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Clinical pathology

May 04, 2023

Clinical pathology is a medical specialty that is concerned with the diagnosis of disease based on the laboratory analysis of bodily fluids, such as blood, urine, and tissue homogenates or extracts using the tools of chemistry, microbiology, hematology, molecular pathology, and Immunohaematology. This specialty requires a medical residency.

Hematology: Blood smears on a glass slide, stained and ready to be examined under the microscope.
Bacteriology: Agar plate with bacterial colonies.
Bacteriology: microscopic image of a mixture of two types of bacteria stained with the Gram stain.
Clinical chemistry: an automated blood chemistry analyser.

Clinical pathology is a term used in the US, UK, Ireland, many Commonwealth countries, Portugal, Brazil, Italy, Japan, and Peru; countries using the equivalent in the home language of "laboratory medicine" include Austria, Germany, Romania, Poland and other Eastern European countries; other terms are "clinical analysis" (Spain) and "clinical/medical biology (France, Belgium, Netherlands, North and West Africa).[1]

Licensing and subspecialities

The American Board of Pathology certifies clinical pathologists, and recognizes the following secondary specialties of clinical pathology:

In some countries other sub specialities fall under certified Clinical Biologists responsibility:[2]

Organization

Clinical pathologists are often medical doctors. In some countries in South-America, Europe, Africa or Asia, this specialty can be practiced by non-physicians, such as Ph.D. or Pharm.D. after a variable number of years of residency.

In United States of America

Clinical pathologists work in close collaboration with clinical scientists (clinical biochemists, clinical microbiologists, etc.), medical technologists, hospital administrators, and referring physicians to ensure the accuracy and optimal utilization of laboratory testing.

Clinical pathology is one of the two major divisions of pathology, the other being anatomical pathology. Often, pathologists practice both anatomical and clinical pathology, a combination sometimes known as general pathology. Similar specialties exist in veterinary pathology.

Clinical pathology is itself divided into subspecialties, the main ones being clinical chemistry, clinical hematology/blood banking, hematopathology and clinical microbiology and emerging subspecialties such as molecular diagnostics and proteomics. Many areas of clinical pathology overlap with anatomic pathology. Both can serve as medical directors of CLIA certified laboratories. Under the CLIA law, only the US Department of Health and Human Services approved Board Certified Ph.D., DSc, or MD and DO can perform the duties of a Medical or Clinical Laboratory Director. This overlap includes immunoassays, flow cytometry, microbiology and cytogenetics and any assay done on tissue. Overlap between anatomic and clinical pathology is expanding to molecular diagnostics and proteomics as we move towards making the best use of new technologies for personalized medicine.[3]

In Europe

Recently, EFLM has chosen the name of "Specialists in Laboratory Medicine" to define all European Clinical pathologists, regardless of their training (M.D., Ph.D. or Pharm.D.).[4]

In France, Clinical Pathology is called Medical Biology ("Biologie médicale") and is practiced by both M.D.s and Pharm.Ds. The residency lasts four years. Specialists in this discipline are called "Biologiste médical" which literally translates as Clinical Biologist rather than "Clinical pathologist".[5]

Tools

Microscopes, analyzers, strips, centrifuges

Macroscopic examination

The visual examination of the taken liquid is a first main indication for the pathologist or the physician. The aspect of the liquid, in addition, conditions the analytical assumption of responsibility that follow and the validity of the end-results.

Microscopical examination

See also: staining

Microscopic analysis is an important activity of the pathologist and the laboratory assistant. They have many different colorings at their disposal (GRAM, MGG, Grocott, Ziehl–Neelsen, etc.). Immunofluorescence, cytochemistry, the immunocytochemistry, and FISH are also used in order make a correct diagnosis.

This stage allows the pathologist to determine the character of the liquid: "normal", tumoral, inflammatory, or even infectious. Microscopic examination can also determine the causal infectious agent – often a bacterium, mould, yeast, parasite, or (rarely) virus.

Physical Analyzers

Automated analysers, by the association of robotics and spectrophotometry, have allowed these last decades better reproducibility of the results of proportionings, in particular in medical biochemistry and hematology[clarification needed].

The companies of in vitro diagnosis henceforth try to sell chains of automats, i.e. a system allowing the automatic transfer of the tubes towards the various types of automats of the same mark. These systems can include the computer-assisted management of a serum library.

These analysers must undergo daily controls to guarantee a result just possible, one speaks about quality control. These analysers must also undergo daily, weekly and monthly maintenance.

Cultures

A big part of the examinations of clinical pathology, primarily in medical microbiology, use culture media. Those allow, for example, the description of one or several infectious agents responsible of the clinical signs.

Values known as "normal" or reference values

Detailed article: Reference range.

See also

Notes and references

  1. ^ "Textes Généraux, Ministère de la Santé et des Sports". Journal Officiel de la République Française. Décrets, arrêtés, circulaires (Texte 15 sur 54). 20 June 2010. Retrieved 4 December 2019. Note: This document does not cover all countries listed.
  2. ^ "Bulletin officiel du n°32 du 4 septembre 2003 - MENS0301444A". www.education.gouv.fr. Retrieved 2023-02-21.
  3. ^
  4. ^ Zerah Simone, Murray Janet, Rita Horvath Andrea (2012). "EFLM Position Statement – Our profession now has a European name: Specialist in Laboratory Medicine". Biochemia Medica. 22 (3): 272–273. doi:10.11613/BM.2012.029. PMC 3900053. PMID 23092058.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  5. ^ Reglementation for French Residency in Clinical Pathology 2008-02-28 at the Wayback Machine

External links

  • American Association for Clinical Chemistry
  • American Society for Clinical Pathology
  • American Board of Pathology
  • College of American Pathologists
  • European Federation of Clinical Chemistry and Laboratory Medicine

May 04, 2023
clinical, pathology, this, article, needs, more, medical, references, verification, relies, heavily, primary, sources, please, review, contents, article, appropriate, references, unsourced, poorly, sourced, material, challenged, removed, find, sources, news, n. This article needs more medical references for verification or relies too heavily on primary sources Please review the contents of the article and add the appropriate references if you can Unsourced or poorly sourced material may be challenged and removed Find sources Clinical pathology news newspapers books scholar JSTOR March 2023 Clinical pathology is a medical specialty that is concerned with the diagnosis of disease based on the laboratory analysis of bodily fluids such as blood urine and tissue homogenates or extracts using the tools of chemistry microbiology hematology molecular pathology and Immunohaematology This specialty requires a medical residency Hematology Blood smears on a glass slide stained and ready to be examined under the microscope Bacteriology Agar plate with bacterial colonies Bacteriology microscopic image of a mixture of two types of bacteria stained with the Gram stain Clinical chemistry an automated blood chemistry analyser Clinical pathology is a term used in the US UK Ireland many Commonwealth countries Portugal Brazil Italy Japan and Peru countries using the equivalent in the home language of laboratory medicine include Austria Germany Romania Poland and other Eastern European countries other terms are clinical analysis Spain and clinical medical biology France Belgium Netherlands North and West Africa 1 Contents 1 Licensing and subspecialities 2 Organization 2 1 In United States of America 2 2 In Europe 3 Tools 3 1 Macroscopic examination 3 2 Microscopical examination 3 3 Physical Analyzers 3 4 Cultures 3 5 Values known as normal or reference values 4 See also 5 Notes and references 6 External linksLicensing and subspecialities EditThe American Board of Pathology certifies clinical pathologists and recognizes the following secondary specialties of clinical pathology Chemical pathology also called clinical chemistry Hematopathology Blood banking Transfusion medicine Clinical microbiology Cytogenetics Molecular genetics pathology In some countries other sub specialities fall under certified Clinical Biologists responsibility 2 Reproductive biology including Assisted reproductive technology Sperm bank and Semen analysis ImmunopathologyOrganization EditClinical pathologists are often medical doctors In some countries in South America Europe Africa or Asia this specialty can be practiced by non physicians such as Ph D or Pharm D after a variable number of years of residency In United States of America Edit Clinical pathologists work in close collaboration with clinical scientists clinical biochemists clinical microbiologists etc medical technologists hospital administrators and referring physicians to ensure the accuracy and optimal utilization of laboratory testing Clinical pathology is one of the two major divisions of pathology the other being anatomical pathology Often pathologists practice both anatomical and clinical pathology a combination sometimes known as general pathology Similar specialties exist in veterinary pathology Clinical pathology is itself divided into subspecialties the main ones being clinical chemistry clinical hematology blood banking hematopathology and clinical microbiology and emerging subspecialties such as molecular diagnostics and proteomics Many areas of clinical pathology overlap with anatomic pathology Both can serve as medical directors of CLIA certified laboratories Under the CLIA law only the US Department of Health and Human Services approved Board Certified Ph D DSc or MD and DO can perform the duties of a Medical or Clinical Laboratory Director This overlap includes immunoassays flow cytometry microbiology and cytogenetics and any assay done on tissue Overlap between anatomic and clinical pathology is expanding to molecular diagnostics and proteomics as we move towards making the best use of new technologies for personalized medicine 3 In Europe Edit Recently EFLM has chosen the name of Specialists in Laboratory Medicine to define all European Clinical pathologists regardless of their training M D Ph D or Pharm D 4 In France Clinical Pathology is called Medical Biology Biologie medicale and is practiced by both M D s and Pharm Ds The residency lasts four years Specialists in this discipline are called Biologiste medical which literally translates as Clinical Biologist rather than Clinical pathologist 5 Tools EditMicroscopes analyzers strips centrifuges Macroscopic examination Edit The visual examination of the taken liquid is a first main indication for the pathologist or the physician The aspect of the liquid in addition conditions the analytical assumption of responsibility that follow and the validity of the end results Microscopical examination Edit See also staining Microscopic analysis is an important activity of the pathologist and the laboratory assistant They have many different colorings at their disposal GRAM MGG Grocott Ziehl Neelsen etc Immunofluorescence cytochemistry the immunocytochemistry and FISH are also used in order make a correct diagnosis This stage allows the pathologist to determine the character of the liquid normal tumoral inflammatory or even infectious Microscopic examination can also determine the causal infectious agent often a bacterium mould yeast parasite or rarely virus Physical Analyzers Edit Automated analysers by the association of robotics and spectrophotometry have allowed these last decades better reproducibility of the results of proportionings in particular in medical biochemistry and hematology clarification needed The companies of in vitro diagnosis henceforth try to sell chains of automats i e a system allowing the automatic transfer of the tubes towards the various types of automats of the same mark These systems can include the computer assisted management of a serum library These analysers must undergo daily controls to guarantee a result just possible one speaks about quality control These analysers must also undergo daily weekly and monthly maintenance Cultures Edit A big part of the examinations of clinical pathology primarily in medical microbiology use culture media Those allow for example the description of one or several infectious agents responsible of the clinical signs Values known as normal or reference values Edit Detailed article Reference range See also EditPathology Medical laboratory Anatomic pathology Medical technologist Veterinary pathology Clinical BiologistNotes and references Edit Textes Generaux Ministere de la Sante et des Sports Journal Officiel de la Republique Francaise Decrets arretes circulaires Texte 15 sur 54 20 June 2010 Retrieved 4 December 2019 Note This document does not cover all countries listed Bulletin officiel du n 32 du 4 septembre 2003 MENS0301444A www education gouv fr Retrieved 2023 02 21 Description of Pathology in USA Zerah Simone Murray Janet Rita Horvath Andrea 2012 EFLM Position Statement Our profession now has a European name Specialist in Laboratory Medicine Biochemia Medica 22 3 272 273 doi 10 11613 BM 2012 029 PMC 3900053 PMID 23092058 a href Template Cite journal html title Template Cite journal cite journal a CS1 maint multiple names authors list link Reglementation for French Residency in Clinical Pathology Archived 2008 02 28 at the Wayback MachineExternal links EditAmerican Association for Clinical Chemistry American Society for Clinical Pathology American Board of Pathology College of American Pathologists European Federation of Clinical Chemistry and Laboratory Medicine Retrieved from https en wikipedia org w index php title Clinical pathology amp oldid 1146401951, wikipedia, wiki, book, books, library,

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