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Archives of Pathology & Laboratory... Sep 2023Eosinophilic diseases of the gastrointestinal tract (EGIDs), eosinophilic gastritis (EoG), and eosinophilic duodenitis (EoD) are rarely suspected clinically and...
CONTEXT.—
Eosinophilic diseases of the gastrointestinal tract (EGIDs), eosinophilic gastritis (EoG), and eosinophilic duodenitis (EoD) are rarely suspected clinically and infrequently detected by pathologists.
OBJECTIVE.—
To determine whether histories of allergic or eosinophilic disorders and requests to rule out EoG and EoD affect pathologists' awareness of eosinophils in gastrointestinal biopsies.
DESIGN.—
Thirty-one community-based pathologists were given 16 sets of biopsies from gastric and duodenal mucosa with elevated eosinophils, Helicobacter pylori gastritis, atrophic gastritis, normal stomach and duodenum, lymphocytosis, and celiac disease. Participants were assigned to 3 groups: group A did not receive histories of allergic or eosinophilic conditions; group B received similar histories plus a clue of possible allergic or eosinophilic conditions; and group C received the same histories as B and was asked to rule out EoG/EoD. A list of gastric and duodenal diagnoses and a space for comments were provided. Results were analyzed descriptively.
RESULTS.—
Pathologists correctly diagnosed most noneosinophilic gastrointestinal disorders, indicating competence in gastrointestinal pathology. With respect to EoG and EoD, pathologists in group C performed significantly better that those in groups A and B. The combined odds ratio with 95% CI was 12.34 (2.87-53.04), P < .001, for A versus C and 4.02 (1.60-10.09), P < .02, for B versus C.
CONCLUSIONS.—
Most pathologists neither reported gastric/duodenal eosinophilia nor diagnosed EoG/EoD, even when provided histories of eosinophilic disorders. Requests to rule out EoG/EoD resulted in only 4 of 11 participants evaluating and counting eosinophils in some cases. Simple evidence-based histopathologic criteria are needed before pathologists can be expected to consider and diagnose EGIDs.
Topics: Humans; Pathologists; Eosinophilia; Gastritis; Duodenum; Duodenitis
PubMed: 36399607
DOI: 10.5858/arpa.2022-0204-OA -
American Journal of Speech-language... Sep 2023This scoping review aimed to explore the extant literature on the experiences and views of speech-language pathologists (SLPs) and SLP students regarding the provision... (Review)
Review
PURPOSE
This scoping review aimed to explore the extant literature on the experiences and views of speech-language pathologists (SLPs) and SLP students regarding the provision of care to people living with dementia (PLWD).
METHOD
A systematic search was conducted using 10 databases for sources published in English from January 2000 through January 2022. Sources were included if participants were practicing SLPs and/or students enrolled in undergraduate communicative disorders or graduate SLP programs and if the concepts of experiences or views on the provision of SLP services to PLWD were explored in the context of any clinical or educational setting. Included sources were systematically extracted for pertinent study characteristics, including SLP roles and settings, concept domains, measures utilized, and facilitators/barriers to effective dementia care.
RESULTS
The majority of the 29 included sources were published in either academic journals ( = 20) or professional organization publications ( = 5) and used a cross-sectional study design ( = 19). Participants included SLPs ( = 22 studies) and graduate ( = 6 studies), undergraduate ( = 3 studies), and doctoral students ( = 1 study). The included studies addressed five primary conceptual domains: experiences, attitudes, roles, knowledge, and confidence. The most commonly addressed barriers and facilitators of effective dementia care were education and training.
CONCLUSIONS
Mapping and analysis of the current body of knowledge within this scoping review illuminated several knowledge gaps that we propose need to be addressed to meet the education and training needs of SLPs to provide optimal care to PLWD. These include systematically measuring access to and outcomes of evidence-based education and training programs both within and outside of an interprofessional collaborative context.
Topics: Humans; Pathologists; Cross-Sectional Studies; Speech; Communication Disorders; Students; Dementia; Speech-Language Pathology
PubMed: 37532246
DOI: 10.1044/2023_AJSLP-22-00410 -
Journal of the American Academy of... Aug 2023A biopsy should be performed whenever the diagnosis is in doubt. A 4-mm punch biopsy sectioned horizontally at multiple levels is best. In general, noncicatricial... (Review)
Review
A biopsy should be performed whenever the diagnosis is in doubt. A 4-mm punch biopsy sectioned horizontally at multiple levels is best. In general, noncicatricial alopecia should be sampled where hair is sparsest (most involved area), and cicatricial alopecia should be biopsied in an area of active disease, which is best determined using a dermatoscope and is most often at the margin of a lesion. The goal with cicatricial alopecia is to capture both follicular scars as well as actively inflamed hairs. Information provided by the clinician to the pathologist can be decisive in rendering a definitive diagnosis. The wording of the biopsy report provides a clue to the confidence of the pathologist's diagnosis.
Topics: Humans; Scalp; Biopsy; Alopecia; Hair; Cicatrix
PubMed: 37591560
DOI: 10.1016/j.jaad.2023.05.047 -
Archives of Dermatological Research Apr 2024This paper explores the role of teledermatology (TD) in Mohs micrographic surgery (MMS) at various stages of patient care. The study aims to assess the benefits,... (Review)
Review
This paper explores the role of teledermatology (TD) in Mohs micrographic surgery (MMS) at various stages of patient care. The study aims to assess the benefits, limitations, and patient experiences surrounding TD integration into MMS practices. We conducted a PubMed search using keywords related to TD and MMS, categorizing selected articles into pre-operative, intra-operative, and post-operative stages of MMS. TD reduced waiting times (26.10 days for TD compared to 60.57 days for face-to-face [FTF]) and consultation failure rates (6% for TD vs. 17% for FTF) for MMS preoperative consultations. It also shortened time to treatment by two weeks and led to notable travel savings (162.7 min, 144.5 miles, and $60.00 per person). Telepathology facilitated communication and decision-making during MMS, improving accuracy and efficiency, especially in challenging cases requiring collaboration where physical presence of another surgeon or pathologist is not feasible. Telepathology definitively diagnosed benign lesions and malignant tumors in 81.8% of cases (18/22). Additionally, there was a 95% agreement between conventional light microscopy diagnosis and telepathology in tumors (19/20), and 100% agreement for all 20 Mohs frozen section consultations. For post-operative follow-up, telephone follow-up (TFU) and text messaging proved effective, cost-efficient alternatives with high patient satisfaction (94% in New Zealand and 96% in the U.K.) and early complication identification. This study underscores TD's multifaceted benefits in MMS: enhanced patient experience preoperatively, improved communication during surgery, and cost-effective postoperative follow-up. Limitations include the financial expense and technical issues that can arise with TD (connectivity problems, delays in video/audio transmission, etc.). Further studies are needed to explore emerging TD modalities in post-operative patient management. The integration of TD into MMS signifies a progressive step in dermatological care, offering convenient, cost-effective, and better solutions with the potential to enhance patient experiences and outcomes.
Topics: Humans; Mohs Surgery; Communication; New Zealand; Pathologists; Patient Satisfaction
PubMed: 38625403
DOI: 10.1007/s00403-024-02851-2 -
Diagnostics (Basel, Switzerland) Jul 2023In modern clinical practice, digital pathology has an essential role, being a technological necessity for the activity in the pathological anatomy laboratories. The... (Review)
Review
In modern clinical practice, digital pathology has an essential role, being a technological necessity for the activity in the pathological anatomy laboratories. The development of information technology has majorly facilitated the management of digital images and their sharing for clinical use; the methods to analyze digital histopathological images, based on artificial intelligence techniques and specific models, quantify the required information with significantly higher consistency and precision compared to that provided by optical microscopy. In parallel, the unprecedented advances in machine learning facilitate, through the synergy of artificial intelligence and digital pathology, the possibility of diagnosis based on image analysis, previously limited only to certain specialties. Therefore, the integration of digital images into the study of pathology, combined with advanced algorithms and computer-assisted diagnostic techniques, extends the boundaries of the pathologist's vision beyond the microscopic image and allows the specialist to use and integrate his knowledge and experience adequately. We conducted a search in PubMed on the topic of digital pathology and its applications, to quantify the current state of knowledge. We found that computer-aided image analysis has a superior potential to identify, extract and quantify features in more detail compared to the human pathologist's evaluating possibilities; it performs tasks that exceed its manual capacity, and can produce new diagnostic algorithms and prediction models applicable in translational research that are able to identify new characteristics of diseases based on changes at the cellular and molecular level.
PubMed: 37510122
DOI: 10.3390/diagnostics13142379 -
Pathology Dec 2023
Topics: Humans; Pathologists; Nomograms
PubMed: 37806946
DOI: 10.1016/j.pathol.2023.08.004 -
Pathologica Oct 2023The crucial role of pathologists in enhancing our understanding of SARS-CoV-2-related disease, from initial pneumonia manifestations to persistent long COVID lung... (Review)
Review
The crucial role of pathologists in enhancing our understanding of SARS-CoV-2-related disease, from initial pneumonia manifestations to persistent long COVID lung symptoms, is the focus of this review. Pathological explorations have offered unprecedented insights into the early stages of severe COVID-19, shedding light on the interplay between the virus and subsequent complications, thereby shaping clinical approaches. Growing interest is directed to residual lung abnormalities of COVID-19 survivors. Although various radiological studies reported long-lasting pulmonary changes (e.g., ground glass opacities, reticulations, and bronchiectasis), the true incidence of pulmonary fibrosis and corresponding pathological findings in these patients remains largely unknown. There are a few high-impact and knowledgeable works on late complications in COVID-19 survivors, several coming from explant or autopsy cases, and rare cases from in vivo sampling. The study of biopsy samples has further deepened our knowledge of the aftermath of COVID-19 on lung tissue, uncovering alterations at the cellular level and shifts in vascular and epithelial dynamics. Despite the substantial progress made, future research is needed to devise a uniform strategy for interpreting lung biopsies, with a focus on leveraging advanced tools such as molecular and digital pathology techniques, along with artificial intelligence.
Topics: Humans; COVID-19; Post-Acute COVID-19 Syndrome; Artificial Intelligence; Pathologists; SARS-CoV-2; Pneumonia; Lung
PubMed: 38054902
DOI: 10.32074/1591-951X-906 -
Archives of Pathology & Laboratory... Feb 2024Mast cells are essential components of the immune system and play crucial pathogenetic roles in several digestive diseases, including mastocytic enterocolitis and... (Review)
Review
CONTEXT.—
Mast cells are essential components of the immune system and play crucial pathogenetic roles in several digestive diseases, including mastocytic enterocolitis and eosinophilic gastrointestinal disorders. Pathologists have rarely been asked to evaluate the distribution and density of mast cells in gastrointestinal (GI) biopsy specimens. However, such requests are becoming more common because of an increasing awareness of the role of mast cells in functional GI disease and in both esophageal and nonesophageal eosinophilic gastrointestinal disorders.
OBJECTIVE.—
To provide pathologists with tools to incorporate the assessment of mast cells in the evaluation of esophageal, gastric, and intestinal specimens by developing a systematic approach to their evaluation, counting, and reporting.
DESIGN.—
This study consisted of a review of the literature followed by multiple consensus sessions to decide where to count mast cells and what a countable mast cell is.
RESULTS.—
We reviewed 135 papers addressing the content of mast cells in the digestive tract, selected 21 that detailed how cells were counted (microscope lens, area of high-power fields, locations evaluated, type of cells considered as countable), and summarized their data in a table. Then, drawing from both the acceptable literature and our own extensive experience, we reached a tentative consensus on: (1) the normal numbers in the different segments of the GI tract; (2) the morphology of countable mast cells; and (3) the locations and strategies for counting them.
CONCLUSIONS.—
The result is a set of suggestions for reporting mast cell counts, their distribution, and their location in a way clinicians can understand and use for management decisions.
Topics: Humans; Mast Cells; Pathologists; Gastrointestinal Tract; Mastocytosis; Gastrointestinal Diseases
PubMed: 37450346
DOI: 10.5858/arpa.2023-0070-OA -
Cytopathology : Official Journal of the... May 2024There is beauty in cytopathology. That beauty and art can be transmitted and shared through fun images on social media.
OBJECTIVE
There is beauty in cytopathology. That beauty and art can be transmitted and shared through fun images on social media.
METHODS
As social media becomes more popular, pathologists and related professionals have started to share the images that they capture at work on their profiles, tagging them with the hashtag #Pathart. #Pathart hashtag unites two concepts innately related: Pathology and art.
RESULTS
When groups of pathologists share concurring ideas, the result is an explosion of creativity that spreads even to new professionals and students. In addition, it attracts the attention of people, dedicated to other subjects such as journalism, who, with their interactions, give visibility to our field. This helps counteract the stereotypes and gives people a better understanding of what we do and why it is important. Therefore, the more pathologists and related professionals meet and interact with each other, the better.
CONCLUSIONS
#Pathart images raise great interest among professionals, which contributes to the creation of a united and strong community of pathologists some of whom are dedicated to cytology. Interaction and professional collaboration between these professionals can positively contribute to disseminating scientific content and creating work/research groups. This might have an impact, both direct and indirect, on improving the quality of diagnoses and treatments in our patients.
Topics: Humans; Pathology; Art
PubMed: 38293751
DOI: 10.1111/cyt.13361 -
Hematology/oncology Clinics of North... Oct 2023Recent advances in our understanding of the molecular alterations underlying different types of renal cell carcinoma (RCC), as well as the implementation of immune... (Review)
Review
Recent advances in our understanding of the molecular alterations underlying different types of renal cell carcinoma (RCC), as well as the implementation of immune checkpoint inhibitors in the treatment of patients with advanced disease, have significantly expanded the role of pathologists in the management of RCC patients and in the identification of predictive biomarkers that can guide patient treatment. In this chapter, we examine pathologists' evolving role in patient care and the development of precision medicine strategies for RCC.
Topics: Humans; Carcinoma, Renal Cell; Pathologists; Biomarkers; Kidney Neoplasms; B7-H1 Antigen; Biomarkers, Tumor
PubMed: 37258353
DOI: 10.1016/j.hoc.2023.04.014