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Deaths occurring with the 30 days following any surgical procedure (perioperative deaths) will be the subject of a new audit coordinated by the Royal College of Surgeons and Anesthetists, which will be generally identified as the Confidential Enquiry into Perioperative Deaths (CEPOD). This study reviews, retrospectively, a series of 213 perioperative death necropsies out of a total of 1,451 carried out in three hospitals in Northern Ireland. All clinical and necropsy records of the test group were examined, and comparisons were drawn between the final clinical diagnoses made by the patients' physicians and those confirmed at the necropsy. Discrepancies noted were divided into 4 classes; two major discrepancies - those which affected patient survival and either could (class I) or could not (class II) have been treated - and two minor discrepancies - either not related to causes of death but could have been treated (class III) or incidental diagnosis that could not have been made before death (class IV). Clinical diagnoses not confirmed at necropsy were described as false positive clinical diagnoses. Diagnoses made at necropsy, but not clinically considered in life, were characterized as false negative diagnoses. Class I discrepancies were found in 44 cases, class II in 62 cases, class III in 63 cases and class IV in 101 cases. No discrepancy was noted in 50 cases. The frequency of discrepant diagnoses points out the importance of necropsies in perioperative deaths, as an audit of patient care and as a learning circumstance. (Consumer Summary produced by Reliance Medical Information, Inc.)

Banerjee S S, Verma S & Shanks J H (2004) Histopathology 44, 2–8 Morphological variants of plasma cell tumours [ABSTRACT FROM AUTHOR]

The Grand Round was held at the Christie Hospital, Manchester, U.K., on 30 November 2002. It followed a presentation by Dr David Dearnaley from the Royal Marsden Hospital in Sutton on ‘Novel approaches and trials in prostate cancer’. Controversies in the management of locally advanced prostate cancer were illustrated by a case presentation and followed by a discussion on the evaluation of disease extent, and the roles of radiotherapy and hormone ablation. [Copyright &y& Elsevier]