The presence of H. pylori in laparoscopic sleeve gastrectomy specimens is associated with increased mucosal thickness, presence of secondary follicles, increased chronic inflammation, and intestinal metaplasia

Helicobacter pylori is putatively present in over half of the global human population and is recognized as a carcinogenic agent that increases the likelihood of infected patients developing gastric adenocarcinoma or gastric lymphoma. Although there are several means for testing for H. pylori, the gold standard remains the invasive histologic evaluation. The current most popular form of bariatric surgery is the laparoscopic sleeve gastrectomy (LSG) and is the only bariatric surgery which supplies a specimen for histologic evaluation. While non-invasive testing is effective in diagnosing and monitoring H. pylori infection, histological examination of biopsies and resections is the only way to grade chronic inflammation and evaluate specimens for additional pathologies such as intestinal metaplasia. The investigators evaluated 203 sequential LSG specimens collected from a major metropolitan hospital over the period of one year. Specimens were processed to paraffin, stained with hematoxylin and eosin, alcian blue, and immunohistochemistry to determine the presence of H. pylori, chronic inflammation, presence of secondary lymphoid follicles in the mucosa, mucosal thickness, and presence of intestinal metaplasia. Statistical analyses demonstrated a significant positive correlation among all factors examined. The overall positivity rate of H. pylori in LSG specimens was 18.2% but ranged from 6.9-23.8% depending on whether the treating clinician performed routine pre-surgical endoscopy. The presence of H. pylori was associated with a higher average chronic inflammation grade, intestinal metaplasia, thicker mucosa, and presence of lymphoid follicles with germinal centers in the mucosa.

Histologic examination of canned cat food

Cat food production is a billion-dollar industry in the United States, with most pet owners trusting pet food companies to provide their pets with complete nutrition. Moist or canned cat food is healthier than dry kibble for cats due to its higher water content promoting healthy kidney function, but ingredient labels on canned cat food are lengthy with ambiguous terminology including 'animal by-products.' Forty canned cat food samples were collected from grocery stores and were processed using routine histologic methods. Hematoxylin and eosin-stained tissue sections were evaluated microscopically to determine the cat food content. Many brands and flavors were composed of well-preserved skeletal muscles admixed with various animal organs, which closely approximates nutritional components found in natural feline prey. However, several samples demonstrated marked degenerative changes suggesting a delay in food processing and potential decrease in nutrient content. Four samples contained cuts consisting of skeletal muscle only with no organ meat. Surprisingly, 10 samples contained fungal spores and 15 demonstrated refractile particulate matter. A cost analysis demonstrated that although the overall quality of canned cat food increases as the average cost per ounce increases, low-cost high-quality canned cat food is available.

The diagnostic interview for narcissistic patients

This report describes the content and development of a semistructured interview, the Diagnostic Interview for Narcissism. The interview evaluates 33 features of pathological narcissism covering five domains of function: grandiosity, interpersonal relations, reactiveness, affects and moods, and social and moral adaptation. Its utility is established by reliability studies and by developing a scoring system from a sample of 24 prototypic narcissistic patients who were compared with 58 others. Because narcissistic personality disorder is a widely used diagnosis whose inclusion in DSM-III-R was without reference to an empirical base, this instrument offers a method for doing much-needed research.