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Bartonella quintana is a small, facultatively intracellular, gram-negative bacillus that is transmitted to humans through the feces of an infected human body louse (Pediculus humanus corporis) (1). B. quintana infection [...]

Human papillomavirus (HPV) infection, the most common sexually transmitted disease (STD) in North America, records some ~5.5x10 (6) cases per year in the United States. Overall prevalence of HPV infection [...], Human papillomavirus (HPV), the most prevalent sexually transmitted disease (STD), continues to pose a significant public health problem especially among the adolescent population. Most precancerous and cancerous cervical changes are associated with HPV. with adolescent women being biologically at highest risk for acquiring HPV. This survey examined the type of information taught to adolescents about HPV, and specific' needs for effective HPV education in middle and high schools in Vermont. The survey addressed knowledge level, behavior, attitudes, enabling factors, motivators, and barriers. Data were analyzed by descriptive statistics and supplemented with contingency table analyses. Replies (n = 108) were received from 79 schools, with 60% of responses from nurses and 40%from teachers. In five of eight questions addressing basic knowledge of HPV, less than 60% of respondents gave the correct answer. Most (73%)felt it was important to teach about HPV relative to HIV/AIDS, but spent less classroom time teaching it. Main motivations for teaching about HPV were its importance, and a desire to increase student knowledge and prevention skills. Main barriers perceived were lack of time and materials and curricula, and need for more knowledge about HPV. The most prominent needs indicated included brochures for students, an increase in the educators' knowledge base, and a high school curriculum. Health educators in Vermont schools recognize the importance of teaching adolescents about HPV, but they lack basic knowledge and resources for teaching about HPV.

The College of American Pathologists offers these protocols to assist pathologists in providing clinically useful and relevant information when reporting results of surgical specimen examinations of surgical specimens. The College [...]

This article focuses on the use of immunohistochemistry (IHC) in the differential diagnosis of a relatively common diagnostic scenario, the 'histologically undifferentiated, pleomorphic spindle cell tumor involving the skin.' Applications [...], Context.--Pleomorphic cutaneous spindle cell tumors can be difficult to distinguish solely on histologic grounds. The use of ancillary immunohistochemical studies can greatly assist in this differential diagnosis. Objective.--To review histologic and immunohistochemical aspects of cutaneous spindle cell tumors and discuss a basic panel of markers to assist in the differential diagnosis. Data Sources.--English-language literature published between 1981 and 2005. Conclusions.--A basic immunohistochemistry panel for high-molecular-weight cytokeratin, melanocytic markers (S100 protein, HMB-45, Melan-A), smooth muscle actin, desmin, and endothelial markers (CD31, CD34) is effective in diagnosing most cutaneous spindle cell tumors.

Consultations in surgical pathology are a routine exercise in most laboratories. In 1993, the Association of Directors of Anatomic and Surgical Pathology published recommendations to help optimize the consultation process. [...]

Cervical lesion grading is critical for effective patient management. A three-tier classification (cervical intraepithelial neoplasia [CIN] grade 1, 2 or 3) based on H&E slide review is widely used. However, for reasons of considerable inter-observer variation in CIN grade assignment and for want of a biomarker validating a three-fold stratification, CAP-ASCCP LAST consensus guidelines recommend a two-tier system: low- or high-grade squamous intraepithelial lesions (LSIL or HSIL). In this study, high-risk HPV E6/E7 and p16 mRNA expression patterns in eighty-six CIN lesions were investigated by RNAscope chromogenic in situ hybridization (CISH). Specimens were also screened by immunohistochemistry for p16INK4a (clone E6H4), and by tyramide-based CISH for HPV DNA. HPV genotyping was performed by GP5+/6+ PCR combined with cycle-sequencing. Abundant high-risk HPV RNA CISH signals were detected in 26/32 (81.3%) CIN 1, 22/22 (100%) CIN 2 and in 32/32 (100%) CIN 3 lesions. CIN 1 staining patterns were typified (67.7% specimens) by abundant diffusely staining nuclei in the upper epithelial layers; CIN 2 lesions mostly (66.7%) showed a combination of superficial diffuse-stained nuclei and multiple dot-like nuclear and cytoplasmic signals throughout the epithelium; CIN 3 lesions were characterized (87.5%) by multiple dot-like nuclear and cytoplasmic signals throughout the epithelial thickness and absence/scarcity of diffusely staining nuclei (trend across CIN grades: P<0.0001). These data are consistent with productive phase HPV infections exemplifying CIN 1, transformative phase infections CIN 3, whereas CIN 2 shows both productive and transformative phase elements. Three-tier data correlation was not found for the other assays examined. The dual discernment of diffuse and/or dot-like signals together with the assay’s high sensitivity for HPV support the use of HPV E6/E7 RNA CISH as an adjunct test for deciding lesion grade when CIN 2 grading may be beneficial (e.g. among young women) or when ‘LSIL vs. HSIL’ assignment is equivocal. [ABSTRACT FROM AUTHOR]

The article offers protocols developed by the College of American Pathologists that will help pathologists in reporting clinically useful and relevant information about surgical specimen examinations of patients with carcinoma of the distal extrahepatic bile ducts. Elements of the protocols were presented in "Surgical Pathology Cancer Case Summary" that are essentials to pathologic reporting. Discussions of disease histologic evaluation, classification, and pathologic staging are also presented.

ABSTRACT: Human papillomavirus (HPV), the most prevalent sexually transmitted disease (STD), continues to pose a significant public health problem especially among the adolescent population. Most precancerous and cancerous cervical changes are associated with HPV, with adolescent women being biologically at highest risk for acquiring HPV. This survey examined the t ype of information taught to adolescents about HPV, and specific needs for effective HPV education in middle and high schools in Vermont. The survey addressed knowledge level, behavior, attitudes, enabling factors, motivators, and barriers. Data were ana lyzed by descriptive statistics and supplemented with contingency table analyses. Replies (n = 108) were received from 79 schools, with 60% of responses from nurses and 40% from teachers. In five of eight questions addressing basic knowledge of HPV, less than 60% of respondents gave the correct answer. Most (73%) felt it was important to teach about HPV relative to HIV/AIDS, but spent less classroom time teaching it. Main motivations for teaching about HPV were its importance, and a desire to increase student knowledge and prevention skills. Main barriers perceived were lack of time and materials and curricula, and need for more knowledge about HPV. The most prominent needs indicated included brochures for students, an increase in the educators' knowledge base, and a high school curriculum. Health educators in Vermont schools recognize the importance of teaching adolescents about HPV, but they lack basic knowledge and resources for teaching about HPV. (J Sch Health. 2003;73(7):253-257) [ABSTRACT FROM AUTHOR]

Aim: Breast cancer is biologically a heterogeneous disease. Patients with the same diagnostic profile have markedly different clinical outcomes. Gene expression studies identified distinct breast cancer subtypes that differ in prognosis. Aim is to identify the immunohistochemical subtypes of breast carcinoma and correlate the results with pathological features associated with adverse prognosis in our study population., Method: We included 107 consecutive cases of invasive breast carcinoma and sub classified using immunohistochemical staining for ER, PR, Her2, and CK5/6 into the following subtypes: luminal A, luminal B, basal-like, Her2(+) and unclassified. Associations between tumor subtypes and tumor characteristics were examined., Results: The proportion of each subtype in our patient population was: luminal A 37.4%, luminal B 11.1%, Her2(+) 29% and basal-like 7.5%. The following variables were significantly associated with IHC breast cancer subtypes: patient age (p<0.05), overall histopathology grade (p<0.001), nuclear grade (p<0.005) and mitotic index (p<0.001). Her2(+) and basal like subtypes were associated with poor differentiation (p<0.01), higher nuclear grade (p<0.05) and high mitotic index (p<0.05)., Conclusions: Our data show a higher proportion of patients in the study population undergo total mastectomy and harbor poorly differentiated, node positive tumors than reported. There was also a relatively high percentage of the Her2(+) subtype (29%).