Crystals encountered within the tissue samples included MCC (3 cases of intravenous drug abuse), crystals consistent with talc (2 cases of intravenous drug abuse, 1 case of talc pleurodesis), mixed silicates (1 case of suspected silicate pneumoconiosis in a rubber worker), and calcium oxalate (1 case of aspergillosis from Aspergillus niger), which were respectively evaluated with the MMPS using routine light microscopy.
To further compare the results of MMPS versus other stains traditionally used for tissue identification of MCC, representative study cases containing MCC or talc, and the 2 cases of mixed silicate or oxalate deposition were also stained using Gomori methenamine silver and Congo red stains.
Patient demographics, the structures of particles seen in lung and/or pleural tissue, and the MMPS stain results are summarized in the Table.
Talc appeared as refractile, stacked crystals that were brightly birefringent and stained weakly light blue with MMPS (Figures 5 through 7).
Crospovidone, another pharmaceutical tablet filler material that was also seen in the lungs of subjects 1 through 3, had an irregular, corallike shape; was nonbirefringent; and stained yellow-green to blue-green with MMPS (Figure 11).
MMPS predicts the probability of death in four categories of disease that are common and frequently lethal among Medicare patients.
MMPS supplements HCFA's risk adjustment technique by incorporating clinical information that bears on hospitalized patients' risk of dying and is not available in administrative records.
MMPS permits hospitals to predict mortality in four diseases that contribute substantially to overall mortality in Medicare patients.
APACHE IIB applies the APACHE system to the four MMPS categories in an effort to broaden usage to the entire patient population.