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American Journal of Clinical Pathology Nov 2021Consultation on surgical pathology specimens is part of the daily professional practice of every pathologist. We evaluated the characteristics of a good consultant and...
OBJECTIVES
Consultation on surgical pathology specimens is part of the daily professional practice of every pathologist. We evaluated the characteristics of a good consultant and the habits that should be avoided.
METHODS
A 1-page questionnaire was prepared to evaluate how pathologists select their consultants.
RESULTS
The questionnaire was emailed to 106 pathologists. Fifty-eight pathologists completed the questionnaire (55% response rate). The most important criteria for a consultant were knowledge and expertise. Accessibility, turnaround time, and teaching (providing explanation about the case) were selected next for choosing a consultant. The 2 factors that contributed to avoiding a consultant were expensive workup and changing the diagnosis. Open questions about "definition of best/worst consultant," "when to change the consultant," and "if the criteria for consultant have changed over time" provided additional valuable information.
CONCLUSIONS
Accessibility, short turnaround time, and teaching are the most important reasons for selecting a consultant. Performing an expensive workup and being in the habit of changing the diagnosis are the factors that make a consultant less favorable.
Topics: Consultants; Humans; Pathologists; Pathology, Surgical; Referral and Consultation; Surveys and Questionnaires
PubMed: 34075389
DOI: 10.1093/ajcp/aqab068 -
Archives of Pathology & Laboratory... Jul 2021Both the incidence of cancer and cancer-related mortality rates are high in sub-Saharan Africa, while resources for diagnosis and management are inadequate. In Benin,...
CONTEXT.—
Both the incidence of cancer and cancer-related mortality rates are high in sub-Saharan Africa, while resources for diagnosis and management are inadequate. In Benin, there is an extreme shortage of pathology services. Because of this shortage we built a histopathology laboratory equipped with an automated immunohistochemistry and a whole-slide imaging and telepathology system.
OBJECTIVE.—
To report our experience of telepathology practice in the improvement of cancer diagnosis.
DESIGN.—
The study was performed in our histopathology laboratory from January 1, 2016, to December 31, 2018. Resident laboratory technicians were trained in the preparation of microscopic and virtual slides by European pathologists. Virtual slides were stored on a Web-accessible server area for reading by 21 telepathologists in Benin and Europe. All patients with a histologic diagnosis of cancer were included in this study. Demographic data of patients, anatomic site of cancer, its histologic type, and its histologic grade were recorded.
RESULTS.—
We registered 399 patients diagnosed with cancer of 1593 patients whose surgical specimens had been analyzed. There were 349 adults including 160 males and 189 females, and 50 children (both sexes) with a mean age of 53.40 years, 46.92 years, and 9.72 years, respectively. Eighty-three of 211 females (39.34%) had infiltrating breast carcinoma, and 34 of 188 males (18.09%) had prostatic carcinoma. Infiltrating carcinoma of no special type represented 51 (91.07%) of all infiltrating breast carcinomas. Prostatic carcinoma and infiltrating breast carcinoma were of high grade in 13 of 23 males (56.52%) and 34 of 56 females (60.71%), respectively.
CONCLUSIONS.—
Telepathology is enabling a great improvement in cancer diagnosis in our hospital.
Topics: Adolescent; Adult; Aged; Automation, Laboratory; Benin; Biomarkers, Tumor; Child; Child, Preschool; Female; Humans; Image Interpretation, Computer-Assisted; Immunohistochemistry; Infant; Male; Middle Aged; Neoplasms; Predictive Value of Tests; Program Evaluation; Remote Consultation; Reproducibility of Results; Retrospective Studies; Telepathology; Young Adult
PubMed: 33091927
DOI: 10.5858/arpa.2019-0437-OA -
Pathologie (Heidelberg, Germany) Sep 2022Accreditation in pathology and neuropathology in Germany is based on the requirements of the DIN EN ISO/IEC 17020 standard, which defines general requirements for the... (Review)
Review
Accreditation in pathology and neuropathology in Germany is based on the requirements of the DIN EN ISO/IEC 17020 standard, which defines general requirements for the bodies performing inspections. In Germany, the national accreditation body of the Federal Republic of Germany (DAkkS) assumes the official task of accreditation. Evaluation in this area is based on a comprehensive assessment by board-certified pathologists (inspection) and is focused on correct diagnosis. The requirement of the DIN EN ISO 15189 standard on quality and competence in medical laboratories is taken into account. In Germany, more than 100 institutes of pathology and neuropathology have successfully performed the accreditation process. Interest in accreditation has been significantly growing in recent months, especially due to changes in the European law with the "Verordnung EO 2017/746 des Europäischen Parlaments und des Rates vom 05. April 2017 über Invitro-Diagnostica".However, accreditation is a demanding process that requires very good preparation. Necessary resources for accreditation should be secured before starting the process. Important framework conditions and requirements, but also some challenges that can arise during the accreditation process, are summarized in this article.
Topics: Academies and Institutes; Accreditation; Certification; Germany; Neuropathology
PubMed: 35925314
DOI: 10.1007/s00292-022-01097-x -
Archives of Pathology & Laboratory... Oct 2020The measurement of cytokines in clinical laboratories is becoming an increasingly routine part of immune monitoring when administering biologic and cell-based...
CONTEXT.—
The measurement of cytokines in clinical laboratories is becoming an increasingly routine part of immune monitoring when administering biologic and cell-based immunotherapies and also for clinical assessment of inflammatory conditions. While a number of commercial assays and platforms are available for cytokine measurement, there is currently little standardization among these analytical methods.
OBJECTIVE.—
To characterize the variability and comparability among cytokine testing platforms that are commonly used in clinical laboratories.
DESIGN.—
We analyzed data for 4 cytokines (interleukin [IL]-1, IL-6, IL-8, and tumor necrosis factor-alpha [TNF-α]) from 6 College of American Pathologists cytokine surveys administered from 2015 to 2018. Analyses interrogated variability between testing methods and variability within each laboratory across the mailings.
RESULTS.—
Significant variability was noted across methods with analysis of IL-1 showing the least variability and IL-6, IL-8, and TNF-α varying between methods to a greater extent. Intralab variability was also significant with TNF-α measurements again showing the greatest variability.
CONCLUSIONS.—
This retrospective analysis of College of American Pathologists proficiency testing data for cytokine measurement is the largest method comparison to date, and this study provides a description of the variation of cytokine measurement across methods, across laboratories, and within laboratories. Serial monitoring of cytokines should preferentially be performed by the same method within the same laboratory.
Topics: Cytokines; Humans; Laboratories; Laboratory Proficiency Testing; Pathology, Clinical; Quality Improvement; Retrospective Studies
PubMed: 32401053
DOI: 10.5858/arpa.2019-0519-CP -
Computer Methods and Programs in... Nov 2023Nuclear segmentation in cervical cell images is a crucial technique for automatic cytopathology diagnosis. Experimental evaluation of nuclear segmentation methods with...
BACKGROUND AND OBJECTIVE
Nuclear segmentation in cervical cell images is a crucial technique for automatic cytopathology diagnosis. Experimental evaluation of nuclear segmentation methods with datasets is helpful in promoting the advancement of nuclear segmentation techniques. However, public datasets are not enough for a reasonable and comprehensive evaluation because of insufficient quantity, single data source, and low segmentation difficulty.
METHODS
Therefore, we provide the largest dataset for cervical nuclear segmentation (CNSeg). It contains 124,000 annotated nuclei collected from 1,530 patients under different conditions. The image styles in this dataset cover most practical application scenarios, including microbial infection, cytopathic heterogeneity, overlapping nuclei, etc. To evaluate the performance of segmentation methods from different aspects, we divided the CNSeg dataset into three subsets, namely the patch segmentation dataset (PatchSeg) with nuclei images collected under complex conditions, the cluster segmentation dataset (ClusterSeg) with cluster nuclei, and the domain segmentation dataset (DomainSeg) with data from different domains. Furthermore, we propose a post-processing method that processes overlapping nuclei single ones.
RESULTS AND CONCLUSION
Experiments show that our dataset can comprehensively evaluate cervical nuclear segmentation methods from different aspects. We provide guidelines for other researchers to use the dataset. https://github.com/jingzhaohlj/AL-Net.
Topics: Female; Humans; Algorithms; Cervix Uteri; Cell Nucleus; Cytology; Image Processing, Computer-Assisted
PubMed: 37544166
DOI: 10.1016/j.cmpb.2023.107732 -
Medicine, Science, and the Law Jan 2021The magnitude of the diagnostic benefit conferred by performing histopathological examinations after medico-legal/forensic autopsies remains debatable. We have tried to...
The magnitude of the diagnostic benefit conferred by performing histopathological examinations after medico-legal/forensic autopsies remains debatable. We have tried to address this issue by reviewing a series of histopathology referrals concerning medico-legal autopsies in real-world routine practice. We present an audit of the consultations provided to forensics by clinical pathologists at our institute between 2015 and 2018. Over this period, 493 post-mortem examinations were performed by forensic pathologists. Of these cases, 52 (11%) were referred for histopathology. Gross assessment was requested in 22/52 (42%) cases. Histopathology examination was performed on single organs in 15/52 (29%) cases, primarily on the lung and heart, whereas parenchymatous multi-organ analysis was carried out in 14/52 (27%) cases. Bone-marrow sampling was studied in 4/52 (8%) cases. Immunohistochemistry was needed in 16/52 (31%) cases, special stains in 9/52 (21%) cases and molecular analysis in 4/52 (8%) cases. Focusing on technical processes, standard methodology on pre-analytical procedures was changed in 10/52 (19%) cases in order to answer specific diagnostic questions. We showed that although most of the time the diagnosis is clear by the end of dissection on the basis of the macroscopic findings, histopathology can provide, modify or confirm the cause of death in many medico-legal/forensic cases. Therefore, it is desirable that forensic pathologists and clinical pathologists establish robust working relationships in a cooperative environment. We conclude that it is important to implement guidelines based on real-world routine practice in order to identify cases where histopathology can provide useful contributions, which in our experience applied to 11% of forensic cases.
Topics: Autopsy; Forensic Pathology; Guidelines as Topic; Humans; Pathologists; Pathology, Clinical; Referral and Consultation
PubMed: 33591882
DOI: 10.1177/0025802420965763 -
American Journal of Clinical Pathology May 2023To characterize the attitudes of treating clinicians toward pathology explanation clinics (PECs).
OBJECTIVES
To characterize the attitudes of treating clinicians toward pathology explanation clinics (PECs).
METHODS
Clinicians from a tertiary care academic medical center were asked, "How interested would you be in having your patient meet with a pathologist to discuss their pathology report and see their tissue under the microscope?" Clinicians ranked their interest, then expanded on concerns and benefits in a semistructured interview. Audio recordings of interviews were transcribed and analyzed using a qualitative thematic approach.
RESULTS
A total of 35 clinicians were interviewed, with 83% reporting some level of interest in PECs. Clinicians felt that highly educated and motivated patients were most likely to benefit from a PEC. Clinicians recognized that PECs could improve understanding and emotional processing but that the patient's information needs must be balanced with the potential for cognitive overload and emotional distress. When integrating the pathologist into the care team, clinicians worried about the pathologist's communication skills, care fragmentation, and increased clinician workload. If performed well, clinicians felt PECs had the potential to increase clinician efficacy and improve quality of care.
CONCLUSIONS
Overall, clinicians are interested in PECs when they fulfill a patient's information needs and are optimally performed.
Topics: Humans; Attitude of Health Personnel; Pathology, Clinical
PubMed: 36821476
DOI: 10.1093/ajcp/aqac175 -
Fa Yi Xue Za Zhi Apr 2020Autopsy of patients who died of infectious diseases is of significance for public health management. Few forensic autopsies have been performed since the outbreak of the... (Review)
Review
Autopsy of patients who died of infectious diseases is of significance for public health management. Few forensic autopsies have been performed since the outbreak of the corona virus disease 2019 (COVID-19) due to some limitations, thus forensic pathological examination failed to contribute to the prevention and treatment of infectious diseases. Virtual autopsy has unique advantages in the forensic examination of patients who died of infectious diseases. Accumulated virtual autopsy image data are of great value to the study of the pathological mechanism and diagnosis of COVID-19. This article reviews the relationship between imaging changes and pathology of the COVID-19 as well as the application of virtual autopsy in autopsy of patients who died of infectious diseases, in order to provide reference for performing virtual autopsy in the outbreak of COVID-19.
Topics: Autopsy; Betacoronavirus; COVID-19; Coronavirus Infections; Forensic Pathology; Humans; Pandemics; Pneumonia, Viral; SARS-CoV-2
PubMed: 32212513
DOI: 10.12116/j.issn.1004-5619.2020.02.001 -
Journal of Veterinary Diagnostic... Jul 2024Telepathology, as a subset of teleconsulting, is pathology interpretation performed at a distance. Telepathology is not a new phenomenon, but since ~2015, significant... (Review)
Review
Telepathology, as a subset of teleconsulting, is pathology interpretation performed at a distance. Telepathology is not a new phenomenon, but since ~2015, significant advances in information technology and telecommunications coupled with the pandemic have led to unprecedented sophistication, accessibility, and use of telepathology in human and veterinary medicine. Furthermore, telepathology can connect veterinary practices to distant laboratories and provide support for underserved animals and communities. Through our scoping review, we provide an overview of how telepathology is being used in veterinary medicine, identify gaps in the literature, and highlight future areas of research and service development. We searched MEDLINE, CAB Abstracts, and the gray literature, and included all relevant literature. Despite the widespread use of digital microscopy in large veterinary diagnostic laboratories, we identified a paucity of literature describing the use of telepathology in veterinary medicine, with a significant gap in studies addressing the validation of whole-slide imaging for primary diagnosis. Underutilization of telepathology to support postmortem examinations conducted in the field was also identified, which indicates a potential area for service development. The use of telepathology is increasing in veterinary medicine, and pathologists must keep pace with the changing technology, ensure the validation of innovative technologies, and identify novel uses to advance the profession.
Topics: Animals; Veterinary Medicine; Telepathology; Pathology, Veterinary
PubMed: 38742388
DOI: 10.1177/10406387241241270 -
Turkish Journal of Ophthalmology Aug 2023To evaluate sarcoidosis-induced tear film changes using subjective and objective diagnostic tests, particularly conjunctival impression cytology (IC), and to compare the... (Observational Study)
Observational Study
OBJECTIVES
To evaluate sarcoidosis-induced tear film changes using subjective and objective diagnostic tests, particularly conjunctival impression cytology (IC), and to compare the results with healthy individuals.
MATERIALS AND METHODS
This study evaluated clinical data collected between January 2019 and January 2021 from 57 right eyes of 57 sarcoidosis patients without ocular involvement (Group 1) and 33 right eyes of 33 healthy individuals with similar demographic characteristics (Group 2). The Schirmer I test, tear break-up time (TBUT), fluorescein staining, and conjunctival IC were all performed as part of the conjunctival and corneal examinations following a thorough ophthalmological examination. The Ocular Surface Disease Index (OSDI) was used to assess subjective ocular symptoms.
RESULTS
The mean ages in Groups 1 and 2 were 49.26±3.18 and 51.91±2.89 years, respectively (p=0.720). The mean Schirmer I test, TBUT, and OSDI scores differed significantly (p<0.05 for all), with Group 1 having a significantly higher percentage of dry eyes than Group 2. Group 1 had significantly higher Nelson's grading system grades than Group 2 based on conjunctival IC analysis (p=0.001). There were no significant differences in visual acuity (p=0.17) or intraocular pressure (p=0.14) between groups.
CONCLUSION
Sarcoidosis patients had significantly higher Nelson grades in conjunctival IC, as well as significantly higher percentages of dry eye as determined by the Schirmer I test, TBUT, and OSDI. Reduced tear quantity and quality may destabilize the tear film layer, resulting in a variety of ocular symptoms.
Topics: Sarcoidosis; Tears; Humans; Middle Aged; Conjunctiva; Cytology; Dry Eye Syndromes; Retrospective Studies
PubMed: 37602549
DOI: 10.4274/tjo.galenos.2022.58153