176
|
Gray W, Bayer-Pietsch E, Chieco P, Cochand Priollet B, Desai M, Drijkoningen M, Griffin M, Hagmar B, Kapila K, Kloboves-Prevodnik V, Kobayashi T, Krogerus L, Majak B, Mihailovici M, Olszewski W, Schenck U, Schmitt F, Shabalova I, Shapiro N, Smith J, Tani E, Totsch M, Vass L, Wiener H, Herbert A. The future of cytopathology in Europe. Will the wider use of HPV testing have an impact on the provision of cervical screening? Cytopathology 2007; 18:278-82. [DOI: 10.1111/j.1365-2303.2007.00487.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
177
|
Almonte M, Kitchener H, Desai M, Sargent A, Bailey A, Turner A, Thomson C, Julian P. O-2 Preliminary results of the ARTISTIC study: a randomised trial in screening to improve cytology. Cytopathology 2007. [DOI: 10.1111/j.1365-2303.2007.00500_2.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
178
|
Narine N, Hughes Y, Rana D, Desai M. O-4 Performance indicators of primary practitioners screening thinprep and surePath liquid based cytology samples in a large screening centre. Cytopathology 2007. [DOI: 10.1111/j.1365-2303.2007.00500_4.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
179
|
Mehta S, Jiandani P, Desai M. Ocular lesions in disseminated candidiasis. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 2007; 55:483-5. [PMID: 17907496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
AIM To assess the prevalence and patterns of ocular involvement in disseminated candidiasis in intensive care setting. MATERIALS AND METHODS Institutional review board approved case review of intensive care admissions. These were patients of septicemia who had undergone ocular examination as part of their initial assessment. The records of patients in whom Candida spp. was detected in two sites or had a clinical diagnosis of candidemia were analyzed. RESULTS Twelve patients (nine male, three female) were diagnosed with candida-induced sepsis during this period. Their ages ranged from 26 to 97 years (mean 52.7 years). Six patients (50%) had ocular lesions. The commonest lesion was chorioretinitis, seen in seven eyes of six patients followed by Roth spots seen in one eye. There was no evidence of vitritis or endophthalmitis in any eye. Systemic immunosuppression was present in three of six (50%) patients with ocular changes. Incidental findings included two eyes with non-proliferative diabetic retinopathy. CONCLUSIONS Any suspicion of disseminated candidiasis should prompt an ocular evaluation which may help in the early diagnosis and in the institution of early antifungal therapy. This may reduce ocular morbidity and patient morbidity.
Collapse
|
180
|
Sharma A, Rana DN, Desai M. Cytomorphological evaluation of a small round blue cell tumour of the head and neck. Cytopathology 2007; 18:197-9. [PMID: 17573767 DOI: 10.1111/j.1365-2303.2007.00387.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
181
|
Nixon W, Augustine G, Desai M, Green A, Weller P. 294* West Midlands cystic fibrosis (CF) newborn screening training evaluation. J Cyst Fibros 2007. [DOI: 10.1016/s1569-1993(07)60269-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
182
|
Stewart L, Alton H, Desai M, van Mourik I. 195 The Stewart Ultrasound Score (SUSS): a new tool for quantitative assessment of CFLD. J Cyst Fibros 2007. [DOI: 10.1016/s1569-1993(07)60178-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
183
|
Desai M, Zeggini E, Horton VA, Owen KR, Hattersley AT, Levy JC, Walker M, Gillespie KM, Bingley PJ, Hitman GA, Holman RR, McCarthy MI, Clark A. An association analysis of the HLA gene region in latent autoimmune diabetes in adults. Diabetologia 2007; 50:68-73. [PMID: 17143607 PMCID: PMC3076207 DOI: 10.1007/s00125-006-0513-z] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2006] [Accepted: 09/19/2006] [Indexed: 11/26/2022]
Abstract
AIMS/HYPOTHESIS Pathophysiological similarities between latent autoimmune diabetes in adults (LADA) and type 1 diabetes indicate an overlap in genetic susceptibility. HLA-DRB1 and HLA-DQB1 are major susceptibility genes for type 1 diabetes but studies of these genes in LADA have been limited. Our aim was to define patterns of HLA-encoded susceptibility/protection in a large, well characterised LADA cohort, and to establish association with disease and age at diagnosis. MATERIALS AND METHODS Patients with LADA (n = 387, including 211 patients from the UK Prospective Diabetes Study) and non-diabetic control subjects (n = 327) were of British/Irish European origin. The HLA-DRB1 and -DQB1 genes were genotyped by sequence-specific PCR. RESULTS As in type 1 diabetes mellitus, DRB1 0301_DQB1 0201 (odds ratio [OR] = 3.08, 95% CI 2.32-4.12, p = 1.2 x 10(-16)) and DRB1 0401_DQB1 0302 (OR = 2.57, 95% CI 1.80-3.73, p = 4.5 x 10(-8)) were the main susceptibility haplotypes in LADA, and DRB1 1501_DQB1 0602 was protective (OR = 0.21, 95% CI 0.13-0.34, p = 4.2 x 10(-13)). Differential susceptibility was conferred by DR4 subtypes: DRB1 0401 was predisposing (OR = 1.79, 95% CI 1.35-2.38, p = 2.7 x 10(-5)) whereas DRB1 0403 was protective (OR = 0.37, 95% CI 0.13-0.97, p = 0.033). The highest-risk genotypes were DRB1 0301/DRB1 0401 and DQB1 0201/DQB1 0302 (OR = 5.14, 95% CI 2.68-10.69, p = 1.3 x 10(-8); and OR = 6.88, 95% CI 3.54-14.68, p = 1.2 x 10(-11), respectively). These genotypes and those containing DRB1 0401 and DQB1 0302 associated with a younger age at diagnosis in LADA, whereas genotypes containing DRB1 1501 and DQB1 0602 associated with an older age at diagnosis. CONCLUSIONS/INTERPRETATION Patterns of susceptibility at the HLA-DRB1 and HLA-DQB1 loci in LADA are similar to those reported for type 1 diabetes, supporting the hypothesis that autoimmune diabetes occurring in adults is an age-related extension of the pathophysiological process presenting as childhood-onset type 1 diabetes.
Collapse
|
184
|
|
185
|
Dowie R, Stoykova B, Desai M. Assessing the wellbeing of cytoscreeners: experience in two NHS cytology laboratories. Cytopathology 2006; 17:366-73. [PMID: 17168920 DOI: 10.1111/j.1365-2303.2006.00383.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Cervical screening programmes in England are in transition as the liquid-based cytology (LBC) method replaces conventional Papanicolaou screening and staff in NHS laboratories are trained to analyse LBC smears. Cytoscreeners and biomedical scientists undertake routine microscopy of slides, but the scientists usually have a wider professional role. Attitudinal surveys were carried out in laboratories where LBC was partially introduced. METHODS Staff in two cytology laboratories in Greater Manchester were surveyed twice over 6 months. The questionnaire assessed work pressures using scales from the Measures of Work Characteristics instrument, work-related stress using the General Survey version of the Maslach Burnout Inventory, job intentions and job satisfaction. RESULTS Cytoscreeners, many aged over 50 years, formed over 60% of respondents in both surveys (27/42 in the first survey), and biomedical scientists and doctors, 30%. Both groups were under moderate pressure from work demands in each survey, but cytoscreeners had significantly less autonomy over their working methods (P < 0.001). Although both groups experienced similar levels of exhaustion, cytoscreeners were much more cynical or indifferent towards work in the second survey (P = 0.008) and had lower expectations of being effective (P < 0.001). For the cytoscreeners, there were strong negative correlations in both surveys between cynicism and the work characteristics of influencing decisions and autonomy/control. CONCLUSIONS The strength of the relationship between work performance and wellbeing serves to emphasize the importance of the new LBC technology in ameliorating low morale where it exists. Further attitudinal research involving larger samples of laboratories is warranted to assess the full impact of this innovation.
Collapse
|
186
|
Sainani NI, Lawande MA, Pungavkar SA, Desai M, Patkar DP, Mohanty PH. Spontaneous intracranial hypotension: A study of six cases with MR findings and literature review. ACTA ACUST UNITED AC 2006; 50:419-23. [PMID: 16981936 DOI: 10.1111/j.1440-1673.2006.01615.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Spontaneous intracranial hypotension is clinically characterized by orthostatic headache and other symptoms caused by low cerebrospinal fluid pressure due to leakage of cerebrospinal fluid from dural punctures or other medical causes. The other symptoms are mainly due to traction of the cranial and spinal nerves owing to descent of the brain caused by low cerebrospinal fluid pressure. Magnetic resonance imaging is very useful in the diagnosis because of its characteristic findings. We describe the MRI findings in six cases that had variable clinical presentation.
Collapse
|
187
|
Shah B, Rana D, Marshall J, Desai M. P-21 POSITIVE PREDICTIVE VALUE OF CERVICAL SMEARS REPORTED AS MILD DYSKARYOSIS. Cytopathology 2006. [DOI: 10.1111/j.1365-2303.2006.00392_13_21.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
188
|
Da Gama-Rose BM, Hodgson E, Hales SA, Desai M. P-15 COMPARISON OF RESULTS FOR A NON-GYNAECOLOGICAL CYTOLOGY EQA SCHEME. Cytopathology 2006. [DOI: 10.1111/j.1365-2303.2006.00392_13_15.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
189
|
Lynch MA, Rana DN, Charan V, Desai M. P-12 A RETROSPECTIVE AUDIT OF FINE NEEDLE ASPIRATION CYTOLOGY OF PANCREAS. Cytopathology 2006. [DOI: 10.1111/j.1365-2303.2006.00392_13_12.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
190
|
Joseph P, Marshall J, Rana D, Desai M. P-4 TRANSFORMATION ZONE COMPONENT IN LIQUID BASED CERVICAL CYTOLOGY. Cytopathology 2006. [DOI: 10.1111/j.1365-2303.2006.00392_13_4.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
191
|
Clark A, Desai M. Comment on: Gale EAM (2005) Latent autoimmune diabetes in adults: a guide for the perplexed. Diabetologia 48:2195-2199. Diabetologia 2006; 49:2222-4. [PMID: 16832661 DOI: 10.1007/s00125-006-0347-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2006] [Accepted: 06/05/2006] [Indexed: 12/18/2022]
|
192
|
Sarkady E, Rana D, Desai M. P-5 AN UNUSUAL FORM OF THYROID PAPILLARY CARCINOMA: COLUMNAR CELL VARIANT WITH NEUROENDOCRINE FEATURES. Cytopathology 2006. [DOI: 10.1111/j.1365-2303.2006.00392_13_5.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
193
|
Joshi P, Evans A, Rana DN, Hale R, Wilson GE, Desai M, Ismail SM. P-3 THE VALUE OF PERITONEAL WASHING CYTOLOGY IN THE STAGING OF GYNAECOLOGICAL MALIGNANCY. Cytopathology 2006. [DOI: 10.1111/j.1365-2303.2006.00392_13_3.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
194
|
Shah B, Rana D, Marshall J, Desai M. P-20 DIAGNOSTIC ACCURACY OF CONVENTIONAL SMEARS AND THINPREP SAMPLES IN CERVICAL SCREENING. Cytopathology 2006. [DOI: 10.1111/j.1365-2303.2006.00392_13_20.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
195
|
Holbrook M, Roebuck J, Rana DN, Marshall J, Roberts S, Desai M. O-5 UNIDIRECTIONAL VERSUS BIDIRECTIONAL SCREENING OF SUREPATHR LIQUID BASED CYTOLOGY SLIDES –PITFALLS & PERILS OF STUDY DESIGN. Cytopathology 2006. [DOI: 10.1111/j.1365-2303.2006.00392_10_5.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
196
|
Lynch MA, Rana DN, Desai M, Denton K. O-12 BLAND DYSKARYOSIS: A NEW PITFALL IN THINPREPR LIQUID BASED CYTOLOGY. Cytopathology 2006. [DOI: 10.1111/j.1365-2303.2006.00392_12_3.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
197
|
Li C, Rana DN, Desai M. P-2 COMPLETING THE AUDIT CYCLE OF NON-GYNAECOLOGIC CYTOLOGY TURNAROUND TIMES. Cytopathology 2006. [DOI: 10.1111/j.1365-2303.2006.00392_13_2.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
198
|
Dowie R, Stoykova B, Crawford D, Desai M, Mather J, Morgan K, Shirt M. Liquid-based cytology can improve efficiency of cervical smear readers: evidence from timing surveys in two NHS cytology laboratories. Cytopathology 2006; 17:65-72. [PMID: 16548990 DOI: 10.1111/j.1365-2303.2006.00304.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Cervical screening programmes in England and Wales were advised by the National Institute for Clinical Excellence in 2003 to adopt liquid-based cytology (LBC) in place of conventional Papanicolaou (Pap) cytology to facilitate laboratory efficiency. Pilot evaluations in England and Scotland monitored daily or weekly workloads of smear readers and concluded that LBC could increase hourly throughput rates. This study, instead, used timing surveys to determine screening rates. METHODS Two National Health Service cytology laboratories in Manchester and Stockport were partially converted to the LBC ThinPrep process for a cervical screening trial. Three 1-week timing surveys were conducted over 7 months. The surveys covered all LBC-trained staff. The first survey in Manchester also covered staff undertaking conventional Pap screening. The smear readers used timers to record time taken for examining and reporting each slide. RESULTS In Manchester, in the first survey, nearly 1 minute per slide was saved by the LBC method during primary microscopy. In both laboratories, the mean microscopy time for primary screening of LBC slides was reduced by almost 1 minute between the first and second surveys. There was no difference between the second and third surveys. Microscopy by cytopathologists was also 1 minute per slide quicker with LBC than conventional Pap. The LBC inadequate rates for both laboratories were <2.0%. Organizational factors impacted on the hourly LBC primary screening rates in the laboratories, the rate for Stockport being higher than the rates in the pilot evaluations. CONCLUSIONS The timing surveys confirm that the LBC ThinPrep technology can improve laboratory efficiency. However, decision-makers should also consider the overall costs and benefits of introducing the technology in screening programmes, including the capital investment and workforce implications.
Collapse
|
199
|
|
200
|
McCann T, Pierorazio PM, Mitchell R, Desai M, Olsson CA, Benson MC, McKiernan J. Pre-biopsy PSA and biopsy gleason sum; evaluating the independence of two independent variables. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.14555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
14555 Background: Traditionally PSA, Gleason sum and Clinical Stage are considered independent predictors of outcome for prostate cancer. The purpose of this study is to investigate a codependence between prostate specific antigen (PSA) and Gleason sum and whether this relationship has evolved during the PSA era. Methods: The Columbia Urologic Oncology Database was reviewed and 2,522 patients were identified who underwent radical prostatectomy from 1988 to 2005; a retrospective cohort of 1,786 patients with complete data was included. Patients were stratified by Gleason sum into groups with Gleason sum <7, =7 and >7. PSA was correlated to Gleason sum to examine a possible relationship between the two variables. Two-sample t-tests with 95% confidence intervals were utilized to determine differences between groups and were confirmed by ANOVA techniques. A Cox regression model using an interaction term between PSA and Gleason sum was fit to determine if an interaction exists between the two variables. Patients were further stratified into two cohorts by median year of surgery (1998) and the PSA-Gleason sum relationship was evaluated over time. Results: Median patient age was 61.9 years. 1,081 patients were identified with Gleason sum <7. 540 patients had a Gleason sum =7. 165 patients had a Gleason sum >7. The mean PSA values were 6.05, 6.89 and 8.41 for <7, =7 and >7 groups respectively. Differences between the means were statistically significant and validated by the ANOVA technique (p < 0.001). A Cox regression model validated PSA, Gleason sum and clinical stage as independent predictors of outcome. The addition of an interaction term into the Cox regression model between PSA and Gleason sum demonstrated a significant interaction effect between PSA and Gleason sum (p < 0.001). The relationship remained between PSA and Gleason sum within the pre and post 1998 groups (p < 0.001). Conclusions: PSA and Gleason sum are highly interrelated variables, although they each carry additional information that significantly contributes to the prediction of biochemical failure (PSA ≥0.2 ng/ml). For an individual patient, the higher the initial PSA the higher the risk of having a high Gleason sum on biopsy. This relationship has remained constant over the PSA era. No significant financial relationships to disclose.
Collapse
|