pitfalls

陷阱
  • 文章类型: Journal Article
    公布过去对无脊椎动物种群的实地研究数据非常重要,因为它们被用作研究这些群体的时空人口和社区动态的基线有很大的附加值。因此,一个由1996年收集的表观无脊椎动物发生数据组成的数据集被标准化为达尔文核心格式,并进行交叉检查,以便按照FAIR数据原则公开提供。随着出版物,它可以有助于陆地无脊椎动物的生物多样性评估,从而提高宏无脊椎动物急需的历史数据集的可用性和可访问性。这里,我们提供了几十年来从农业生产中撤出的四个草原的无脊椎动物的采样事件数据,有效地显示了农业扩张效果的时间序列。数据是通过使用金字塔陷阱的标准化采样设计收集的,陷阱和土壤样本。
    本数据文件中提供的原始数据之前尚未发布。它们由来自121个分类组的近70,000个样本的20,000个记录组成。使用标准化的现场研究设置收集数据,并由分类学专家鉴定标本。大多数群体都是在家庭层面确定的,确定了八个物种级别。发生数据由植物组成信息补充,气象数据和土壤物理特征。该数据集已在全球生物多样性信息设施(GBIF)中注册:http://doi.org/10.15468/7n499e。
    UNASSIGNED: Publication of data from past field studies on invertebrate populations is of high importance, as there is much added value for them to be used as baselines to study spatiotemporal population and community dynamics in these groups. Therefore, a dataset consisting of occurrence data on epigaeic invertebrates collected in 1996 was standardised into the Darwin core format and cross-checked in order to make it publicly available following FAIR data principles. With publication, it can contribute to the biodiversity assessment of terrestrial invertebrates, thereby improving the availability and accessibility of much-needed historical datasets on macro-invertebrates.Here, we present sampling event data on invertebrates from four grasslands taken out of agricultural production over the span of several decades, effectively displaying a chronosequence on the effects of agricultural extensification. The data were collected by means of a standardised sampling design using pyramid traps, pitfall traps and soil samples.
    UNASSIGNED: The raw data presented in this data paper have not been published before. They consist of 20,000+ records of nearly 70,000 specimens from 121 taxonomic groups. The data were collected using a standardised field study set-up and specimens were identified by taxonomic specialists. Most groups were identified up to family level, with eight groups identified up to species level. The occurrence data are complemented by information on plant composition, meteorological data and soil physical characteristics. The dataset has been registered in the Global Biodiversity Information Facility (GBIF): http://doi.org/10.15468/7n499e.
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  • 文章类型: Journal Article
    背景:巴氏试验中的陷阱可以定义为假阳性,假阴性或未诊断的结果,可能导致不必要的诊断程序或延迟和不充分的治疗。这可能是对本文描述的某些形态实体的误解的结果。
    结论:本文概述了常见缺陷来源的形态特征和外观,例如萎缩,修复,宫内节育器更换,输卵管化生,超色拥挤的群体,辐射变化。诸如Arias-Stella变化之类的陷阱的罕见原因,天疱疮,肿瘤素质本身,罕见类型的宫颈癌,包括疣状和乳头状鳞状细胞癌,还描述了胃型和子宫内膜样腺癌。
    结论:意识到宫颈细胞学的缺陷对于细胞病理学家和临床医生来说是重要的,以避免将来的错误。对错误诊断的巴氏试验的审查对于细胞学实验室的质量控制很重要,必须将其视为教育和经验建设程序。细胞病理学家不应该在重大诊断中退缩,尤其是在HPV阴性病例中。
    BACKGROUND: Pitfalls in Pap test could be defined as false positive, false negative, or underdiagnosed results which can lead to unnecessary diagnostic procedures or delayed and inadequate treatment. It can be a consequence of misinterpretation of certain morphological entities which are described in this paper.
    CONCLUSIONS: The paper presents an overview of the morphological features and look-alikes of the common sources of pitfalls such as atrophy, repair, intrauterine device change, tubal metaplasia, hyperchromatic crowded groups, and radiation changes. Rare causes of pitfalls such as Arias-Stella changes, pemphigus, tumor diathesis per se, rare types of cervical cancer, including verrucous and papillary squamous cell cancer, gastric type, and endometrioid adenocarcinoma are also described.
    CONCLUSIONS: The awareness of pitfalls in cervical cytology is important for cytopathologists and clinicians to avoid future errors. Review of Pap tests with erroneous diagnosis is important for quality control in cytology laboratory, and it must be considered an educational- and experience-building procedure. Cytopathologist should not pull back in significant diagnoses, especially in human papillomavirus-negative cases.
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  • 文章类型: Editorial
    暂无摘要。
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  • 文章类型: Journal Article
    嗜铬细胞瘤和副神经节瘤(PPGL),由嗜铬细胞引起的罕见神经内分泌肿瘤,由于其临床稀有性和多态症状学,因此提出了重大的诊断挑战。临床病例证明了结合临床评估的综合方法的重要性,生化检测,和成像来区分PPGL和模仿条件,如阻塞性睡眠呼吸暂停和干扰药物效应,这可能导致假阳性的生化结果。虽然是罕见的情况,嗜铬细胞瘤中可能出现假阴性的间肾上腺素水平,但是影像学检查结果可以提供一些线索,并增加对嗜铬细胞瘤诊断的怀疑。此专家内分泌咨询强调了评估分析前条件和预测试概率在PPGL的生化诊断中的关键作用。此外,仔细区分PPGL与相似条件,仔细选择和解释诊断测试,专注于理解和减少假阳性,以提高诊断准确性和患者预后,至关重要。
    Pheochromocytomas and paragangliomas (PPGLs), rare neuroendocrine tumors arising from chromaffin cells, present a significant diagnostic challenge due to their clinical rarity and polymorphic symptomatology. The clinical cases demonstrate the importance of an integrated approach that combines clinical assessment, biochemical testing, and imaging to distinguish PPGLs from mimicking conditions, such as obstructive sleep apnea and interfering medication effects, which can lead to false-positive biochemical results. Although a rare condition, false-negative metanephrine levels can occur in pheochromocytomas, but imaging findings can give some clues and increase suspicion for a pheochromocytoma diagnosis. This expert endocrine consult underscores the critical role of evaluating preanalytical conditions and pretest probability in the biochemical diagnosis of PPGLs. Moreover, a careful differentiation of PPGLs from similar conditions and careful selection and interpretation of diagnostic tests, with focus on understanding and reducing false positives to enhance diagnostic accuracy and patient outcomes, is crucial.
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  • 文章类型: Journal Article
    纵隔肿块手术患者的围手术期管理在多个临床专业中提出了持续的挑战。全身麻醉管理进一步增加围手术期心肺代偿失调的风险。跨学科团队在确保安全的围手术期方面发挥着至关重要的作用。然而,由于纵隔肿块综合征的稀有性和变异性,缺乏具体的管理协议。这篇综述旨在概述纵隔肿块综合征患者围手术期管理过程中遇到的众多挑战和陷阱。我们描述了诊断评估,术前优化,术中注意事项,和术后护理策略,强调多学科方法和个性化治疗计划的首要意义。术前多学科讨论,细致的麻醉管理,和完善的协议的紧急情况是关键,以确保患者的安全。参与纵隔肿块综合征患者护理的医疗保健提供者必须抓住这些挑战和陷阱,使他们能够提供安全有效的围手术期管理。
    The perioperative management of patients undergoing mediastinal mass operations presents a persistent challenge across multiple clinical specialties. General anesthesia administration further increases the risk of perioperative cardiorespiratory decompensation. The interdisciplinary team plays a crucial role in ensuring a safe perioperative period. However, due to the rarity and variability of mediastinal mass syndromes, specific management protocols are lacking. This review aims to outline the multitude of challenges and pitfalls encountered during perioperative management in patients with the mediastinal mass syndrome. We describe diagnostic evaluation, preoperative optimization, intraoperative considerations, and postoperative care strategies, emphasizing the paramount significance of a multidisciplinary approach and personalized treatment plans. Preoperative multidisciplinary discussions, meticulous anesthetic management, and well-established protocols for emergency situations are pivotal to ensuring patient safety. Healthcare providers involved in the care of patients with mediastinal mass syndrome must grasp these challenges and pitfalls, enabling them to deliver safe and effective perioperative management.
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  • 文章类型: Journal Article
    背景细胞病理学是呼吸系统疾病的调查和诊断不可或缺的,在过去的十年左右,通过支气管内超声进行经支气管针吸活检,可以在一次手术中对恶性胸部肿瘤进行诊断和分期。此外,介入团队越来越多地包括细胞病理学家和细胞技师,通过提供快速的现场评估,确保胸腔内目标的有效采样,以准确诊断为最终目标,并为全面的预测性测试提供足够的材料。尽管如此,“传统”细胞学检查,如支气管冲洗,仍在进行刷洗和灌洗,以调查可疑的肿瘤和非肿瘤条件,所有这些程序仍然产生标本,其中的良性细胞模仿恶性肿瘤,而真正的肿瘤细胞静静地潜伏在背景中。此外,即使没有怀疑肿瘤,准备和解释中的问题可能会导致最终评估不准确,因此,临床上无益,或误导。在本概述中,我们试图采用一种格式,部分模拟从临床采集到实验室终点的标本,从而在沟通中潜在的陷阱,临床相互作用,运输,和基于临床的制备以及形态学,免疫细胞化学和预测性测试的适用性。它不是详尽的,但突出了可能经常遇到的领域,或者是我们个人经验的一部分。摘要该帐户强调了从采集到报告的关键阶段呼吸道细胞病理学中的潜在陷阱,并以流程图和表格形式介绍了这些陷阱。我们希望这对于细胞技师和细胞病理学家日益合作的角色以及他们在临床研究团队中的更广泛参与是有用的。关键信息正确的临床和放射学信息至关重要,并促进细胞病理学标本的正确获取和处理。跨学科协作工作确保最有效地使用标本,使诊断,并对最佳材料进行预测测试,减少误解的可能性。尽管如此,即使使用最佳材料,形态学模拟和非典型抗原表达可能会误导并使准确诊断具有挑战性。
    BACKGROUND: Cytopathology is integral to the investigation and diagnosis of respiratory disease, and, in the last decade or so, transbronchial needle aspiration by endobronchial ultrasound has made possible diagnosis and staging of malignant thoracic tumours at a single procedure. In addition, interventional teams increasingly include cytopathologists and cytotechnologists who, by providing rapid onsite evaluation, ensure efficient sampling of intrathoracic targets with the ultimate goal of accurate diagnosis as well as sufficient material for comprehensive predictive testing. Nonetheless, \"traditional\" cytological investigations such as bronchial washings, brushings, and lavages are still carried out for investigation of both suspected neoplastic and non-neoplastic conditions, and all these procedures still produce specimens in which florid benign cells mimic malignancy, while truly neoplastic cells lurk quietly in the background. Furthermore, even when neoplasia is not suspected, issues in preparation and interpretation may render a final assessment inaccurate and, therefore, clinically unhelpful or misleading. In this overview, we have tried to adopt a format partly modelled on the passage of a specimen from clinical acquisition to laboratory endpoint, thus taking in potential pitfalls in communication, clinical interaction, transport, and clinic-based preparation, as well as in morphology, immunocytochemistry, and suitability for predictive testing. It is not exhaustive but highlights areas that may frequently be encountered or are part of our personal experience.
    CONCLUSIONS: The account highlights potential pitfalls in respiratory cytopathology at key stages of the process from acquisition to reporting and presents these in both flow diagram and tabular form. We hope this is useful for the increasingly collaborative roles of cytotechnologist and cytopathologist and their wider involvement in the clinical investigative teams.
    CONCLUSIONS: Correct clinical and radiological information is crucially important and promotes the correct acquisition and processing of cytopathological specimens. Cross-discipline collaborative working ensures the most efficient use of the specimen such that diagnoses and predictive tests are performed on optimal material, reducing the potential for misinterpretation. Nonetheless, even with optimal material, morphological mimics and atypical antigen expression may mislead and render accurate diagnosis challenging.
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  • 文章类型: Journal Article
    各种各样的实验室设备和分析的自动化产生了大量可用于研究目的的实验室数据。因此,支持研究人员变得越来越重要,特别是那些没有或有限的实验室背景,识别和处理与使用这些数据相关的潜在偏见和陷阱。本评论回顾了从登记册中提取和分析常规生化实验室生成数据的研究人员的五个主要考虑因素,为了提高质量,准确度,以及未来研究的透明度。1.为什么生化实验室数据与检验假设相关,以及在研究中如何利用变量?2。在感兴趣的研究人群中收集标本的主要适应症是什么?3.是否有任何分析前的情况会影响测试结果?4.随着时间的推移,生产实验室和单个实验室内的数据是否具有可比性?5.就研究人群和关键变量的完整性而言,数据库是否具有代表性?
    OBJECTIVE: To inform researchers of central considerations and limitations when applying biochemical laboratory-generated registry data in clinical and public health research.
    METHODS: After review of literature on registry-based studies and the utilization of clinical laboratory registry data, relevant paragraphs and their applicability toward the creation of considerations for the use of biochemical registry data in research were evaluated. This led to the creation of an initial ten considerations. These were elaborated, edited, and merged after several read-throughs by all authors and discussed thoroughly under influence by the authors\' personal experiences with laboratory databases and research registries in Denmark, leading to the formulation of five central considerations with corresponding items and illustrative examples.
    RESULTS: We recommend that the following considerations should be addressed in studies relying on biochemical laboratory-generated registry data: why are biochemical laboratory data relevant to examine the hypothesis, and how were the variable(s) utilized in the study? What were the primary indications for specimen collection in the study population of interest? Were there any pre-analytical circumstances that could influence the test results? Are data comparable between producing laboratories and within the single laboratory over time? Is the database representative in terms of completeness of study populations and key variables?
    CONCLUSIONS: It is crucial to address key errors in laboratory registry data and acknowledge potential limitations.
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  • 文章类型: Journal Article
    每年订购越来越多的分子成像研究,用于不断扩大和年龄增加的肿瘤人群。这些研究对肿瘤患者的进一步护理的重要性强调了区分良性和恶性结果的必要性。特别是对于偶然发现的人群。这篇综述的目的是提供良性肌肉骨骼病变的图像示例,这些病变可能在分子成像中发现,并且可能被误认为是恶性过程。影像范例以射线照片的形式提供,骨闪烁显像,计算机断层扫描,和氟-18氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描(FDGPET/CT)扫描。特别注意有助于缩小鉴别诊断范围并区分良性和恶性过程的特定特征。目的是避免不必要的侵入性程序。
    An increasing amount of molecular imaging studies are ordered each year for an oncologic population that continues to expand and increase in age. The importance of these studies in dictating further care for oncologic patients underscores the necessity of differentiating benign from malignant findings, particularly for a population in whom incidental findings are common. The aim of this review is to provide pictorial examples of benign musculoskeletal pathologies which may be found on molecular imaging and which may be mistaken for malignant processes. Imaging examples are provided in the form of radiographs, bone scintigraphy, computed tomography, and fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) scans. Special attention is paid to specific features that help narrow the differential diagnosis and distinguish benign from malignant processes, with the goal of avoiding unnecessary invasive procedures.
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  • 文章类型: Journal Article
    目的:在诊断或治疗性给予I-131后进行的全身扫描(WBS)对分化型甲状腺癌患者有用。然而,在各种情况下都可能是假阳性的。我们旨在从临床角度报告一系列陷阱。
    方法:在数据库PubMed中使用以下术语进行搜索:“假放射性碘摄取”和“假阳性碘131扫描”已于2023年1月进行。在筛选的346项研究中,本次审查包括230人,共收集了370起案件。生理摄取被排除。对于每个病人来说,性别,年龄,给药I-131的剂量,评估了摄取的区域和特定器官以及错误摄取的原因。
    结果:报告了370例错误的放射性碘摄取,19.1%在头颈部区域,胸部占34.2%,腹部占14.8%,骨盆占20.8%,在软组织和骨骼系统中占11.1%。在205/370例中,错误的放射性碘摄取的起源涉及非肿瘤疾病(55.1%),良性肿瘤108/370例(29.5%),恶性肿瘤25/370例(6.7%),和其他原因的32/370例(8.7%)。
    结论:WBS可用于分化型甲状腺癌患者的随访,然而,在各种情况下,它可能是假阳性的。出于这个原因,将闪烁显像结果与患者的病史相关联是至关重要的,血清甲状腺球蛋白水平,额外的影像学研究和细胞学和/或组织学结果。
    OBJECTIVE: whole body scan (WBS) performed following diagnostic or therapeutic administration of I-131 is useful in patients with differentiated thyroid carcinoma. However, it can be falsely positive in various circumstances. We aimed to report a series of pitfalls in a clinical perspective.
    METHODS: A search in the database PubMed utilizing the following terms: \"false radioiodine uptake\" and \"false positive iodine 131 scan\" has been made in January 2023. Among the 346 studies screened, 230 were included in this review, with a total of 370 cases collected. Physiological uptakes were excluded. For each patient, sex, age, dose of I-131 administered, region and specific organ of uptake and cause of false uptake were evaluated.
    RESULTS: 370 cases of false radioiodine uptake were reported, 19.1% in the head-neck region, 34.2% in the chest, 14.8% in the abdomen, 20.8% in the pelvis, and 11.1% in the soft tissues and skeletal system. The origin of false radioiodine uptake was referred to non-tumoral diseases in 205/370 cases (55.1%), benign tumors in 108/370 cases (29.5%), malignant tumors in 25/370 cases (6.7%), and other causes in 32/370 cases (8.7%).
    CONCLUSIONS: WBS is useful in the follow-up of patients with differentiated thyroid carcinoma, however it can be falsely positive in various circumstances. For this reason, it is critically important to correlate the scintigraphic result with patient\'s medical history, serum thyroglobulin levels, additional imaging studies and cytologic and/or histologic result.
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  • 文章类型: Journal Article
    SMARCA4缺陷的未分化肿瘤(SMARCA4-UT)是一种新描述的实体,通常在胸腔中看到。然而,这些肿瘤已经在其他身体部位被描述过,包括食道.这些肿瘤很罕见,侵袭性肿瘤,以SMARCA4(婆罗门相关基因1)的蛋白质产物丢失和INI1(SMARCB1)表达的保留为特征。这里,我们介绍了两种食管SMARCA4-UT肿瘤的显微外观和免疫组织化学特征。我们还包括SMARCA4缺陷型管状胃肠道肿瘤的文献综述,以及每个样本的免疫组织化学和错配修复谱。由于其非特异性组织学外观和扩大的免疫组织化学面板中的可变染色,这种肿瘤经常与其他类型的肿瘤重叠,使SMARCA4-UT的诊断具有挑战性。这些肿瘤通常与食道的肠上皮化生有关,被认为代表了常规食管腺癌的高级未分化转化。这些肿瘤通常与差的临床结果相关,并且对常规疗法具有差的响应。目前,目前尚无治疗这些肿瘤的标准指南;然而,姑息性放疗和全身化疗可能会带来益处。最近,免疫治疗和新的治疗靶点对这些患者显示出一些希望.
    SMARCA4-deficient undifferentiated tumors (SMARCA4-UT) are a newly described entity and are typically seen in the thoracic cavity. However, these tumors have been described in other body sites, including the esophagus. These tumors are rare, aggressive neoplasms, characterized by the loss of protein product of SMARCA4 (Brahma-related gene-1) and the preservation of INI1 (SMARCB1) expression. Here, we present two tumors of SMARCA4-UT of the esophagus with its microscopic appearance and immunohistochemical profile. We also include a literature review of SMARCA4-deficient tumors of the tubular gastrointestinal tract with their immunohistochemical and mismatch repair profiles for each specimen. Due to its non-specific histologic appearance and variable staining in expanded immunohistochemical panels, this tumor frequently overlaps with other tumor types, making the diagnosis of SMARCA4-UT challenging. These tumors are often associated with intestinal metaplasia of the esophagus and are thought to represent a high-grade undifferentiated transformation of a conventional esophageal adenocarcinoma. These tumors are typically associated with poor clinical outcomes and have poor response to conventional therapies. Currently, there are no standard guidelines for treatment of these tumors; however, palliative radiotherapy and systemic chemotherapy may provide benefit. More recently, immunotherapy and novel therapeutic targets have shown some promise for these patients.
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