What is the pathology of?

From the Guidelines

Pathology plays a crucial role in the diagnosis and treatment of diseases, including cancer, by examining body tissues, organs, and fluids to identify abnormalities and guide treatment decisions. In the context of non-small-cell lung cancer (NSCLC), a thorough comprehensive diagnosis is always recommended whenever possible, as emphasized in the ESMO clinical practice guidelines for diagnosis, treatment, and follow-up 1. The recent World Health Organization (WHO) classification of NSCLC, with its further sub-classification of adenocarcinoma, highlights the importance of pathological diagnosis in determining metastatic pattern, recurrence, and survival between different histological subtypes 1. Some key points to consider in the pathology of NSCLC include:

• The beneficial effects of adjuvant chemotherapy post-resection may differ depending on the adenocarcinoma subclassification 1
• The pathological classification at diagnosis may influence initial treatment decisions, such as the initial surgical approach 1
• Certain subtypes, such as adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), and lepidic predominant (Lep), have been found to have no metastasis in N1 or N2 lymph nodes, whereas other categories have a higher rate of N1 or N2 involvement 1. The pathological examination is essential for diagnosing conditions, determining their severity, and guiding treatment decisions, and modern pathology incorporates various techniques to provide comprehensive diagnostic information. In real-life clinical practice, the pathology report is a critical component of patient care, and clinicians should work closely with pathologists to ensure that accurate and timely diagnostic information is available to inform treatment decisions.

From the FDA Drug Label

The incidence of warmth, tightness or induration was 17% (3/17) after IM administration of 350 mg/mL and 5% (1/20) after IM administration of 250 mg/mL. General disorders and administration site conditions Injection site pain (0.6%). Hypersensitivity Rash (1.7%). Less frequently reported (<1%) were pruritus, fever or chills. Infections and infestations Genital fungal infection (0. 1%). Hematologic Eosinophilia (6%), thrombocytosis (5.1%) and leukopenia (2.1%). Less frequently reported (<1%) were anemia, hemolytic anemia, neutropenia, lymphopenia, thrombocytopenia and prolongation of the prothrombin time. Blood and lymphatic disorders Granulocytopenia (0.9%), coagulopathy (0.4%). Gastrointestinal Diarrhea/loose stools (2. 7%). Less frequently reported (<1%) were nausea or vomiting, and dysgeusia. The onset of pseudomembranous colitis symptoms may occur during or after antibacterial treatment (see WARNINGS). Hepatic Elevations of aspartate aminotransferase (AST) (3.1%) or alanine aminotransferase (ALT) (3. 3%). Less frequently reported (<1%) were elevations of alkaline phosphatase and bilirubin. Renal Elevations of the BUN (1. 2%). Less frequently reported (<1%) were elevations of creatinine and the presence of casts in the urine. Central nervous system Headache or dizziness were reported occasionally (<1%). Genitourinary Moniliasis or vaginitis were reported occasionally (<1%). Miscellaneous Diaphoresis and flushing were reported occasionally (<1%). Investigations Blood creatinine increased (0. 6%). Other rarely observed adverse reactions (<0. 1%) include abdominal pain, agranulocytosis, allergic pneumonitis, anaphylaxis, basophilia, biliary lithiasis, bronchospasm, colitis, dyspepsia, epistaxis, flatulence, gallbladder sludge, glycosuria, hematuria, jaundice, leukocytosis, lymphocytosis, monocytosis, nephrolithiasis, palpitations, a decrease in the prothrombin time, renal precipitations, seizures, and serum sickness

The pathology of ceftriaxone includes:

• Hematologic changes: eosinophilia, thrombocytosis, leukopenia, anemia, hemolytic anemia, neutropenia, lymphopenia, thrombocytopenia
• Hepatic changes: elevations of aspartate aminotransferase (AST) or alanine aminotransferase (ALT)
• Renal changes: elevations of the BUN, creatinine, and presence of casts in the urine
• Gastrointestinal changes: diarrhea/loose stools, pseudomembranous colitis
• Central nervous system changes: headache, dizziness, seizures
• Genitourinary changes: moniliasis, vaginitis
• Dermatologic changes: rash, exanthema, allergic dermatitis, urticaria, edema 2

From the Research

Pathology of Infections

• The pathology of infections involves the use of laboratory tests to guide antimicrobial therapy, including antimicrobial susceptibility testing, determination of bacterial beta-lactamase production, and assay of serum inhibitory and bactericidal activity 3, 4.
• These tests are essential in determining the effectiveness of antimicrobial agents and in identifying bacterial resistance to these agents 3, 4.
• The results of these tests can help clinicians make informed decisions about the use of antimicrobial agents, including the selection of the most appropriate agent and the determination of the optimal dosage and duration of treatment 3, 4.

Clinical Practice Guidelines

• Clinical practice guidelines (CPGs) are systematically developed statements that assist practitioners and patients in making informed healthcare decisions 5.
• CPGs should be developed based on the principles of bias minimization, systematic evidence retrieval and review, and a focus on patient-relevant outcomes 5.
• The development of CPGs involves the synthesis and translation of a large amount of evidence into practice recommendations, which can help reduce the use of unnecessary or harmful interventions and minimize risk 5.

Diagnostic Variables

• Clinical and laboratory variables, such as C-reactive protein (CRP), procalcitonin (PCT), interleukin 6 (IL-6), and white blood cell count (WBC), can be used to predict infections that require antibiotic treatment 6.
• These variables can also be used to identify patients with bacteraemia and severe sepsis, and to guide antibiotic decisions in the emergency department 6.
• However, the diagnostic accuracy of these variables can be limited, and better tests are required to improve antibiotic stewardship 6.

Generalizability of Research Findings

• The generalizability of research findings refers to the ability to apply the results of a study to patients who present for care 7.
• Clinicians must make reasoned decisions about the generalizability of research findings beyond a study population, taking into account the condition that defines the population, the study intervention, and the patient 7.
• The level of generalizability of a study can influence the weight given to the information in arriving at a treatment decision 7.