Immunophenotypic aspects of cylindroma and nodular hidradenoma

Background Some adnexal tumours have many controversies about their histogenesis. Objectives To evaluate the eccrine and/or apocrine differentiation phenotype in cases of cylindroma and clear cell hidradenoma with CD15 and p63 antibodies. Methodology Slides and blocks of six cases of cylindroma and seven cases of nodular hidradenoma (clear cells) were analyzed by the technique of immunohistochemistry with CD15 and p63 antibodies. Results In all cases of cylindroma we obtained negative results for CD15 antibody and positive for p63 antibody. In five of seven cases of nodular hidradenoma (clear cell), we could easily observe clear cells between 20% and 50% of tumour cells. In the two other cases, cystic lesions were present and occasional clear cells could be seen. The reaction with CD15 antibody was positive in granular and cytoplasmic pattern in six of seven cases, especially in cells with suggestive clear cytoplasm in lower proportion than this clear cells could be seen in haematoxylin and eosin. The positivity for p63 antibody, nuclear pattern, was observed in six of seven cases, in the major part of tumour cells. In only one case, the positivity was in 20% of cells. Limitation Samples are in small number because these are relatively rare tumours. Conclusions The present study suggests eccrine origin for both tumours: cylindroma and clear cell hidradenoma.     

Direct uterine sampling with the Tao brush sampler using a liquid‐based preparation method for the detection of endometrial cancer and atypical hyperplasia

BACKGROUND.

Endometrial cytology sampling devices for direct uterine sampling have been shown in previous studies to be a reliable and relatively painless method for detecting endometrial lesions. The purpose of the current study was to determine the performance characteristics of endometrial cytology for the detection of malignancy and atypical hyperplasia using liquid‐based cytology specimens collected with the Tao brush sampler.

METHODS.

Brushings of the endometrial cavity were obtained from 139 hysterectomy specimens before routine histopathologic evaluation. Cytology specimens were fixed in PreservCyt and processed using ThinPrep technology. Cytology diagnoses were classified as nondiagnostic, negative, atypical, or positive for malignancy. Histopathologic findings were used as the gold standard for determining the performance characteristics of cytology.

RESULTS.

Histopathologic results from the 139 patients included 81 (58%) endometrial cancers, 7 (5%) complex hyperplasias with atypia, 2 (1%) complex hyperplasias without atypia, and 49 (35%) patients with benign histology. The number of specimens diagnosed cytologically as positive, atypical, negative, or nondiagnostic was 60 (43%), 40 (29%), 37 (27%), and 2 (1%) specimens, respectively. The overall sensitivity and specificity of cytology for detecting endometrial cancer and atypical hyperplasia were 95% and 66% when atypical cytology specimens were considered positive.

CONCLUSIONS.

The results of the current study indicate that direct endometrial sampling by liquid‐based endometrial cytology collected with the Tao brush sampler produces specimens that contain cellular material that may be identified as endometrial cancer or atypical hyperplasia. Both atypical and positive cytology diagnoses are indicators for triage to more specific methods of diagnosis. Cancer (Cancer Cytopathol) 2008. © 2008 American Cancer Society     

Otoacoustic emissions as a screening test for hearing impairment in children

Transient evoked otoacoustic emissions (TEOAEs) are low amplitude sound waves produced by the healthy cochlea. They can be recorded with a microphone in the external ear. TEOAEs are abolished by hearing losses of 30 dB or more. The feasibility of using TEOAEs as a screening test for hearing loss in children was studied. TEOAE recordings were attempted in 56 children attending an audiology clinic. Recordings were possible from both ears in 52 children; of these 104 ears, 32 had hearing deficits of 30 dB or more. Hearing status was compared with the results of six TEOAE screening criteria. All criteria had a sensitivity of 1.00. Four standard TEOAE criteria yielded specificities of 0.46-0.58. Two new criteria derived from analysis of limited frequencies from the TEOAE waveform gave specificities of 0.76 and 0.82. It can be concluded that, when appropriate pass/fail criteria are employed, TEOAEs are a feasible screening test in children.     

Association between honey consumption and infant botulism

Infant botulism, a disease that results in a blockade of voluntary motor and autonomic functions, was first recognized in the United States in the late 1970s. Since then, more than 1000 cases in this country have been reported to the Centers for Disease Control and Prevention (CDC). Numerous studies have shown that the ingestion of honey is linked with infant botulism. In addition, honey samples across the United States have tested positive for Clostridium botulinum spores and toxins. Such substantial evidence led the CDC to recommend that honey not be given to infants younger than 12 months old. It is important that clinicians be familiar with this risk and should not recommend honey-containing products or supplements or the use of honey as a flavoring agent for infants in this age group.     

Subjetivity and interconsultation in front of the new pathologies and technologies

The technological advance in medicine was accompanied paradoxically of a lack of consideration toward the human being subjective dimension. This resulted in the appearance of new and unexpected inconveniences, caused by the patient's attitudes that cannot be understood neither solved by the specialist doctors, hindering the application of important achieved advantages. This development is particularly remarkable in the most spectacular innovations (transplantation and reimplantation of organs, protesis, electronic ortesis, hormonal substitutions, chemotherapy, etc.) that can mean the difference between life and death. There are human and subjective motivations behind all these problems that have not been kept in mind although constitute the specific sphere of work and investigation of the medical-psychological interconsultation.     

Absorbable hemostatic agents.

PURPOSE: The pharmacology, clinical efficacy, adverse effects and toxicities, drug interactions, dosage and administration, and safety issues related to the use of absorbable hemostatic agents are reviewed. SUMMARY: Absorbable hemostatic agents exert their pharmacologic effects at various points within the coagulation cascade. These agents are indicated for use during surgical procedures as adjunctive therapy when bleeding is not controlled by conventional methods. Early clinical data on absorbable hemostatic agents revealed a beneficial effect with regard to controlling capillary bleeding, achieving hemostasis during vascular surgery, and controlling bleeding from fistula-puncture sites. Few randomized controlled clinical trials have directly compared available agents, but case reports describing the efficacy of absorbable hemostatic agents in specific situations, especially unlabeled uses of thrombin, abound. Existing trials have compared the efficacy of established agents with newer agents, including fibrin sealants, with varying results. A variety of rarely occurring adverse effects have been reported with the administration of absorbable hemostatic agents; some of these rare effects, such as paralysis, are quite severe. No standardized dosing regimens are available for these agents, although surgeons may have a preference for a particular regimen based on their own clinical experience. No drug interactions involving absorbable hemostatic agents have been published; however, the use of these agents with other medications that affect hemostasis may disrupt clot formation. CONCLUSION: Absorbable hemostatic agents are useful as adjunctive therapy during surgical procedures when conventional methods do not control bleeding. Although rare adverse effects have occurred with these agents, their careful administration will prevent serious adverse outcomes.     

Identification of constituents of human neutrophil azurophil granules that mediate fungistasis against Histoplasma capsulatum

Previously we demonstrated that human neutrophils mediate potent and long-lasting fungistasis against Histoplasma capsulatum yeasts and that all of the fungistatic activity resides in the azurophil granules. In the present study, specific azurophil granule constituents with fungistatic activity were identified by incubation with H. capsulatum yeasts for 24 h and by quantifying the subsequent growth of yeasts via the incorporation of [(3)H]leucine. Human neutrophil defensins HNP-1, HNP-2, and HNP-3 inhibited the growth of H. capsulatum yeasts in a concentration-dependent manner with maximum inhibition at 8 microg/ml. At a concentration of 4 microg/ml, all possible paired combinations of defensins exhibited additive fungistatic activity against H. capsulatum yeasts. Cathepsin G and bactericidal-permeability-increasing protein (BPI) also mediated fungistasis against H. capsulatum in a concentration-dependent manner. The fungistatic activities of combinations of cathepsin G and BPI were additive, as were those of combinations of cathepsin G or BPI with HNP-1, HNP-2, and HNP-3. Lysozyme and elastase exhibited modest antifungal activity, and azurocidin and proteinase 3 exhibited no significant fungistasis against H. capsulatum yeasts. Thus, defensins, cathepsin G, and BPI are the major anti-H. capsulatum effector molecules in the azurophil granules of human neutrophils.