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Adequacy
Kinds of Adequacy Selected AbstractsENUMERATION OF AEROMONAS FOR VERIFICATION OF THE HYGIENIC ADEQUACY OF SWINE CARCASS DRESSING PROCESSES,JOURNAL OF FOOD SAFETY, Issue 1 2000SHEW-LING YU ABSTRACT Populations of Aeromonas spp. and aerobic bacteria from dehairing equipment and from carcasses passing through different processing steps in a swine slaughtering plant were evaluated to identify the hygienic risks of each operation. Sponge samples were taken from the scraper flails in dehairing machines and the surface of the shackling table at pre- and post-operation times, with 20 samples from each location being collected at each time. Increased post-operation levels of Aeromonas spp. indicated a buildup and possible spread of these bacteria to carcasses. The belly skins of 40 dehaired carcasses were each sampled at five points along the process line which were after the shackling, after the final singeing, after the final polishing, after the final wash and after chilling. The levels of microbial contaminants on carcasses varied at each processing step. The heaviest contamination of carcasses with Aeromonas (1.88 log CFU/cm2) and aerobic bacteria (2.66 log CFU/cm2) occurred after shackling. Counts were reduced at other steps as a result of singeing, washing and chilling operations. However, singed carcasses were recontaminated with Aeromonas and aerobic bacteria during the polishing operation. Aeromonas hydrophila were the most prominent motile aeromonads (74.1%) recovered at the plant. The findings for Aeromonas spp. were similar to those for aerobic bacteria (r2= 0.9995) which suggested that Aeromonas spp. are appropriate indicators for assessing carcass dressing processes. [source] COMPARISON OF ATTRIBUTE LIKING AND JAR SCALES TO EVALUATE THE ADEQUACY OF SENSORY ATTRIBUTES OF MILK DESSERTSJOURNAL OF SENSORY STUDIES, Issue 5 2009GASTÓN ARES ABSTRACT Just-about-right (JAR) scales and attribute liking questions are usually used to study consumer perception of the sensory characteristics of food products. The aim of the present work was to compare the performance of attribute liking and JAR scales to evaluate consumers' perceived adequacy of flavor and texture of milk puddings. Two groups of consumers were asked to evaluate eight milk desserts using (1) overall liking followed by attribute liking for texture and flavor and (2) overall liking followed by JAR scales for thickness, creaminess, sweetness and vanilla flavor. Overall liking scores were significantly different when JAR scales or attribute liking questions were considered. Texture, flavor and overall liking scores were highly correlated to each other, providing the same information. JAR scales correlated better with the intensity of sensory attributes evaluated by a trained sensory panel, being JAR percentages a reliable tool to study the adequacy of sensory attributes. PRACTICAL APPLICATIONS Results from the present work showed that consumers might not be able to independently evaluate their liking of different sensory attributes of a product. For this reason, the use of attribute liking questions for studying the adequacy of sensory attributes in complex products would not be recommended. JAR scales were better indicators of the adequacy of sensory attributes. Consumers were able to independently evaluate texture and flavor attributes using JAR scales. However, the influence of JAR scales on overall liking scores should be taken into account when including these scales on consumer studies. [source] SAFETY AND ADEQUACY OF NATIVE RENAL BIOPSYNEPHROLOGY, Issue 3 2000Jardine M [source] Predictive ability of propofol effect,site concentrations during fast and slow infusion ratesACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 4 2010P. O. SEPÚLVEDA Background: The performance of propofol effect,site pharmacokinetic models during target-controlled infusion (TCI) might be affected by propofol administration rate. This study compares the predictive ability of three effect,site pharmacokinetic models during fast and slow infusion rates, utilizing the cerebral state index (CSI) as a monitor of consciousness. Methods: Sixteen healthy volunteers, 21,45 years of age, were randomly assigned to receive either a bolus dose of propofol 1.8 mg/kg at a rate of 1200 ml/h or an infusion of 12 mg/kg/h until 3,5 min after loss of consciousness (LOC). After spontaneous recovery of the CSI, the bolus was administered to patients who had first received the infusion and vice versa. The study was completed after spontaneous recovery of CSI following the second dose scheme. LOC was assessed and recorded when it occurred. Adequacies of model predictions during both administration schemes were assessed by comparing the effect,site concentrations estimated at the time of LOC during the bolus dose and during the infusion scheme. Results: LOC occurred 0.97 ± 0.29 min after the bolus dose and 6.77 ± 3.82 min after beginning the infusion scheme (P<0.05). The Ce estimated with Schnider (ke0=0.45/min), Marsh (ke0=1.21/min) and Marsh (ke0=0.26/min) at LOC were 4.40 ± 1.45, 3.55 ± 0.64 and 1.28 ± 0.44 ,g/ml during the bolus dose and 2.81 ± 0.61, 2.50 ± 0.39 and 1.72 ± 0.41 ,g/ml, during the infusion scheme (P<0.05). The CSI values observed at LOC were 70 ± 4 during the bolus dose and 71 ± 2 during the infusion scheme (NS). Conclusion: Speed of infusion, within the ranges allowed by TCI pumps, significantly affects the accuracy of Ce predictions. The CSI monitor was shown to be a useful tool to predict LOC in both rapid and slow infusion schemes. [source] Adequacies or inadequacies in midwifery post-anaesthetic recovery skillsANAESTHESIA, Issue 1 2010P. Gandre No abstract is available for this article. [source] Subgrouping and grading of soft-tissue sarcomas by fine-needle aspiration cytology: A histopathologic correlation studyDIAGNOSTIC CYTOPATHOLOGY, Issue 5 2001Hal E. Palmer M.D. Abstract To evaluate the accuracy and reproducibility of subgrouping and grading soft-tissue sarcomas by fine-needle aspiration biopsy (FNAB), a blind review was conducted of 84 FNAB specimens from 77 malignant and 7 benign soft-tissue lesions. Cytomorphologic subgroups included 31 spindle-cell, 24 pleomorphic, 11 myxoid, 7 epithelioid/polygonal, 3 small round cell, and 8 nondiagnostic cases. Malignancies included one lymphoma and 41 primary, 15 recurrent, and 20 metastatic soft-tissue sarcomas. Adequacy was defined as a majority of slides with at least 5 clusters of 10 unobscured cells. Five originally false-negative cases were considered nondiagnostic on review. Sarcoma was recognized in 59 of 64 adequate cases (92%) with available histology; however, the specific histopathologic subtype was identified in only 9 cases (14%). Benign myxoid and spindle-cell lesions were difficult to separate from low-grade sarcomas in 4 cases, and a B-cell lymphoma with sclerosis mimicked a low-grade myxoid sarcoma. The assigned cytologic grade accurately reflected the histologic grade in 90% of sarcomas when segregated into high and low grades. Pleomorphic, small round cell, and epithelioid/polygonal subgroups corresponded to high-grade sarcomas in all cases with only minor noncorrelations. Major grading noncorrelations occurred in 50% of myxoid and 9% of spindle-cell sarcomas. Therefore, attention should be given to specimen adequacy, and caution should be exercised when attempting to grade myxoid and spindle-cell sarcomas by FNAB. Diagn. Cytopathol. 24:307,316, 2001. © 2001 Wiley-Liss, Inc. [source] Identifying Essential Topics in General and Special Education Introductory Assessment TextbooksEDUCATIONAL MEASUREMENT: ISSUES AND PRACTICE, Issue 1 2007Cynthia Campbell We reviewed the five top-selling introductory assessment textbooks in both general and special education to identify topics contained in textbooks and to determine the extent of agreement among authors regarding the essentialness of topics within and across discipline. Content analysis across the 10 assessment textbooks yielded 73 topics related to 13 categories: Decisions, Law, Technical Adequacy, Plan Assessment, Create Assessment, Score Assessment, Assessment Target, Assessment Type, Assessment Method, Interpret Assessment, Communicate Assessment Results, Assessment Population, and Computer-Assisted Assessment. Many of the topics identified were consistent with traditional assessment expectations of general and special education environments, while other, arguably important, topics were not identified as essential. The idea of core assessment topics for all teachers is introduced. [source] Beating-Heart Valvular Surgery: A Possible Alternative for Patients with Severely Compromised Ventricular FunctionJOURNAL OF CARDIAC SURGERY, Issue 2 2002Richard J. Kaplon M.D. We report a novel approach to myocardial protection in a patient requiring multi-valve surgery who had an ejection fraction of 15%. Warm oxygenated blood was infused continuously both antegrade and retrograde during aortic valve replacement and mitral and tricuspid valve repair. Adequacy of perfusion was confirmed by the absence of electrocardiographic changes. Clinical improvement suggests that this strategy of myocardial protection warrants further investigation. [source] Adequacy of Oral Health Information for Patients with DiabetesJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 2 2009Hon K. Yuen PhD, OTR/L Abstract Objective: We investigated the perception of dental hygienists regarding their adequacy of providing diabetics with diabetes-related oral health preventive education. Methods: A one-page questionnaire printed on both sides was mailed to 2,237 licensed registered dental hygienists with a South Carolina (SC) mailing address. In addition to the dental hygienists' background and practice characteristics, their perception of adequacy for educating patients with diabetes on various diabetes-related oral health topics and reasons for inadequate coverage of materials were queried in the survey. Results: After two follow-up mailings, 995 completed and usable surveys were returned. An average of 93.6 percent of respondents indicated that they adequately covered topics of oral hygiene and general oral health issues. However, about 60 percent of respondents reported not covering all essential materials related to oral health when educating diabetic patients. The three most common reasons were: a) insufficient time (60.1 percent); b) patient disinterest (41.2 percent); and c) insufficient information on oral care and diabetes (39.7 percent). Respondents reporting insufficient information were less likely to adequately address the effect of periodontal disease on diabetes (P < 0.001), effect of uncontrolled diabetes on periodontal disease (P < 0.001), and dry mouth management (P = 0.03). Conclusion: This study indicates that SC dental hygienists do not routinely provide patient education on diabetes-related oral health and healthy lifestyle topics. Lack of time, patient disinterest, and insufficient information were the three main reasons for respondents not covering these essentials. A practical method for improving dental hygienists' comprehensive service to patients with diabetes is to offer them more continuing education on diabetes and oral health to supplement their knowledge, skills, and confidence to educate this growing population. [source] Responsiveness to General Education Instruction as the First Gate to Learning Disabilities IdentificationLEARNING DISABILITIES RESEARCH & PRACTICE, Issue 3 2003Deborah L. Speece Most definitions of learning disabilities (LD) include a qualification that adequate general education instruction was received and the child with LD did not benefit. Rarely is this tenet assessed in either practice or research before a diagnosis is made. We review three studies that investigated children's responsiveness to general education reading instruction as an indicator of need for more intensive interventions. Adequacy of instruction was quantified by children's level and rate of progress, compared to classmates, as measured by curriculum-based measures of oral reading fluency. We found that the response-to-instruction model tested was valid in that (1) children who differ from their peers on level and slope of performance (dual discrepancy) have more severe academic and behavioral problems than children who have IQ-achievement discrepancies or low achievement; (2) children who demonstrate persistent nonresponsiveness over three years differ from other at-risk children on reading, reading-related, and behavioral measures; and (3) at-risk children who participated in specially designed general education interventions had better outcomes than at-risk children who did not participate. We conducted additional analyses to assess low achievement definitional variations and found that they lack sensitivity and coverage compared to a dual discrepancy definition. [source] The Use of Cerebral Oximetry as a Monitor of the Adequacy of Cerebral Perfusion in a Patient Undergoing Shoulder Surgery in the Beach Chair PositionPAIN PRACTICE, Issue 4 2009Gregory W. Fischer MD Abstract Four cases of ischemic injury have been reported in patients undergoing orthopedic surgery in the upright position. We describe the use of cerebral oximetry as a monitor of the adequacy of cerebral perfusion in a 63-year-old woman who underwent arthroscopic rotator cuff surgery in a beach chair under general anesthesia. During positioning, a decrease in blood pressure was accompanied by a decrease in cerebral oxygen saturation (SctO2) and was treated with phenylephrine. When spontaneous ventilation resumed, an increase in end-tidal carbon dioxide was accompanied by an increase in SctO2. Cerebral oximetry may prove useful as a guide monitor and manage nonsupine patients. [source] Generalized self-efficacy and performance on the 20-metre shuttle run in childrenAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 2 2008John Cairney It has been argued that motivation significantly affects the measurement of aerobic capacity when using field tests with children. In this study, the impact of generalized self-efficacy on performance (Stage Completed) in the Léger shuttle run is examined in a cohort of children (N = 2,245, 9.38 ± 0.52 years old) in Grade 4 from 75 elementary schools. Children completed the Children's Self-perceptions of Adequacy in and Predilection for Physical Activity scale (CSAPPA) to establish levels of generalized self-efficacy toward physical activity, were measured for height and weight, and then completed the Léger Shuttle run to predict aerobic capacity. Regression analysis was used to study the impact of self-efficacy on test performance. After adjusting for age, gender, and BMI, two of the three CSAPPA factor subscales, higher perceived adequacy regarding physical activity (, = 0.196, P < 0.001) and greater predilection to select physical over sedentary activities (, = 0.123, P < 0.001), were independently associated with better test performance as indicated by stage completed. Together, self-efficacy accounted for 9% of the total variation in Léger shuttle run performance. A significant interaction between BMI and perceived adequacy was found (, = ,0.106, P < 0.005). Children with both high BMI scores and below average perceived adequacy had the poorest performance results. Generalized self-efficacy, as measured by the CSAPPA, is significantly related to Léger shuttle run performance. Moreover, self-efficacy influences the relationship between other known factors affecting test performance (BMI), suggesting that self-perception of ability/competence has a complex effect on test performance. These results illustrate the importance of considering psychological factors when interpreting physiologic assessments in children. Am. J. Hum. Biol., 2008. © 2007 Wiley-Liss, Inc. [source] BREAST SPECIMEN ULTRASOUND AND MAMMOGRAPHY IN THE PREDICTION OF TUMOUR-FREE MARGINSANZ JOURNAL OF SURGERY, Issue 12 2006Kok-Yang Tan Background: Adequacy of margins is important for local recurrence control in breast-conserving surgery for breast cancer. This study aims to compare the accuracy of intraoperative specimen ultrasonography (IOUS) and specimen mammography in the prediction of achieving adequate histologically tumour-free margins during breast-conserving surgery. Methods: Between March 2003 and September 2004, a prospective study was carried out on 25 patients who underwent breast-conserving surgery. After wide excision, IOUS and specimen mammography were used to assess adequacy of margins. Further surgery was undertaken when either method showed an inadequate margin. The margins were assessed histologically and correlated with IOUS and mammographic findings. Results: Using IOUS alone, higher rates of histologically tumour-free margins were achieved compared with mammography alone. Combined IOUS and mammography achieved similar or slightly higher rates of histologically tumour-free margins compared with IOUS alone. If the margin measured on IOUS is twice the desired histological margin, this will result in achieving a histologically tumour-free rate of >90%. Associated ductal carcinoma in situ was the only significant factor found to decrease the rate of achieving adequate margins. Conclusion: Intraoperative specimen ultrasonography is useful in predicting histologically tumour-free margins during breast conserving surgery for cancer. [source] Long term review of laparoscopic sacrocolpopexyBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 8 2005P.J. Higgs Objective Assessment of long term outcome following laparoscopic sacrocolpopexy. Design Retrospective follow up study using standardised examination with pelvic organ prolapse quantification system (POP-Q) and questionnaires. Setting A tertiary urogynaecology unit in the North West of England. Population One hundred and forty consecutive cases who had a laparoscopic sacrocolpopexy at St Mary's Hospital, Manchester, between 1993 and 1999. Methods Women completed questionnaires and were examined in gynaecology clinic or sent postal questionnaires if unable to attend the clinic. Main outcome measures Adequacy of vault support and recurrent vaginal prolapse assessed by POP-Q score. Assessment of prolapse, urinary and bowel symptoms and sexual function using questionnaires. Results One hundred and three women were contacted after a median of 66 months. Sixty-six women were examined and a further 37 women filled in questionnaires only. Recurrent vault prolapse occurred in 4 of the 66 women who were examined. Prolapse had recurred or persisted in 21 of 66 women, with equal numbers of anterior and posterior vaginal wall prolapse. Overall, 81/102 (79%) said that their symptoms of prolapse were ,cured' or ,improved'; 39/103 (38%) still had symptoms of prolapse. For every two women who were cured of their urinary or bowel symptoms, one woman developed worse symptoms. Conclusions Among the 66 women available for examination laparoscopic sacrocolpopexy provided good long term support of the vault in 92%. Forty-two percent of these women had recurrent vaginal wall prolapse. Despite this, 79% of women felt that their symptoms of prolapse were cured or improved following surgery. [source] Preliminary testing for normality: some statistical aspects of a common conceptCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 6 2006V. Schoder Summary Background., Statistical methodology has become an increasingly important topic in dermatological research. Adequacy of the statistical procedure depends among others on distributional assumptions. In dermatological articles, the choice between parametric and nonparametric methods is often based on preliminary goodness-of-fit tests. Aim., For the special case of the assumption of normally distributed data, the Kolmogorov,Smirnov test is the most popular choice. We investigated the performance of this test on four types of non-normal data, representing the majority of real data in dermatological research. Methods., Simulations were run to assess the performance of the Kolmogorov,Smirnov test, depending on sample size and severity of violations of normality. Results., The Kolmogorov,Smirnov test performs badly on data with single outliers, 10% outliers and skewed data at sample sizes <,100, whereas normality is rejected to an acceptable degree for Likert-type data. Conclusion., Preliminary testing for normality is not recommended for small-to-moderate sample sizes. [source] Usefulness of Serial Assessment of Natriuretic Peptides in the Emergency Department for Patients With Acute Decompensated Heart FailureCONGESTIVE HEART FAILURE, Issue 4 2008Salvatore DiSomma MD The value of natriuretic peptides, both B-type natriuretic peptide (BNP) and N-terminal prohormone brain natriuretic peptide (NTproBNP), for determining diagnosis, severity, and prognosis of emergency department (ED) patients with acute decompensated heart failure (ADHF) has been well documented. Emerging data support the hypothesis that repeated natriuretic peptide determinations in the acute phase of ADHF may assist in confirming the diagnosis, monitoring drug therapy, and evaluating the adequacy of patient stabilization. Data from the authors' group demonstrate that in patients admitted to the ED for acute dyspnea, serial NTproBNP measurement at admission and 4, 12, and 24 hours later was useful in confirming the diagnosis of ADHF compared with patients with chronic obstructive pulmonary disease. Moreover, in the same patients receiving intensive intravenous diuretic therapy, there was a progressive reduction of NTproBNP blood levels from hospitalization to discharge (P<.001), accompanied by clinical improvement and stabilization of heart failure. More recently, the authors also demonstrated that in ADHF patients improving with diuretics, a progressive reduction in BNP levels was observed, starting 24 hours after ED admission and continuing until discharge. Comparing BNP and NTproBNP, there was a significant correlation between NTproBNP and BNP levels but not between NTproBNP's and BNP's percent variation compared with baseline. In ADHF, serial ED measurements of BNP are useful for monitoring the effects of treatment. A reduction in BNP from admission to discharge is indicative of clinical improvement. [source] Comparative Overview of Cardiac Output Measurement Methods: Has Impedance Cardiography Come of Age?CONGESTIVE HEART FAILURE, Issue 2 2000Anthony N. De Maria MD Cardiac output, usually expressed as liters of blood ejected by the left ventricle per minute, is a fundamental measure of the adequacy of myocardial function to meet the perfusion needs of tissue at any time. Decreases in cardiac output over time (when cardiac output is measured under similar conditions) may signal myocardial functional deterioration and the onset or progression of heart failure. Conversely, improvements in cardiac output may indicate a positive response to medical therapy. However, most methods for evaluating cardiac output are technically demanding, require specialized training and specialized environments for measurement, and are costly. Therefore, most measurement techniques are impractical for routine evaluation of disease progression and/or response to treatment in the prevention and/or management of heart failure. This paper provides a comparative overview of commonly employed cardiac output measurement strategies with emphasis on developments in impedance cardiography which suggest that impedance cardiography has the potential to make routine assessment and trending of cardiac output a viable alternative to assist in the management of both chronically and acutely ill patients, including those with heart failure. [source] Developing Models for Patient Flow and Daily Surge Capacity ResearchACADEMIC EMERGENCY MEDICINE, Issue 11 2006Brent R. Asplin MD Between 1993 and 2003, visits to U.S. emergency departments (EDs) increased by 26%, to a total of 114 million visits annually. At the same time, the number of U.S. EDs decreased by more than 400, and almost 200,000 inpatient hospital beds were taken out of service. In this context, the adequacy of daily surge capacity within the system is clearly an important issue. However, the research agenda on surge capacity thus far has focused primarily on large-scale disasters, such as pandemic influenza or a serious bioterrorism event. The concept of daily surge capacity and its relationship to the broader research agenda on patient flow is a relatively new area of investigation. In this article, the authors begin by describing the overlap between the research agendas on daily surge capacity and patient flow. Next, they propose two models that have potential applications for both daily surge capacity and hospitalwide patient-flow research. Finally, they identify potential research questions that are based on applications of the proposed research models. [source] Head and neck cancer in the UK: what is expected of cytopathology?CYTOPATHOLOGY, Issue 2 2009G. Kocjan Objective:, This review highlights the role of cytopathology in cancer management within UK Head and Neck Cancer Networks and informs on the issues raised by recent UK Department of Health documents and other UK professional guidance. UK guidance requires the formal involvement of cytopathologists within multidisciplinary cancer teams, with medical and non-medical cytopathology staff setting up and running rapid access lump clinics, and support for image-guided fine needle aspiration cytology (FNAC) services. UK guidance also makes recommendations for training, resources and quality control. This review also highlights the resource gap between best practice evidence-based guidance for head and neck (HN) cancer services and existing UK provision for cytopathology, as evidenced by lack of availability of experienced staff and adequacy of training and quality control (QC). Finally, it stresses the importance in the UK of the Royal College of Pathologists' guidance, which defines the need for training, the experience needed for new consultants, the requirements for audit and QC. The implications for the additional resources required for HN cancer cytopathology services are discussed. Recent professional guidance specifying the provision of HN cancer services in the UK includes a cytopathology service for cancer networks, such as rapid access FNAC clinics. Although these clinics already operate in some institutions, there are many institutions where they do not and where the provision of cytopathology services would have to be restructured. This would need the support of local cancer networks and their acceptance of the detailed requirements for cytopathology, including resources, training and QC. The standards are not defined locally, as Strategic Health Authorities and Primary Care Trusts have been instructed by the Department of Health to support, invest and implement them. [source] A CRITICAL LOOK AT PAP ADEQUECY: ARE OUR CRITERIA SATISFACTORY?CYTOPATHOLOGY, Issue 2006D.R. Bolick Liquid based Pap (LBP) specimen adequacy is a highly documented, yet poorly understood cornerstone of our GYN cytology practice. Each day, as cytology professionals, we make adequacy assessments and seldom wonder how the criteria we use were established. Are the criteria appropriate? Are they safe? What is the scientific data that support them? Were they clinically and statistically tested or refined to achieve optimal patient care? In this presentation, we will take a fresh look at what we know about Pap specimen adequacy and challenge some of the core assumptions of our daily practice. LBP tests have a consistent, well-defined surface area for screening, facilitating the quantitative estimates of slide cellularity. This provides an unprecedented opportunity to establish reproducible adequacy standards that can be subjected to scientific scrutiny and rigorous statistical analysis. Capitalizing on this opportunity, the TBS2001 took the landmark step to define specimen adequacy quantitatively, and set the threshold for a satisfactory LBP at greater than 5,000 well visualized squamous epithelial cells. To date, few published studies have attempted to evaluate the validity or receiver operator characteristics for this threshold, define an optimal threshold for clinical utility or assess risks of detection failure in ,satisfactory' but relatively hypocellular Pap specimens. Five years of cumulative adequacy and cellularity data of prospectively collected Pap samples from the author's laboratory will be presented, which will serve as a foundation for a discussion on ,Pap failure'. A relationship between cellularity and detection of HSIL will be presented. Risk levels for Pap failure will be presented for Pap samples of different cellularities. The effect of different cellularity criterion on unsatisfactory Pap rates and Pap failure rates will be demonstrated. Results from this data set raise serious questions as to the safety of current TBS2001 adequacy guidelines and suggest that the risk of Pap failure in specimens with 5,000 to 20 000 squamous cells on the slide is significantly higher than those assumed by the current criteria. TBS2001 designated all LBP to have the same adequacy criterion. Up to this point, it has been assumed that ThinPrep, SurePath, or any other LBP would be sufficiently similar that they should have the same adequacy criteria. Data for squamous cellularity and other performance characteristics of ThinPrep and SurePath from the author's laboratory will be compared. Intriguing data involving the recently approved MonoPrep Pap Test will be reviewed. MonoPrep clinical trial data show the unexpected finding of a strong correlation between abundance of endocervical component and the detection of high-grade lesions, provoking an inquiry of a potential new role for a quantitative assessment of the transition zone component. The current science of LBP adequacy criteria is underdeveloped and does not appear to be founded on statistically valid methods. This condition calls us forward as a body of practitioners and scientists to rigorously explore, clarify and define the fundamental nature of cytology adequacy. As we forge this emerging science, we will improve diagnostic performance, guide the development of future technologies, and better serve the patients who give us their trust. Reference:, Birdsong GG: Pap smear adequacy: Is our understanding satisfactory? Diagn Cytopathol. 2001 Feb; 24(2): 79,81. [source] How should adequacy of liquid-based cytology be defined?CYTOPATHOLOGY, Issue 4 2006M. Desai No abstract is available for this article. [source] Comparative study: conventional cervical and ThinPrep® Pap tests in a routine clinical settingCYTOPATHOLOGY, Issue 4 2002A. Grace The conventional Papanicolaou smear is associated with variable false positive and false negative rates, difficulties with interpretation and high unsatisfactory and suboptimal rates. Newer fluid-based methods such as the ThinPrep® 2000 system (Cytyc Corp., Boxborough, MA) are said to overcome these difficulties. The aim of this study was to compare the conventional smear with the ThinPrep® method in a busy, routine cytology screening laboratory setting. One thousand split samples were evaluated. Using ThinPrep®, the results showed an increased sensitivity and a dramatic improvement in specimen adequacy, with a combined 17.2% reduction in ,unsatisfactory' and ,suboptimal' reports. Screening time per slide was also reduced to 3,4 min. In conclusion, we report an increase in sensitivity, a reduction in screening time and a dramatic improvement in specimen adequacy with the ThinPrep® method. [source] Liquid-based cytology: is this the way forward for cervical screening?CYTOPATHOLOGY, Issue 2 2002R. P. MOSELEY Liquid-based cytology: is this the way forward for cervical screening? Liquid-based cytology (LBC) is currently being marketed as an alternative methodology to replace the conventional PAP smear in cervical cytology. A substantial body of literature exists in support of LBC, some of which is at least partially sponsored by product manufacturers. The majority of published literature in support of LBC employs Bethesda reporting terminology. In this study we have analysed published raw data and presented this in NHSCSP terminology. Claims relating to sensitivity, specificity and smear adequacy have then been considered with reference to this data. Our analysis of existing data does not support the nationwide implementation of LBC at present. Further studies are recommended in order to evaluate the place of this technology within the NHSCSP. [source] The utility of transbronchial (Wang) fine needle aspiration in lung cancer diagnosisCYTOPATHOLOGY, Issue 1 2001M. T. Siddiqui The utility of transbronchial (Wang) fine needle aspiration in lung cancer diagnosis We evaluated our experience with transbronchial fine needle aspiration (TBNA) in cancer diagnosis over a period of 1 year. A total of 51 aspirates were performed by specialist chest physicians in the presence of a cytopathologist who made on spot evaluation of Diff-Quik smears for adequacy and guided the aspirator for additional sampling if necessary. Two clusters of at least 10 malignant cells were required on the Diff-Quik smears to render an on the spot positive diagnosis of malignancy. Aspirates showing atypical cells or few malignant cells not fulfilling the above criteria were placed in a suspicious category and additional material was requested. The TBNA results were correlated with the transbronchial biopsy when available. [source] Employer burden of mild, moderate, and severe major depressive disorder: mental health services utilization and costs, and work performance,DEPRESSION AND ANXIETY, Issue 1 2010Howard G. Birnbaum Ph.D. Abstract Background: Treatment utilization/costs and work performance for persons with major depressive disorder (MDD) by severity of illness is not well documented. Methods: Using National Comorbidity Survey-Replication (2001,2002) data, US workforce respondents (n=4,465) were classified by clinical severity (not clinically depressed, mild, moderate, severe) using a standard self-rating scale [Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR)]. Outcomes included 12-month prevalence of medical services/medications use/costs and workplace performance. Treatment costs (employer's perspective) were estimated by weighing utilization measures by unit costs obtained for similar services used by MDD patients in claims data. Descriptive analysis across three severity groups generated ,2 results. Results: Using a sample of 539 US workforce respondents with MDD, 13.8% were classified mild, 38.5% moderate, and 47.7% severe cases. Mental health services usage, including antidepressants, increased significantly with severity, with average treatment costs substantially higher for severe than for mild cases both regarding mental health services ($697 vs. $388, ,2=4.4, P=.019) and antidepressants ($256 vs. $88, ,2=9.0, P=.001). Prevalence rates of unemployment/disability increased significantly (,2=11.7, P=.003) with MDD severity (15.7, 23.3, and 31.3% for mild, moderate, and severe cases). Severely and moderately depressed workers missed more work than nondepressed workers; the monthly salary-equivalent lost performance of $199 (severely depressed) and $188 (moderately depressed) was significantly higher than for nondepressed workers (,2=10.3, P<.001). Projected to the US workforce, monthly depression-related worker productivity losses had human capital costs of nearly $2 billion. Conclusions: MDD severity is significantly associated with increased treatment usage/costs, treatment adequacy, unemployment, and disability and with reduced work performance. Depression and Anxiety, 2010. © 2009 Wiley-Liss, Inc. [source] The prevalence of depressive symptoms in a white European and South Asian population with impaired glucose regulation and screen-detected Type 2 diabetes mellitus: a comparison of two screening toolsDIABETIC MEDICINE, Issue 8 2010N. Aujla Diabet. Med. 27, 896,905 (2010) Abstract Aims, To compare the identification of prevalent depressive symptoms by the World Health Organization-5 Wellbeing Index (WHO-5) and Centre for Epidemiological Studies Depression Scale (CES-D) for South Asian and white European people, male and female, attending a diabetes screening programme, and to explore the adequacy of the screening tools for this population. An additional aim was to further explore associations of depressive symptoms with impaired glucose regulation (IGR) and Type 2 diabetes mellitus (Type2 DM). Methods, Eight hundred and sixty-four white European (40,75 years old) and 290 South Asian people (25,75 years old) underwent an oral glucose tolerance test (OGTT), detailed history and anthropometric measurements and completed the WHO-5 and CES-D. Depressive symptoms were defined by a WHO-5 score , 13, and CES-D score , 16. Results, Unadjusted prevalence of depressive symptoms with the WHO-5, for people with Type2 DM was 42.3% (47.4% in white European; 28.6% in South Asian) and for IGR 30.7% (26% in white European; 45.8% in South Asian). With the CES-D, the prevalence in Type2 DM was 27.2% (25.4% in white European; 31.8% in South Asian) and for IGR 30.7% (27.8% in white European; 40.7% in South Asian). Statistically significant differences in the prevalence of depressive symptoms for sex or ethnicity were not identified. Odds ratios adjusted for age, sex and ethnicity showed no significant association of depression with Type2 DM or IGR, with either WHO-5 or CES-D. Agreement was moderate (, = 0.48, 95% confidence intervals 0.42,0.54), and reduced when identifying depressive symptoms in people with Type2 DM. For this group, a WHO-5 cut-point of , 10 was optimal. Conclusions, Depressive symptoms, identified by WHO-5 or CES-D, were not significantly more prevalent in people with Type2 DM or IGR. The WHO-5 and CES-D differed in their identification of depressive symptoms in people with Type2 DM, though discrepancies between sex and ethnicity were not identified. [source] Utility of the thromboplastin-plasma cell-block technique for fine-needle aspiration and serous effusionsDIAGNOSTIC CYTOPATHOLOGY, Issue 2 2009D.M.L.T., Manisha B. Kulkarni M.Sc. Abstract (I) To assess the feasibility of thromboplastin-plasma (TP) method for cell block, (II) to concentrate the minimal cellular material from effusions and needle-rinses by block preparation and improve visual details, (III) to compare conventional cytological smears with cell blocks for final assessment, and (IV) to assess utility of immunocytochemistry (ICC) for diagnostic accuracy. Seventy cell blocks were prepared by TP technique using surplus fluid from 38 serous effusions, and for 32 ultrasonography-guided fine-needle aspiration cytology (FNAC) material, rinses of syringes and needles were collected in normal saline after conventional cytological smears. Then, cell blocks were compared with conventional smears for adequacy, morphologic preservation, and ICC. Absolute concordance seen in 66 cases (94%) between the smears and cell blocks. Advantages with the blocks were cellular concentration in a limited field and better cellular preservation with architectural pattern. Quality of ICC was comparable to that of standard controls. Diagnostic discrepancy was seen in two cases where cell blocks were positive but smears were negative. Two cell blocks were nonrepresentative. Cell block serves as a useful adjunct to traditional cytological smears. TP method is simple, cost effective, and reproducible. It is easy when compared with agar-embedding technique. Ancillary techniques like ICC can be performed successfully. Diagn. Cytopathol. 2009. © 2008 Wiley-Liss, Inc. [source] Comparison of conventional Papanicolaou smears and fluid-based, thin-layer cytology with colposcopic biopsy control in central Italy: A consecutive sampling study of 461 casesDIAGNOSTIC CYTOPATHOLOGY, Issue 1 2009Siavash Rahimi M.D. Abstract The aim of this study was to compare the cytologic diagnosis and specimen adequacy of conventional Papanicolaou (CP) and fluid-based, thin-layer [ThinPrep (TP), Cytyc, Boxborough, MA] cervical cytology in a population from central Italy. CP and TP samples were collected simultaneously using a consecutive sampling method on women presenting for cervical screening. Colposcopy was performed as clinically indicated, and biopsy results were compared with cytologic diagnoses. Among the 461 patients included in the study, 413 were negative at both CP and TP, 9 had unsatisfactory results at both tests and 39 patients presented abnormal results at CP, TP or both. Cohen's Kappa was 0.77 showing good agreement between CP and TP test results. Histological data were available for 20 (51.28%) of the 39 patients with at least one positive test. Among the 13 patients with HSIL at histology, 7 had HSIL at CP (sensitivity 53.85%) and 5 at TP (sensitivity 38.46%). For all three patients with squamous cell carcinoma (SCC) at histology, CP and TP had shown the same diagnosis (sensitivity 100%). The positive predictive values were 33.33% for CP and 25.0% for TP regarding the LSIL diagnosis and 100% for both CP and TP regarding HSIL and SCC diagnoses. Our results may be influenced by the consecutive sampling procedure. Diagn. Cytopathol. 2009. © 2008 Wiley-Liss, Inc. [source] ThinPrep are superior to conventional smears in the cytological diagnosis of subfertile men by testicular fine-needle aspirationDIAGNOSTIC CYTOPATHOLOGY, Issue 1 2008Grigoris Grimbizis M.D., Ph.D. Abstract The aim of this study was the comparison of liquid-based cytology (ThinPrep, TS) to conventional smears (CS) in the investigation of subfertile men with testicular fine-needle aspiration (FNA). Between January and December 2004, testicular FNA biopsies were performed in 30 subfertile men. Both TS and CS were diagnosed according to Meng classification. Features specifically recorded in each smear included sample adequacy, tissue cells preservation, contamination with red blood cells, quality of smear background, ease of cell recognition, and the cytological diagnosis. There was agreement in the cytological diagnosis between TS and CS (P = 0.88) and sample adequacy (P = 0.73). TS was superior to CS regarding cell preservation, presence of red blood cells or tissue artifacts, quality of the smear background, and cell recognition (P < 0.0001). In testicular FNA cytology, TS appear to be superior to CS in respect to cell preservation, absence of red blood cells, background quality, and cell recognition. These advantages, however, are not translated in improved cytological diagnosis. Diagn. Cytopathol. 2008;36:1,7. © 2007 Wiley-Liss, Inc. [source] Utility of cell blocks in the diagnosis of thyroid aspiratesDIAGNOSTIC CYTOPATHOLOGY, Issue 2 2006Niria Sanchez M.D. Abstract Cell blocks (CBs) are often prepared with fine-needle aspirates (FNAs) from multiple organs as an adjunct to smears in the diagnosis of aspirated lesions. However, the literature contains few reports on their utility with regard to specific organ sites. At our institution, CBs are made routinely on FNAs when there is sufficient material remaining after smear preparation, with thyroid representing the largest volume. The aim of this study was to determine the utility of CBs in the diagnosis of thyroid lesions. From January 2002 to April 2004, 546 thyroid FNAs were performed. Eighty-two (15%) cases, from 60 females and 20 males (age range, 17,88 yr; mean, 50 yr), had CBs and formed the basis of this study. Seventy-four (90%) of the cases were performed by the radiologist or the clinician and 8 (10%) by the pathologist, all of which had an immediate assessment for adequacy. One to 7 passes were performed with an average of 3/case. The needles were immediately rinsed in Hanks' Balanced Salt Solution after smear preparation. CBs were made on bloody specimens/those with tissue fragments. Cell-block slides were reviewed for the presence of cellular elements and classified into three categories: (1) contributory, (2) noncontributory, or (3) provides additional information. Of the 82 cases, 23 (28%) were neoplastic, 51 (62%) were nonneoplastic, and 8 (10%) were nondiagnostic. Fifteen of the neoplastic cases had confirmatory biopsies, 9 of which were papillary carcinoma. The overall cellularity of the CBs was low, varying from 0 to 2 follicular groups in the noncontributory CBs and 3 to 6 follicular groups or papillary formations in the contributory CBs. CBs were contributory in 25 (31%) cases: 5 neoplastic (1 follicular neoplasm, 3 papillary carcinoma, and 1 suspicious for papillary carcinoma), 18 nonneoplastic, and 2 nondiagnostic. CBs were noncontributory in 56 (68%) cases: 18 neoplastic (4 papillary carcinomas, 1 suspicious for papillary carcinoma, 4 Hürthle cell neoplasms, and 9 follicular neoplasms), 33 nonneoplastic, and 5 nondiagnostic. One case was categorized as provided additional information because the CB showed material that was not present on the slides; however, it was still nondiagnostic. In summary, CBs did not help in the majority of cases. They were contributory in only 25 (31%) of the 82 cases, and of the 23 neoplastic cases, only 5 (22%) CBs were contributory. The contribution of the CBs in the diagnosis of thyroid lesions was minimal because of the low cellularity. On-site assessment of specimen adequacy often results in fewer passes, thus contributing to the low cellularity present in cell-block preparations. Ancillary studies may require additional passes. Diagn. Cytopathol. 2006; 34:89,92. © 2006 Wiley-Liss, Inc. [source] | ||||||||||||||||||||||||||||||||||||||||||||||||||||