Sixty percent lidocaine tape alleviates pain on injection of propofol after diminishing venipuncture pain

Cytological changes of feather pulp lesions (FPL) sampled chronologically from the same specific-pathogen free chickens inoculated with Marek's disease virus serotype 1 (MDV) were examined, comparing with their histological changes. The birds having Marek's disease (MD) lymphomas or nerve lesions exhibited the characteristic lesion changes on the cytological smears of FPL; the initial non-suppurative inflammatory to the late lymphomatous FPL. The birds having neither the MD visceral lymphomas nor the nerve lesions manifested only non-suppurative inflammatory FPL on the cytological smears throughout the experimental periods. Histological evaluation of FPL sampled from the same birds confirmed as above mentioned cytological results. From these results, the cytological evaluation of FPL proved to be an effective diagnostic and prognostic tool in foreseeing MD incidence.     

Duration of use of intrauterine contraception

Data from cytological examination of smears from the surface of IUD's were studied in 310 women; 94 of them had used IUDs up to 1 year, 150 from 1 to 3 years and 66 for 3 years or more. The study revealed a membrane isolated from the endometrium, consisting of bloodcells (red corpuscles and dead leucocytes), mature squamous and glandular epithelium, amorphous protein mass, fibrin filaments, fibroblasts and multinuclear giant cells. None of these smears revealed any atypical cells. An examination of 116 washings from the surface of removed IUD's was done. Biopsies were performed on the endometrium of 154 women; the morphological picture was identical. In several cases a local, nonspecific inflammation of the endometrium was detected. There was no clinical disorder. Intrauterine devices should not be used without interruption for more than 6 or 7 years, and the interruptions should last at least 2 or 3 months. Regular, careful examinations should be performed on women using intrauterine devices.     

Screening for cervix carcinoma--a retrospective comparison between new and established federal German states

OBJECTIVE: There is no doubt about the effect of cytological screening programmes on the reduction of incident cases with invasive cervical carcinoma. The question is, to what extent this reduction was caused by cytological screening exclusively. A retrospective analysis of the former East German cytological mass screening could give information of early and late screening effects and also on the efficacy. Based on data from the Saarland cancer registry, common aspects and differences between the old and new federal states of Germany can be addressed regarding incidences and mortality trends for cervical carcinoma. RESULTS: Since the sixties the incidence of CIS has increased by 625% while the incidence of invasive carcinoma has decreased by 44% in the new federal states. Since the seventies mortality due to cervical carcinoma decreased by 44%. Incidences and mortality rates of the Saarland were considerably lower than of the new federal states. CONCLUSION: This study describes noteworthy early screening effects and proves the efficacy of mass cancer screening. Changes of incidence and, particularly, mortality rates are not exclusively due to these programmes.     

A marked increase in the rate of diagnosed prostate cancer in the Netherlands during 1990-1996

OBJECTIVE: To study the variation of the number of histologically detected adenocarcinomas of the prostate in the Netherlands during the period 1990-1996. DESIGN: Retrospective. SETTING: National study. METHOD: Use was made of data from the National Automated Morbid-Anatomical Record Department (PALGA), Utrecht. The following data were established for each year of the study period: the total number of histological examinations of the prostate, the number of men involved (often several histological examinations of the prostate of the same man in the same year), how often adenocarcinoma was diagnosed by these examinations and how many men were involved, as well as the age of all carcinoma patients. These data were compared with those concerning variation and incidence of cancer of the prostate obtained from the Netherlands. Cancer Registration and the Central Statistics Office. RESULTS: In 7 years a total of 205,525 histological examinations of the prostate were performed in 179,298 men; the diagnosis 'adenocarcinoma of the prostate' was made 52,964 times in 44,182 men. The number of tissue examinations with the diagnosis 'carcinoma of the prostate' increased by 63% (from 5,596 to 9,146), the number of men in whom this diagnosis was made increased by 62% (from 4,710 to 7,614). The relative frequency of prostate carcinoma in relation to all examinations of the prostate increased in 6 years (1991-1996) from 22% to 28%. In that period, the (uncorrected) incidence increased by 50%, while mortality corrected for age remained the same. CONCLUSION: Of the marked increase of the number of detected cases of carcinoma of the prostate in the study period, only a small part could be attributed to demographic changes. Since autopsies have shown that there exists a large 'stock' of subclinical carcinomas, most of the growth can probably be explained by the more intensive diagnostics with prostate-specific antigen and transrectal ultrasonography.     

Negative smears in women developing invasive cervical cancer

Fifty-six cervical smears originally classified as Pap. I, from women in whom cervical cancer of stage I to IV was detected within 4 to 5 years after the cytological check, were re-examined in order to estimate the screening error and sampling failure. At the review, 35 smears were classified as Pap. II to V. The incidence of changed classification of the smears obtained from population screening was 70% and that of the smears taken at private specialists or at hospitals was about 50%. The influence of sampling failure on the evaluation of the smears classified as Pap. II should be considered. On 14 slides, correctly interpreted as negative, there were no columnar cells present, a fact that may indicate inefficient sampling of cells from the squamo-columnar junction.     

Entropy in the assessment of diagnostic importance of changes in urine

Entropy, as the measure of that part of the heat or energy of a system which is not available to perform work, is suitable for application in numerous medical investigations. It is determined in regard to two states of the system: states above and below the examined level of studied parameters. By application of entropy function in completed examinations sometimes it is possible to gain additional conclusions or to confirm already existing. This method of entropy determination was performed in final quantitative bacteriological and cytological examinations of samples gained from the first morning urine of 314 persons without symptoms or signs of urinary tract infection, 422 patients with symptoms and signs of bacterial infection and 31 deceased persons with autopsy confirmed pyelonephritis. Gathered results confirm the diagnostic and prognostic significance of quantitative bacteriological and cytological urine examination. However, by examination of these findings in patients with pyelonephritis, as well as the nature of bacteria, it can be concluded that the lowest of bacteriuria is between 10(3) and 10(4) in 1 ml of urine.     

Early regression of cervical lesions in HIV-seropositive women receiving highly active antiretroviral therapy

OBJECTIVE: Advanced HIV disease is associated with a high prevalence of cervical squamous intra-epithelial lesions (SIL) and of infection with oncogenic human papillomavirus (HPV) genotypes. Triple-combination antiretroviral therapy results in decreased plasma HIV viral load, increased CD4 cell counts and partial restoration of immune functions in patients with severe HIV disease. This study investigated the outcome of SIL in HIV-seropositive women undergoing triple combination antiretroviral treatment. METHODS: Forty-nine women who started triple-combination antiretroviral therapy, including a protease inhibitor, were examined prior to and after a median 5-month treatment. We collected cytological, colposcopic and histologic data and assessed the presence of HPV DNA in cervical smears by PCR and Southern blot hybridization (SBH). RESULTS: The prevalence of SIL decreased from 69 to 53% during follow-up (P < 0.0001). Among 13 women who initially presented with high-grade SIL, conversion to lower grade was observed in two women and a full regression to normality was observed in one. Cytology also returned to normality in nine out of 21 women who initially presented with low-grade SIL. The high prevalence of HPV infection as detected by SBH and PCR was similar at the first and second examinations and the same high-risk viral genotypes were identified at both examinations in all infected patients but one. There was a higher increase in absolute CD4 cells in the subgroup of patients whose lesions regressed (99 versus 50 x 10(6)/l, P=0.03). CONCLUSION: Our observations demonstrate that active antiretroviral therapy may result in a reduced prevalence of cervical squamous intra-epithelial lesions despite the absence of clearance of HPV infection.     

Papillomatous digital dermatitis on a commercial dairy farm in Mexicali, Mexico: incidence and effect on reproduction and milk production

This retrospective study of papillomatous digital dermatitis (PDD) was performed using data for cows that calved between July 1993 and June 1994 on a Mexicali, Mexico, dairy farm in order to calculate incidence rates, and to compare milk yield and reproduction data between affected and nonaffected dairy cows. A total of 190 out of 577 (33%) cows were affected during lactation and six (1%) during the dry period. Fifty-two of 77 (68%) cows that had lesions in the previous lactation and were also present on the farm in the current lactation had lesions in the current lactation. The highest risk for PDD occurred during the first month of lactation (9%). The yearly estimated cumulative incidence risk was 35% and the incidence density rate was 44.6 cases per 1000 cow-months. More animals were affected in summer and fall than in winter and spring. Purchased animals were 3.4 times more likely to be affected than animals born on the farm. Survival analyses indicated healthy cows conceived 93 days after calving (median), but affected cows conceived 113 days after calving (median) (P < 0.01). PDD-affected animals produced less milk than healthy cows, but the difference was not statistically significant in the multiple regression.     

Hormonal regulation and germ cell-specific expression of heat shock protein 60 (hsp60) in the testis of macaque monkeys (Macaca mulatta and M. fascicularis)

FNA smears from six histologically documented cases of tubular adenoma of breast were critically analysed and compared with 10 histologically confirmed cases of fibroadenoma (five pericanalicular and five intracanalicular). Initially a cytological diagnosis of tubular adenoma was rendered only in one case. On review, two cases could be characterized as tubular adenoma, while the findings were suggestive in two others. The features helpful in diagnosis of tubular adenoma were the presence of benign ductal cells as three-dimensional cohesive balls and tubular structures in highly cellular smears. Stroma was conspicuously scanty or absent. Myoepithelial cells were present along with sheets of ductal cells as well as bipolar naked nuclei. Confusion with fibroadenoma occurred in two cases due to presence of a stag-horn pattern of ductal cells.     

Rare association of human herpesvirus 6 DNA with human papillomavirus DNA in cervical smears of women with normal and abnormal cytologies

We investigated by nested PCR the possible association of human herpesvirus 6 (HHV-6) and human papillomavirus (HPV) genomes in the cervixes of 109 women with normal and abnormal cytological smears. HPV DNA was detected in 8.33% of 24 women with normal cytologies and in 41.1% of 85 women with abnormal cytologies; the proportion of HPV DNA was directly related to the severity of the lesions. HHV-6 DNA was found in only one patient, who had a cytological pattern of koilocytosis. The HHV-6 genome was classified by restriction enzyme analysis as variant B. The study indicates that detection of the HHV-6 genome in the cervixes of women with a wide spectrum of gynecological complaints is a rare event and rules out the possible association between HHV-6 and HPV genomes in cervical cancer lesions.     

Significant reduction in the rate of false-negative cervical smears with neural network-based technology (PAPNET Testing System)

False-negative cervical Pap smears may lead to disability or death from carcinoma of the uterine cervix. New computer technology has led to the development of an interactive, neural network-based vision instrument to increase the accuracy of cervical smear screening. The instrument belongs to a new class of medical devices designed to provide computer-aided diagnosis (CADx). To test the instrument's performance, 487 archival negative smears (index smears) from 228 women with biopsy-documented high-grade precancerous lesions or invasive cervical carcinoma (index women) were retrieved from the files of 10 participating laboratories that were using federally mandated quality assurance procedures. Samples of sequential negative smears (total 9,666) were retrieved as controls. The instrument was used to identify evidence of missed cytological abnormalities, including atypical squamous or glandular cells of undetermined significance (ASCUS, AGUS), low-grade or high-grade squamous intraepithelial lesions (LSIL, HSIL) and carcinoma. Using the instrument, 98 false-negative index smears were identified in 72 of the 228 index women (31.6%, 95% confidence interval [CI]: 25% to 38%). Disregarding the debatable categories of ASCUS or AGUS, there were 44 women whose false-negative smears disclosed squamous intraepithelial lesions (SIL) or carcinoma (19.3%; 95% CI: 14.2% to 24.4%). Unexpectedly, SILs were also identified in 127 of 9,666 control negative smears (1.3%; 95% CI: 1.1% to 1.5%). Compared with historical performance data from several participating laboratories, the instrument increased the detection rate of SILs in control smears by 25% and increased the yield of quality control rescreening 5.1 times (P < 0.0001). These data provide evidence that conventional screening and quality control rescreening of cervical smears fail to identify a substantial number of abnormalities. A significant improvement in performance of screening of cervical smears could be achieved with the use of the instrument described in this report.     

Pathology, clinical correlates, radiology and surgery of cystic adventitial degeneration of the peripheral blood vessels. 2. Clinical correlates and arteriography

Drosophila nigricruria has a distribution ranging from northern Mexico to Chile. It is a relatively rare species, primarily limited to cactus deserts or pine-oak associations at altitudes of 1200 to 2100 meters above sea level. The species comprises two cytological races with a zone of hybridization in the Oaxaca and Puebla regions of Mexico. Despite the zone of hybridization, gene flow for chromosome 4 genes is limited, or non-existent, between the two races. Sexual isolation tests were run using a population from the northern race, a hybrid population, and a population that is essentially southern. Sexual discrimination among these strains was on the same order of magnitude as that found between geographical populations of other species. There was no evidence to indicate that sexual isolation is any stronger between the cytological races of nigricruria than one might expect between any two geographical populations within a species.     

Obituary: Leon Festinger (1919–1989).

Presents an obituary for Leon Festinger. The science fiction writer, Stanislaw Lem, speculated that if Newton and Galileo had died in childhood, classical mechanics would have emerged with only a slight delay. But if Dostoevski had been executed and Picasso killed in World War I, there would not have been a Crime and Punishment or a Guernica. One can safely say that if there was never the configuration of genes and experience that emerged as Leon Festinger, there would not have been a theory of cognitive dissonance, and social psychology would not be what it is today. It is even doubtful if experimental social psychology would have emerged as a discipline at all. This is saying on the one hand that experimental social psychology is in some ways a form of art, and on the other that Festinger was experimental social psychology's Picasso. For one must view Festinger's unique laboratory methods of studying social situations as nothing short of a high form of art, and his research as products of rare beauty. An inveterate smoker, who knew the data on smoking better than many, Leon Festinger died of liver cancer—quietly—in his hometown, on February 11, 1989, saying, "Make sure everyone knows that it wasn't lung cancer!" (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relation between sampling device and detection of abnormality in cervical smears: a meta-analysis of randomised and quasi-randomised studies

OBJECTIVE: To assess the diagnostic yield of different sampling devices used in cervical screening. DESIGN: Meta-analysis of randomised and quasi-randomised studies. SETTING: All randomised and quasi-randomised studies comparing the yield of cytological or histological abnormalities when two or more different sampling devices were used. SUBJECTS: 85,000 patients included in 29 studies reported in 28 papers. MAIN OUTCOME MEASURES: Pooled relative risk and 95% confidence interval of the yield of mild dysplasia or worse in smears recovered by each sampling method versus each other method with which it was compared; sensitivity or positive predictive value, or both, of cytological versus histological results in six studies from which sufficient data were available. RESULTS: There were no substantial differences in the yield of cytological abnormalities between the Ayre spatula, the Cytobrush, and the cotton swab used alone. There were also no substantial differences in the yield of cytological abnormalities between the extended tip spatula, the Ayre spatula combined with the Cytobrush or cotton swab, or the Cervex brush. The Ayre spatula, Cytobruah, or cotton swab used alone generally performed significantly worse than the combinations, the extended tip spatula, or the Cervex brush. There were no substantial differences in sensitivity or positive predictive value between the sampling methods. CONCLUSIONS: These results support the use of either the extended tip spatula, a combination of any spatula plus the Cytobrush or cotton swab, or the Cervex brush for cervical screening.     

Cervical intraepithelial neoplasia in HIV seropositive patients

In order to assess the frequency of cervical intraepithelial neoplasia (CIN) in a high risk population, 32 women infected with human immunodeficiency virus (HIV), with no AIDS-related symptoms, underwent colposcopic, cytologic and histologic examinations of the uterine cervix. In seven cases (21.9%) cervical smears showed dysplasia and in nine cases (28.1%) histologic evaluation indicated CIN. No invasive carcinomas were observed. In seven of the nine women CIN was associated with lesions due to human papillomavirus infection (HPV). These data confirm that HIV-positive women are at increased risk for developing neoplasias in the lower genital tract and are in need of regular and careful cytologic and, in particular, colposcopic and histologic examinations.     

Decreasing rates of cervical cancer among American Indians and Hispanics in New Mexico (United States)

Minority women in New Mexico (United States)--including American Indian and Hispanic women--have shown disproportionately high incidence rates of invasive cervical cancer during the 1960s and 1970s. Several public health programs in New Mexico were directed toward early detection of cervical cellular abnormalities, particularly targeting the state's minority women. To evaluate the effectiveness of these programs, we examined the New Mexico Surveillance, Epidemiology, and End Results (SEER) data collected from 1969-92, and calculated average annual, age-specific, and age-adjusted incidence rates by ethnic group (American Indian, Hispanic, and non-Hispanic White) for five-year time intervals. We also calculated age-adjusted mortality rates for cervical cancer in the same ethnic groups using state vital records. Age-adjusted incidence rates for invasive cervical cancer show substantial temporal decreases, especially for minority women in the state. The age-adjusted incidence rate decreased by 66 percent, from 30.3 to 10.3 per 100,000 for American Indian women, and by 61 percent, from 26.1 to 10.2 per 100,000 for Hispanic women. A stage shift to earlier stages of cervical neoplasia occurred over the study period, with a substantially higher proportion of in situ compared with invasive cancers diagnosed in the most recent cf the most remote time period. The ratio of incidence rates of in situ to invasive cancers changed dramatically for both American Indian and Hispanic women. Cervical cancer mortality rates decreased steadily among Hispanic women from 1958 to 1992; the decrease among American Indian women was less stable and fluctuated due to small numbers. Ongoing targeted screening programs should help to reduce cervical cancer incidence and mortality further in New Mexico.     

Cancer of the bladder in spinal cord injury patients

Since 1963, 10 cases of bladder carcinoma have been detected in 1,052 new admissions to our center. A high percentage of these patients had squamous cell carcinoma and/or squamous elements. This relatively high incidence stimulated a prospective study of 81 spinal cord injury patients either maintained on intraurethral catheter drainage for 10 years or an external appliance for 15 years. There were changes of squamous metaplasia in 19 per cent of the cases but no cancer was detected. It remains undetermined if squamous metaplasia is a pre-malignant lesion. However, the incidence of squamous metaplasia and squamous cell carcinoma in paraplegics with chronically infected bladders is not uncommon. Any spinal cord injury patient with hematuria needs a complete bladder evaluation and any long-term paraplegic with chronic infection should undergo cystoscopy and Papanicolaou smears as part of the yearly checkup.     

Assessment of testicular cytology by fine-needle aspiration and the imprint technique: are they reliable diagnostic modalities?

OBJECTIVE: To investigate whether testicular cytology may be considered diagnostic in the evaluation of infertile men. PATIENTS AND METHODS: Specimens of testicular tissue obtained either surgically (imprint smear) or through fine-needle aspiration (FNA) were used as a source of cytological smears; 58 testes from 24 men with azoospermia or severe oligospermia and from five men with advanced prostate cancer were evaluated cytologically and compared with the histological diagnosis. RESULTS: FNA caused no apparent trauma. The results from FNA smears generally agreed with the histological findings but four patients with no spermatozoa in the FNA smears were diagnosed histologically as hypospermatogenic and two others judged histologically as having Sertoli-cell-only (SCO) syndrome and spermatogenic arrest had detectable spermatozoa in their FNA smears. There was complete agreement between the results of imprint smears and histological findings in those patients with SCO syndrome and spermatogenic arrest. There were no evident differences in sperm counts between hypospermatogenesis and normal spermatogenesis on the imprint slides, but FNA smears detected this difference. CONCLUSION: FNA of the testis is a relatively non-invasive and reproducible technique for evaluating qualitative and quantitative cytology. However, it is insufficient for diagnosing some testicular pathologies. Imprint smears supplement the histological diagnosis, especially if the histological slides are stained unsatisfactorily.     

Effects of orthotopic liver transplantation on body composition

The aim of this prospective noninvasive follow-up study was (1) to assess the progression of cardiac involvement (CI) in patients with myotonic dystrophy (MD), Becker's muscular dystrophy (BMD) and mitochondrial myopathy (MMP), (2) to find out if CI and neurologic impairment are related and (3) to determine how often cardiac investigations should be performed. Clinical, electrocardiographic, echocardiographic and 24-hour ambulatory electrocardiographic examinations were performed at yearly intervals. CI was assessed qualitatively by the presence of pathologic examinations and quantitatively by the number of pathologic examinations. Qualitatively, CI was present at baseline in 36 of the 38 cases (18-68 years) and the number of cases did not change. Quantitatively, CI progressed after 1 (2) year in 50% (50%) of patients with MD (n = 16), 0% (43%) of patients with BMD (n = 7) and 27% (27%) of patients with MMP (n = 15). CI and neurologic impairment were not related (p = 0.54). Cardiac investigations should be repeated at yearly intervals irrespective of whether there is neurologic deterioration or not.