altering: presence of muscularis in specimen or tumor involvement in muscularis. Additional clinically-significant discrepancies including presence of secondary histology, carcinoma in situ, lymphovascular invasion, micropapillary features, tumor stage, and overall accumulative discrepancy rate were also analyzed. Results: Median time from original procedure to internal review was 34 days (range: 9-368). 56/91 (62%) patients had at least one of the predefined clinically-significant discrepancies. 27/91 (30%) patients had at least one treatment-altering discrepancy, including 25 with discrepant muscle in specimen and 11 with discrepant muscle invasion. Regarding tumor stage, 8 patients were upstaged, 71 were unchanged, and 12 were downstaged on internal review. Conclusions: Repeat pathologic review of primary bladder specimens at a tertiary care center has the potential to alter clinical care for the majority of patients. Further studies are needed to determine if these discrepancies and the decisions they influence have a significant impact on patient outcomes.

scholarly journals Impact of Rapid PCR Influenza Testing on the Rate of Inpatient Admissions During Influenza Season at a Tertiary-Care Center

2020 ◽  
Vol 41 (S1) ◽  
pp. s263-s264
Author(s):  
Jordan Polistico ◽  
Avnish Sandhu ◽  
Teena Chopra ◽  
Erin Goldman ◽  
Jennifer LeRose ◽  
...  
Keyword(s):  
Influenza Season ◽  
Care Center ◽  
Tertiary Care ◽  
The United States ◽  
Turnaround Time ◽  
Care Hospital ◽  
Tertiary Care Center ◽  
Pediatric Hospital ◽  
Rapid Pcr ◽  
The Impact

Background: Influenza causes a high burden of disease in the United States, with an estimate of 960,000 hospitalizations in the 2017–2018 flu season. Traditional flu diagnostic polymerase chain reaction (PCR) tests have a longer (24 hours or more) turnaround time that may lead to an increase in unnecessary inpatient admissions during peak influenza season. A new point-of-care rapid PCR assays, Xpert Flu, is an FDA-approved PCR test that has a significant decrease in turnaround time (2 hours). The present study sought to understand the impact of implementing a new Xpert Flu test on the rate of inpatient admissions. Methods: A retrospective study was conducted to compare rates of inpatient admissions in patients tested with traditional flu PCR during the 2017–2018 flu season and the rapid flu PCR during the 2018–2019 flu season in a tertiary-care center in greater Detroit area. The center has 1 pediatric hospital (hospital A) and 3 adult hospitals (hospital B, C, D). Patients with influenza-like illness who presented to all 4 hospitals during 2 consecutive influenza seasons were analyzed. Results: In total, 20,923 patients were tested with either the rapid flu PCR or the traditional flu PCR. Among these, 14,124 patients (67.2%) were discharged from the emergency department and 6,844 (32.7%) were admitted. There was a significant decrease in inpatient admissions in the traditional flu PCR group compared to the rapid flu PCR group across all hospitals (49.56% vs 26.6% respectively; P < .001). As expected, a significant proportion of influenza testing was performed in the pediatric hospital, 10,513 (50.2%). A greater reduction (30% decrease in the rapid flu PCR group compared to the traditional flu PCR group) was observed in inpatient admissions in the pediatric hospital (Table 1) Conclusions: Rapid molecular influenza testing can significantly decrease inpatient admissions in a busy tertiary-care hospital, which can indirectly lead to improved patient quality with easy bed availability and less time spent in a private room with droplet precautions. Last but not the least, this testing method can certainly lead to lower healthcare costs.Funding: NoneDisclosures: None

scholarly journals A retrospective observational study of poisoning and hanging cases during lockdown as a marker of emotional tide of COVID-19 pandemic in a tertiary care center in Northwestern India

2021 ◽  
Vol 8 (9) ◽  
pp. 1354
Author(s):  
Aradhana Singh ◽  
C. L. Nawal ◽  
H. L. Saini ◽  
Khusboo . ◽  
Abhishek Yadav ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Public Health Emergency ◽  
Behavioral Changes ◽  
Tertiary Care Center ◽  
Legal Cases ◽  
Medical College ◽  
Northwestern India ◽  
Organophosphorus Poisoning ◽  
The Impact

Background: In January 2020, WHO declared the outbreak of a new coronavirus disease COVID-19 to be a public health emergency of international concern. Worldwide lockdown led to panic, mass unemployment, poverty and domestic violence. The present study was designed to observe the impact of lockdown on the spectrum of medico-legal cases being admitted with drastic events of poisoning and hanging.Methods:In this retrospective, observational and comparative study, around 131 patients were recruited from the admitted patients in the medicine wards in SMS medical college and hospital during COVID-19 lockdown period from 23 March 2020 to 31 May 2020 after applying inclusion and exclusion criterias. Their clinical profile were noted and comparatively assessed with patients admitted in medicine wards during adjoining pre-lockdown period, that is, from 12 January 2020 to 22 March 2020.Results: Out of 131 cases recruited during lockdown period, hanging cases were 10 (8%) while it was 10 cases out of 213 (5% )during pre-lockdown period. Organophosphorus poisoning was 4.5% and 1.4%, celphos poisoning was 3.8% and 2.3%, rat killer poisoning was 3.05% and 1.4% during lockdown and pre-lockdown period respectively. Cases due to ingestion of other than the major group of poisoning were lower (3.8%) during lockdown period while it was 10.3% during pre-lockdown period.Conclusions:Extreme negative behavioral changes precipitated by corona and this might be aggravated further by complete lockdown, to which people resorted to the means which were easily available to them at home like hanging and common poisonings. 

scholarly journals A Study of the Impact of Lockdown on Vaccination Coverage at a Tertiary Care Center

2020 ◽  
Vol 2 (2) ◽  
pp. 51-54
Author(s):  
Halak Vasavada ◽  
Purvi Patel ◽  
Snehal V Patel ◽  
Khushbu Patel ◽  
Payal Rathva
Keyword(s):  
Vaccination Coverage ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
The Impact

scholarly journals Prevalence of ABO, RhD and other clinically significant Blood Group Antigens among blood donors at tertiary care center, Gwalior

2020 ◽  
Vol 9 (2) ◽  
pp. 437
Author(s):  
Shelendra Sharma ◽  
Dharmesh Chandra Sharma ◽  
Sunita Rai ◽  
Anita Arya ◽  
Reena Jain ◽  
...  
Keyword(s):  
Blood Group ◽  
Blood Donors ◽  
Care Center ◽  
Tertiary Care ◽  
Blood Group Antigens ◽  
Tertiary Care Center ◽  
Clinically Significant

The impact of health insurance status on the stage of cervical cancer diagnosis at a tertiary care center in Massachusetts

2018 ◽  
Vol 150 (1) ◽  
pp. 67-72 ◽  
Author(s):  
Michelle Davis ◽  
Kyle Strickland ◽  
Sarah Rae Easter ◽  
Michael Worley ◽  
Colleen Feltmate ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Health Insurance ◽  
Cancer Diagnosis ◽  
Care Center ◽  
Tertiary Care ◽  
Insurance Status ◽  
Tertiary Care Center ◽  
Health Insurance Status ◽  
The Impact

The impact of a segregated team roster on obstetric and gynecology services in response to the COVID‐19 pandemic in a tertiary care center in India

2020 ◽  
Vol 151 (3) ◽  
pp. 341-346
Author(s):  
Reeta Mahey ◽  
Aparna Sharma ◽  
Archana Kumari ◽  
Garima Kachhawa ◽  
Monica Gupta ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
The Impact

scholarly journals The Impact of Antimicrobial Resistance and Aging in VAP Outcomes: Experience from a Large Tertiary Care Center

PLoS ONE ◽  
2014 ◽  
Vol 9 (2) ◽  
pp. e89984 ◽  
Author(s):  
Marios Arvanitis ◽  
Theodora Anagnostou ◽  
Themistoklis K. Kourkoumpetis ◽  
Panayiotis D. Ziakas ◽  
Athanasios Desalermos ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Large Tertiary Care ◽  
The Impact

The Impact of Two Freestanding Emergency Departments on a Tertiary Care Center

2011 ◽  
Vol 41 (2) ◽  
pp. 215
Author(s):  
E.L. Simon ◽  
P.L. Griffin ◽  
N.J. Jouriles ◽  
E.L. Simon ◽  
N.J. Jouriles
Keyword(s):  
Emergency Departments ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
The Impact
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