While fine needle aspiration (FNA) is certainly not a new biopsy technique, recent developments in advanced imaging techniques, molecular testing, and targeted therapies have coincided with a rapid increase in the number of FNA procedures being performed. Concurrently, the demand for on-site evaluation of adequacy (OSEA) has also increased, outstripping the capacity of available cytopathologists at some institutions. Among the several alternatives to cytopathologist-performed OSEA, cytotechnologist-attended OSEA stands out because it preserves the representation of the pathology service at the time of the procedure. Herein, we review the current literature about OSEA and the necessity of cytotechnologists to expand access of this useful pathology service to a broader patient population. We also examine how cytotechnologists are likely to fit into the emerging practice of telecytology.
Biopsy ; Biopsy, Fine-Needle ; Humans ; Telepathology

Neurogenic bladder is a general term encompassing various neurologic dysfunctions of the bladder and the external urethral sphincter. These can be caused by damage or disease. Therapeutic management options can be conservative, minimally invasive, or surgical. The current standard for surgical management is bladder augmentation using intestinal segments. However, because intestinal tissue possesses different functional characteristics than bladder tissue, numerous complications can ensue, including excess mucus production, urinary stone formation, and malignancy. As a result, investigators have sought after alternative solutions. Tissue engineering is a scientific field that uses combinations of cells and biomaterials to encourage regeneration of new, healthy tissue and offers an alternative approach for the replacement of lost or deficient organs, including the bladder. Promising results using tissue-engineered bladder have already been obtained in children with neurogenic bladder caused by myelomeningocele. Human clinical trials, governed by the Food and Drug Administration, are ongoing in the United States in both children and adults to further evaluate the safety and efficacy of this technology. This review will introduce the principles of tissue engineering and discuss how it can be used to treat refractory cases of neurogenic bladder.
Adult ; Biocompatible Materials ; Child ; Humans ; Meningomyelocele ; Mucus ; Neurologic Manifestations ; Regeneration ; Regenerative Medicine ; Research Personnel ; Tissue Engineering ; United States ; United States Food and Drug Administration ; Urethra ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urinary Calculi

Novel therapies resulting from regenerative medicine and tissue engineering technology may offer new hope for patients with injuries, end-stage organ failure, or other clinical issues. Currently, patients with diseased and injured organs are often treated with transplanted organs. However, there is a shortage of donor organs that is worsening yearly as the population ages and as the number of new cases of organ failure increases. Scientists in the field of regenerative medicine and tissue engineering are now applying the principles of cell transplantation, material science, and bioengineering to construct biological substitutes that can restore and maintain normal function in diseased and injured tissues. In addition, the stem cell field is a rapidly advancing part of regenerative medicine, and new discoveries in this field create new options for this type of therapy. For example, new types of stem cells, such as amniotic fluid and placental stem cells that can circumvent the ethical issues associated with embryonic stem cells, have been discovered. The process of therapeutic cloning and the creation of induced pluripotent cells provide still other potential sources of stem cells for cell-based tissue engineering applications. Although stem cells are still in the research phase, some therapies arising from tissue engineering endeavors that make use of autologous, adult cells have already entered the clinical setting, indicating that regenerative medicine holds much promise for the future.
Adult ; Amniotic Fluid ; Biocompatible Materials ; Bioengineering ; Cell Transplantation ; Clone Cells ; Cloning, Organism ; Embryonic Stem Cells ; Female ; Humans ; Regenerative Medicine ; Stem Cells ; Tissue Donors ; Tissue Engineering ; Transplants

BACKGROUND: By current estimates, it takes 17 years to adopt a new evidence-based practice (EBP) intervention. Nursing efforts to increase EBP adoption typically focus on education. But, there is a research gap in that there is a lack of evidence to support that education impacts the adoption of evidence-based practice. This study explored factors associated with adopting quantitative pupillometry (QP). METHODS: This longitudinal, retrospective study used registry data to calculate QP usage rates between 2015 and 2021. Events and interventions hypothesized to increase EBP adoption were identified through stakeholder interviews and literature search. Events were categorized as: conference presentations, publications, education, new study sites, QP adoption on other nursing units, equipment purchase, and policy changes. Scatterplots and Spearman's Rho were used to examine the relationship between time and usage rate of QP. Odds ratio analyses were conducted to explore the relationship between the selected event types and changes in usage rate from month-to-month. RESULTS: Using 74,428 QP observations from 3,976 patients, there was a significant positive relationship between usage rate of QP and time (r = .642, P < .0001). However, there was no statistically significant odds of any event-type (alone or in combination) impacting the rate of QP adoption. CONCLUSION Time was the only independent variable significantly associated with an increase in EBP adoption for this intervention. Common methods used to accelerate nursing adoption of EBP may have limited effect.