Pathology: platelet antibodies

The Scientific Board of the California Medical Association presents the following inventory of items of progress in pathology. Each item, in the judgment of a panel of knowledgeable physicians, has recently become reasonably firmly established, both as to scientific fact and important clinical significance. The items are presented in simple epitome and an authoritative reference, both to the item itself and to the subject as a whole, is generally given for those who may be unfamiliar with a particular item. The purpose is to assist busy practitioners, students, research workers, or scholars to stay abreast of these items of progress in pathology that have recently achieved a substantial degree of authoritative acceptance, whether in their own field of special interest or another.The items of progress listed below were selected by the Advisory Panel to the Section on Pathology of the California Medical Association and the summaries were prepared under its direction.     

Survey of medical training in cytopathology carried out by the journal Cytopathology

Anshu, A. Herbert, B. Cochand‐Priollet, P. Cross, M. Desai, R. Dina, J. Duskova, A. Evered, A. Farnsworth, W. Gray, S. S. Gupta, K. Kapila, I. Kardum‐Skelin, V. Kloboves‐Prevodnik, T. K. Kobayashi, H. Koutselini, W. Olszewski, B. Onal, M. B. Pitman, ?. Marin?ek, T. Sauer, U. Schenck, F. Schmitt, I. Shabalova, J. H. F. Smith, E. Tani, L. Vass, P. Vielh and H. Wiener
Survey of medical training in cytopathology carried out by the journal Cytopathology This report of the Editorial Advisory Board of Cytopathology gives the results of a survey of medical practitioners in cytopathology, which aimed to find out their views on the current situation in undergraduate and postgraduate training in their institutions and countries. The results show that training in cytopathology and histopathology are largely carried out at postgraduate level and tend to be organized nationally rather than locally. Histopathology was regarded as essential for training in cytopathology by 89.5% of respondents and was mandatory according to 83.1%. Mandatory cytopathology sections of histopathology were reported by 67.3% and specific examinations in cytopathology by 55.4%. The main deficiencies in training were due to its variability; there were insufficient numbers of pathologists interested in cytology and a consequent lack of training to a high level of competence. Pathologists without specific training in cytopathology signed out cytology reports according to 54.7% of responses, more often in centres where training was 3–6 months or less duration. Although 92.2% of respondents thought that specialist cytology should not be reported by pathologists without experience in general cytopathology, that practice was reported by 30.9%, more often in centres with small workloads. The survey report recommends that 6–12 months should be dedicated to cytopathology during histopathology training, with optional additional training for those wanting to carry out independent practice in cytopathology. Formal accreditation should be mandatory for independent practice in cytopathology. When necessary, temporary placements to centres of good practice should be available for trainees intending to practise independently in cytopathology. There should be adequate numbers of pathologists trained in cytopathology to a high level of competence; some of their time could be released by training cytotechnologists and trainee pathologists to prescreen cytology slides and assess adequacy of fine‐needle aspiration samples when immediate diagnosis was not required. The survey demonstrated a clear need for European and international guidelines for training in cytopathology.     

Pathology: Tumor Necrosis Factor in Human Disease

The Scientific Board of the California Medical Association presents the following inventory of items of progress in pathology. Each item, in the judgment of a panel of knowledgeable physicians, has recently become reasonably firmly established, both as to scientific fact and important clinical significance. The items are presented in simple epitome and an authoritative reference, both to the item itself and to the subject as a whole, is generally given for those who may be unfamiliar with a particular item. The purpose is to assist busy practitioners, students, researchers, or scholars to stay abreast of these items of progress in pathology that have recently achieved a substantial degree of authoritative acceptance, whether in their own field of special interest or another.The items of progress listed below were selected by the Advisory Panel to the Section on Pathology of the California Medical Association, and the summaries were prepared under its direction.     

Continuing medical education in Europe: NVVC,CVOI, ESC,UEMS and EBAC

The European Board for Accreditation in Cardiology (EBAC) is a joint initiative of the European Society of Cardiology (ESC) and the Cardiology Section of the Union of European Medical Specialists or Union Européenne des Médecins Spécialistes (UEMS). EBAC operates independently from these parent organisations. The ESC is the highest cardiovascular scientific authority in Europe and the most important provider of Continuing Medical Education (CME) in cardiology. The UEMS officially represents the European medical specialists at the European Union (EU). The UEMS consists of different mono-specialist sections, among which the Cardiology Section. The recognition of the importance of CME and the need for quality standards and quality control led the UEMS to establish the European Accreditation Council for CME (EACCME) in January 2000. CME activities that seek European accreditation have to comply with the regulations of this council. As a consequence of the establishment of EACCME, the mono-specialist sections of the UEMS together with the different European scientific societies started to create accreditation boards with the aim to assess international CME activities in accordance with the regulations of UEMS and EACCME. EBAC was founded in 2000. EBAC accreditation is complimentary to national CME accreditation. The Netherlands Society of Cardiology (Nederlandse Vereniging voor Cardiologie, NVVC) and its Institute for CME, the Netherlands Institute for Continuing Cardiovascular Education (Cardio-Vasculair Onderwijs Instituut, CVOI) formally recognise EBAC accreditation and Attendance Certificates.     

Dedicating specific sessions of cytopathology courses to medical students. A survey/consensus study

OBJECTIVE: To establish a consensus among medical schools in North America on whether to dedicate specific sessions to teaching cytopathology to medical students. STUDY DESIGN: A list of all the medical schools in the United States, Canada and Puerto Rico was retrieved from the American Association of Medical Colleges Web site in conjunction with the information provided by the 33rd edition of the Directory of Pathology Training Programs, published by the Intersociety Committee on Pathology Information. A total of 147 schools were found. A questionnaire was designed to include 7 questions addressing this issue and was sent to each medical student pathology course director. RESULTS: Of the 147 questionnaires, 65 (44%) responses were received. Fifty-four (83%) indicated the total number of pathology lectures given to medical students in each course. The number of lectures ranged between 19 and 201, with a mean of 85. Seven (11%) stated that their systems used problem based learning and that therefore a specific number of pathology lectures could not be given accurately. Sixteen (25%) have cytology sessions incorporated in their pathology courses. Thirteen (20%) prefer to include cytopathology sessions in the course and are committed to doing so. Therefore, 29 (45%) institutions either have or prefer to have specific sessions dedicated to cytopathology education. CONCLUSION: Incorporating specific sessions dedicated to cytopathology education in the medical student curriculum is highly recommended. Using new educational techniques, including computer-based methods with real case studies, would add more educational value.     

Pathology: Cervical Pathology—The Bethesda System and the `Atypical Squamous Cells of Undetermined Significance' Controversy

The Council on Scientific Affairs of the California Medical Association presents the following epitomes of progress in pathology. Each item, in the judgment of a knowledgeable physicians, has recently become reasonably firmly established, both as to scientific fact and clinical importance. The items are presented in simple epitome, and an authoritative reference, both to the item itself and to the subject as a whole, is generally given for those who may be unfamiliar with a particular item. The purpose is to assist busy practitioners, students, researchers, and scholars to stay abreast of progress in medicine, whether in their own field of special interest or another.The epitomes included here were selected by the Advisory Panel to the Section on Pathology of the California Medical Association, and the summaries were prepared under the direction of Yutaka Kikkawa, MD, and the panel.     

Pathology-important advances in clinical medicine: assessing fetal lung maturity

The Scientific Board of the California Medical Association presents the following inventory of items of progress in pathology. Each item, in the judgment of a panel of knowledgeable physicians, has recently become reasonably firmly established, both as to scientific fact and important clinical significance. The items are presented in simple epitome and an authoritative reference, both to the item itself and to the subject as a whole, is generally given for those who may be unfamiliar with a particular item. The purpose is to assist busy practitioners, students, research workers or scholars to stay abreast of these items of progress in pathology that have recently achieved a substantial degree of authoritative acceptance, whether in their own field of special interest or another.The items of progress listed below were selected by the Advisory Panel to the Section on Pathology of the California Medical Association and the summaries were prepared under its direction.     

French Ambivalence Towards the Concept of ‘Indigenous People’: Museums and the Māori

ABSTRACT

Museums around the globe have experienced important changes in recent years in response to decolonisation processes and the demands of indigenous peoples. French museums are no exception, but the transformations have certain French hallmarks. This article explores the way France is dealing with its colonial legacy and, by means of two case studies, unravels the diverse political and historical particularities of the French context. The first looks at the results of a comparative analysis of the French and Québécois public’s response to the travelling exhibition E tū ake: Standing Strong produced by the Museum of New Zealand Te Papa Tongarewa. The second focuses on the repatriation ceremony of Māori toi moko (tattooed preserved heads) that took place in Paris in January 2012. These two case studies examine the French uses of concepts such as ‘community’, ‘minority’, and ‘indigeneity’ as well as the complex relations between religion and rationality, ancestral presence and materialism in French public life. The article investigates how these concepts participate in the fabric of French society, and thus in shaping contemporary museum landscapes.     

Training in molecular cytopathology testing

Training in molecular cytopathology testing is essential in developing and maintaining skills in modern molecular technologies as they are introduced to a universal health care system such as extant in the UK and elsewhere. We review the system in place in Northern Ireland (NI) for molecular testing of solid tumours, as an example to train staff of all grades, including pathologists, clinical scientists, biomedical scientists and equivalent technical grades. We describe training of pathologists as part of the NI Deanery medical curriculum, the NI training programme for scientists and laboratory rotation for Biomedical Scientists. Collectively, the aims of our training are two‐fold: to provide a means by which individuals may extend their experience and skills; and to provide and maintain a skilled workforce for service delivery. Through training and competency, we introduce new technologies and tests in response to personalised medicine therapies with a competent workforce. We advocate modifying programmes to suit individual needs for skill development, with formalised courses in pre‐analytical, analytical and postanalytical demands of modern molecular pathology. This is of particular relevance for cytopathology in small samples such those from formalin‐fixed paraffin‐embedded cell blocks. We finally introduce how university courses can augment training and develop a skilled workforce to benefit the delivery of services to our patients.     

Gender Differences in Associations of Eating Pathology between Mothers and Their Adolescent Offspring

Objective: To study the association of eating pathology between mothers and their adolescent offspring in a population sample. Research Methods and Procedures: The participants were 481 women (mean age, 47 ± SD 5 years; BMI, 25 ± 4 kg/m²) and their 481 adolescent children 16 to 17 years old (BMI, 21 ± 3 kg/m²) of the Stockholm Weight Development Study. Assessment methods were the Three‐Factor Eating Questionnaire Revised 18 and the Eating Disorder Inventory 2. Results: A higher body weight was most related to cognitive restraint for adolescents and to emotional eating for adult women. A mother‐daughter link could be identified for eating pathology, with the strongest link found for emotional eating. No mother‐son link could be identified. Age subgroup analyses revealed a stronger mother‐daughter link for body attitudes in younger mothers and for cognitive restraint in older mothers. Discussion: Gender differences revealed that eating pathology was shared by mothers and daughters but not by mothers and sons. A psychological strategy such as eating as a response to negative emotions was most interrelated between mothers and daughters. Younger mothers shared more attitudes toward the body with their daughters, whereas older mothers shared more restrictive eating behaviors with their daughters. The mother‐daughter links found may be due to gender‐specific genetic and psychological family transmission and gender‐specific environmental influences. The sons’ eating behaviors seem to be more independent and would be formed by other factors than for the girls.     

Papillary Hyperplastic Nodule: Pitfall in the Cytopathologic Diagnosis of Papillary Thyroid Carcinoma

ObjectiveTo identify the pitfalls of overdiagnosing papillary formation as papillary thyroid carcinoma (PTC) in thyroid cytology specimens.MethodsPatients with papillary hyperplastic nodules who had preoperative fine-needle aspiration biopsy (FNAB) were selected for this study. All patients had been diagnosed as having either PTC or lesions suggestive of PTC on preoperative FNAB. Pathology reports, surgical reports, and cytopathology slides were reviewed and analyzed for demographic data, nature of surgery, and pathologic features.ResultsSix women and 2 men with a mean age of 49 years (range, 16-79 years) were included. The lesion size ranged from 1.0 to 3.5 cm. Four patients were diagnosed as having PTC and 4 as having lesions suspicious for PTC. FNAB specimens were available for review in 6 cases. Surgical pathology slides were reviewed in all cases. When cytologic material was evaluated for the morphologic features that led to the misdiagnosis of PTC by comparing it with FNAB specimens of classic variant of PTC, the specimens from these patients showed follicular cells arranged in short, nonbranching papillae in a background of watery colloid and macrophages. The follicular cells were round and demonstrated oncocytic change with nuclear enlargement, prominent central nucleoli, nuclear chromatin clearing, and intranuclear grooves.ConclusionsCaution should be exercised rendering the diagnosis of PTC on FNAB samples when a thyroid lesion shows papillary configurations and oncocytic cells and if convincing nuclear features of PTC are not present. Furthermore, some morphologic features on thyroid aspiration can help differentiate these cases from true PTC. (Endocr Pract. 2008;14:863-868)     

医院行政管理人员培训需求的调查研究

目的 明确医院行政管理队伍培训需求,为建立规范化培训体系,提高医院管理水平奠定基础。方法 采用问卷调查法,面向医院行政管理人员开展个人培训需求意愿、医院内部管理体系运行现状及个人岗位胜任能力调查,在此基础上进行组织、岗位及个人层面的培训需求分析。结果 医院行政管理人员接受培训的意愿较为突出,而不同层级之间对培训内容、时间及方式的需求存在明显差异。结论 医院行政管理人员具有较为强烈的培训需求,建立一套科学实用的长效培训机制是建设高素质医院管理队伍的基础性工程。     

Development of children adopted to the United States following a social–emotional intervention in St. Petersburg (Russian Federation) institutions

This study is a post-adoption follow-up of social–emotional interventions in St. Petersburg, Russian Federation Baby Homes (BHs). Children previously resided in BHs and received Care as Usual (CAU, N?=?220), Training Only (TO, N?=?94), or Training plus Structural Changes (T?+?SC, N?=?45). This study examined intervention effects 0–6.5 years post-adoption to the United States, at age 9 months to 7 years old. Adoptive parents completed questionnaires on their child’s social and behavioral development. Intervention graduates had better attachment security, less indiscriminate friendliness, and fewer behavior problems than CAU graduates. Children who had longer exposure to intervention conditions had better attachment security, but poorer executive function, externalizing and internalizing problems, and competence. Thus, although postinstitutionalized children were generally functioning in the normal range in early childhood and effect sizes were small, a social–emotional intervention in institutions is associated with modest benefits to attachment and behavior problems and apparent decrements to executive function.     

Correction: Simultaneous confidence regions for closed tests,including Holm‐, Hochberg‐, and Hommel‐related procedures

Algorithm 1 in Guilbaud (2012, p. 327) in Biometrical Journal (DOI: 10.1002/bimj.201100123 ) reproduced a recently detected index error in a theorem concerning a shortcut for rejection decisions for certain multiple‐testing procedures as it was stated in Bernhard et al. (2004, p. 8) in Statistical Papers (DOI: 10.1007/BF02778266 ). This short article provides: (i) the correction to be made to Algorithm 1 and (ii) a brief discussion of the consequences. Although the theoretical developments in Guilbaud (2012) are not affected, the numerical illustrations in Section 7 are affected. A corrected version of that section is given in the Supporting Information.     

‘Candidatus Tisiphia’ is a widespread Rickettsiaceae symbiont in the mosquito Anopheles plumbeus (Diptera: Culicidae)

Symbiotic bacteria can alter host biology by providing protection from natural enemies, or alter reproduction or vectoral competence. Symbiont-linked control of vector-borne disease in Anopheles has been hampered by a lack of symbioses that can establish stable vertical transmission in the host. Previous screening found the symbiont ‘Candidatus Tisiphia’ in Anopheles plumbeus, an aggressive biter and potential secondary vector of malaria parasites and West Nile virus. We screened samples collected over 10-years across Germany and used climate databases to assess environmental influence on incidence. We observed a 95% infection rate, and that the frequency of infection did not fluctuate with broad environmental factors. Maternal inheritance is indicated by presence in the ovaries through FISH microscopy. Finally, we assembled a high-quality 1.6 Mbp draft genome of ‘Ca. Tisiphia’ to explore its phylogeny and potential metabolic competence. The infection is closely related to strains found in Culicoides biting midges and shows similar patterns of metabolism, providing no evidence of the capacity to synthesize B-vitamins. This infection offers avenues for onward research in anopheline mosquito symbioses. Additionally, it provides future opportunity to study the impact of ‘Ca. Tisiphia’ on natural and transinfected hosts, especially in relation to reproductive fitness and vectorial competence and capacity.     

Impact factor in cytopathology journals: what does it reflect and how much does it matter?

B. AbdullGaffar
Impact factor in cytopathology journals: what does it reflect and how much does it matter? Objective: To study the trends of impact factor (IF) in four cytopathology journals. To investigate the factors that might influence IF in cytopathology literature and whether IF has any impact on cytopathology practice. Methods: The IFs of four cytopathology journals were searched from 2005 to 2009. The IFs and their relationships with the types and number of publications, publishers, the official societies, readership, the quality of their contents, the topics covered and the levels of evidence were compared. Results: Cancer Cytopathology (CC) had the highest IF. Acta Cytologica (AC) had the lowest IF, which appeared to be in decline. Cytopathology (C) and Diagnostic Cytopathology (DC) had a slow but steady increase in their IF. Components that might influence these differences could include the category and the society of the journal, targeted readers and certain types of publications. Publishers, the number of publications, the types of topics covered and the levels of evidence probably have no major effect on IF. Conclusions: IF has its own benefits and original applications. IF is a quantitative measure that does not reflect the levels of evidence in cytopathology journals. IF should not be abandoned because it might encourage competition between cytopathology journals, but it should not dictate their contents.     

Fine needle aspiration cytology: a survey of current European practice

Fine needle aspiration cytology (FNAC) is practised widely throughout Europe. The majority of countries have dedicated cytopathologists as well as histopathologists practicing cytology. Despite this, FNAC is performed mostly by clinicians and radiologists except in the larger centres with dedicated staff with a special interest in cytopathology. The advent of One-Stop diagnostic services and image-guided procedures are prompting further development of FNAC clinics where cytopathologists take their own samples, issue reports in the same clinical session and take extra material for ancillary tests to complete the diagnosis. The volume of FNAC work varies accordingly; in dedicated centres FNAC represents up to 80% of the workload whilst, in the majority of countries, it represents one quarter or less. Hence, the rate of inadequate FNAC varies widely, depending on the local sampling policies and the organ, but does not exceed 25% in any of the countries. The most sampled organs are breast and thyroid, followed by lymph nodes. Most countries have dedicated training in cytopathology for pathology trainees, the duration varying between 6 months and 2 years of the total training time. This discussion, focusing on European practices, highlights the heterogeneity of FNAC activity but also its success in many centres where it is practiced to a high standard, particularly in breast, thyroid and lymph node pathology. The relatively high rate of inadequate material in some centres reflects local policies and calls for greater uniformity of FNAC practice, particularly specimen sampling. To achieve this, the future direction should concentrate on specialist training, to include performing as well as interpreting FNAC, as part of the curriculum. Current emphasis on web-based training may not provide first hand experience of the FNAC procedure and should be supplemented by attending FNAC clinics and developing the technique to its full potential.