[Experiences with telepathology in northern Afghanistan : A 10-year success story].

Afghanistan is in a military conflict lasting more than 20 years and according to recent political development, in a downhill spiral towards a failed society. This scenario faces the question of the usefulness of international medical aid, especially morphological diagnostics in crisis situations. On the basis of ten years of experience from a telemedicine project, need, feasibility and results in Afghanistan will be discussed.

The Importance of Clinical Data for the Diagnosis of Breast Tumours in North Afghanistan.

Background: This study was performed in knowledge of the increasing gap between breast disease treatment in countries with restricted resources and developed countries with increasingly sophisticated examination methods.

Methods: The authors present the analysis of a breast disease register consisting of diagnostic cases from Mazar e Sharif and Herat in 2018 and 2019. The study comprises a total of 567 cases, which were presented to experts via telemedicine for final diagnosis.

Telepathological evaluation of paediatric histological specimens in support of a hospital in Tanzania.

Background/objective: In a project of telepathology (TP) between German pathologists and a hospital in Tanzania, trained technical assistants have uploaded digital histological images onto the internet-based platform ipath. The diagnoses from 486 paediatric specimens were analysed.

Methods: The investigation included diagnoses, either primarily done via TP or secondarily after a further workup of the paraffin-embedded tissue, which was sent to Germany for cases which could not be solved via TP.

How can we strengthen pathology services in Cambodia?

Rapid economic growth and a changing disease burden have increased the demand for pathology services in Cambodia. This paper describes the status of pathological services and international support for pathology professionals in Cambodia, and discusses future needs for strengthening pathology services. In 2016, there were only four pathologists and 18 pathology technologists in Cambodia.

Re-evaluation of challenging telepathological diagnoses in support of a hospital in Tanzania.

Since 2007, a hospital in Tanzania has been supported with histopathological reports via telepathology (TP) by German pathologists. For this, the Internet-based platform iPath is used. The aim of this study was to analyse the rate of discrepancies in defined diagnostic groups.

Experience with telepathology in combination with diagnostic assistance systems in countries with restricted resources.

Introduction: We describe the use of telepathology in countries with restricted resources using two diagnosis assistance systems (Isabel and Memem7) in addition to the diagnoses made by experts in pathology via the iPath-Network.

Methods: A total of 156 cases, largely from Afghanistan, were analysed; 18 cases had to be excluded because of poor image quality.

Results: Of the remaining 138 cases (100%), a responsible physician provided a tentative diagnosis for 61.

Diagnostic validity of static telepathology supporting hospitals without local pathologists in low-income countries.

Introduction: Static telepathology (TP) was used to support a hospital in Tanzania that cannot employ a resident pathologist but has a basic laboratory. Histological slides were prepared by the local technical staff and digital images were uploaded into an Internet-based system; consultant pathologists in Germany could give their opinion. The aim of the study was to examine the diagnostic validity of this project without local pathologists.

Benign cystic mesothelioma of the peritoneum in a 12-year-old boy, diagnosed via telepathology.

Low resource countries often have inadequate healthcare systems that, among other problems, suffer from a severe shortage of local expertise. In fields such as pathology, however, where diagnoses are mainly based on macroscopic and histological images, telemedicine can provide an opportunity to supplement the local capabilities by involving a world-wide network of experts. For this, the local pathologist can upload images to an online platform and then consult with international colleagues via teleconferencing, which can be particularly useful in rare or difficult cases.

A hybrid approach to telepathology in Cambodia.

We established a hybrid telepathology network at the Children's Surgical Centre (CSC) in Cambodia, based on store-and-forward communication using iPATH and videoconferencing using Skype. We retrospectively analysed all data from the CSC stored on the iPATH server and reviewed the patient notes over an 8-month period. Of 115 patients for histopathology diagnosis during the study period, 38 cases were uploaded onto iPATH for further telemedicine discussion.

Diagnostic telepathology: long-term experience of a single institution.

Objectives: The paper reviews the development of the application of telepathology in a department of surgical pathology between 1991 and 2003. The goal of the efforts during this time was to give up the concept of programming a single application, available only between two fixed workstations with sophisticated devices and special software, and to find the virtual "largest common denominator" for implementing as many different applications as possible with the same basic system.

Methods: A new telepathology system was designed as a client-server system with a relational database at its centre.