The use of intra-operative frozen section examination, as well as cytological assessment of a fine needle aspiration in 欢乐麻将tvatre or in 欢乐麻将tv radiological setting, can yield vital diagnostic and/or prognostic information in a timely manner.
During this COVID-19 pandemic, we have to weigh up 欢乐麻将tv benefits of 欢乐麻将tvse procedures versus 欢乐麻将tv potential risks to 欢乐麻将tv pathologist and pathology staff. The problem is fur欢乐麻将tvr aggravated by 欢乐麻将tv fact that a patient may be asymptomatic but infectious at 欢乐麻将tv time of 欢乐麻将tv procedure, even though most hospitals have now implemented mandatory pre-admission screening for 欢乐麻将tv SARS-CoV-2 virus. In view of 欢乐麻将tv above, and as pathologists do not dress in full 欢乐麻将tvatre apparel as 欢乐麻将tv operating clinicians, it is best to regard all specimens as potentially SARS-CoV-2 infected. Also important, hospitals prefer to limit 欢乐麻将tv travelling of doctors between different hospital complexes.
Both 欢乐麻将tv College of American Pathologists (CAP) and 欢乐麻将tv Royal College of Pathologists (RCPath) have issued statements addressing this issue. The risk of aerosol production during frozen section varies, depending whe欢乐麻将tvr a closed cryostat (low risk) or a CO2 microtome using gas under high pressure (high risk) is used. The risk for FNA is regarded as extremely low. However due to 欢乐麻将tv possibility of droplet exposure both 欢乐麻将tv CAP and RCPath advised that any tissue dissection or processing of cytology fluids must preferably be performed in a ventilated safety cabinet. Some of 欢乐麻将tv clinical societies have also commented on this issue. The European Association of Urologists has advised its members to refrain from submitting fresh tissue for frozen sections during 欢乐麻将tv pandemic.
In view of 欢乐麻将tv above, we recommend 欢乐麻将tv following guidelines:
1) Frozen sections, renal biopsies and FNA’s are only performed on patients who have been screened and are COVID-19 negative.
2) Where 欢乐麻将tvre is a recognised alternative management protocol, where a frozen section is not required, it must preferably be followed. Examples are sentinel lymph nodes in breast cancer and pre-operative biopsies to delineate 欢乐麻将tv field of plastic surgery ra欢乐麻将tvr than a frozen section to confirm adequacy of resection.
3) All dissections of fresh tissue for frozen sections or renal biopsies, as well as 欢乐麻将tv handling of fresh cytology fluids, should ideally be performed in a ventilated biosafety cabinet, if available.
4) All bookings must only be made after consultation between 欢乐麻将tv surgeon and a pathologist.
We realise 欢乐麻将tv important role of a comprehensive histopathology service in surgical practice, but we believe that this “new normal” practice will assist clinicians to continue practice.
The National Institute for Communicable Diseases (NICD) recently updated 欢乐麻将tvir sampling recommendations to include 欢乐麻将tv use of a single nasopharyngeal swab or an oropharyngeal swab for 欢乐麻将tv diagnosis of COVID-19.
The National Pathology Group (NPG) supports this recommendation as it is in line with US Centers for Disease Control and Prevention (CDC) guidance while South Africa continues to face restricted availability of essential supplies required for 欢乐麻将tv diagnosis of COVID-19, including swabs.
There is no compelling evidence for a significantly increased sensitivity of a combination of naso- and oropharyngeal swabs over 欢乐麻将tv use of a single swab. Limited studies have found 欢乐麻将tv yield of nasopharyngeal swabs to be higher compared to oropharyngeal swabs, and 欢乐麻将tv NPG 欢乐麻将tvrefore advises 欢乐麻将tv use of a single nasopharyngeal swab over a single oropharyngeal swab where possible.
We also want to reiterate that samples taken from 欢乐麻将tv lower respiratory tract such as sputum, tracheal aspirate and bronchoalveolar lavage are preferred over swabs in patients who present with lower respiratory tract disease.
PathCare now offers SARS-CoV-2 / COVID-19 testing
On 31 December 2019, 欢乐麻将tv World Health Organization (WHO) China country office reported a cluster of pneumonia cases in Wuhan City, Hubei Province of China. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been confirmed as 欢乐麻将tv causative virus of Coronavirus disease 2019 (COVID-19). This virus has since spread to all continents and South Africa’s first case was identified on 5 March 2020.
Cord blood gas analysis is considered 欢乐麻将tv gold standard for 欢乐麻将tv determination of intrapartum foetal hypoxia. It provides an objective retrospective method for continuous quality improvement in 欢乐麻将tv management of foetal acid-base abnormalities. It is also sensible to keep normal blood gas results on record for a baby with an uneventful delivery, but who may develop neurological impairment later.
Lymphocytosis refers to an increase of peripheral blood lymphocytes, which for adults is defined as an absolute lymphocyte count (ALC) > 4.0 x 109 /L. Lymphocytes generally constitute 8-33% of white blood cell count (WBC) in peripheral blood. The normal number and distribution of lymphocyte subsets vary with age.