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Clinical Anatomy (New York, N.Y.) Oct 2021William Hunter's writings, lectures and his collection of circa 1,400 pathological specimens at the University of Glasgow show that, within the scientific limitations of...
William Hunter's writings, lectures and his collection of circa 1,400 pathological specimens at the University of Glasgow show that, within the scientific limitations of the 18th Century, he had a sound grasp of the significance of morbid anatomical appearances. Unlike John Hunter's collection at the Royal College of Surgeons of England, few of the Hunterian specimens at Glasgow have an accompanying case history. Within the Special Collections at the Glasgow University Library are a small number of post mortem reports, including four involving William Hunter's aristocratic patients. This article explores these patient cases, and also the only instance recorded by John Hunter of William working with him on a post mortem of an aristocrat, that of the Marquis of Rockingham, Prime Minister, who died in 1782. The study aims to better understand William Hunter's medical practice and his professional connections with other practitioners. The post mortem examinations were carried out by a surgeon/anatomist and observed by the patient's physician(s). For aristocratic post mortems, those attending were senior and well-established practitioners. The notes made were not particularly detailed. The reports show clearly that William Hunter's practice, in the 1760s at least, was not confined to midwifery.
Topics: Anatomists; Dissection; Forensic Medicine; History, 18th Century; Humans; Obstetrics; Pathologists; Scotland
PubMed: 33580903
DOI: 10.1002/ca.23730 -
Archives of Pathology & Laboratory... Aug 2019
Topics: Career Choice; Humans; Pathologists; Pathology, Clinical; Students, Medical
PubMed: 31339753
DOI: 10.5858/arpa.2019-0020-ED -
Archives of Pathology & Laboratory... Jul 2017Pathologists' advocacy plays a central role in the establishment of continuously improving patient care quality and patient safety, and in the maintenance and progress...
Pathologists' advocacy plays a central role in the establishment of continuously improving patient care quality and patient safety, and in the maintenance and progress of pathology as a profession. Pathology advocacy's primary goal is the betterment of patient safety and quality medical care; however, payment is a necessary and appropriate component to both, and has a central role in advocacy. Now is the time to become involved in pathology advocacy; the Medicare Access and Children's Health Insurance Program (CHIP) Reauthorization Act of 2015 (MACRA) and the Protecting Access to Medicare Act of 2014 (PAMA) are 2 of the most consequential pieces of legislation impacting the pathology and laboratory industry in the last 20 years. Another current issue of far-reaching impact for pathologists is balance billing, and yet many pathologists have little or no understanding of balance billing. Pathologists at all stages of their careers, and in every professional setting, need to participate. Academic pathologists have a special obligation to, if not become directly involved in advocacy, at least have a broad and current understanding of those issues, as well as the need and responsibility of pathologists to actively engage in advocacy efforts to address them, in order to teach residents the place of advocacy, and its value, as an inseparable and indispensable component of their professional responsibilities.
Topics: Humans; Pathologists; Pathology, Clinical; Patient Advocacy
PubMed: 28418280
DOI: 10.5858/arpa.2017-0105-SA -
European Respiratory Review : An... Mar 2018Classifying pulmonary fibrotic disease into various diagnostic categories provides the clinician with expectations for both prognosis and proper treatment. Despite years... (Review)
Review
Classifying pulmonary fibrotic disease into various diagnostic categories provides the clinician with expectations for both prognosis and proper treatment. Despite years of experience with histological, radiological and clinical guidelines, a group of patients remains with unclassifiable interstitial lung disease. In this article, the possible barriers to classification will be explored, and some strategies will be discussed to aid in overcoming these barriers.
Topics: Aged; Biopsy; Clinical Decision-Making; Female; Humans; Lung; Lung Diseases, Interstitial; Male; Middle Aged; Pathologists; Predictive Value of Tests; Prognosis
PubMed: 29491037
DOI: 10.1183/16000617.0132-2017 -
Archives of Pathology & Laboratory... May 2017
Topics: Artificial Intelligence; Deep Learning; Forecasting; Humans; Male; Pathologists
PubMed: 28447901
DOI: 10.5858/arpa.2017-0023-ED -
Lancet (London, England) May 2018Insufficient awareness of the centrality of pathology and laboratory medicine (PALM) to a functioning health-care system at policy and governmental level, with the... (Review)
Review
Insufficient awareness of the centrality of pathology and laboratory medicine (PALM) to a functioning health-care system at policy and governmental level, with the resultant inadequate investment, has meant that efforts to enhance PALM in low-income and middle-income countries have been local, fragmented, and mostly unsustainable. Responding to the four major barriers in PALM service delivery that were identified in the first paper of this Series (workforce, infrastructure, education and training, and quality assurance), this second paper identifies potential solutions that can be applied in low-income and middle-income countries (LMICs). Increasing and retaining a quality PALM workforce requires access to mentorship and continuing professional development, task sharing, and the development of short-term visitor programmes. Opportunities to enhance the training of pathologists and allied PALM personnel by increasing and improving education provision must be explored and implemented. PALM infrastructure must be strengthened by addressing supply chain barriers, and ensuring laboratory information systems are in place. New technologies, including telepathology and point-of-care testing, can have a substantial role in PALM service delivery, if used appropriately. We emphasise the crucial importance of maintaining PALM quality and posit that all laboratories in LMICs should participate in quality assurance and accreditation programmes. A potential role for public-private partnerships in filling PALM services gaps should also be investigated. Finally, to deliver these solutions and ensure equitable access to essential services in LMICs, we propose a PALM package focused on these countries, integrated within a nationally tiered laboratory system, as part of an overarching national laboratory strategic plan.
Topics: Clinical Laboratory Services; Developing Countries; Health Education; Health Services Needs and Demand; Humans; Pathologists; Point-of-Care Systems; Public Health; Quality of Health Care; Telepathology; Universal Health Insurance; Workforce
PubMed: 29550027
DOI: 10.1016/S0140-6736(18)30459-8 -
Clinical Breast Cancer Jun 2016Molecular characterization of breast cancer is pivotal for identifying new molecular targets and determining the appropriate treatment choices. Advances in molecular... (Review)
Review
Molecular characterization of breast cancer is pivotal for identifying new molecular targets and determining the appropriate treatment choices. Advances in molecular profiling technology have given greater insight into this heterogeneous disease, over and above hormone receptor and human epidermal growth factor receptor 2 status. Agents targeting recently characterized molecular biomarkers are under clinical development; the success of these targeted agents is likely to depend on identifying the patient population most likely to benefit. Therefore, clinical trials of breast cancer often require prescreening for, or stratification by, relevant molecular markers or exploratory analyses of biomarkers that can predict or monitor the response to treatment. Consequently, the role of the pathologist has become increasingly important. The key considerations for pathologists include tissue availability, ownership of archival tissue, type of diagnostic/biomarker test required, method of sample processing, concordance between different tests and testing centers, and tumor heterogeneity. In the present review, we explore how pathology is used in current clinical trials of breast cancer and describe the various technologies available for molecular testing. Furthermore, the factors required for the successful application of pathology in clinical trials of breast cancer and the issues that can arise and how these can be circumvented are discussed.
Topics: Biomarkers, Tumor; Breast Neoplasms; Clinical Trials as Topic; Female; Humans; Pathologists; Pathology, Molecular
PubMed: 27103546
DOI: 10.1016/j.clbc.2016.02.016 -
Brazilian Oral Research 2022Good communication between clinicians and pathologists is a vital element in the diagnostic process, and poor communication can adversely affect patient care. There is a... (Review)
Review
Good communication between clinicians and pathologists is a vital element in the diagnostic process, and poor communication can adversely affect patient care. There is a lack of research about communication in diagnostic oral and maxillofacial pathology. This narrative review explores different aspects of the quality of communication between clinicians and oral pathologists, with a focus on the diagnosis of oral and maxillofacial diseases. An electronic search was carried out in MEDLINE through the PubMed, Scopus, and Embase databases up to April 2021. No studies reporting communication, its adequacy or the required skills between clinicians and pathologists in oral diagnosis were found. According to studies published in medicine, strategies for improving communication skills include clinician-pathologist collaboration; a well-formatted, clear and thorough report; training in communication skills; and patient-centered care. Further studies evaluating the current practices and quality in oral and maxillofacial pathology are required to identify barriers and encourage optimal communication to facilitate diagnosis, as well as patient safety.
Topics: Communication; Dentists; Humans; Pathologists; Patient-Centered Care
PubMed: 35081226
DOI: 10.1590/1807-3107bor-2022.vol36.0008 -
Arquivos de Gastroenterologia 2021Ileitis is defined as an inflammation of the ileum, which is evaluated during colonoscopy. Biopsies should be performed on altered ileus, aiding to the diagnosis.
BACKGROUND
Ileitis is defined as an inflammation of the ileum, which is evaluated during colonoscopy. Biopsies should be performed on altered ileus, aiding to the diagnosis.
OBJECTIVE
Evaluate the correlation of anatomopathological findings on ileitis between pathologists and endoscopists.
METHODS
A retrospective, cross-sectional study, between 2013 and 2017. Examination report, indications for colonoscopy, and medical records were evaluated to identify whether the colonoscopic findings were clinically significant. Anatomopathological samples were reviewed by a pathologist expert in gastrointestinal tract. Patients over 18 years of age who had undergone ileoscopy were included, whereas patients below 18 years of age and those with previous intestinal resections were excluded. The correlation was assessed using the kappa coefficient index.
RESULTS
A total of 5833 colonoscopies were conducted in the study period and 3880 cases were included. Ileal alterations were observed in 206 cases, with 2.94% being clinically significant. A hundred and sixty three biopsies were evaluated using the kappa index, resulting in agreement among pathologists of 0.067 and among pathologist and endoscopist of 0.141.
CONCLUSION
It was observed that despite the low concordance between pathologists and endoscopists, there was no change in patient outcomes. This study confirms the importance of knowledge of the main anatomopathological changes related to ileitis by pathologists and endoscopists, making the best diagnosis and follow-up.
Topics: Adolescent; Adult; Colonoscopy; Cross-Sectional Studies; Humans; Ileitis; Language; Pathologists; Retrospective Studies
PubMed: 34231660
DOI: 10.1590/S0004-2803.202100000-25 -
Der Pathologe Dec 2019The label cancer in itself leads to complex psychological reactions in patients that are closely related to previous experiences and self-image. A cancer diagnosis can... (Review)
Review
The label cancer in itself leads to complex psychological reactions in patients that are closely related to previous experiences and self-image. A cancer diagnosis can lead to increased distress and subsequent mental comorbidity such as depression or anxiety disorders. The responsibility of the pathologist, as the person who first uses the label cancer, is high. The pathologist must be conscious and focus not only on the accuracy of the anatomical pathology, but also on the potential influences the wording may have on the mental health of the patient. The word "carcinoma" should only be used in the case of tumors with the respective biological behavior. The example of non-invasive follicular thyroid neoplasm with papillary-like nuclear features shows that changing a label can lead to an improvement in distress and quality of life.
Topics: Adaptation, Psychological; Humans; Mental Health; Neoplasms; Pathologists; Professional-Patient Relations; Psycho-Oncology; Quality of Life; Stress, Psychological
PubMed: 31705241
DOI: 10.1007/s00292-019-00687-6