CLINICAL CYTOLOGY: WHY AND HOW?

Klinička citologija je morfološka dijagnostička struka koja u današnjoj medicini nije odgovarajuće iskorištena ponajviše zbog nedovoljne obaviještenosti liječnika o njenim dijagnostičkim mogućnostima i prednostima. Ovim osvrtom na povijesni razvoj kliničke citologije i na njezino dijagnostičko značenje želimo pridonijeti boljoj obaviještenosti o današnjim mogućnostima citološke dijagnostike i njezinom budućem usmjeravanju u eri ubrzanog tehnološkog razvoja i skretanju medicine u profitabilnost, što donosi brojne negativne posljedice. Bitne osobine citološke dijagnostike: neagresivnost, jednostavnost, brzina i točnost moraju se sačuvati i uz praćenje novih tehnoloških mogućnosti. Standardna citomorfologija je osnova na temelju koje se donosi odluka o dodatnim tehnologijama iz citološkog uzorka i/ili direktno na citološkim razmazima (citokemija, imunocitokemija, protočna citometrija, molekularna analiza i citogenetika), kako u svrhu točnije dijagnoze tako i subtipizacije i prognoze novotvorina. Uvjet za to je odgovarajuća izobrazba citologa i citotehničara kao i odgovarajuća organizacija citološke struke pri čemu je potrebna uska suradnja s kliničarima, patolozima i ostalim dijagnostičkim strukama. Kao i u povijesnom razvoju citologije, važan je entuzijazam pojedinaca da se sačuva i unaprijedi sve njezine mogućnosti za dobrobit bolesnika.Clinical cytology is a morphological diagnostic profession, which has not been properly utilized in current medicine, primarily due to inadequate awareness among physicians of its diagnostic possibilities and advantages. The purpose of this historical review of clinical cytology and its diagnostic role is to contribute to higher awareness of the current possibilities offered by cytologic diagnosis and its future development in the era of technological progress and medical striking into profitability, with its negative connotations. The main features of cytologic diagnosis, i.e. non-aggressiveness, simplicity, promptness and accuracy, should be maintained while following new technological possibilities. Standard cytomorphology provides a basis for deciding on using additional technologies (cytochemistry, immunocytochemistry, flow cytometry, molecular analysis and cytogenetics) after thorough microscopic analysis, on cytologic samples or/and cytologic smears. The conditio sine qua non for that purpose is appropriate education of cytologists and cytotechnologists as well as appropriate organization of cytology in the healthcare system. As in the historical development of clinical cytology, enthusiasts are necessary to maintain and even improve all its possibilities to the benefit of our patients

Clinical Cytology and Primary Health Care of Children and Adults

Clinical cytology is a diagnostic branch of medicine, best known by the Papa test in gynaecology. But, cytology can be applied in almost all fields of clinical medicine. Its advantages – high accuracy, simplicity, with little or no aggressiveness and low cost – are not used as widely as they could be. Medical practice, as well as medical research, and also medical education, are nowadays often directed at profitable use and not at the real benefit of the patient. Primary practitioners do not have enough chance to get acquainted with clinical cytology as a whole although they need true information, based on the cost-effectiveness and patient-benefit. A panel discussion on this subject was organised at the 4th Croatian Congress of Clinical Cytology, in Split, October 11–14, 2009 by the Croatian Society for Clinical Cytology-Croatian Medical Asoctiation, to inform primary practitioners about the possibilities of cytodiagnostics in the health care of children and adults. Indications for cytodiagnostics in infectious diseases (T. Jeren and A. Vince), haematology (I. Kardum-Skelin), pulmonology (S. Smojver-Je`ek), thyroid diseases (A. Kne`evi}-Obad), breast diseases (I. Kardum-Skelin), gastroenterology and urology (G. Kai}) were discussed, as well as technical procedures and the interpretation of the cytological findings. Moderator (@. Znidar~i}) opened the panel with presentation about the role of clinical cytology, particularly in the primary health care. The discussion finally pointed at the necessity of better communication between primary practitioners and cytologists. This review article presents contents of the panel discussion

Clinical cytology and primary health care of children and adults [Klinička citologija i primarna zdravstvena zaštita djece i odraslih]

Clinical cytology is a diagnostic branch of medicine, best known by the Papa test in gynaecology. But, cytology can be applied in almost all fields of clinical medicine. Its advantages--high accuracy, simplicity, with little or no aggressiveness and low cost--are not used as widely as they could be. Medical practice, as well as medical research, and also medical education, are nowadays often directed at profitable use and not at the real benefit of the patient. Primary practitioners do not have enough chance to get acquainted with clinical cytology as a whole although they need true information, based on the cost-effectiveness and patient-benefit. A panel discussion on this subject was organised at the 4th Croatian Congress of Clinical Cytology, in Split, October 11-14, 2009 by the Croatian Society for Clinical Cytology-Croatian Medical Association, to inform primary practitioners about the possibilities of cytodiagnostics in the health care of children and adults. Indications for cytodiagnostics in infectious diseases (T. Jeren and A. Vince), haematology (I. Kardum-Skelin), pulmonology (S. Smojver-Jezek), thyroid diseases (A. Knezević-Obad), breast diseases (I. Kardum-Skelin), gastroenterology and urology (G. Kaić) were discussed, as well as technical procedures and the interpretation of the cytological findings. Moderator (Z. Znidarcić) opened the panel with presentation about the role of clinical cytology, particularly in the primary health care. The discussion finally pointed at the necessity of better communication between primary practitioners and cytologists. This review article presents contents of the panel discussion