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Gastroenterology Apr 2021
Topics: Colitis, Ulcerative; Colonoscopy; Humans; Pathologists
PubMed: 33508287
DOI: 10.1053/j.gastro.2021.01.213 -
Archives of Pathology & Laboratory... Aug 2019Fatal dermatologic diseases and ones with high morbidity can occur in the inpatient setting. In such cases, prompt and accurate assessment of a bedside skin biopsy is... (Review)
Review
CONTEXT.—
Fatal dermatologic diseases and ones with high morbidity can occur in the inpatient setting. In such cases, prompt and accurate assessment of a bedside skin biopsy is required. This may be challenging for many pathologists who are not familiar with the complexity of skin pathology and skin terminology within the fields of dermatopathology and dermatology.
OBJECTIVE.—
To provide the pathologist with a practical, up-to-date, and "must-know" reference guide on dermatologic urgencies and emergencies from a real-world perspective, highlighting diagnostic pearls, diagnostic pitfalls, and commonly encountered practice gaps. This review will focus on key diseases with which every pathologist should be familiar, including angioinvasive fungal infections, Stevens-Johnson syndrome/toxic epidermal necrolysis, staph-scalded-skin syndrome, acute graft-versus-host disease, bullous pemphigoid, calciphylaxis, Sweet syndrome and its histiocytoid variant, pyoderma gangrenosum, and leukocytoclastic vasculitis, as well as those in their clinical and histopathologic differential.
DATA SOURCES.—
This review is based on peer-reviewed literature and our personal experiences with these diseases at major academic institutions, including one where a large number of stem cell transplants are performed. This review is unique as it represents collaborative expert opinion from both a dermatopathology and a dermatology standpoint.
CONCLUSIONS.—
This review outlines the critical role that the pathologist plays in the outcomes of patients with dermatologic urgencies and emergencies. Improved patient care will result from prompt and accurate histopathologic diagnoses as well as an open line of communication with the dermatologist.
Topics: Acute Disease; Biopsy; Dermatology; Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Humans; Pathologists; Pathology, Clinical; Skin; Skin Diseases
PubMed: 30785787
DOI: 10.5858/arpa.2018-0239-RA -
Critical Reviews in Clinical Laboratory... Jun 2024No standard tool to measure pathologist workload currently exists. An accurate measure of workload is needed for determining the number of pathologists to be hired,... (Review)
Review
No standard tool to measure pathologist workload currently exists. An accurate measure of workload is needed for determining the number of pathologists to be hired, distributing the workload fairly among pathologists, and assessing the overall cost of pathology consults. Initially, simple tools such as counting cases or slides were used to give an estimate of the workload. More recently, multiple workload models, including relative value units (RVUs), the Royal College of Pathologists (RCP) point system, Level 4 Equivalent (L4E), Work2Quality (W2Q), and the University of Washington, Seattle (UW) slide count method, have been developed. There is no "ideal" model that is universally accepted. The main differences among the models come from the weights assigned to different specimen types, differential calculations for organs, and the capture of additional tasks needed for safe and timely patient care. Academic centers tend to see more complex cases that require extensive sampling and additional testing, while community-based and private laboratories deal more with biopsies. Additionally, some systems do not account for teaching, participation in multidisciplinary rounds, quality assurance activities, and medical oversight. A successful workload model needs to be continually updated to reflect the current state of practice.Awareness about physician burnout has gained attention in recent years and has been added to the World Health Organization's International Classification of Diseases (World Health Organization, WHO) as an occupational phenomenon. However, the extent to which this affects pathologists is not well understood. According to the WHO, burnout syndrome is diagnosed by the presence of three components: emotional exhaustion, depersonalization from one's work (cynicism related to one's job), and a low sense of personal achievement or accomplishment. Three drivers of burnout are the demand for productivity, lack of recognition, and electronic health records. Prominent consequences of physician burnout are economic and personal costs to the public and to the providers.Wellness is physical and mental well-being that allows individuals to manage stress effectively and to thrive in both their professional and personal lives. To achieve wellness, it is necessary to understand the root causes of burnout, including over-work and working under stressful conditions. Wellness is more than the absence of stress or burnout, and the responsibility of wellness should be shared by pathologists themselves, their healthcare organization, and governing bodies. Each pathologist needs to take their own path to achieve wellness.
Topics: Humans; Workload; Burnout, Professional; Pathologists
PubMed: 38809116
DOI: 10.1080/10408363.2023.2285284 -
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 -
American Journal of Clinical Pathology Aug 2018
Topics: Humans; Pathologists
PubMed: 30165557
DOI: 10.1093/ajcp/aqy119 -
Current Cancer Drug Targets 2018The effectiveness of new personalized treatment procedures in oncology is based on the fact that certain tumors exhibit specific molecular features. More in detail,... (Review)
Review
The effectiveness of new personalized treatment procedures in oncology is based on the fact that certain tumors exhibit specific molecular features. More in detail, neoplastic tissues of patients should display a specific biomarker, most often a specific genetic alteration and/or under/overexpression of a definite protein, that could be the target of its respective drug. Immunohistochemical and molecular analyses, which usually include examination of nucleic acids from either tissues or fluids, are common tests to define the status of a tumor. This review focuses on the pathologist's role in carefully controlling pre- analytic procedures and standard operating procedures that are a crucial prerequisite to reach reliable and reproducible results. Six paradigmatic applications of targeted therapy, for which pathological diagnosis plays a fundamental role, are summarized. Traditional and next-generation sequencing are also addressed from the pathologist's perspective as well as the importance pathologists have in this shift to more accurate definition of disease risk and prognostication of therapy response in the personalized medicine era.
Topics: Antineoplastic Agents; Humans; Molecular Targeted Therapy; Neoplasm Proteins; Neoplasms; Pathologists; Precision Medicine; Prognosis
PubMed: 29189158
DOI: 10.2174/1568009618666171129145703 -
Modern Pathology : An Official Journal... Jan 2020Inflammatory dermatopathology remains a challenging area for surgical pathologists. Yet every surgical pathologist encounters inflammatory dermatoses as part of routine... (Review)
Review
Inflammatory dermatopathology remains a challenging area for surgical pathologists. Yet every surgical pathologist encounters inflammatory dermatoses as part of routine practice. This review will focus on selected diagnoses that are either commonly encountered in the routine practice of surgical pathology or are critically important. The following entities will be covered: spongiotic dermatoses, lichen simplex chronicus, and early lichen sclerosus in the setting of vulvar biopsies, as well as graft versus host disease, Stevens-Johnson syndrome/toxic epidermal necrolysis, granuloma anulare, pyoderma gangrenosum, and calciphylaxis. Practical points and key histologic features will be emphasized.
Topics: Biopsy; Dermatitis; Diagnosis, Differential; Humans; Pathologists; Predictive Value of Tests; Skin
PubMed: 31676787
DOI: 10.1038/s41379-019-0400-z -
Indian Journal of Pathology &... Jun 2021Newer molecular diagnostics and improved understanding of cancer pathogenesis have identified multiple pathways that can be potentially targeted with the use of novel... (Review)
Review
Newer molecular diagnostics and improved understanding of cancer pathogenesis have identified multiple pathways that can be potentially targeted with the use of novel therapeutics in development. These developments have ushered cancer therapeutics in newer era of personalized medicine. Same is reflected on current management strategies for advanced gastrointestinal malignancies. Molecular profiling for BRAF and RAS is standard for colorectal cancer while Her2 and PDL1 status is needed for planning therapy of advanced gastroesophageal cancers. Tissue agnostic markers like MSI, TMB and NTRK are making headways in therapeutic armamentarium. While newer targeted therapies against FGFR, EGFR, PI3K-AKT, DDR pathways are showing promising results in initial studies. Here we review traditional as well as upcoming molecular markers in field of GI malignancies, methods of testing and evidence for rational use in clinical practice.
Topics: Antineoplastic Agents; Biomarkers, Tumor; Gastrointestinal Neoplasms; Humans; Molecular Targeted Therapy; Mutation; Pathologists; Pathology, Molecular; Precision Medicine
PubMed: 34135137
DOI: 10.4103/IJPM.IJPM_1239_20 -
The Journal of Pathology Jul 2021The use of three-dimensional (3D) culture models for cancer research has expanded greatly in recent years, with studies in almost every tumor type addressing a wide... (Review)
Review
The use of three-dimensional (3D) culture models for cancer research has expanded greatly in recent years, with studies in almost every tumor type addressing a wide variety of research questions. Multiple distinct 3D culture approaches are now available, each with its own advantages and disadvantages, as well as most effective applications. In this review, we focus on one of these 3D culture models, organoids, in which multicellular units are isolated from primary or metastatic tumors and cultured in extracellular matrix gels. Organoids can be studied in acute cultures for short times after isolation, or passaged and biobanked for long-term use. We define this model system and describe some key studies in which organoid culture models were used to investigate cellular strategies and molecular mechanisms driving cancer initiation and progression, highlighting research questions for which this model is particularly well suited. In addition, as interest in implementing organoid systems continues to expand, we discuss key considerations in developing a new organoid research program. Our goal is to demonstrate the power and utility of organoid models and provide guidance for investigators who are considering implementation of these models in their own research programs. © 2021 The Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
Topics: Animals; Cell Culture Techniques; Humans; Neoplasms; Organoids; Pathologists
PubMed: 33886125
DOI: 10.1002/path.5684 -
Archives of Pathology & Laboratory... Aug 2019
Topics: Career Choice; Humans; Pathologists; Pathology, Clinical; Students, Medical
PubMed: 31339753
DOI: 10.5858/arpa.2019-0020-ED