SEARCH · PubMed Health

Results for “Pathologists”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources

PubMed1992

A decade of acceptable autopsy rates. Does concordance of clinician and pathologist views explain relative success?

In an attempt to better understand the basis and significance of an annual autopsy rate consistently over 45% for the past decade, we recently investigated the attitudes and practices of 36 pathologists and 176 clinicians in our institution with respect to the function of the autopsy service and the utility of the autopsy. The autopsy report was "not used in a consistent manner" by 57% of clinical respondents. Several clinicians thought that autopsy reports were too long (20%) and too slow (38%), but not with the frequency that pathologists did, 73% and 58%, respectively. Significantly more pathologists than clinicians believed autopsy rates have fallen over the past 20 years because (1) people think that everything about the deceased is already known, (2) medical students are poorly educated about the autopsy, (3) pathologists have diminished interest, (4) physicians fear litigation, (5) physicians fear "being wrong," (6) pathologists lack financial incentives, and (7) Joint Commission on Accreditation of Healthcare Organizations requirement is not in place. Perceptions regarding the frequency of major discrepancies between clinical and autopsy findings were comparable, 17% and 13%, for pathologists and clinicians, respectively. Our "high" institutional autopsy rate does not reflect concordance of perceptions expressed by clinicians and pathologists and, thus, other factors may be important in the maintenance of an acceptable rate.

Attitude of Health Personnel↗

PubMed1990

[The status and outlook of the training of pathologists in the RSFSR].

Pathology service in the RSFSR suffers, at present, from the lack of pathologists: only 2393 (57.3%) of 4174 positions are occupied. Particularly difficult is the situation in Eastern Siberia and Moscow where only 47.7 and 48.6% positions, respectively, are covered. Lack of professional pathologists is aggravated by an artificial decrease of positions number as compared to real need, by the increase of proportion of persons retired or those having a preretirement age (30%), by a high percentage (over 30% of positions) of persons experiencing pathology as a second profession (65% of them do not have a sufficient knowledge and practice in pathology), by a low level of medical education in general and nonsufficient promotion of pathologists (only 39.3% pathologists have attestation categories). To solve the crisis the RSFSR Ministry of Health started in 1988/89 4-year training of pathologists at the pathology chairs of the RSFSR Medical Institutes: subinternship (1 year), internship (1 year), clinical internship (2 years). The realization of this program will result in turning out of 724 pathologists by 1994. The progress in pathologists training will require the improvement of technical basis of pathology chairs and departments and solution of certain organizational problems.

Certification↗

PubMed1975

Mortality study of pathologists and medical laboratory technicians.

Membership lists of professional bodies were used to establish study populations of British pathologists (1955-73) and medical laboratory technicians (1963-73). The standardised mortality ratio (SMR) for pathologists was 60 and for medical laboratory technicians 67. Twenty-seven of the 310 deaths were due to suicide. These numbers gave SMRs of 250 for pathologists and 243 for medical laboratory technicians. Suicide was the commonest cause of death in female technicians. Access to lethal chemicals at work is a possible factor explaining the high proportion of suicide by poisoning compared with the general population. Suicide rates for pathologists exceed those of all medical practitioners; similary medical laboratory have higher rates than all laboratory technicians. Excess deaths from lymphatic and haemopoietic neoplasms were noted in English male pathologists (observed 8, expected 3-3; P less than 0-01). This difference is not due to Hodgkin's disease or leukaemia and remains unexplained. No other neoplastic diseases were noted as causing excess mortality in either occupational group but a small, possibly spurious, excess number of deaths was noted for aortic aneurysm in male pathologists (observed 4, expected 1-8).

Female↗

PubMed1989

The pathologist and the clinical oncologist: a new effective partnership in assessing tumor prognosis.

During the past 20 years, we have witnessed a progressive radical change in the role of the pathologist vis à vis several aspects of clinical oncology. From the traditional description by light microscopy of resected specimens and study of tumor classifications, the modern pathologist has expanded his domain of action which now results in deeper and more effective interactions with the surgeon, radiotherapist and medical oncologist. The wide application of fine-needle biopsy has substantially improved early diagnosis of primary neoplasms and local and distant recurrences. The histogenetic classification based on type of tissue formed by the tumor rather than type of tissue from which tumor arises, the results of pathologic staging as well as the degree of tumor cell necrosis following primary chemotherapy are now being correlated with treatment outcome. The assessment of tumor grade and ploidy can allow more accurate selection of patient subgroups at high risk of early relapse. Last but not least, the morphologic recognition of certain types of iatrogenic morbidity helps in the reassessment of given drug combinations. During the past decade, pathologists have contributed to the development of several new investigative techniques whose first applications, in most instances, were in laboratories dedicated to basic research. More recently, some pathologists have begun to explore the feasibility of applying these same techniques to clinical cancer research. Modern sophisticated technology, including flow cytometry, immunohistochemistry and monoclonal antibodies, can now provide research physicians with important prognostic indicators such as tumor cell proliferative activity, steroid receptor status, occult distant micrometastases, immunologic phenotypes and gene amplification. By fulfilling several new tasks, which have contributed to the knowledge of the natural history of many tumors, the pathologist has become an integral part of the team planning new treatment strategies and evaluating their final outcome.

Humans↗

PubMed1975

Training and organization for pathology in Britain. The role of chemical pathologists.

In Britain, the term "clinical pathology" indicates the discipline of pathology applied to patients, whereas "chemical pathology" refers to pathology in its chemical and biochemical aspects, both as a basic science and for patient care. The initial training of a chemical pathologist is usually in general pathology, in metabolic medicine, or in research. This training continues solely in chemical pathology, and the specialist qualification, namely Membership of the Royal College of Pathologists, is taken at about 32 years of age. Training is similar in the other disciplines of pathology, and a pathologist usually achieves a senior permanent appointment by the age of 34 years. By national policy, pathology laboratories, each with departments of chemical pathology, hematology, histopathology, and microbiology, are centered in about 250 District General Hospitals. The chemical pathology section ideally includes both a medical consultant and an equivalent non-medical scientist. These ideals are unlikely to be reached because of pathologists usually include laboratory supervision, clinical liaison, teaching, and research. Many chemical pathologists also have specific clinical consultant activities, such as overseeing a Metabolic Unit.

Chemistry, Clinical↗

PubMed1988

Differing interpretations by pathologists of the pT category and grade of transitional cell cancer of the bladder.

The UICC pT category for transitional cell cancer (TCC) of the bladder was recorded as assigned from the routine service of a pathology laboratory. All reports had been passed for release after review by pathologists of the status of senior registrar or above. After 99 cases had been collected, the slides available to the original pathologist were reviewed by one dedicated pathologist in continuous session who was ignorant of the original report. No new sections were cut. There was disagreement with the original report of pT category in 14 cases: 13 were downstaged (including 6 from invasive to superficial) and 1 upstaged. There was disagreement with the original differentiation grade in 13 cases: 10 TCC were considered to be more differentiated and 3 less differentiated than the original report. A second pathologist reviewed the pT category only of 13 of the 14 cases, disagreeing with the original pT category on 8 occasions and with the pT category assigned by the dedicated pathologist on 7 occasions. These findings have important implications for advising patients on prognosis and clinical management and in the design and reporting of therapeutic trials.

Carcinoma, Transitional Cell↗

PubMed1990

Pathologist agreement in the interpretation of colorectal polyps.

Practicing physicians commonly perform flexible sigmoidoscopy in their offices. Polyploid lesions are frequently biopsied and sent to community hospitals for pathological interpretation. The pathologist's opinion often determines the course of medical follow-up for the patient, especially in cases in which early malignancy is suspected. This paper addresses the agreement of community-based pathologists regarding the interpretation of colorectal polyp pathology. Ten pathological slide sections were sent to 22 different community-based pathologists in southeast Michigan. These pathologists were asked to record their diagnosis of the specific histologies represented in each of the slides. The results indicated a high level of agreement of histologies in the dichotomous categories of hyperplasia versus adenoma. However, there was considerable disagreement on the presence of moderate or severe atypia. The results of this study indicate that clinicians performing biopsies on patients at risk for colorectal cancer should be aware of the potential for diagnostic variability among pathologists, and should plan follow-up strategies which may include seeking second pathological opinions when a significant patient management decision must be made.

Adenoma↗

PubMed1986

Grading ovarian tumors. Evaluation of decision making by different pathologists.

Although grading of ovarian tumors is widely performed, the criteria for each grade are not well defined; as a result, pathologists tend to establish their own criteria without, however, assessing the actual predictive value of the criteria. In order to investigate this relationship, four gynecologic pathologists independently reviewed and carefully graded as benign, borderline or malignant (grade I, II or III) 40 "common" epithelial tumors of the ovary, without reference to clinical, prognostic or other findings. Intermediate grades were allowed. Subsequently, a subjective grading form was completed for each case; the form contained questions regarding the histologic and cytologic features. The sets of features with the biggest correlation with the tumor grades differed among the pathologists. This may indicate that the observers use different features in their grading processes. Moreover, the pathologist with the highest number (five) of significant microscopic features in the multivariate model had the lowest coefficient of correlation between his tumor grade and his feature set. The correlation coefficients for the other pathologists were quite similar, although the features used (no more than two or three) varied. The participants in the study felt that the methodologic approach had an educational value for them. Further investigations are required to evaluate whether the differences in the underlying decision making process also result in frank disagreement in ovarian tumor grading.

Carcinoma↗

PubMed1986

Mortality of radiologists and pathologists in the Radiation Registry of Physicians.

The overall and cause-specific mortality experience of male radiologists and a comparable group of medical specialists, pathologists, who were included in the Radiation Registry of Physicians, is presented. The study population consists of an early-entry cohort of physicians who were members of either the American College of Radiology or the College of American Pathologists as of Jan. 1, 1962, and a late-entry cohort of similar members who joined these societies between January 1962, and June 1972. The purpose of the study was to determine if occupational exposure to low levels of ionizing radiation resulted in excess mortality from all causes and specific causes, or decreased survival patterns for radiologists compared with pathologists over the 16-year period, 1962 to 1977. The data revealed that radiologists and pathologists were comparable regarding overall mortality experience for all entrants, the early-entry cohort, and the late-entry cohort. Further analyses revealed a gradient in mortality between the two specialties, with the largest differences in the earliest birth subcohorts for all three groups, and a significant excess in mortality among radiologists in those subcohorts of the late-entry cohort born before 1920. Such a gradient may indicate an exposure effect associated with time of first exposure or duration of exposure, but not associated with time of entry into a professional society. Nevertheless, overall age-specific and age-adjusted mortality rates among radiologists and pathologists were lower in the late-entry cohort compared with the early-entry cohort, thus indicating some effect of time of entry within each specialty.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1991

Mortality study of British pathologists.

Pathologists eligible for inclusion in the study were identified from the membership lists of the Royal College of Pathologists from 1974 to 1987, establishing a population of 4,512 members. Overall mortality was lower among the study group compared with the general population of England and Wales, although there were significantly more deaths due to suicide (observed 13, expected 4.9, SMR 265, 95% CI 141-454). Excess deaths due to cancer of the lymphatic and hemopoietic system were noted but they were not significantly increased. An excess of brain cancer death was marginally significant for male pathologists (observed 6, expected 2.5, SMR 240, 95% CI 88-522). Six of the 9 (66.7%) cases of all types of brain tumors reported in total were among hematologists, although this sub-specialty comprises approximately 16% of all pathologists.

Adult↗

PubMed1987

The prognostic variability of ovarian tumor grading by different pathologists.

In a multicenter ovarian tumor study, it was shown that there are considerable differences between different pathologists when grading the same ovarian tumors. The question arises whether these differences in grading also reflect prognostic differences. To investigate this, the survival curves of the various tumor grades assigned to the same tumors by four different pathologists were investigated. The results of the present study indicate that tumor grade was strongly correlated with the prognosis, although there were considerable variations in the survival curves and in the five year survival of patients of the same grade assessed by the different pathologists. Five-year survival varied from 82 to 100% in the borderline tumors, from 49 to 80% in the well, and from 21 to 48% in the moderately differentiated tumor groups. Only the poorly differentiated cancers showed less variation. Similar interobserver differences were found in the histological typing and (strictly predefined) malignancy grades. The intraobserver variation, which was also tested after a 6-month interval, was somewhat lower, but was still present for each of the pathologists. These data clearly indicate the necessity for objective, sharply defined, reproducible criteria rather than subjective grades.

Cell Differentiation↗

PubMed1977

[The issue of professional discretion for pathologists (author's transl)].

According to German law the physician shall not disclose secrets that were confided or made known to him. The definition reads: physician is who practises the healing art (including medicine and surgery). When considering this definition part of the jurisprudence is of the opinion, therefore, that subject of such healing is exclusively the living human being and the pathologist acting as post-mortem examiner makes solely statements concerning the dead body and thus is not to be considered as physician. This opinion does not do justice to the real tasks of the pathologist. The basic idea of the tasks of the pathologist is the consultation and assistance of the physician practising the healing art. Hence the post- mortem examinations serve indirectly as healing treatment. Consequently the pathologist acts as physician and is bound to professional discretion. The result corresponds with the law enforce according to which secrets are subject to protection beyond death.

Confidentiality↗

PubMed1991

Team acceptance of specific recommendations for the treatment of VPI as provided by speech pathologists.

This retrospective study describes the frequency of one team's acceptance of speech pathologists' recommendations for specific secondary treatment procedures for the correction of VPI for 100 consecutive patients. In addition, assessment was made of the level of success in eliminating VPI relative to treatments utilized that were recommended by speech pathologists versus level of success when treatment other than that recommended by speech pathologists were used. For the 78 patients who received the treatment procedure recommended by speech pathologists, only 10 percent continued to demonstrate any clinically significant residual speech problem associated with VPI. However, for the 22 patients who received treatment other than that which had been recommended, 32 percent continued to demonstrate clinically significant speech problems associated with VPI. Data is presented on the success rate for correcting VPI relative to specific treatment recommendations including pharyngeal flap, palatal pushback, pharyngeal wall implant, tonsillectomy, prosthetic palatal lifts, and speech therapy.

Clinical Protocols↗

PubMedDate not supplied

Focal acantholytic dyskeratosis: a snare for the pathologist. Report of two cases associated to psoriasis and fibrous papule of the nose.

Two specimens containing clinically inapparent histologic features of acantholytic dyskeratosis (on the base of a fibrous papule of the nose and overlying a psoriatic lesion) are presented. The authors discuss the conduct to be followed by the pathologist in similar cases. The general pathologist should be well trained in dermatopathology since cutaneous biopsies account for 10 to 25% of the specimens submitted for histologic diagnosis or, even, form the major part of the workload (Berry). There is a wall between the physician who submits the skin biopsies (who may be or not a dermatologist) and the pathologist. The clinical information provided by dermatologists is scant and incomplete and physicians who are not dermatologists seldom submit any information. The histological pictures found in skin biopsies are, often, common to several nosological entities and an adequate understanding of their meaning is desirable for a thorough evaluation. We ought to assess it with the maximum scientific severity, searching to solve the puzzle without depreciating the information received. In this report the authors analyse the histopathological approach to the cutaneous lesions of two patients. They displayed the association between acantholytic dyskeratosis (AD) and another cutaneous pathology. Findings like these may obstruct the final diagnosis to be issued by the pathologist.(ABSTRACT TRUNCATED AT 250 WORDS)

Acantholysis↗

PubMed1992

Attitudes to specialist recertification: results of a national survey among pathologists.

AIMS: to evaluate attitudes and preferred mechanisms in the establishment of specialist recertification for pathologists. METHODS: a national survey was conducted amongst the membership of the New Zealand Society of Pathologists. RESULTS: responses were received from 54 (62%) financial members of the society. The majority of respondents agreed with the concept of compulsory periodic recertification. The ideal recertification period should be 10 years and the system should be supervised by the New Zealand Society of Pathologists. The favoured recertification mechanism was by continuing medical education which should be funded by the individual candidate. The majority of respondents supported the establishment of voluntary recertification on a trial basis. CONCLUSIONS: the survey suggested a favourable attribute amongst pathologists to the introduction of continuing education based periodic recertification.

Attitude of Health Personnel↗

PubMed1992

[Postgraduate training of pathologists].

Specialization of institutions engaged in training of pathologists is a key condition of skilled specialists turn out. Medical colleges should be responsible for training hospital and junior physicians. Institutes for postgraduate medical education must ensure updating of the practicing pathologists knowledge and prepare them for getting special degrees and diplomas including "European Pathologist". The system of continuous training of pathologists should rest on fundamental legal base which should be warranted by the Russian Federation Ministry of Public Health.

Education, Medical, Continuing↗

PubMedDate not supplied

[Intraoperative extemporaneous examination of the parathyroid gland: what is the role of the pathologist in parathyroid pathology?].

Hyperparathyroidism (HPT), once considered a rare disease, is nowadays observed and diagnosed more frequently. Consequently, surgical treatment of HPT is often performed with good therapeutic results. The success of parathyroid surgery depends mainly on the accuracy of histopathologic diagnosis through intraoperative examination of frozen tissue specimens. Yet, parathyroid gland pathology is very complex and some of its topics even controversial. Terminology and clinico-pathological concepts in this field are constantly changing and even basic characteristics such as weight, stromal fat content and "normal " histologic patterns of these glands are still actively discussed. The pathologist must often determine, merely by studying a small bioptic specimen, not only the parathyroidal (or non-parathyroidal) origin of the examined tissue, but also the histological "normal" or "abnormality" of the tissue. In carrying out his work the experienced pathologist takes on an important task and responsibility in distinguishing between normal, early hyperplastic (asymmetric), hyperplastic or adenomatous parathyroid glands. New diagnostic technical approaches (such as Electron Microscopy, intracellular fat morphometric evaluation, parenchymal cell mass study by density gradient, etc.) enhance the possibility of reaching a reliable pathologic diagnosis, but they do not solve all the present problems and sometimes can even lead the pathologist astray. Presently the diagnosis and treatment of primary HPT should be considered an open and current problem inasmuch as definite criteria to be followed in distinguishing between normal or single enlarged glands microscopically are still lacking. Neither the degree of accuracy of intraoperative frozen section examination during parathyroid surgery nor the possibility of misleading observations in such a study has been fully evaluated. A close cooperation between the pathologist and head and neck surgeon is of utmost importance to assure the best therapeutical results obtainable from parathyroid surgery in HPT.

Adenoma↗

PubMed1991

The pathologist's workstation. Issues and an early prototype.

The role of a pathologist demands the efficient collection, processing and communication of information. Although computerization has been readily adopted in the laboratory to help with specimen processing, educational programs and technological tools for the pathologist's own information handling are at the inception stage. Many pathologists feel their role as a consultant would be enhanced by easy-to-use microcomputer information tools linked to their laboratory databases. This article provides an overview of emerging computer science trends and reviews areas in which a workstation is likely to be useful to the pathologist. A currently operational project embodying some of these concepts is described.

Clinical Laboratory Information Systems↗