Core roll preparations and the pathologist as consultant.

fibrillation and mortality after coronary artery bypass surgery. A comparsion between oral antiarrhythmic drugs in the prevention of atrial fibrillation after cardiac surgery: the pilot study of prevention of postop-erative atrial fibrillation (SPPAF), a randomized, placebo controlled trial. Supraventricular tachya-rrythmia prophylaxis after coronary artery surgery in chronic obstructive pulmonary disease patients (early amiodarone prophylaxis trial). Cost-effectiveness of targeting patients undergoing cardiac surgery for therapy with intravenous amiodarone to prevent atrial fibril-lation. amiodarone compared with placebo for prevention of atrial fibrillation after coronary artery bypass surgery. Hibbert CL, et al. Definitions and methods of cost assessment: an intensivist's guide; ESICM section on health research and outcome working group on cost effectiveness. Intensive Care Med 2002; 28:680 – 685 14 Macario A, Vitez TS, Dunn B, et al. Where are the costs in perioperative care? Analysis of hospital costs and charges for inpatient surgical care. I n this issue of CHEST (see page 738), the article by Chandan and colleagues offers a look at the utility of core roll preparations (CRPs) for the immediate assessment of neoplastic lung lesions. For those who have not heard the phrase core roll preparation before, it is used by the authors to refer to a type of imprint cytology sample that can be obtained from core needle biopsy specimens. Essentially , the core needle biopsy sample is transferred to and lightly rolled on a glass slide, to produce a cellular preparation that can be rapidly air-dried, stained, and reviewed by the pathologist to provide feedback about lesional representation and, often, diagnosis. The authors retrospectively reviewed stained slides from fine-needle aspiration (FNA) and core needle biopsy/CRP samples collected from the same patient during the same visit, and have reported that a specific malignant cell type could be determined for 23 of 25 patients (92%). This result was superior to those they obtained from FNAs alone or CRPs alone, both of which usually provided a malignant diagnosis but often were not conclusive, alone, for the determination of a specific histologic tumor type. Whether the results reflect the complementary values of both techniques or, instead, reflect the added value of more samples, cannot be discerned from the numbers. The authors, however, favor complementarity and suggest that the CRP smear pattern can provide architectural information that can help with the assignment of a specific histologic tumor type. Applications of imprint cytology to the evaluation of core biopsy samples have been …