New England Journal of Medicine, Ahead of Print.
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Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Δευτέρα 22 Φεβρουαρίου 2016
Long-Term Results of Stenting versus Endarterectomy for Carotid-Artery Stenosis
A Randomized, Controlled Trial of Total Knee Replacement
New England Journal of Medicine, Volume 374, Issue 7, Page 691-692, February 2016.
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A Randomized, Controlled Trial of Total Knee Replacement
New England Journal of Medicine, Volume 374, Issue 7, Page 698-698, February 2016.
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Belatacept and Long-Term Outcomes in Kidney Transplantation
New England Journal of Medicine, Volume 374, Issue 7, Page 698-698, February 2016.
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A Multinational Trial of Prasugrel for Sickle Cell Vaso-Occlusive Events
New England Journal of Medicine, Volume 374, Issue 7, Page 625-635, February 2016.
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Asymmetric Thinking about Return on Investment
New England Journal of Medicine, Volume 374, Issue 7, Page 606-608, February 2016.
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Effects of Testosterone Treatment in Older Men
New England Journal of Medicine, Volume 374, Issue 7, Page 611-624, February 2016.
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The Doctor’s New Dilemma
New England Journal of Medicine, Volume 374, Issue 7, Page 608-609, February 2016.
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Epigenetic Modulators and the New Immunotherapies
New England Journal of Medicine, Volume 374, Issue 7, Page 684-686, February 2016.
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Cost of Smoking among Homeless Adults
New England Journal of Medicine, Volume 374, Issue 7, Page 697-698, February 2016.
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Vibratory Urticaria Associated with a Missense Variant in ADGRE2
New England Journal of Medicine, Volume 374, Issue 7, Page 656-663, February 2016.
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Central Pontine Myelinolysis
New England Journal of Medicine, Volume 374, Issue 7, February 2016.
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Establishing a Framework — Does Testosterone Supplementation Help Older Men?
New England Journal of Medicine, Volume 374, Issue 7, Page 682-683, February 2016.
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Adaptive Servo-Ventilation for Central Sleep Apnea in Heart Failure
New England Journal of Medicine, Volume 374, Issue 7, Page 687-691, February 2016.
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Case 5-2016
New England Journal of Medicine, Volume 374, Issue 7, Page 671-680, February 2016.
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Drug-Induced Megaloblastic Anemia
New England Journal of Medicine, Volume 374, Issue 7, Page 695-697, February 2016.
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How Employers Are Responding to the ACA
New England Journal of Medicine, Volume 374, Issue 7, Page 604-606, February 2016.
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Statin-Associated Autoimmune Myopathy
New England Journal of Medicine, Volume 374, Issue 7, Page 664-669, February 2016.
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Zika Virus in the Americas — Yet Another Arbovirus Threat
New England Journal of Medicine, Volume 374, Issue 7, Page 601-604, February 2016.
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Recombinant IgA production for mucosal passive immunization, advancing beyond the hurdles
Vaccination is a successful strategy to proactively develop immunity to a certain pathogen, but most vaccines fail to trigger a specific immune response at the mucosal surfaces, which are the first port of entry for infectious agents. At the mucosal surfaces, the predominant immunoglobulin is secretory IgA (SIgA) that specifically neutralizes viruses and prevents bacterial colonization. Mucosal passive immunization, i.e. the application of pathogen-specific SIgAs at the mucosae, can be an effective alternative to achieve mucosal protection. However, this approach is not straightforward, mainly because SIgAs are difficult to obtain from convalescent sources, while recombinant SIgA production is challenging due to its complex structure. This review provides an overview of manufacturing difficulties presented by the unique structural diversity of SIgAs, and the innovative solutions being explored for SIgA production in mammalian and plant expression systems.
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Peptide-level robust ridge regression improves estimation, sensitivity, and specificity in data-dependent quantitative label-free shotgun proteomics
Peptide intensities from mass spectra are increasingly used for relative quantitation of proteins in complex samples. However, numerous issues inherent to the mass spectrometry workflow turn quantitative proteomic data analysis into a crucial challenge. We and others have shown that modeling at the peptide level outperforms classical summarization-based approaches, which typically also discard a lot of proteins at the data preprocessing step. Peptide-based linear regression models, however, still suffer from unbalanced datasets due to missing peptide intensities, outlying peptide intensities and overfitting. Here, we further improve upon peptide-based models by three modular extensions: ridge regression, improved variance estimation by borrowing information across proteins with empirical Bayes and M-estimation with Huber weights. We illustrate our method on the CPTAC spike-in study and on a study comparing wild-type and ArgP knock-out Francisella tularensis proteomes. We show that the fold change estimates of our robust approach are more precise and more accurate than those from state-of-the-art summarization-based methods and peptide-based regression models, which leads to an improved sensitivity and specificity. We also demonstrate that ionization competition effects come already into play at very low spike-in concentrations and confirm that analyses with peptide-based regression methods on peptide intensity values aggregated by charge state and modification status (e.g. MaxQuant's peptides.txt file) are slightly superior to analyses on raw peptide intensity values (e.g. MaxQuant's evidence.txt file).
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Plant vascular development: from early specification to differentiation
Vascular tissues in plants are crucial to provide physical support and to transport water, sugars and hormones and other small signalling molecules throughout the plant. Recent genetic and molecular studies have identified interconnections among some of the major signalling networks that regulate plant vascular development. Using Arabidopsis thaliana as a model system, these studies enable the description of vascular development from the earliest tissue specification events during embryogenesis to the differentiation of phloem and xylem tissues. Moreover, we propose a model for how oriented cell divisions give rise to a three-dimensional vascular bundle within the root meristem.
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Fiscal policy and TFP in the OECD: measuring direct and indirect effects
This paper analyzes the direct and indirect effects of fiscal policy on total factor productivity (TFP) in a panel of OECD countries over the period 1970–2012. Our contribution is twofold. First, when estimating the impact of fiscal policy on TFP from a production function approach, we identify the worldwide available level of technology by exploiting the observed strong cross-sectional dependence between countries instead of using ad hoc proxies for technology. Second, next to direct effects, we allow for indirect effects of fiscal policy by modeling the access of countries to worldwide available technology as a function of fiscal policy and other variables. Empirically, we propose and implement a nonlinear version of the common correlated effects pooled (CCEP) estimator of Pesaran (Econometrica 74(4):967–1012, 2006). The estimation results show that through the direct channel, budget deficits harm TFP. A shift toward productive expenditures has a strong positive impact on TFP, whereas a shift toward social transfers reduces TFP. Through the indirect channel, significant positive effects on a country's access to global technology come from reducing the statutory corporate tax rate and from reducing barriers to trade.
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Meiotic wave adds extra asymmetry to the development of female chicken gonads
Development of female gonads in the chicken is asymmetric. This asymmetry affects gene expression, morphology, and germ cell development; consequently only the left ovary develops into a functional organ, whereas the right ovary remains vestigial. In males, on the other hand, both gonads develop into functional testes. Here, we revisited the development of asymmetric traits in female (and male) chicken gonads between Hamburger Hamilton stage 16 (HH16) and hatching. At HH16, primordial germ cells migrated preferentially to the left gonad, accumulating in the left coelomic hinge between the gut mesentery and developing gonad in both males and females. Using the meiotic markers SYCP3 and phosphorylated H2AFX, we identified a previously undescribed, pronounced asymmetryc meiotic progression in the germ cells located in the central, lateral, and extreme cortical regions of the left female gonad from HH38 until hatching. Moreover, we observed that-in contrast to the current view-medullary germ cells are not apoptotic, but remain arrested in pre-leptotene until hatching. In addition to the systematic analysis of the asymmetric distribution of germ cells in female chicken gonads, we propose an updated model suggesting that the localization of germ cells-in the left or right gonad; in the cortex or medulla of the left gonad; and in the central part or the extremities of the left cortex-has direct consequences for their development and participation in adult reproduction.
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Practical reliability-based calculation tool for the post-fire assessment of concrete beams
If a structure has been able to maintain stability during fire exposure, the residual load-bearing capacity of the structural elements after fire should be determined when deciding upon the further use of the structure. Since adequate safety is a primary requirement for all structures and since many uncertainties are associated with the post-fire assessment, only a reliability-based assessment can be acceptable for real-life applications. In this contribution an easy-to-use reliability-based tool is presented for the post-fire assessment of the load-bearing capacity of concrete beams.
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Hmga2 is dispensable for cutaneous squamous cell carcinoma
Abstract
Hmga2 functions as a chromatin associated factor during development, but is not expressed in most adult tissues. Expression of Hmga2 in adult tissues has been associated with a variety of human cancers. Numerous studies have implicated Hmga2 in epithelial to mesenchymal transition (EMT) and cancer progression through gain of function studies, but it is unclear whether Hgma2 is necessary for EMT, tumor formation and tumor progression. We deleted Hmga2 in two mouse models of squamous cell carcinoma and found this gene to be dispensable. In fact, EMT, tumor initiation and progression all appeared to be mostly unaffected by the absence of Hmga2. Tumors lacking the ability to induce Hmga2 proceeded to initiate cutaneous spindle cell and squamous cell carcinomas with all the typical pathological and molecular hallmarks of these cancers.
This article is protected by copyright. All rights reserved.
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Predictors of and attitudes toward counseling about SUDEP and other epilepsy risk factors among Austrian, German, and Swiss neurologists and neuropediatricians
Summary
Objective
To examine the attitudes toward counseling about sudden unexpected death in epilepsy (SUDEP) and other epilepsy risk factors among Austrian, German, and Swiss neurologists and neuropediatricians, and to determine factors associated with not discussing SUDEP.
Methods
Questionnaires were sent to approximately 5,000 neurologists and neuropediatricians in 2014 regarding respondents' demographics, their working environments, and how often they discussed SUDEP, suicidal ideations on anticonvulsive medication, driving restrictions, and risks in daily life activities.
Results
In total, 519 surveys were completed (respondents' mean age: 45.5 years, 41.6% female, 66.9% adult neurologists, 31.0% neuropediatricians). A minority of 2.7% reported that they counseled all of their patients on SUDEP, 8.7% counseled most of the time (50–90%), 20.8% sometimes (10–49%), 44.5% rarely (1–9%), and 23.3% reported not counseling about SUDEP at all. In contrast, 92.9% reported that they counseled all patients about driving restrictions and 81.5% about risks in daily life activities. Suicidal ideations were discussed in 59.0% for some and in 3.3% for all patients, whereas 35.1% of respondents reported never discussing suicidal ideations. Independent predictors of not discussing SUDEP were no additional epilepsy training, no or uncertain SUDEP cases in the past, <10 years in practice, <25 epilepsy patients seen per quarter, and the opinion of a lack of consequences in SUDEP prevention. The opinion that SUDEP is a risk factor in particular patient groups and the attitude that all risks should be discussed predicted counseling on SUDEP.
Significance
Our findings show a discrepancy between guidelines and practice regarding the discussion of premature mortality due to SUDEP or suicidality. Both are not discussed at all by a substantial proportion of neurologists and neuropediatricians. This is in contrast to ubiquitous education about driving restrictions. Dissemination of knowledge among physicians about potential preventive strategies might increase the likelihood of discussion. Clinical practice guidelines are welcomed by the majority of physicians in this process.
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A study of diaphyseal nutrient foramina in human femur
2016-02-22T06-20-27Z
Source: International Journal of Research in Medical Sciences
Roopam Kumar Gupta, Aruna Kumari Gupta.
Background: The external opening of the nutrient canal in a bone is the nutrient foramen (NF). It is clinically important to have an understanding of the location, number, direction and caliber of diaphyseal nutrient foramina in femur, especially in orthopedic surgical procedures. Here we study the diaphyseal nutrient foramina of femur in detail. Methods: This study was conducted on 312, (154 right and 158 left), macerated specimens of adult human femur. All the important parameters were studied using osteometric board, vernier calipers and other precision measuring instruments. Results: The mean number of nutrient foramina per femur bone was 1.64 and mean distance of NF from upper end of femur was 19.48 cms. The foraminal index obtained was 45.01%. The most common location of NF was on the medial lip of linea aspera (40.9%). 44.6% femur had only one NF, while 49.4% had two NF, 3.8% femur had three NFs and 2.24% femur had four NFs. 50.48% of NFs were of big size caliber, 26.6% were of medium size and 22.8% were of small caliber. So 77.1% NFs in femur were dominant foramina. In all the bones studied the direction of the nutrient foramina was always directed upwards. Conclusions: The findings of this study on nutrient foramina adds to the information from studies in the past by other authors but the importance of this study lies in the large sample size and the detailed study of caliber of the nutrient foramen for the first time.
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Variability of the Phenotype and Proliferation and Migration Characteristics of Human Mesenchymal Stromal Cells Derived from the Deciduous Teeth Pulp of Different Donors
We performed a comparative study of cell phenotype and proliferation and migration activities in vitro of mesenchymal stromal cells from human exfoliated deciduous teeth (SHED cells) from three donors. In the primary cultures, the cells of different donors had the same morphology and cytophenotype, but differed by proliferative and migration capacities. The results indicate that individual mesenchymal stromal cells cultures can differ considerably by important cell properties, and this should be considered when evaluating their potential therapeutic efficacy and in experimental studies.
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Quantitative Evaluation of Changes in the Striatal Astrocyte Axons in Simulated Parkinsonism
Three parkinsonism models using neurotoxin 6-OHDA and pesticides rotenone and paraquat were reproduced in Wistar rats and parameters of astrocyte processes in the striatum (axon number and length, area occupied by them, and axon branching pattern) detected by immunohistochemical reaction for acid glial fibrillary protein were studied by computer morphometry. By these parameters, three morphological types of astrocytes were distinguished. Two variants of changes were found in the used parkinsonism models: 1) more intense branching and even elongation of all axons and 2) reduction of small and elongation of the main remaining stems, which manifested in polarization of glial cell. Type 1 reaction was obviously associated with compensatory increase in astrocyte interaction with neurons, while type 2 reflected astrocyte response to injury and impaired glioneuronal interactions.
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Effects of Hypobaric Hypoxia in Various Modes on Expression of Neurogenesis Marker NeuroD2 in the Dentate Gyrus of Rats Hippocampus
The expression of neurogenesis marker – NeuroD2 transcription factor – in the hippocampal dentate gyrus was studied in rats exposed to severe destructive hypoxia, a single or three episodes of moderate hypobaric hypoxia, preconditioned severe hypoxia, and severe hypoxia followed by 3 sessions of postconditioning by moderate hypobaric hypoxia. All the studied hypoxic exposure modes led to an increase of NeuroD2 level. Three-fold moderate hypoxia per se and in the preconditioning mode (followed by exposure to severe hypoxia) produced most pronounced up-regulatory effect on NeuroD2 expression. The results indicated that stimulation of neurogenesis processes seemed to be one of the aspects of the neuroprotective effect of three-fold preconditioning moderate hypoxia, but not of hypoxic postconditioning.
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Quantitative PCR studies of Aggregatibacter actinomycetemcomitans and Treponema denticola / Tanerella forsythensis Complex as Etiological Factors of Chronic Periodontitis
Real-time quantitative PCR (Dentofl or kit) was used to detect DNA of periodontal pathogens in specimens from 92 patients with chronic periodontitis and from a control sample of 12 normal subjects. A bimodal distribution of patients by periodontium colonization with A. actinomycetemcomitans, P. gingivalis, P. intermedia, T. forsythensis, and T. denticola was demonstrated. A new approach to interpretation of the results of quantitative evaluation of periodontal pathogens, including the notion of pathological colonization level, led to classification of all cases with chronic generalized periodontitis into 3 groups: associated with A. actinomycetemcomitans, with T. forsythensis/T. denticola complex, and cases of uncertain genesis.
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Possibility of Using Mesenchymal Stromal Cells to Restore Lymph Flow in Experimental Phlebothrombosis
The possibility of formation of lymphatic vessels after introduction of autologous bone marrow-derived multipotent mesenchymal stromal cells transfected with GFP gene into thrombosed femoral vein was studied by fluorescent microscopy. Vascular thrombosis caused by ligation of the great vein with subsequent injection of thrombin solution was accompanied by blockade of regional lymph flow. The cells injected into thrombosed vein directly participate in the formation of new lymphatic vessels in the paravasal tissue surrounding the vein, its tissue region, and around regional lymph nodes. This is seen from bright specific fluorescence of individual cells in the walls of lymphatic vessels and all vascular layers and valves in UV light.
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Characteristics of Multipotent Mesenchymal Stromal Cells Isolated from Human Endometrium
Cell cultures isolated from human endometrium by enzyme digestion consisted of highly viable fibroblast-like mesenchymal cells expressing CD90, CD73, and CD105. During passage 1, the cultures contained a small fraction of cytokeratin-7+ epithelial cells that disappeared by passage 2. The cultures from the endometrium could be induced to adipogenic, osteogenic and chondrogenic differentiation in vitro. These findings suggest that human endometrium is a convenient source of biomaterial for minimally invasive isolation of cultures that exhibit typical morphology and immunophenotypic profile of resident multipotent mesenchymal stromal cells retain high viability in vitro.
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Structural Characteristics of Gastric Cell Populations in Chronic Gastritis and Chronic Hepatitis under Conditions of Helicobacter pylori Persistence
Helicobacter pylori persistence in patients with chronic gastritis is associated with a complex of nonspecific structural reactions, the type of these reactions correlates with the severity of infection: catarrhal fibrotic changes in the gastric mucosa predominate in cases with manifest colonization, while the absence of H. pylori is associated with predominance of fibrotic process. Analysis of the incidence of some pathomorphological phenomena (degeneration, atrophy, metaplasia, and dysplasia of the surface epithelium) shows no relationship between the presence of H. pylori and colonization intensity. In all patients with chronic hepatitis, the gastric mucosa is involved in the pathological process; fibrosis (gastropathy) was the most common process. No appreciable correlations between the structural changes and hepatitis activity and the presence of H. pylori were detected.
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Effect of Endothelial Cells on Angiogenic Properties of Multipotent Stromal Cells from the Umbilical Cord during Angiogenesis Modeling in the Basement Membrane Matrix
Short-term cell culturing on basement membrane matrix is a common and very convenient in vitro model of angiogenesis. We studied the possibility of interaction of multipotent stromal cells from the umbilical cord and Ea.hy926 endothelial cells on this model at the early and late periods of the experiment. Multipotent stromal cells alone and in combination with endothelial cells formed an unstable tubular network. Clusters formed after its disassembling later became the sprouting centers in co-culture of the two cell types, but not in pure culture of multipotent stromal cells. Multipotent stromal cells with CD31+ phenotype constitute the structural basis of newly formed stable 3D capillary-like network. Prolongation of the time of culturing and combination of the two in vitro models of angiogenesis (tubulogenesis and sprouting) allowed more complete assessment of the angiogenic potential of multipotent stromal cells.
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Effects of Millimeter-Wave Electromagnetic Radiation on the Experimental Model of Migraine
Effects of millimeter-wave electromagnetic radiation (40 GHz frequency, 0.01 mW power) on the spontaneous fi ring of convergent neurons of the spinal trigeminal nucleus and their responses to electrical stimulation of the dura mater were studied in neurophysiological experiments on rats. Irradiation of the area of cutaneous receptive fields of spinal trigeminal nucleus reversibly inhibited both spontaneous discharges and activity induced by electrical stimulation of the dura mater. The second and third exposures to electromagnetic radiation with an interval of 10 min were ineffective. These results suggest that suppression of neuronal excitability in the spinal trigeminal ganglion can be a mechanism of the anti-migraine effects of electromagnetic radiation observed in clinical practice.
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The Use of Atomic Force Microscopy for Cytomorphological Analysis of Bacterial Infection Agents
Cytomorphological signs of bacterial infection agents were studied by atomic force microscopy. Analysis of the elastic mechanical characteristics of Staphylococcus spp. from the skin of patients with chronic dermatoses showed lower elasticity of S. aureus cell membrane in comparison with that of transitory flora representatives. Significant differences in characteristics of cell membrane relief and presence of fimA pathogenicity factor were detected in E. coli isolated from the reproductive tract mucosa of clinically healthy women and patients with inflammatory urogenital infections.
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Efficiency of Umbilical Cord Blood Cells in Patients with Treatment-Resistant Depressions
We studied the efficacy of umbilical cord blood cells in the therapy of treatment-resistant depressive states in women. Concentrated umbilical cord blood cells were administered in a dose of 250 millions cells (4 injections at 1-week intervals). The control group received placebo. In both groups, reduction of depressive disorders and the decrease in hypothymia severity were observed. Infusions of cell concentrate contributed to delayed correction of treatment resistance and reduced the severity of depression to moderate. In the main group, significant, persistent, and long-term positive dynamics was observed in the cognitive sphere. The therapeutic potential of umbilical cord blood cell concentrate can be used to overcome treatment resistance formed in depressive patients.
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Comparative Analysis of Proliferation and Viability of Multipotent Mesenchymal Stromal Cells in 3D Scaffolds with Different Architectonics
3D biodegradable materials (scaffolds) containing bioactive hydroxyapatite molecules fabricated by foaming in supercritical carbon dioxide and by selective laser sintering were used for culturing of mesenchymal stromal cells from the human adipose tissue. Experiments showed that stromal cells from the human adipose tissue adhered and proliferated on all studied types of structures. Addition of hyproxyapatite to the scaffold stimulated proliferation of stromal adipose tissue cells.
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Effect of Vascular Endothelial Growth Factor and Erythropoietin on Functional Activity of Fibroblasts and Multipotent Mesenchymal Stromal Cells
The study examined the effect of VEGF and erythropoietin on proliferative and migratory activities of skin fibroblasts and multipotent mesenchymal stromal cells of human adipose tissue. VEGF stimulated proliferation and migration of fi broblasts, but produced no significant effect on functional activity of multipotent mesenchymal stem cells. Erythropoietin stimulated proliferation of both cell types, but did not affect their migration.
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New Silk Fibroin-Based Bioresorbable Microcarriers
We fabricated bioresorbable microcarriers from water solution of Bombyx mori silk fi broin. The microcarriers are 3D structures with intricate surface and pores allowing penetration of culture medium, gas exchange, and cell adhesion. Fibroin molecules form hydrophobic structures and normally have a negative charge, which stimulates migration, but inhibits cell adhesion and makes it less effective. In order to improve adhesion efficiency and velocity, gelatin (hydrophilic biopolymer with integrin-recognizing RGD sequence) was added to the microcarrier composition. The resultant bioresorbable microcarriers support adhesion and proliferation of 3T3 murine fibroblasts.
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Cytopathological yarn of a suprasellar mass lesion: Diagnostic clues and pitfalls
GV Manjunath, CS Sheeladevi, Sunila , MC Sapna Patel, BN Kumarguru
CytoJournal 2016 13(1):5-5
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CytoJournal 2016 13(1):5-5
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Fine needle aspiration biopsy of metastatic malignant mesothelioma with myxoid change and signet ring cells: A case report and review of the literature
Manisha M Mishra, Carol F Farver, Deborah J Chute
CytoJournal 2016 13(1):4-4
Malignant mesothelioma (MM) is a rare neoplasm, which is most commonly encountered in cytology through effusion specimens. Fine needle aspiration biopsy of MM, particularly the epithelioid subtype, can be a source of diagnostic difficulty and may mimic sampling of an adenocarcinoma. This is the first case report to demonstrate abundant extracellular myxoid material and numerous intracellular vacuoles, including signet ring cells, in a fine needle aspirate of metastatic MM. A review of the literature for myxoid change and vacuoles in fine needle aspiration biopsies of MM discloses that vacuoles are found in up to 35% of aspirates of MM, but myxoid change is very rare, reported in <5% of the cases. Cytologists should be aware of this rare morphologic pattern of metastatic epithelioid MM.
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CytoJournal 2016 13(1):4-4
Malignant mesothelioma (MM) is a rare neoplasm, which is most commonly encountered in cytology through effusion specimens. Fine needle aspiration biopsy of MM, particularly the epithelioid subtype, can be a source of diagnostic difficulty and may mimic sampling of an adenocarcinoma. This is the first case report to demonstrate abundant extracellular myxoid material and numerous intracellular vacuoles, including signet ring cells, in a fine needle aspirate of metastatic MM. A review of the literature for myxoid change and vacuoles in fine needle aspiration biopsies of MM discloses that vacuoles are found in up to 35% of aspirates of MM, but myxoid change is very rare, reported in <5% of the cases. Cytologists should be aware of this rare morphologic pattern of metastatic epithelioid MM.
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Detecting uterine glandular lesions: Role of cervical cytology
Baneet Bansal, Parikshaa Gupta, Nalini Gupta, Arvind Rajwanshi, Vanita Suri
CytoJournal 2016 13(1):3-3
Background: The sensitivity of cervical cytology for detection of glandular lesions is reported to be low. We conducted this study to assess the diagnostic accuracy of cervical Papanicolaou (Pap) smears for uterine glandular lesions and to compare the diagnostic utility of conventional and liquid-based cytology (LBC) smears for glandular lesions. Materials and Methods: Archived histopathology records of all cases reported as endocervical and endometrial adenocarcinoma in the study period were identified and the available corresponding Pap smears (in preceding 1 year) were retrieved. In addition, the Pap smears reported as glandular cell abnormalities (GCA) during the same study period were retrieved. The overall prevalence of GCA, sensitivity, and specificity of Pap smears for the detection of GCA was calculated. The diagnostic accuracy of conventional and LBC smears for the diagnosis of GCA was also compared. Results: The prevalence of GCA in our study was 0.32%. The overall specificity of Pap smears for the diagnosis of GCA was 60.8%, this was not significantly different between conventional and LBC smears (P = 0.4). The overall sensitivity of Pap smears for the detection of GCA was 41.8%; LBC smears had significantly better sensitivity as compared to conventional smears for the detection of endometrial as compared to endocervical adenocarcinoma (P < 0.05). Conclusions: The prevalence of GCA in Pap smears is low. The specificity of Pap smears, for diagnosis of GCA, was found to be moderate. However, the overall sensitivity of Pap smears for the detection of GCA was low, though better for LBC as compared to conventional smears.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1KDJWPe
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CytoJournal 2016 13(1):3-3
Background: The sensitivity of cervical cytology for detection of glandular lesions is reported to be low. We conducted this study to assess the diagnostic accuracy of cervical Papanicolaou (Pap) smears for uterine glandular lesions and to compare the diagnostic utility of conventional and liquid-based cytology (LBC) smears for glandular lesions. Materials and Methods: Archived histopathology records of all cases reported as endocervical and endometrial adenocarcinoma in the study period were identified and the available corresponding Pap smears (in preceding 1 year) were retrieved. In addition, the Pap smears reported as glandular cell abnormalities (GCA) during the same study period were retrieved. The overall prevalence of GCA, sensitivity, and specificity of Pap smears for the detection of GCA was calculated. The diagnostic accuracy of conventional and LBC smears for the diagnosis of GCA was also compared. Results: The prevalence of GCA in our study was 0.32%. The overall specificity of Pap smears for the diagnosis of GCA was 60.8%, this was not significantly different between conventional and LBC smears (P = 0.4). The overall sensitivity of Pap smears for the detection of GCA was 41.8%; LBC smears had significantly better sensitivity as compared to conventional smears for the detection of endometrial as compared to endocervical adenocarcinoma (P < 0.05). Conclusions: The prevalence of GCA in Pap smears is low. The specificity of Pap smears, for diagnosis of GCA, was found to be moderate. However, the overall sensitivity of Pap smears for the detection of GCA was low, though better for LBC as compared to conventional smears.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1KDJWPe
via IFTTT
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