TAILIEUCHUNG - Wide Spectra of Quality Control Part 10

Tham khảo tài liệu 'wide spectra of quality control part 10', kỹ thuật - công nghệ, cơ khí - chế tạo máy phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả | 260 Wide Spectra of Quality Control of routine pathologic examination after elective joint arthroplasty for presumed osteoarthritis. The cost savings they estimate are enormous and patient management did not change because of an unexpected histologic diagnosis. On the other hand some studies find higher percentages of unexpected pathological diagnoses and therefore advise routine histopathological examination Billings et al. 2000 Clark et al. 2000 DiCarlo et al. 1994 Lauder et al. 2004 Palmer et al. 1999 Sugihara et al. 1999 Zwitser et al. 2009 . DiCarlo et al. documented a disagreement between the clinical and pathologic diagnoses of 1794 femoral heads from total joint arthroplasties with a large-cell lymphoma myeloma sarcoma ochronosis Gaucher s disease Paget s disease and enchondroma. The authors recommended routine pathology for elective arthroplasty to both verify the diagnosis and to serve as a measure of quality control. Billings et al. described the unexpected finding of an occult primary bone sarcoma in two patients with otherwise benign clinical findings and therefore underscore the necessity for routine pathological examination of femoral head specimens from patients who are at risk for the development of a secondary malignant tumor Billings et al. 2000 . Lauder et al. describe a patient with histopathological findings indicative for a low grade B cell lymphoma who developed systemic disease after 8 months. They underscore the fact that without routine pathologic examination neoplasms could still be missed even in patients who lack risk factors for malignancy and despite of a thorough preoperative evaluation. Furthermore they discuss the fact that studies in which low grade malignancies were found suggested that their patients had been free of signs or symptoms for underlying disease but did not perform a formal hematological evaluation for malignancy Kocher et al. 2000 Campbell et al. 1997 . They ask what the cost-benefit is when one is able to .

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