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At least 613 records · Page 34Linked to original sources

PubMed1992

Identification of patients who are at high risk for locoregional breast cancer recurrence after conservative surgery and radiotherapy: a review article for surgeons, pathologists, and radiation and medical oncologists.

PURPOSE: Many retrospective reports have been published identifying risk factors for locoregional (LR) recurrence after breast conservation therapy (BCT). We review these reports, with the purpose of better enabling surgeons, pathologists, radiation oncologists, and medical oncologists to develop strategies for an individualized treatment approach. DESIGN AND RESULTS: English-language retrospective and prospective randomized studies published in the 1980s were reviewed. Histopathologic predictors, young age, extent of conservative surgery (CS), lobular carcinoma, and the impact of adjuvant chemotherapy are all examined as reported risk factors for LR. CONCLUSIONS: Recognition of these factors provides rationale for individualizing the extent of CS based on histopathologic features. In addition, the aggressiveness of radiotherapy (RT) should be dictated by the extent of CS and by identifiable prognostic factors. Strategies are presented for an individualized treatment approach based on a clear understanding of the prognostic factors for LR.

Breast Neoplasms↗

PubMed2005

Grand rounds: latex-induced occupational asthma in a surgical pathologist.

CONTEXT: Latex allergy and sensitization have been an important problem facing health care workers. Providing a latex-safe environment is the intervention of choice. CASE PRESENTATION: A 46-year-old surgical pathologist presented with increasing shortness of breath for the previous 4 years. Twenty years before presentation, he noted a pruritic, erythematous rash on his hands, associated with latex glove use. Fourteen years before presentation, during pathology residency, he developed a nonproductive cough, wheezing, and an urticarial rash, temporally associated with use of powdered latex gloves. These symptoms improved while away from work. At presentation, he had one-flight dyspnea. His skin prick test was positive for latex, and pulmonary function testing showed mild obstruction, which was reversible with bronchodilator use. Because the patient was at risk for worsening pulmonary function and possible anaphylaxis with continued exposure, he was removed from the workplace because no reasonable accommodation was made for him at that time. DISCUSSION: The patient's presentation is consistent with latex-induced occupational asthma. Initially noting dermal manifestations, consistent with an allergic contact dermatitis secondary to accelerators present in latex gloves, he later developed urticaria, flushing, and respiratory symptoms, consistent with a type I hypersensitivity reaction to latex. He also has reversible airways disease, with significant improvement of peak expiratory flow rate and symptoms when away from work. RELEVANCE TO CLINICAL OR PROFESSIONAL PRACTICE: The ideal treatment for latex sensitization is removal from and avoidance of exposure. Clinicians should consider occupational asthma when patients present with new-onset asthma or asthmatic symptoms that worsen at work.

Asthma↗

PubMed1998

Speech-language pathologists in schools for the deaf. A survey of scope of practice, service delivery, caseload, and program features.

Analyses of surveys of speech-language pathologists (SLPs) in schools for the Deaf across the United States enable a profile of SLPs' scope of practice, caseload size and characteristics, and delivery of services, as well as features of programs through which they serve students. The findings are compared to previous results of surveys, both large and small, of SLPs in local school programs. Results point favorably to the services provided by SLPs in schools for the Deaf in terms of SLPs' proficiency in sign language, their smaller caseloads, the amount of time they spend in direct services, and a broad range of practice that focuses on written language, sign language, and functional communication.

Deafness↗

PubMed2002

The ribonuclease protection assay: a powerful tool for the veterinary pathologist.

Veterinary pathologists engaged in basic research use a variety of methods to study disease pathogenesis at the light microscopic and submicroscopic (protein and mRNA) levels. The ribonuclease protection assay is a sensitive and accurate method to measure mRNA expression. The major advantages of the assay are that multiple mRNA species can be measured simultaneously in a single total RNA sample and that the assay has relatively high throughput. The major disadvantage is that the assay requires moderate technical skill.

Animals↗

PubMed1985

Psychological scaling of speech by students in training compared to that by experienced speech-language pathologists.

Direct magnitude estimation was the psychological rating technique for obtaining ratings of severity of the speech of 16 cerebral palsied dysarthric speakers. The ratings of students in training (inexperienced) were compared to those of experienced speech-language pathologists. For this method and this communication disorder, students' ratings were comparable to those of the professionals.

Clinical Competence↗

PubMed1984

External quality assurance in microbiology. The programme of the Royal College of Pathologists of Australasia.

Since 1967 the Royal College of Pathologists of Australasia has been providing an external quality assurance programme in microbiology. The number of participants has risen from 70 to 222, and the samples distributed for investigation have increased in quantity, now totalling 35-40 per annum, and in variety, so that most aspects of clinical microbiology are now touched on. In recent years clerical accuracy and the adequacy of reports have been examined. However, more emphasis is needed on the stability of the specimens (freeze-drying will be introduced soon), the assessment of a laboratory's general performance, the standardization of methods and the educational aspects of external quality control.

Accreditation↗

PubMed1985

External quality assurance in hematology. The programme of the Royal College of Pathologists of Australasia.

The Royal College of Pathologists of Australasia introduced a comprehensive national external quality assurance programme (QAP) in hematology in 1979. This now provides regular monthly trials of full blood counting, supplemented by 3-monthly sets of samples for a large variety of other tests for "state of the art" studies, together with case slides for diagnosis for 294 participants. In addition educational supplements are provided, based on one or other aspect of each major quarterly trial. The frequency and variety of tests and analysis of participants' results conform to suggested standards for similar national schemes elsewhere in the world. There is evidence that the programme has helped raise the standards of hematopathology in Australasia and has identified areas which require improvement. It is envisaged that the scheme will satisfy the requirements of state legislation designed to accredit pathology laboratories. Future development should include a refinement of objective methods of scoring performance, especially in areas such as morphology where participants' results cannot readily be expressed numerically.

Asia↗

PubMedDate not supplied

Phenotypic cytoskeletal heterogeneity in melanoma, a challenge to the surgical pathologist evaluating a poorly differentiated neoplasm: an illustrative case.

Characterization of poorly differentiated neoplasms can be a challenging task for the surgical pathologist. It is essential that the entire spectrum of immunomorphologic findings of various tumors be recognized to avoid improper characterization of a given neoplasm, which may in turn adversely affect patient management. Tumor characterization is complicated by the immunomorphologic transformations that malignant cells may undergo by virtue of which they may depart from expression of expected features and acquire new, unexpected characteristics. Traditionally, amelanotic melanomas have been difficult to characterize because of the diversity of their light microscopic morphology (epithelioid, spindle, and combined varieties). As a result, several other neoplasms are usually considered in the differential diagnosis. This report describes a primarily spindle-cell amelanotic melanoma that created a diagnostic dilemma, which could only be resolved by combining the information obtained from extensive evaluation by means of several diagnostic techniques. This case also stresses the phenotypic heterogeneity of the cytoskeleton of malignant melanomas and therefore their varied immunomorphologic characteristics.

Cell Nucleus↗

PubMed1996

Interactions between recovery in aphasia, emotional and psychosocial factors in subjects with aphasia, their significant others and speech pathologists.

Associations between clinical and functional aphasia recovery and perceptions of emotional and psychosocial adjustment accompanying aphasia were examined in five subjects at 3 and 9 months post-onset of stroke using a range of objective and subjective measures. The subjective well-being and optimism of significant others of aphasic patients was also examined, and speech pathologists completed measures of optimism. Unique patterns of individual emotional and psychosocial adjustment were found over time in patients and their significant others, even in patients with similar aphasia type and severity. Individual variability in emotional and psychosocial adjustment and their impact on recovery from aphasia are discussed.

Adaptation, Psychological↗

PubMed1986

Autopsy findings and syndromic diagnoses: Bayesian calculations for pediatric pathologists.

Application of a standard statistical method known as a Bayesian calculation to the findings in pediatric anatomic pathology may help the pediatric pathologist to recognize and express the likelihood of syndromic diagnoses. This assessment can be useful in counseling and deciding which (if any) confirmatory tests are warranted. An example shows the method and its utility.

Chromosome Aberrations↗

PubMed2006

Rudolf Ludwig Karl Virchow: pathologist, physician, anthropologist, and politician. Implications of his work for the understanding of cerebrovascular pathology and stroke.

The history of apoplexy and descriptions of stroke symptoms date back to ancient times. It was not until the mid-nineteenth century, however, that the contributions of Rudolf Ludwig Karl Virchow, including his descriptions of the phenomena he called "embolism" and "thrombosis" as well as the origins of ischemia, changed the understanding of stroke. He suggested three main factors that conduce to venous thrombosis, which are now known as the Virchow triad. He also showed that portions of what he called a "thrombus" could detach and form an "embolus." Thus, Virchow coined these terms to describe the pathogenesis of the disorder. It was also not until 1863 that Virchow recognized and differentiated almost all of the common types of intracranial malformations: telangiectatic venous malformations, arterial malformations, arteriovenous malformations, cystic angiomas (possibly what are now called hemangioblastomas), and transitional types of these lesions. This article is a review of the contributions of Rudolf Virchow to the current understanding of cerebrovascular pathology, and a summary of the life of this extraordinary personality in his many roles as physician, pathologist, anthropologist, ethnologist, and politician.

Anthropology↗

PubMedDate not supplied

The role of the pathologist in the management of breast cancer.

The pathologist is a consultant in breast cancer management whose responsibility is to establish the histologic diagnosis of cancer as well as its anatomic extent once sufficient tissue has been provided. The consultation also provides data that may be used to aid in selecting primary or adjuvant therapy, evaluating new therapies, estimating prognosis, and assessing outcome. Examples of such data are the TNM histopathologic classification of the anatomic extent of the cancer used for the stage grouping (T = the extent of the primary tumor, N = the absence or presence and extent of regional lymph node metastasis, and M = the absence or presence of distant metastasis); tumor size, histologic type, and histologic and/or nuclear grade; assessment of blood vessel and lymphatic vessel invasion; analysis of steroid receptors, and other special studies as appropriate.

Biopsy, Needle↗

PubMedDate not supplied

Stereotactic core-needle biopsy of the breast: a report of the Joint Task Force of the American College of Radiology, American College of Surgeons, and College of American Pathologists.

A national task force consisting of members from the American College of Radiology, the American College of Surgeons, and the College of American Pathologists examined the issues surrounding stereotactic core-needle biopsy for occult breast lesions. Their report includes indications and contraindications, informed consent, specimen handling, and management of indeterminate, atypical, or discordant lesions.

Biopsy, Needle↗

PubMed1992

Clinicopathologic and immunophenotypic study of non-Hodgkin's lymphoma in Korea. Lymphoreticular Study Group of the Korean Society of Pathologists.

This study sponsored by the Lymphoreticular Study Group of the Korean Society of Pathologists was carried out to provide nationwide data about the histopathologic-immunophenotypic features of malignant lymphomas in Korea. Two hundred and ninety Non-Hodgkin's lymphoma (NHL) among 312 malignant lymphomas collected from three representative areas in Korea were histologically reclassified. Two hundred and fifty three cases were immunohistochemically studied. T-cell lymphoma comprised 35.2% of NHL in this study and showed a quite comparable incidence to that of Japan and China, but it was much higher than in Western countries. A very low prevalence rate of the follicular variety (4.0%) and a higher propensity of primary extranodal involvement (60%) are additional characteristics of NHL in Korea. The most common histologic subtype of B cell lymphoma was diffuse large cell type, whereas the most common subtype of T cell lymphoma was diffuse mixed small and large cell type.

Adolescent↗

PubMed2006

Assessing risks for gastric cancer: new tools for pathologists.

Although the Sydney Systems (original and updated) for the classification of gastritis have contributed substantially to the uniformity of the reporting of gastric conditions, they lack immediacy in conveying to the user information about gastric cancer risk. In this review, we summarize the current understanding of the gastric lesions associated with an increased risk for cancer, and present the rationale for a proposal for new ways of reporting gastritis. In addition to the traditional histopathological data gathered and evaluated according to the Sydney System rules, pathologists could add an assessment expressed as grading and staging of the gastric inflammatory and atrophic lesions and integrate these findings with pertinent laboratory information on pepsinogens and gastrin levels. Such an integrated report could facilitate clinicians' approach to the management of patients with gastric conditions.

Biopsy↗

PubMed2026

Clinical Variant Interpretation with the Integrative Genomics Viewer (IGV) for Molecular Pathologists.

The integrative genomics viewer (IGV) is a pivotal tool in clinical genomics, enabling the visualization and interpretation of complex sequencing data. Bringing clinical knowledge to bear with visual evaluation of sequencing results is the primary means by which molecular pathologists and other professionals assess and finalize cases. A variety of software tools can assist, but their relationship to the underlying data must be understood and applied systematically. This study includes essential background on next-generation sequencing (NGS) data file types (e.g., FASTQ, BAM, VCF) with a discussion of their format and purpose. We then describe features of IGV that derive nuances from these files. We utilize a series of curated practical cases based on clinical vignettes through which the reader will interact with clinical NGS sequencing data using the IGV software to review various types of clinically relevant variants relative to the human reference genome. These clinical vignettes have been curated to describe examples of some of the complexities of interpretation of genomic data, and how utilizing IGV as part of a routine workflow can provide additional interpretive information for variants beyond routine bioinformatic software algorithm variant calls. The visual inspection of genomic variants utilizing the tools within IGV can unmask subtle contextual cues (i.e., variant allele frequency, strand bias, tissue-specific context) that can influence the interpretation of genomic variants. Although this study focuses on using IGV for the detection and interpretation of somatic variants, the provided applications can be extrapolated for use in the germline setting, including analysis of complex variants and detection of mosaicism.

Humans↗

PubMed1999

Assessment of laboratory performance with Streptococcus pneumoniae antimicrobial susceptibility testing in the United States: a report from the College of American Pathologists Microbiology Proficiency Survey Program.

OBJECTIVE: To assess the performance of clinical microbiology laboratories in the United States when conducting in vitro susceptibility tests with Streptococcus pneumoniae. METHODS: The results of a nationwide College of American Pathologists Proficiency Survey test sample, in which susceptibility testing of an isolate of S. pneumoniae was performed, were assessed with respect to precision and accuracy. RESULTS: Wide variability was noted among participating laboratories with both minimum inhibitory concentration procedures and disk diffusion susceptibility tests when both methods were applied to S. pneumoniae. Despite this high degree of variation, categorical interpretive errors were uncommon. Numerous laboratories reported results for antimicrobial agents that are not recommended by the National Committee for Clinical Laboratory Standards for tests with S. pneumoniae. CONCLUSIONS: Current susceptibility testing practices with S. pneumoniae in the United States indicate limited precision and a tendency for laboratories to test and report results obtained with antimicrobial agents of questionable therapeutic value against this organism. Continued efforts to standardize susceptibility testing of S. pneumoniae in the United States are warranted. In addition, modifications of existing interpretive criteria may be necessary.

Anti-Bacterial Agents↗

PubMed1999

Autopsy result utilization: a College of American Pathologists Q-probes study of 256 laboratories.

OBJECTIVES: To document the level of involvement and communication with nonpathology clinical personnel regarding autopsies and to document the destination of autopsy reports. DESIGN: The College of American Pathologists Q-Probes format was used to collect information on 15 consecutively performed autopsies per institution or for 6 months, whichever occurred first. The following information was recorded for each autopsy: decedent's age, hospital service, length of hospital stay, whether organs were donated, who was present at autopsy, methods of communicating preliminary and final autopsy results, special techniques used to arrive at a preliminary diagnosis, activities for which the autopsy was used, and destination of final report. PARTICIPANTS: Two hundred fifty-six laboratories collected information on 2755 autopsies. RESULTS: The aggregate autopsy rate was 12.4% (median 8.5%). Nonpathology clinical personnel attended 35.8% of all autopsies. A clinical physician was more likely to attend an autopsy if the patient was from a surgical service. Three primary methods were used to communicate preliminary autopsy results, namely, written reports (82.5%), telephone calls (50.6%), and meetings (11.5%). The primary care physician was sent the autopsy report in 91.1% of cases. Approximately half of the autopsy cases were used in both pathology departmental and extradepartmental activities. Aggregate autopsy data were distributed in the majority of cases to various departmental chairpersons and institutional quality assurance committees. CONCLUSIONS: This study provides a comparative multiinstitutional database for the utilization of autopsy results by clinicians and clinical departments. Although autopsy rates are low, autopsy results are routinely being used for hospital quality assurance activities and for educational purposes.

Autopsy↗