[Master of Research for pathology residents: Why ? How ?]

A Master of Research is a training course providing the opportunity to learn about research methodology and to widen his/her area of expertise. It enables to get a foothold in research environment by integrating a team in order to carry out a research project and may represent a pathway to an academic career. The aims of this article are to detail the Master of Research goals and schedule and to explain how to get ready for this course as a resident.

[Two experimental models for wound vitality evaluation in forensic pathology: A clinical prospective non-interventional study and an animal model]

AIM OF THE STUDY

In forensic pathology, wound age evaluation allows to determine if a wound was inflicted before or after death, and to date wounds of different ages. This dating is performed in conventional histopathology by observing inflammatory cells and hemorrhage at the wound site. However, these criteria seem to show low sensitivity and/or specificity. The aim of our study was to compare two models of wound vitality evaluation: a human surgical model, and a porcine experimental model; using these histological criteria.

PATIENTS AND METHOD

In the two human (n=38) and porcine (n=11) models, three wounds were performed at regular time-lapse before devascularization/sacrifice, and a control wound after devascularization/sacrifice. The main evaluation criteria were the presence of interstitial hemorrhage and the number of interstitial polymorphonuclear neutrophils at 10 high power fields.

RESULTS

In the two models, the number of polymorphonuclears neutrophils was significantly higher in vital wounds compared to the post-devascularization/sacrifice wounds (P<0.001), with a very low sensitivity (human model: 4.3%; porcine: 47%). Hemorrhagic infiltration was more frequent in vital wounds (human: P<0.001; porcine: P=0.01), with a low specificity (human: 48%; porcine: 54%).

DISCUSSION AND CONCLUSION

This first study confirms, in the two models, the limitations of conventional histopathology in wound vitality evaluation. The next step will be testing several immunohistochemical markers in the two models.

[Forensic autopsies and pathological examination: Current practice in Montpellier's jurisdiction. A retrospective study of 630 autopsies]

INTRODUCTION

In France, pathological examination is not systematically required in forensic autopsies. The factors affecting the decision to carry out a pathological expertise have not yet been defined. The aim of this study was to describe in which conditions a pathological expertise was required after forensic autopsy by the high court of Montpellier.

METHODS

This study included and analyzed retrospectively all of the autopsy elements, of all forensic autopsies carried out over a year. These elements were classified: pre-autopsy, per-autopsy, and post-autopsy.

RESULTS

A pathological expertise was required in 19.2% of 630 cases, among which 31% in a context of undetermined cause of death and in 14% of cases of determined causes of death. The forensic practitioner recommended a pathological expertise in 10 to 31% of autopsies. Overall, 64 pathological examinations were realized out of 121 recommended examinations (52.9%), this rate varied from 25 to 73% depending on the court. The magistrate tended to favor anatomopathological expertise in cases of determined causes of death, and in certain manner of death (80% homicide versus 35% natural). The pathologist's expertise enabled to change the cause of death in 22% of cases and the manner of death in 19%. The pathological approach was a major asset in the 65% of unknown manner of deaths and in the 20% of natural, whereas the expertise did not help in cases of homicides, suicides and accidents. The cause of death was modified in 5.6% of initially determined causes of death, against 42.9% in case of initially unknown cause.

CONCLUSION

The use of pathologic examination in forensic autopsies is scarce and uneven. The factors resulting to its request are not directly linked to its scientific assets. A conjoint work between forensic and pathologist practitioners would be beneficial.

Evolution of the fabric of cardiovascular science: Saga of an enduring process of refinement

BACKGROUND

The core elements of cardiovascular science have been established by scholarly pursuits of numerous scientists across centuries. In this article, we have tried to trace the evolutionary journey of cardiovascular science from a rudimentary form in ancient period to a robust scientific discipline in modern times.

METHODS

A literature search of relevant, peer-reviewed, published articles was undertaken from indexed databases (Medline & Pubmed, Scopus, Embase, CINAHL Plus, Web of Science and Google Scholar).

RESULTS

Cardiovascular science has its roots in antiquity, when Greek scholars mostly relied on philosophical thoughts and ancient texts. This was followed by addition of few structural details to the theory of circulation by Galen based on animal dissection. Arab scholar Ibn al-Nafis provided new insights regarding circulation pathway in humans. Nevertheless, an erroneous concept prevailed into the onset of European Renaissance. Even with legalization of human dissection, little headway could be made till sixteenth century due to persistent reliance of anatomists on ancient Galenic principles. During seventeenth century, the circulatory pathway (as we know it today) was established due to significant contributions from scholars like Harvey and Malpighi. Their efforts were based on findings from experiments and logical conclusions. Eighteenth century witnessed the emergence of autopsy based methods which led to valuable contributions from Vieussens, Thebesius, Morgagni and Hunter regarding normal and pathologic anatomy of cardiovascular system. With structural details mostly established, researchers during nineteenth century focussed on innovations in diagnostic methods based on human experiments. Further development of advanced human experiment models during twentieth century led to emergence of contemporary treatment methods for various cardiac conditions. In the twenty-first century, cardiovascular science is undergoing comprehensive progress at an exponential rate due to technological advances.

CONCLUSION

The evolutionary journey of cardiovascular science as a discipline across centuries has been intriguing and eventful.

[Pathology of primary cardiac tumors]

Primary heart neoplasms are rare and poorly known by general pathologists. However, they are not exceptionally encountered in pathology laboratories having a recruitment of cardiac surgery specimens. About 80 % of them are benign tumors and 20 % are malignant tumors. Some tumors are specific to the heart or have characteristics when they grow in the heart, including myxoma and papillary fibroelastoma. The classification currently in use is the 4th edition of the WHO classification of heart tumors published in 2015, which takes into account the evolution of knowledge in the field of sarcomas, but which does not yet recognize cardiac intimal sarcoma. recently individualized in its intracardiac location.

[Innovations in medical undergraduate pathology education: The Paris Descartes medicine faculty experience]

At the Paris Descartes medicine faculty, we tested some newly developed tools to enhance the pedagogic value of the pathology teaching. In our faculty, this teaching is largely multidisciplinary and integrated in various teaching units; a large part is dedicated to practice works with thirteen 90min sessions. Virtual slides have been used for years in numerous medicine faculties; we successfully implemented this tool by adding contextual annotations, which facilitate students revising. We showed that rewarding students' assiduity enhanced their exam success. To do so, we now propose a short continuous assessment exam at the beginning of each practice session in the form of electronic multi-choice questions. Finally, we now propose a completely computerized final exam, on touchpads, that enhanced its docimologic value.