Day 2 :
Keynote Forum
Mary Ann G Sanders
University of Louisville, USA
Keynote: Decline in frozen section diagnosis of sentinel lymph nodes for breast cancer as a result of the ACOSOG Z0011 trial
Time : 10:00-10:30
Biography:
Mary Ann G Sanders has received her Bachelor's degree from the University of Wisconsin-Madison. After she obtained her MD and PhD degrees from Washington University in St. Louis, she completed an Anatomic Pathology and Clinical Pathology Residency at the University of Louisville followed by a Breast Pathology Fellowship at the Brigham and Women’s Hospital, Harvard Medical School. She joined the Department of Pathology Faculty at the University of Louisville in 2011 as an Assistant Professor and Breast Pathologist for James Graham Brown Cancer Center, and is an Associate Program Director for the University of Louisville Pathology Residency Program.
Abstract:
Results of the multicenter American College of Surgeons Oncology Group (ACOSOG) Z0011 trial published in 2011 showed that patients with early-stage breast cancer and limited sentinel lymph node (SLN) metastasis treated with breast conserving surgery and systemic therapy did not benefit from axillary lymph node dissection (ALND). The Z0011 trial was practice changing for the surgical management of breast cancer, and in turn, has proven to be equally impactful on the pathologic diagnosis of SLNBs. The purpose of this study is to demonstrate the impact of the Z0011 trial on intraoperative frozen section diagnosis of SLNBs.
Keynote Forum
Raja Alyusuf
Ministry of Health, Bahrain
Keynote: The immunoexpression of glucocorticoid receptors in breast carcinomas, lactational change and normal breast epithelium and its possible role in mammary carcinogenesis
Time : 11:50-12:20
Biography:
Dr. Raja Alyusuf is a Fellow of the Royal College of Pathologists since 1998. She is a Consultant histopathologist with special interest in the area of breast treatment. She chaired the Department of Pathology at the Salmaniya Medical Complex for 10 years after which she became the Deputy Chief of Medical Staff for Diagnostic Affairs at the Salmaniya Medical Complex. In addition, she is a part-time Associate Professor of Pathology in the Royal College of Surgeons of Ireland-Bahrain branch. She has over 20 publications is reputable journals and is a member of a number of international and national professional associations.
Abstract:
Glucocorticoids (GC) are known to play a role in mammary development and differentiation, thus it is of interest to attempt to delineate it’s immunoexpression across a spectrum of mammary epithelia. This study aims to delineate the distribution pattern of GRs in malignant versus non-malignant epithelium with particular emphasis on lactational change epithelium as its cells are considered the most terminally differentiated mammary cells. Immunohistochemistry (IHC) for glucocorticoid receptors (GR) was performed on archival formalin fixed paraffin embedded tissue blocks of 97 cases comprising 53 invasive carcinomas, 21 cases with lactational change and 23 cases showing normal mammary tissue histology. The results reveal an over-expression of GR receptors in mammary malignant epithelium compared to both the normal and lactational group individually and combined together as a non-malignant group. This is the first study to compare GR expression in human lactating epithelium versus malignant and benign epithelium. GR overexpression was also established in Her-2 negative cancers as compared to Her-2 positive ones, while GR immunoexpression in tumors categorized according to grade, estrogen (ER), progesterone receptor (PR) or axillary lymph node (ALN) status showed no statistical difference. It seems that GR expression in mammary epithelium promotes the development of her-2 negative breast cancer, thus such receptors may become targets for the development of therapeutic interventions. Further studies are required to determine the level of caution that is needed if any in the use of steroid therapy in such category of patients.
- Clinical Applications of Molecular Biology |Clinical Hematology | Clinical Microbiology | Antibiotics in Laboratory Medicine | Pediatric Laboratory Medicine | Transfusion medicine & Advances |Histocompatibility Complex (HLA)
Chair
Brian Bennett
Marquette University, USA
Co-Chair
Mary Ann G Sanders
University of Louisville, USA
Session Introduction
Asma Asif
Jinnah Sindh Medical University
Title: Iron deficiency and thalassemia trait in vitamin B12 deficient patients with normal or low mean corpuscular volume
Biography:
Asma Asif has completed my M.Phil in Hematology from Dow University of Health Sciences in 2016. She is currently working in Jinnah Sindh Medical University Karachi Pakistan.
Abstract:
Statement of the Problem: Vitamin B12 is one of the most important vitamins of the B-complex group. Its deficiency is not always accompanied by macrocytic picture refracted in the form of raised MCV. This rise in MCV can be blunted by concomitant iron deficiency or thalassemia trait. Due to these coexistent conditions, B12 deficiency can be missed on routine CBC leading to development of severe complications and few of them can be irreversible like neuropathy. The purpose of this research is to study the importance of normal or low MCV in vitamin B12 deficiency due to co-existence of iron deficiency or beta thalassemia trait masking a rise in mean corpuscular volume.
Methodology & Theoretical Orientation: Clinical records of 105 vitamin B12 deficient cases (vitamin B12 less than 200 ng/l) who had presented with normal or low mean corpuscular volume (MCV less than 95 fl) on complete blood count were determined from Dow diagnostic research and reference laboratory. Serum ferritin, red blood cell folate level and Hb electrophoresis for beta thalassemia trait were analyzed in these patients.
Findings: A total of 105 vitamin B12 deficient patients who fulfilled the inclusion criteria were enrolled in this study from which 39 (37.14%) were male and 66 (62.85%) were females. Amongst them 36.19% were microcytic with the mean age of 37±16.2 years and 63.8% were normocytic with the mean age of 41.58±15.65 years. In microcytic group, the percent value of iron deficient, beta thalassemia trait, combined deficiency of B12, iron and beta thalassemia trait and RBC folate deficient were 52.6%, 34.21%, 7.8% and 2.63%, respectively. In normocytic group, the percent value of iron deficient, beta thalassemia trait and RBC folate deficient were 13.4%, 00% and 11.9%, respectively.
Conclusion: It was concluded that frequency of iron deficiency and beta thalassemia trait are significant in vitaminB12 deficient cases with normal or low mean corpuscular volume. It is more common in females having age group of 20-40 years. Index of suspicion should be kept high and serum ferritin and Hb electrophoresis should be done in all such patients who present with B12 deficiency anemia with normal or low MCV.
Parviz Parvizi
Pasteur Institute of Iran
Title: Analyses of five nuclear and mitochondrial genes for the identification the old and new world Leishmania parasites
Biography:
Parviz Parvizi has completed his PhD from the London School of Hygiene and Tropical Medicine (London University) and Natural History Museum (London) in 2004. He has been a Full Professor since 2015 and honored as the Head of Parasitology department and as the Director of Parasitology, Immunology and Mycology Research Group at Pasteur Institute of Iran. He has published more than 60 papers in reputed journals.
Abstract:
Background: The polymorphism and genetic diversity of Leishmania genus have status under discussion depending on many items from clinical samples, reservoir hosts and vectors.
Objectives: The objectives are to compare genetic changes and the role of each two enzymatic and mitochondrial genes (COII and Cyt b) or housekeeping and nuclear genes (nagt, ITS-rDNA and HSP70) for accurate identification of Leishmania parasites.
Methods: After DNA extractions, PCR products were sequenced and evaluation of genetic proximity and phylogenetic analysis were performed using MEGA6 and DnaSP5 software.
Results: Of the 72 sequences, 54 new haplotypes from five Leishmania species were submitted to GenBank. The number of polymorphic sites was significantly lower as compared to the monomorphic sites.
Conclusions: The highest and lowest levels of haplotype diversity were observed in L. tropica (81.35%) and L. major (28.38%). Tajima’s D index analyses showed that Cyt b gene in L. tropica species was significantly negative, while COII and nagt genes were produced through evolutionary processes for both L. tropica and L. major.
Biography:
Eric S Donkor has done his Doctoral degrees in Infectious Diseases and Public Health from London School of Hygiene and Tropical Medicine, and University of Iceland, respectively. He holds Master degrees in Molecular Biology and Animal Microbiology from Birkbeck College, University of London and University of Ghana, respectively. He has received several researches funding and has published 50 peer reviewed articles in the areas of Infectious Diseases, Food Safety and Environmental Health. Currently, he is an Associate Professor of Public Health Microbiology at University of Ghana.
Abstract:
Background: In Africa, little is known about urinary tract infection (UTI) in relation to stroke patients. The aim of the study was to investigate the epidemiology of UTI among stroke patients at the Korle-Bu Teaching Hospital (KBTH) in Ghana.
Methods: This was a longitudinal study involving 55 outpatients and 16 inpatients of stroke from the physiotherapy clinic and stroke admission ward of KBTH, respectively. Urine cultures for inpatient subjects were done each day until the patient was discharged. With outpatients, urine specimens were analyzed every week or two for 6 months. Information on demographics and clinical history of the study participants were extracted from their clinical records.
Results: Prevalence of UTI among stroke outpatients and inpatients were 10.9% (6/55) and 18.8% (3/16), respectively (p=0.411). Incidence of UTI among stroke outpatients and inpatients were 1.8% (1/55) and 6.3% (1/16), respectively (p=0.125). Overall, 11% (1/9) of the UTI cases among the stroke patients were symptomatic. Severe stroke (OR=17.7, p=0.008) and pyuria (OR=38.7, p=0.002) were identified as predictors of UTI. Escherichia coli was the most common organism implicated in UTI and was susceptible to amikacin, but resistant to augmentin, ampicillin, cefuroxime, co-trimoxazole, meropenem, norfloxacin and tetracycline.
Conclusion: UTI is a common complication among both stroke inpatients and outpatients, though it appears to be more common among the former. Stroke severity appears to be the main stroke related determinant of UTI among stroke patients. UTI among stroke patients is mainly asymptomatic and E. coli is the most important aetiological agent.