scholarly journals Application of Bethesda terminology to categorize buccal epithelial smears among petroleum station workers in Taif city, KSA

2016 ◽  
Vol 5 (3) ◽  
pp. 172 ◽  
Author(s):  
Basem Hassan Elesawy ◽  
Amal Abd El hafez ◽  
Abdelaty Shawky Mohamed ◽  
Magdi Mansour A. Salih
Keyword(s):  
Petroleum Products ◽  
High Grade ◽  
Potential Health ◽  
Petrol Station ◽  
Squamous Cells ◽  
Significant Difference ◽  
Mucosal Cells ◽  
Cytological Abnormality ◽  
Cytological Changes ◽  
Terminology System

Background and Objectives: Exposure to Petroleum products has a well-established mutagenicity and carcinogenicity of some compo-nents such as benzene. Buccal mucosal cells are capable of metabolizing the carcinogenic compounds to reactive chemicals. We investigated the buccal epithelial cell cytological changes resulting from the occupational exposure to Petroleum derivatives such as benzene.Methods: Samples were obtained from 70 Petrol station workers in Taif city-KSA, examined using the Papanicolaou stained smears and categorized based on Bethesda Terminology System. Statistical analysis was carried out with the SPSS.Results: About 38.6% of petrol station workers exhibited buccal cytological changes ranging from atypical squamous cells of undetermined significance (ASC-US) to high-grade squamous intraepithelial lesions (HSIL). Atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H) was the most frequent cytological abnormality. Buccal smears with abnormal cytological findings dominated among smokers in contrast to non-smokers with a statistically significant difference (P = 0.026). No significant associations were detected between the category of buccal cytological changes and the duration of work or the participant's age.Conclusion: Bethesda Terminology System can be efficiently applied to buccal smears. Petrol products induce precancerous epithelial changes in buccal epithelial cells indicating a potential health risk for Petrol station workers, thus annual checkup for those workers should be set as primary prevention of occupational-related cancer. Cigarette smoke is a co-factor that exacerbates the effects of Petrol derivatives.

scholarly journals “Three-Step Approach” Versus “See-and-Treat Procedure” in women with “High Grade Squamous Intraepithelial Lesion” (HSIL) or “Atypical Squamous Cells cannot exclude HSIL” (ASC-H) Cytology

2018 ◽  
Vol 24 (3) ◽  
pp. 151
Author(s):  
Mustafa Erkan Sari ◽  
Ibrahim Yalcin ◽  
Hanifi Sahin ◽  
Mehmet Mutlu Meydanli ◽  
Tayfun Gungor
Keyword(s):  
Retrospective Review ◽  
Cytological Diagnosis ◽  
High Grade ◽  
Histological Findings ◽  
Squamous Intraepithelial Lesion ◽  
Time Saving ◽  
Squamous Cells ◽  
Significant Difference ◽  
Intraepithelial Lesion ◽  
Approach Group

<p><strong>Objective:</strong> The purpose of this study was to examine the correlation between histological findings in women with HSIL or ASC-H who have undergone loop electrosurgical excisional procedure with “Three-Step Approach” and “See-and-Treat Procedure".</p><p><strong>Study Design:</strong> A retrospective review was performed in 171 women with cytologically detected HSIL or ASC-H. Sixty five women with HSIL cytology and 35 women with ASC-H cytology were managed by “Three-Step Approach”, 35 women with ASC-H and 36 women with HSIL cytology were managed by "See-and-Treat Procedure”. Rates of histopathological findings were compared in two strategies with respect to previous cytology.</p><p><strong>Results:</strong> Fifteen women with ASC-H (42.9%), and 24 women with HSIL (68.5%) had CIN 2-3 at loop electrosurgical excisional procedure specimens in the “See-and-Treat” group whereas 14 women with ASC-H (38.8%), and 43 women with HSIL (66.2%) had CIN 2-3 at loop electrosurgical excisional procedure specimens in the “Three-Step Approach” group. There was no significant difference in the rate of CIN 2+ lesions when two strategies were compared in women with HSIL and ASC-H (p=0.71 and p=0.72, respectively). The overtreatment rates were 22.9% and 48.6% for HSIL and ASC-H cytology, respectively in the “See and Treat” group.</p><p><strong>Conclusion:</strong> In the ASC-H group, the rate of CIN 2+ lesions is significantly high (51.4%). It seems rational to perform “See-and-Treat procedure” in the setting of ASC-H smears although the overtreatment rate seems to be high. Because of the rate of overtreatment, the “Three-Step Approach” seems to be more reasonable in women with ASC-H cytology who also have fertility concerns. After a cytological diagnosis of HSIL, “see and treat” approach seems to be a safe and time saving strategy.</p>

scholarly journals A descriptive analysis of end-of-life discussions for high-grade glioma patients

2021 ◽  
Author(s):  
Ai Chikada ◽  
Sayaka Takenouchi ◽  
Yoshiki Arakawa ◽  
Kazuko Nin
Keyword(s):  
End Of Life ◽  
Health Care Providers ◽  
Patient Participation ◽  
High Grade Glioma ◽  
Team Approach ◽  
High Grade ◽  
Care Providers ◽  
Patient Goals ◽  
Significant Difference ◽  
Eol Care

Abstract Background End-of-life discussions (EOLDs) in patients with high-grade glioma (HGG) have not been well described. Therefore, this study examined the appropriateness of timing and the extent of patient involvement in EOLDs and their impact on HGG patients. Methods A cross-sectional survey was conducted among 105 bereaved families of HGG patients at a university hospital in Japan between July and August 2019. Fisher’s exact test and the Wilcoxon rank-sum test were used to assess the association between patient participation in EOLDs and their outcomes. Results In total, 77 questionnaires were returned (response rate 73%), of which 20 respondents replied with refusal documents. Overall, 31/57 (54%) participated in EOLDs at least once in acute hospital settings, and a significant difference was observed between participating and nonparticipating groups in communicating the patient’s wishes for EOL care to the family (48% vs 8%, P = .001). Moreover, &gt;80% of respondents indicated that the initiation of EOLDs during the early diagnosis period with patients and families was appropriate. Most EOLDs were provided by neurosurgeons (96%), and other health care providers rarely participated. Additionally, patient goals and priorities were discussed in only 28% of the EOLDs. Patient participation in EOLDs was not associated with the quality of EOL care and a good death. Conclusions Although participation in EOLDs is relatively challenging for HGG patients, this study showed that participation in EOLDs may enable patients to express their wishes regarding EOL care. It is important to initiate EOLDs early on through an interdisciplinary team approach while respecting patient goals and priorities.

Is Atypical Squamous Cells That Cannot Exclude High-grade Squamous Intraepithelial Lesion Clinically Significant?

2007 ◽  
Vol 11 (2) ◽  
pp. 86-89 ◽  
Author(s):  
Michael T. McHale ◽  
Jessica Souther ◽  
John C. Elkas ◽  
Bradley J. Monk ◽  
Terry A. Harrison
Keyword(s):  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Squamous Cells ◽  
Intraepithelial Lesion ◽  
Clinically Significant

Necessity for subsequent surgery in women of child-bearing age with positive margins after cold knife conization: A retrospective cohort study

2021 ◽  
Author(s):  
Xinmei Wang ◽  
Juan Xu ◽  
Yang Gao ◽  
Pengpeng Qu
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
High Grade ◽  
Transformation Zone ◽  
Positive Margins ◽  
Child Bearing ◽  
Significant Difference ◽  
Cold Knife ◽  
Cold Knife Conization ◽  
Residual Lesions

Abstract Background: Risk factors for positive margins and residual lesions after cold knife conization (CKC) for high-grade cervical intraepithelial neoplasias (CIN) were assessed in women of child-bearing age. A design for postoperative management and avoiding these situations is offered.Methods: This was a retrospective study on 1,309 premenopausal women with high-grade CIN (including CIN3 and CIN2) based on a cervical biopsy under colposcopy used to diagnose a positive or negative margin. Age, gravidity, parity, HPV species, cytology, transformation zone type, results of endocervical curettage (ECC), quadrant involvement, glandular involvement, and CIN grade were analyzed. Among those with positive margins, 245 underwent surgery within three months, including CKC, a loop electrosurgical excision procedure, and total hysterectomy. Residual lesions were also assessed.Results: There was no significant difference in age, gravidity, parity, glandular involvement, and CIN grade between the two groups (P>0.3). There was a significant difference in HPV species, cytology, ECC results, and quadrant involvement (P<0.002). Multivariate analysis showed a major cytology abnormality, high-risk HPV infection, type III transformation zone, positive ECC result, and multiple quadrant involvement were independent risk factors for positive margins and residual lesions (P<0.02). Age >35 years was also a risk factor (P<0.03).Conclusion: High-risk women should be treated appropriately considering fertility. Patients with positive margins should be managed uniquely. Surgery for women without fertility may be appropriate. Close follow-up is necessary for women who have fertility requirements or are unwilling to undergo subsequent surgery if they have no risk factors, especially for women <35 years.

Interobserver Variability in Subclassification of Squamous Intraepithelial Lesions

1999 ◽  
Vol 123 (11) ◽  
pp. 1079-1084 ◽  
Author(s):  
Sherry L. Woodhouse ◽  
Janet F. Stastny ◽  
Patricia E. Styer ◽  
Mary Kennedy ◽  
Amy H. Praestgaard ◽  
...  
Keyword(s):  
Interlaboratory Comparison ◽  
Interobserver Variability ◽  
High Grade ◽  
Test Results ◽  
Squamous Intraepithelial Lesions ◽  
Papanicolaou Test ◽  
Management Guidelines ◽  
Significant Difference ◽  
Intraepithelial Lesion ◽  
Intraepithelial Lesions

Abstract Objective.—To determine whether, on a national cytology proficiency test, a competent cytologist can consistently distinguish grades of squamous intraepithelial lesions. Design.—Results for low- and high-grade squamous intraepithelial lesion referenced slides from the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology for 1996 and 1997 were analyzed including educational, nongraded vs graded validated slides. Results.—The discrepant rate between low- and high- grade lesions ranged from 9.8% to 15% for cytotechnologist, pathologist, laboratory, and all responses. There was a statistically significant difference in performance on graded, validated slides vs educational slides with better performance on validated slides. Conclusion.—This significant interobserver variability in subclassification of squamous lesions should be considered in management guidelines for abnormal Papanicolaou test results and implementation of national cytology proficiency testing.

scholarly journals Low-Grade Squamous Intraepithelial Lesion or High-Grade Squamous Intraepithelial Lesion? Concordance Between the Interpretation of Low-Grade Squamous Intraepithelial Lesion and High-Grade Squamous Intraepithelial Lesion in Papanicolaou Tests: Results From the College of American Pathologists PAP Education Program

2018 ◽  
Vol 143 (1) ◽  
pp. 81-85 ◽  
Author(s):  
Barbara A. Crothers ◽  
Mohiedean Ghofrani ◽  
Chengquan Zhao ◽  
Leslie G. Dodd ◽  
Kelly Goodrich ◽  
...  
Keyword(s):  
Education Program ◽  
Repeated Measures ◽  
False Negative ◽  
Misclassification Rate ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Significant Difference ◽  
Intraepithelial Lesion ◽  
Diagnostic Concordance

Context.— Obtaining diagnostic concordance for squamous intraepithelial lesions in cytology can be challenging. Objective.— To determine diagnostic concordance for biopsy-proven low-grade squamous intraepithelial lesion (LSIL) and high-grade squamous intraepithelial lesion (HSIL) Papanicolaou test slides in the College of American Pathologists PAP Education program. Design.— We analyzed 121 059 responses from 4251 LSIL and HSIL slides for the interval 2004 to 2013 using a nonlinear mixed-model fit for reference diagnosis, preparation type, and participant type. We evaluated interactions between the reference diagnosis and the other 2 factors in addition to a repeated-measures component to adjust for slide-specific performance. Results.— There was a statistically significant difference between misclassification of LSIL (2.4%; 1384 of 57 664) and HSIL (4.4%; 2762 of 63 395). There was no performance difference between pathologists and cytotechnologists for LSIL, but cytotechnologists had a significantly higher HSIL misclassification rate than pathologists (5.5%; 1437 of 27 534 versus 4.0%; 1032 of 25 630; P = .01), and both were more likely to misrepresent HSIL as LSIL (P &lt; .001) than the reverse. ThinPrep LSIL slides were more likely to be misclassified as HSIL (2.4%; 920 of 38 582) than SurePath LSIL slides (1.5%; 198 of 13 196), but conventional slides were the most likely to be misclassified in both categories (4.5%; 266 of 5886 for LSIL, and 6.5%; 573 of 8825 for HSIL). Conclusions.— More participants undercalled HSIL as LSIL (false-negative) than overcalled LSIL as HSIL (false-positive) in the PAP Education program, with conventional slides more likely to be misclassified than ThinPrep or SurePath slides. Pathologists and cytotechnologists classify LSIL equally well, but cytotechnologists are significantly more likely to undercall HSIL as LSIL than are pathologists.

Comparative Acute Toxicity of Shale and Petroleum Derived Distillates

1985 ◽  
Vol 5 (6) ◽  
pp. 1005-1016 ◽  
Author(s):  
Charles R. Clark ◽  
Paul W. Ferguson ◽  
Mark A. Katchen ◽  
Michael W. Dennis ◽  
Douglas K. Craig
Keyword(s):  
Acute Toxicity ◽  
Skin Irritation ◽  
Inhalation Exposure ◽  
Petroleum Products ◽  
Health Impacts ◽  
Shale Oil ◽  
Potential Health ◽  
Low Toxicity ◽  
Distillate Fractions ◽  
Comparative Acute Toxicity

In anticipation of the commercialization of its shale oil retorting and upgrading process, Unocal Corp. conducted a testing program aimed at better defining potential health impacts of a shale industry. Acute toxicity studies using rats and rabbits compared the effects of naphtha, Jet-A, JP-4, diesel and “residual” distillate fractions of both petroleum derived crude oils and hydrotreated shale oil. No differences in the acute oral (> 5 g/kg LD50) and dermal (> 2 g/kg LD50) toxicities were noted between the shale and petroleum derived distillates and none of the samples were more than mildly irritating to the eyes. Shale and petroleum products caused similar degrees of mild to moderate skin irritation. None of the materials produced sensitization reactions. The LC50 after acute inhalation exposure to Jet-A, shale naphtha, (> 5 mg/L) and JP-4 distillate fractions of petroleum and shale oils was greater than 5 mg/L. The LC50 of petroleum naphtha (> 4.8 mg/L) and raw shale oil (> 3.95 mg/L) also indicated low toxicity. Results demonstrate that shale oil products are of low acute toxicity, mild to moderately irritating and similar to their petroleum counterparts. The results further demonstrate that hydrotreatment reduces the irritancy of raw shale oil.

scholarly journals Aboriginal women have a higher risk of cervical abnormalities at screening; South Australia, 1993–2016

2018 ◽  
Vol 26 (2) ◽  
pp. 104-112
Author(s):  
Ming Li ◽  
David Roder ◽  
Lisa J Whop ◽  
Abbey Diaz ◽  
Peter D Baade ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Relative Risk ◽  
Confidence Interval ◽  
Cervical Screening ◽  
South Australia ◽  
Low Grade ◽  
High Grade ◽  
Mixed Effect ◽  
Aboriginal Women ◽  
Cytological Abnormality

Objective Cervical cancer mortality has halved in Australia since the national cervical screening program began in 1991, but elevated mortality rates persist for Aboriginal and Torres Strait Islander women (referred to as Aboriginal women in this report). We investigated differences by Aboriginal status in abnormality rates predicted by cervical cytology and confirmed by histological diagnoses among screened women. Methods Using record linkage between cervical screening registry and public hospital records in South Australia, we obtained Aboriginal status of women aged 20–69 for 1993–2016 (this was not recorded by the registry). Differences in cytological abnormalities were investigated by Aboriginal status, using relative risk ratios from mixed effect multinomial logistic regression modelling. Odds ratios were calculated for histological high grade results for Aboriginal compared with non-Aboriginal women. Results Of 1,676,141 linkable cytology tests, 5.8% were abnormal. Abnormal results were more common for women who were younger, never married, and living in a major city or socioeconomically disadvantaged area. After adjusting for these factors and numbers of screening episodes, the relative risk of a low grade cytological abnormality compared with a normal test was 14% (95% confidence interval 5–24%) higher, and the relative risk of a high grade cytological abnormality was 61% (95% confidence interval 44–79%) higher, for Aboriginal women. The adjusted odds ratio of a histological high grade was 76% (95% confidence interval 46–113%) higher. Conclusions Ensuring that screen-detected abnormalities are followed up in a timely way by culturally acceptable services is important for reducing differences in cervical cancer rates between Aboriginal and non-Aboriginal women.

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