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Hematology: Blood smears on a glass slide, stained and ready to be examined under the microscope.
Hematology: microscopic image of a normal blood smear. a:erythrocytes, b:neutrophil, c:eosinophil, d:lymphocyte.
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 chemistry: microscopic image of crystals in urine.

Clinical pathology (US, UK, Ireland, Commonwealth, Portugal, Brazil, Italy), Laboratory Medicine (Germany, Romania, Poland, Eastern Europe), Clinical analysis (Spain) or Clinical/Medical Biology (France, Belgium, Netherlands, Austria, North and West Africa...),[1] 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 and molecular pathology. This specialty requires a medical residency and should not be confused with Biomedical science, which is not necessarily related to medicine.

Licensing and subspecialties[edit]

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

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

Organization[edit]

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[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 subspecialities 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. 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 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]

Place of work[edit]

See Medical laboratory.

Tools of Clinical Pathology[edit]

Microscopes, analyzers, strips, centrifugal machines...

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]

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

See also: staining

This stage allows the pathologist to determine the character of the liquid: “normal”, tumoral, inflammatory even infectious. Indeed, microscopic examination can often determine the causal infectious agent, in general a bacterium, a mould, a yeast, or a parasite, more rarely a virus.

Analyzers[edit]

See Automated analyser.

The analysers, by the association of robotics and spectrophotometry, allowed these last decades a better reproducibility of the results of proportionings, in particular in medical biochemistry and hematology.

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 maintenances.

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[edit]

Notes and references[edit]

External links[edit]


Original courtesy of Wikipedia: http://en.wikipedia.org/wiki/Clinical_pathology — Please support Wikipedia.
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1958 news items

Monroe News Star

Monroe News Star
Sat, 24 Jan 2015 16:39:49 -0800

Students can complete a Bachelor of Science degree in this program, which makes them eligible to take the national certification exam by the Board of Certification of the American Society for Clinical Pathology. Medical laboratory scientists are ...
 
Reuters
Wed, 21 Jan 2015 03:26:31 -0800

(The following statement was released by the rating agency) LONDON, January 21 (Fitch) Fitch Ratings has revised the Outlook on French clinical pathology laboratory group Cerba European Lab SAS (Cerba) to Negative from Stable. Its Issuer Default Rating ...

Healio

Healio
Thu, 22 Jan 2015 12:15:00 -0800

So much has been done,” Francesco Negro, MD, of the divisions of gastroenterology and hepatology and of clinical pathology at the University Hospitals of Geneva in Switzerland, told Endocrine Today. “You cannot ignore what has been done up until now.” ...
 
Business Wire (press release)
Mon, 05 Jan 2015 09:15:00 -0800

“This successful transaction with Aurora supports our ongoing commitment to advance treatment outcomes and improve patient care,” says Bob Garvey, CEO of Dominion Diagnostics. “The launch of a new clinical pathology division in Greensboro will allow ...
 
Moodys.com (press release) (subscription)
Fri, 23 Jan 2015 09:15:00 -0800

These factors are balanced to an extent by (1) Cerba's vertical integration within clinical pathology, allowing for synergies between its three operating segments; (2) high barriers to market entry as a result of complex logistics, as well as the ...
 
Mondaq News Alerts (registration)
Thu, 22 Jan 2015 04:56:15 -0800

Regarding health actions and services, activities in support of health care are those developed by human genetics, production and supply of medicines and health products laboratories, as well as clinical, pathology and diagnostic imaging laboratories ...
 
Law360 (subscription)
Tue, 20 Jan 2015 16:11:51 -0800

Felix, who is a professor of clinical pathology and obstetrics and gynecology at the Keck School of Medicine at the University of Southern California and has been researching HPV since 1988, cited several factors that he said made him certain that the ...

Fox News

Medscape
Fri, 09 Jan 2015 03:00:23 -0800

In 2011, the American Cancer Society, the American Society for Colposcopy and Cervical Pathology, and the American Society for Clinical Pathology updated their screening guidelines regarding early diagnosis of cervical cancer and its precursors. At ...
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