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Selected AbstractsRole of Pap Test terminology and age in the detection of carcinoma invasive and carcinoma in situ in medically underserved California womenDIAGNOSTIC CYTOPATHOLOGY, Issue 4 2004Lydia P. Howell M.D. Abstract Our goals were to evaluate Pap Test findings classified by the Bethesda system, and follow up biopsies from participants in the California Breast and Cervical Cancer Control Program (Ca-BCCCP) for: 1) correlation in the detection of carcinoma in situ (CIS) and carcinoma invasive (CI), and 2) age-related trends, with discussion in the context of the 2001 ASCCP Management Guidelines. Women (n = 52,339) who had their initial screening Pap Tests with Ca-BCCCP between January 1995,December 1999 were followed for diagnostic services through December 2000. Descriptive and analytical methods were used in the analysis. Of the Pap results, 81.9% were negative, 10.6% showed infection, 4.7% showed an epithelial abnormality as defined by the Bethesda system (atypical squamous cells of undertermined significance (ASCUS), low-grade squamous intraepithelial lesion (LSIL), or high-grade squamous intraepithelial lesion (HSIL)), 0.1% showed squamous-cell cancer (SCC), and 2.7% showed other or unsatisfactory. Subsequent to the initial Pap Test, follow-up results of carcinoma in situ (CIS) and carcinoma invasive (CI) accounted for 0.36% and 0.05% of the population, respectively. Among HSIL Pap Tests (n = 285), 40.7% had follow-up showing CIS. Among SCC Pap Tests, 17.9% had follow-up results of CIS and 28.6% CI. Of the 191 patients with CIS as a follow-up finding, the initial Pap smear showed: HSIL 60.7%, SCC 2.6%, LSIL 10.5%, ASCUS 13.6%, and negative or infection 9.9%. Of the 27 patients with CI, the initial Pap Test showed: HSIL 40.7%, SCC 29.6%, LSIL 7.4%, ASCUS 7.4%, and negative or infection 11.1%. Pap diagnoses of other or unsatisfactory accounted for 2.6% of the Pap results from patients with CIS and 3.7% of Pap results from patients with CI. Except for LSIL, there was an increasing age trend in the number of cases in each of Pap results, with the exception of age 65+ yr. However, the ratio of LSIL and ASCUS to negative cases decreased with age. (P < 0.0001 and 0.0293, respectively). HSIL Pap results indicate a reasonably high probability of CIS and CI. However, approximately 1/3 of patients with CIS and 1/4 of patients with CI presented with Pap diagnoses of less severity than HSIL. When a negative Pap Test result is chosen as reference group, there is a negative age trend for LSIL and ASCUS, and no age trend for other results. These findings all have important implications in the design of follow-up strategies, and support the 2001 ASCCP Consensus Guidelines for the Management of Women with Cervical Abnormalities. Diagn. Cytopathol. 2004;30:227,234. © 2004 Wiley-Liss, Inc. [source] The effects of calcium on stem lesions of silver birch seedlingsFOREST PATHOLOGY, Issue 2 2007A. Lilja Summary In this study, we tested the hypothesis that decreased liming of growth medium has a role in the increase of stem lesions and top dying caused by Phytophthora cactorum in containerized silver birch seedlings (Betula pendula) in Finnish forest nurseries. The effect of limestone dose rates on growth and the nutrient status was also monitored. An index based on severity of symptom expression was used to compare the effect of different liming treatments on P. cactorum infection. Limestone amended into the sphagnum peat growth medium increased the amount of calcium in the seedling stems. Liming did not significantly decrease the disease severity although index values in most cases decreased with the increased limestone dose rates. In general, the lesions were restricted after out-planting and the mortality of seedlings was low. Only inoculated seedlings on which the lesions had spread around the stem in the nursery died. Phytophthora cactorum appears to be a nursery pathogen, as it did not survive under conditions present in the field. Four years after out-planting, the tallest birches were those grown in sphagnum peat amended with the highest limestone dose of 8 kg m,3. [source] Mortality patterns in infectious salmon anaemia virus outbreaks in New Brunswick, CanadaJOURNAL OF FISH DISEASES, Issue 11 2005K L Hammell Abstract Mortality levels attributed to infectious salmon anaemia viral (ISAV) infections were examined at the net pen and site level in the 1996 smolt year class in three areas of New Brunswick, Canada. The year class in this region was the first known to have potential exposure to ISAV beginning at the time of seawater transfer. There was considerable variability in mortality patterns among net pen groups of fish. Net pen outbreak definitions were based on at least seven high mortality days in which there were at least 100 per 100 000 fish per day or >5% cumulative mortality for the study period. There were 106 net pen outbreaks in a study population consisting of 218 net pens. Although the number of new cases decreased as water temperature decreased, overall mortality levels at the study sites did not decrease noticeably. The median peak daily mortality rate during outbreaks was 492 per 100 000 fish per day, with 10% of cases experiencing >5200 mortalities per 100 000 fish per day. The median duration of outbreaks in net pens for which the fish were not slaughtered during the outbreak was 33 days and the median total loss in those outbreaks was 6600 per 100 000 fish. [source] Enzyme immobilization on ultrafine cellulose fibers via poly(acrylic acid) electrolyte graftsBIOTECHNOLOGY & BIOENGINEERING, Issue 4 2005Hong Chen Abstract Ultrafine cellulose fiber (diameter 200,400 nm) surfaces were grafted with polyacrylic acid (PAA) via either ceric ion initiated polymerization or methacrylation of cellulose with methacrylate chloride (MACl) and subsequent free-radical polymerization of acrylic acid. PAA grafts by ceric ion initiated polymerization increased with increasing reaction time (2,24 h), monomer (0.3,2.4 M), and initiator (1,10 mM) concentrations, and spanned a broad range from 5.5,850%. PAA grafts on the methacrylated cellulose fibers also increased with increasing molar ratios of MACl to cellulosic hydroxyl groups (MACl/OH, 2,6.4) and monomer acrylic acid (AA) to initiator potassium persulfate (KPS) ratios ([AA]/[KPS], 1.5,6), and were in a much narrower range between 12.8% and 29.4%. The adsorption of lipase (at 1 mg/ml lipase and pH 7) and the activity of adsorbed lipase (pH 8.5, 30°C), in both cases decreased with increasing PAA grafts. The highest adsorption and activity of the lipase on the ceric ion initiated grafted fibers were 1.28 g/g PAA and 4.3 U/mg lipase, respectively, at the lowest grafting level of 5.5% PAA, whereas they were 0.33 g/g PAA and 7.1 U/mg lipase, respectively, at 12.8% PAA grafts on the methacrylated and grafted fibers. The properties of the grafted fibers and the absorption behavior and activity of lipase suggest that the PAA grafts are gel-like by ceric-initiated reaction and brush-like by methacrylation and polymerization. The adsorbed lipase on the ceric ion-initiated grafted surface possessed greatly improved organic solvent stability over the crude lipase. The adsorbed lipases exhibited 0.5 and 0.3 of the initial activity in the second and third assay cycles, respectively. © 2004 Wiley Periodicals, Inc. [source] Impact of a Triage Liaison Physician on Emergency Department Overcrowding and Throughput: A Randomized Controlled TrialACADEMIC EMERGENCY MEDICINE, Issue 8 2007Brian R. Holroyd MD BackgroundTriage liaison physicians (TLPs) have been employed in overcrowded emergency departments (EDs); however, their effectiveness remains unclear. ObjectivesTo evaluate the implementation of TLP shifts at an academic tertiary care adult ED using comprehensive outcome reporting. MethodsA six-week TLP clinical research project was conducted between December 9, 2005, and February 9, 2006. A TLP was deployed for nine hours (11 am to 8 pm) daily to initiate patient management, assist triage nurses, answer all medical consult or transfer calls, and manage ED administrative matters. The study was divided into three two-week blocks; within each block, seven days were randomized to TLP shifts and the other seven to control shifts. Outcomes included patient length of stay, proportion of patients who left without complete assessment, staff satisfaction, and episodes of ambulance diversion. ResultsTLPs assessed a median of 14 patients per shift (interquartile range, 13,17), received 15 telephone calls per shift (interquartile range, 14,20), and spent 17,81 minutes per shift consulting on the telephone. The number of patients and their age, gender, and triage score during the TLP and control shifts were similar. Overall, length of stay was decreased by 36 minutes compared with control days (4:21 vs. 4:57; p = 0.001). Left without complete assessment cases decreased from 6.6% to 5.4% (a 20% relative decrease) during the TLP coverage. The ambulance wait time and number of episodes of ambulance diversion were similar on TLP and control days. ConclusionsA TLP improved important outcomes in an overcrowded ED and could improve delivery of emergency medical care in similar tertiary care EDs. [source] | |||||||||||||