Pathology

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Dennis W Dickson - One of the best experts on this subject based on the ideXlab platform.

  • association between vascular Pathology and rate of cognitive decline independent of alzheimer s disease Pathology
    2017
    Co-Authors: Ali Ezzati, Dennis W Dickson, Cuiling Wang, Richard B Lipton, Dorothea Altschul, Mindy J Katz, Carol A Derby
    Abstract:

    Objectives To examine the association between vascular Pathology and rate of cognitive decline in older adults independent of Alzheimer's disease (AD) Pathology. Design Prospective cohort study. Setting Community sample. Participants Individuals from the Einstein Aging Study autopsy series (N = 62). Measurements The Blessed Information-Memory-Concentration (BIMC) test was used to assess global cognitive status. AD Pathology was quantified according to Braak stage (<3 vs ≥ 3). Vascular Pathology was quantified using a previously reported macrovascular lesion (MVL) score. The association between vascular Pathology and antemortem rates of cognitive decline adjusted for level of AD Pathology was assessed using linear mixed-effects models. Results Mean age was 81.8 at enrollment and 89.0 at death. Participants with more than two MVLs had faster cognitive decline than those with no MVLs (difference in annual rate of change in BIMC 0.74 points/yr, P = .03). Braak stage was also associated with cognitive decline (difference 0.57 points/yr, P = .03). The difference in rate of cognitive decline between those with more than two MVLs and those free of vascular lesions persisted after adjustment for AD Pathology (difference in rate of change in BIMC 0.68 points/yr, P = .04). The effect of vascular Pathology on cognitive decline was not significantly different according to AD Pathology. Conclusion Vascular brain Pathology is associated with rate of cognitive decline after adjusting for level of AD Pathology.

  • distribution and characteristics of transactive response dna binding protein 43 kda Pathology in progressive supranuclear palsy
    2017
    Co-Authors: Shunsuke Koga, Monica Sanchezcontreras, Keith A Josephs, Ryan J Uitti, Neill R Graffradford, Jay A Van Gerpen, William P Cheshire, Zbigniew K Wszolek, Rosa Rademakers, Dennis W Dickson
    Abstract:

    BACKGROUND: This study aimed to determine the frequency of transactive response DNA binding protein 43 kDa Pathology in PSP, the clinical features of patients with this Pathology, and genetic risk factors for it. METHODS: Hippocampal sections were screened with immunohistochemistry for transactive response DNA binding protein 43 kDa in 945 PSP cases. A subset of 261 cases that were negative in hippocampus was screened in the amygdala. The density and disruption of this Pathology, as well as regional tau burden, and clinical and genetic characteristics were analyzed. RESULTS: We observed transactive response DNA binding protein 43 kDa Pathology in 47 cases in the hippocampus and an additional 9 cases that only affected the amygdala. Hippocampal sclerosis was the strongest risk factor, followed by Alzheimer's disease Pathology, argyrophilic grain disease, and older age at death. Five stages of transactive response DNA binding protein 43 kDa Pathology were identified in PSP: Stage A had Pathology only in the amygdala (16%); stage I had Pathology confined to the hippocampus and entorhinal cortex (9%); stage II included both regions of stage A and I (38%); stage III spread further to medial occipitotemporal gyrus (20%); and stage IV had Pathology in the dorsolateral frontal lobe (18%). Anatomical areas vulnerable to PSP Pathology had varying degrees of this Pathology in stage II and later. PSP with transactive response DNA binding protein 43 kDa Pathology were older at disease onset and had lower median MMSE scores; however, the latter was driven by concurrent pathologies. CONCLUSIONS: Distribution and clinical characteristics of transactive response DNA binding protein 43 kDa Pathology in PSP were influenced by concurrent pathologies. This is the first study to observe that PSP-vulnerable regions are also susceptible to this non-tau Pathology. © 2016 International Parkinson and Movement Disorder Society.

  • vascular Pathology is associated with rate of cognitive decline independent of ad Pathology einstein aging study p6 222
    2016
    Co-Authors: Ali Ezzati, Dennis W Dickson, Cuiling Wang, Richard B Lipton, Dorothea Altschul, Mindy J Katz, Carol A Derby
    Abstract:

    Objective: To examine the separate and joint influence of vascular Pathology and Alzheimer’s disease (AD) Pathology on the rate of cognitive decline in older adults. Background: Presence of vascular Pathology exacerbates the clinical presentation of AD and increases risk of clinically evident cognitive impairment. Methods: The Einstein Aging Study (EAS) autopsy series comprises 223 well characterized individuals, including 62 eligible for this study. Eligible participants were free of dementia at study baseline, and had a clinical evaluation within 5 years of death. The Blessed-information memory-concentration test (BIMC) was used to assess global cognitive status. AD Pathology was quantified based on Braak stage (<3 vs. ≥ 3). The Vascular Lesion Score (VLS) quantified vascular Pathology. The association of vascular Pathology with antemortem rates of cognitive decline adjusted for level of AD Pathology was assessed using linear mixed effects models with years prior to death as the time scale. Results: The mean age at enrollment was 81.8 and the mean age at death was 89.0 years. Compared to persons free of vascular lesions, those with moderate/severe vascular Pathology showed faster cognitive decline (difference in annual rate of change in BIMC=0.74; p=0.03). Braak stage was also associated with greater cognitive decline (p=0.03). The association of VLS with cognitive decline persisted after adjustment for AD Pathology (Difference in rate of change in BIMC=0.68, p=0.04). There was an interaction between vascular and AD Pathology; vascular Pathology had a greater effect on cognitive decline in persons who had higher Braak stages. (p for interaction = 0.03). Conclusions: Vascular brain Pathology is associated with the rate of cognitive decline after adjusting for level of AD Pathology. The effect of vascular Pathology on cognitive decline is greater among individuals with higher burden of AD Pathology. Disclosure: Dr. Ezzati has nothing to disclose. Dr. Wang has nothing to disclose. Dr. Lipton has received personal compensation for activities with Allergan, American Headache Society, Autonomic Technologies, Boston Scientific, Bristol Myers Squibb, Cognimed, Colucid, Eli-Lilly, eNeura Therapeutics, Merck, Novartis, Pfizer, Teva, and V Dr. Altschul has nothing to disclose. Dr. Katz has received research support from Bristol Myers Squibb. Dr. Dickson has nothing to disclose. Dr. Derby has nothing to disclose.

  • progressive aphasia secondary to alzheimer disease vs ftld Pathology
    2008
    Co-Authors: Keith A Josephs, Bradley F. Boeve, Joseph R Duffy, Neill R Graffradford, Jennifer L Whitwell, Wendy A Vanvoorst, Edyth A Strand, Joseph E Parisi, David S Knopman, Dennis W Dickson
    Abstract:

    Background: The Pathology causing progressive aphasia is typically a variant of frontotemporal lobar degeneration, especially with ubiquitin-positive inclusions (FTLD-U). Less commonly the underlying Pathology is Alzheimer disease (AD). Objective: To compare clinicopathologic and MRI features of subjects with progressive aphasia and AD Pathology to subjects with aphasia and FTLD-U Pathology and subjects with typical AD. Methods: We identified 5 subjects with aphasia and AD Pathology and 5 with aphasia and FTLD-U Pathology with an MRI from a total of 216 aphasia subjects. Ten subjects with typical AD clinical features and AD Pathology were also identified. All subjects with AD Pathology underwent pathologic reanalysis with TDP-43 immunohistochemistry. Voxel-based morphometry (VBM) was used to assess patterns of gray matter atrophy in the aphasia cases with AD Pathology, aphasia cases with FTLD-U, and typical AD cases with AD Pathology, compared with a normal control group. Results: All aphasic subjects had fluent speech output. However, those with AD Pathology had better processing speed than those with FTLD-U Pathology. Immunohistochemistry with TDP-43 antibodies was negative. VBM revealed gray matter atrophy predominantly in the temporoparietal cortices, with notable sparing of the hippocampus in the aphasia with AD subjects. In comparison, the aphasic subjects with FTLD-U showed sparing of the parietal lobe. Typical AD subjects showed temporoparietal and hippocampal atrophy. Conclusions: A temporoparietal pattern of atrophy on MRI in patients with progressive fluent aphasia and relatively preserved processing speed is suggestive of underlying Alzheimer disease Pathology rather than frontotemporal lobar degeneration with ubiquitin-only immunoreactive changes. GLOSSARY: AD = Alzheimer disease; ADPR = Alzheimer9s Disease Patient Registry; ADRC = Alzheimer9s Disease Research Center; aphasia–AD = subjects with progressive aphasia and Alzheimer disease Pathology; aphasia–FTLD-U = subjects with progressive aphasia and frontotemporal lobar degeneration with ubiquitin-only immunoreactive changes Pathology; CDR = Clinical Dementia Rating; DCT = discrete cosine transformation; FTLD = frontotemporal lobar degeneration; FTLD-U = frontotemporal lobar degeneration with ubiquitin-only immunoreactive changes; FWHM = full-width at half-maximum; GM = gray matter; MMSE = Mini-Mental State Examination; MNI = Montreal Neurological Institute; NA = not applicable; NIA = National Institute on Aging; NR = not reported; NS = not significant; PPA = primary progressive aphasia; typical AD = subjects with a clinical and pathologic diagnosis of Alzheimer disease; VBM = voxel-based morphometry; WAIS-R = Wechsler Adult Intelligence Scale–Revised; WM = white matter; WMS-R = Wechsler Memory Scale–Revised.

Arlene Thompson - One of the best experts on this subject based on the ideXlab platform.

  • Pathology informatics essentials for residents a flexible informatics curriculum linked to accreditation council for graduate medical education milestones
    2017
    Co-Authors: Walter H Henricks, Donald S Karcher, James H Harrison, John H Sinard, Michael Warren Riben, Philip J Boyer, Sue Plath, Arlene Thompson
    Abstract:

    Context.—Recognition of the importance of informatics to the practice of Pathology has surged. Training residents in Pathology informatics has been a daunting task for most residency programs in the United States because faculty often lacks experience and training resources. Nevertheless, developing resident competence in informatics is essential for the future of Pathology as a specialty. Objective.—To develop and deliver a Pathology informatics curriculum and instructional framework that guides Pathology residency programs in training residents in critical Pathology informatics knowledge and skills, and meets Accreditation Council for Graduate Medical Education Informatics Milestones. Design.—The College of American Pathologists, Association of Pathology Chairs, and Association for Pathology Informatics formed a partnership and expert work group to identify critical Pathology informatics training outcomes and to create a highly adaptable curriculum and instructional approach, supported by a multiyear ch...

  • Pathology informatics essentials for residents a flexible informatics curriculum linked to accreditation council for graduate medical education milestones
    2016
    Co-Authors: Walter H Henricks, Donald S Karcher, James H Harrison, John H Sinard, Michael Warren Riben, Philip J Boyer, Sue Plath, Arlene Thompson
    Abstract:

    Context: Recognition of the importance of informatics to the practice of Pathology has surged. Training residents in Pathology informatics have been a daunting task for most residency programs in the United States because faculty often lacks experience and training resources. Nevertheless, developing resident competence in informatics is essential for the future of Pathology as a specialty. Objective: The objective of the study is to develop and deliver a Pathology informatics curriculum and instructional framework that guides Pathology residency programs in training residents in critical Pathology informatics knowledge and skills and meets Accreditation Council for Graduate Medical Education Informatics Milestones. Design: The College of American Pathologists, Association of Pathology Chairs, and Association for Pathology Informatics formed a partnership and expert work group to identify critical Pathology informatics training outcomes and to create a highly adaptable curriculum and instructional approach, supported by a multiyear change management strategy. Results: Pathology Informatics Essentials for Residents (PIER) is a rigorous approach for educating all Pathology residents in important Pathology informatics knowledge and skills. PIER includes an instructional resource guide and toolkit for incorporating informatics training into residency programs that vary in needs, size, settings, and resources. PIER is available at http://www.apcprods.org/PIER (accessed April 6, 2016). Conclusions: PIER is an important contribution to informatics training in Pathology residency programs. PIER introduces Pathology trainees to broadly useful informatics concepts and tools that are relevant to practice. PIER provides residency program directors with a means to implement a standardized informatics training curriculum, to adapt the approach to local program needs, and to evaluate resident performance and progress over time.

  • Pathology informatics essentials for residents a flexible informatics curriculum linked to accreditation council for graduate medical education milestones a secondary publication
    2016
    Co-Authors: Walter H Henricks, Donald S Karcher, James H Harrison, John H Sinard, Michael Warren Riben, Philip J Boyer, Sue Plath, Arlene Thompson
    Abstract:

    Recognition of the importance of informatics to the practice of Pathology has surged. Training residents in Pathology informatics has been a daunting task for most residency programs in the United States because faculty often lacks experience and training resources. Nevertheless, developing resident competence in informatics is essential for the future of Pathology as a specialty.To develop and deliver a Pathology informatics curriculum and instructional framework that guides Pathology residency programs in training residents in critical Pathology informatics knowledge and skills, and meets Accreditation Council for Graduate Medical Education Informatics Milestones.The College of American Pathologists, Association of Pathology Chairs, and Association for Pathology Informatics formed a partnership and expert work group to identify critical Pathology informatics training outcomes and to create a highly adaptable curriculum and instructional approach, supported by a multiyear change management strategy.Pathology Informatics Essentials for Residents (PIER) is a rigorous approach for educating all Pathology residents in important Pathology informatics knowledge and skills. PIER includes an instructional resource guide and toolkit for incorporating informatics training into residency programs that vary in needs, size, settings, and resources. PIER is available at http://www.apcprods.org/PIER (accessed April 6, 2016).PIER is an important contribution to informatics training in Pathology residency programs. PIER introduces Pathology trainees to broadly useful informatics concepts and tools that are relevant to practice. PIER provides residency program directors with a means to implement a standardized informatics training curriculum, to adapt the approach to local program needs, and to evaluate resident performance and progress over time.

Carol A Derby - One of the best experts on this subject based on the ideXlab platform.

  • association between vascular Pathology and rate of cognitive decline independent of alzheimer s disease Pathology
    2017
    Co-Authors: Ali Ezzati, Dennis W Dickson, Cuiling Wang, Richard B Lipton, Dorothea Altschul, Mindy J Katz, Carol A Derby
    Abstract:

    Objectives To examine the association between vascular Pathology and rate of cognitive decline in older adults independent of Alzheimer's disease (AD) Pathology. Design Prospective cohort study. Setting Community sample. Participants Individuals from the Einstein Aging Study autopsy series (N = 62). Measurements The Blessed Information-Memory-Concentration (BIMC) test was used to assess global cognitive status. AD Pathology was quantified according to Braak stage (<3 vs ≥ 3). Vascular Pathology was quantified using a previously reported macrovascular lesion (MVL) score. The association between vascular Pathology and antemortem rates of cognitive decline adjusted for level of AD Pathology was assessed using linear mixed-effects models. Results Mean age was 81.8 at enrollment and 89.0 at death. Participants with more than two MVLs had faster cognitive decline than those with no MVLs (difference in annual rate of change in BIMC 0.74 points/yr, P = .03). Braak stage was also associated with cognitive decline (difference 0.57 points/yr, P = .03). The difference in rate of cognitive decline between those with more than two MVLs and those free of vascular lesions persisted after adjustment for AD Pathology (difference in rate of change in BIMC 0.68 points/yr, P = .04). The effect of vascular Pathology on cognitive decline was not significantly different according to AD Pathology. Conclusion Vascular brain Pathology is associated with rate of cognitive decline after adjusting for level of AD Pathology.

  • vascular Pathology is associated with rate of cognitive decline independent of ad Pathology einstein aging study p6 222
    2016
    Co-Authors: Ali Ezzati, Dennis W Dickson, Cuiling Wang, Richard B Lipton, Dorothea Altschul, Mindy J Katz, Carol A Derby
    Abstract:

    Objective: To examine the separate and joint influence of vascular Pathology and Alzheimer’s disease (AD) Pathology on the rate of cognitive decline in older adults. Background: Presence of vascular Pathology exacerbates the clinical presentation of AD and increases risk of clinically evident cognitive impairment. Methods: The Einstein Aging Study (EAS) autopsy series comprises 223 well characterized individuals, including 62 eligible for this study. Eligible participants were free of dementia at study baseline, and had a clinical evaluation within 5 years of death. The Blessed-information memory-concentration test (BIMC) was used to assess global cognitive status. AD Pathology was quantified based on Braak stage (<3 vs. ≥ 3). The Vascular Lesion Score (VLS) quantified vascular Pathology. The association of vascular Pathology with antemortem rates of cognitive decline adjusted for level of AD Pathology was assessed using linear mixed effects models with years prior to death as the time scale. Results: The mean age at enrollment was 81.8 and the mean age at death was 89.0 years. Compared to persons free of vascular lesions, those with moderate/severe vascular Pathology showed faster cognitive decline (difference in annual rate of change in BIMC=0.74; p=0.03). Braak stage was also associated with greater cognitive decline (p=0.03). The association of VLS with cognitive decline persisted after adjustment for AD Pathology (Difference in rate of change in BIMC=0.68, p=0.04). There was an interaction between vascular and AD Pathology; vascular Pathology had a greater effect on cognitive decline in persons who had higher Braak stages. (p for interaction = 0.03). Conclusions: Vascular brain Pathology is associated with the rate of cognitive decline after adjusting for level of AD Pathology. The effect of vascular Pathology on cognitive decline is greater among individuals with higher burden of AD Pathology. Disclosure: Dr. Ezzati has nothing to disclose. Dr. Wang has nothing to disclose. Dr. Lipton has received personal compensation for activities with Allergan, American Headache Society, Autonomic Technologies, Boston Scientific, Bristol Myers Squibb, Cognimed, Colucid, Eli-Lilly, eNeura Therapeutics, Merck, Novartis, Pfizer, Teva, and V Dr. Altschul has nothing to disclose. Dr. Katz has received research support from Bristol Myers Squibb. Dr. Dickson has nothing to disclose. Dr. Derby has nothing to disclose.

Cheryl M Coffin - One of the best experts on this subject based on the ideXlab platform.

  • critical values in pediatric surgical Pathology definition implementation and reporting in a children s hospital
    2007
    Co-Authors: Cheryl M Coffin, Krista Spilker, Amy Lowichik, Holly Zhou, Kim Nielson, Lance K Erickson, Theodore J Pysher
    Abstract:

    Timely communication of significant or unexpected findings in surgical Pathology can significantly improve patient care. Although surgical Pathology critical values have been published, no systematic assessment in pediatric surgical Pathology has been published. We surveyed pediatric pathologists and pediatric subspecialists to develop pediatric surgical Pathology critical values for verbal reporting before the final Pathology report. A policy and process for reporting and documentation was implemented, with retrospective and prospective quality review. Critical values cases constituted 9.4% of surgical Pathology accessions. Retrospective analysis revealed that 80% (73/91) had been reported and documented before policy implementation. Following implementation, 97.3% (402/413) were verbally reported and documented. A multidisciplinary group provided valuable information about critical values that might not have been obvious to pediatric pathologists but are important for patient care. Although the term critical values has become embedded in the surgical Pathology literature, we would propose an alternative term for significant or unexpected findings that require timely communication and documentation.

  • pediatric surgical Pathology pitfalls and strategies for error prevention
    2006
    Co-Authors: Cheryl M Coffin
    Abstract:

    Abstract Context.—Few data exist regarding quality measures for pediatric surgical Pathology, types of errors, or how error-prone situations and diagnostic pitfalls can be minimized. Objective.—This review reports on survey findings regarding methodology for quality assurance and error detection measurement and classification in pediatric surgical Pathology. It presents information regarding, and quality aspects of, intraoperative consultations in pediatric surgical Pathology. General strategies for identifying diagnostic pitfalls in pediatric surgical Pathology are briefly discussed. Data Sources.—A survey of children's hospitals based on a survey created by the Association of Directors of Anatomic and Surgical Pathology, literature review, and institutional quality assurance records provided information for this review. Conclusions.—Approaches to quality assurance and error reduction in pediatric surgical Pathology are similar to those used in general surgical Pathology. The children's hospitals that we...

Puay Hoon Tan - One of the best experts on this subject based on the ideXlab platform.

  • digital Pathology exploring its applications in diagnostic surgical Pathology practice
    2010
    Co-Authors: Ana Richelia Jaralazaro, Thomas Paulraj Thamboo, Ming Teh, Puay Hoon Tan
    Abstract:

    There has been a recent upsurge in worldwide attention on digital Pathology, which has transformed from static snapshots from camera-equipped microscopes to its modern form that encompasses scanning of whole glass slides with evaluation of histological images on a computer screen, along with management of its accompanying information. Although it has been widely accepted in education and research, its implementation in diagnostic surgical Pathology practice is not without challenges in workflow integration, technological infrastructure, pathologist acclimatisation, global standardisation for clinical practice, and cost issues, among others. Nonetheless, early adopters have harnessed its benefits in specific niches, like frozen section services and remote second opinion consultations. Its tremendous potential is worthy of further validation to compare with conventional glass slide evaluation, even while it is already paving the way for advancement into virtual three-dimensional imaging technology, with a glimpse into a possible future digital diagnostic Pathology practice.