Concordance of acid-fast stain result and histopathologic vs clinical diagnosis of leprosy: A three-year retrospective study in a Tertiary Government Hospital and Sanitarium in the Philippines

Objectives@#In the Philippines, there has been a lack of information on the concordance between classifications of Hansen’s disease or leprosy clinically, histopathologically, and with AFS results. The study ultimately aimed to determine the concordance between the clinical diagnosis, histopathological results, and AFS results of patients with leprosy seen at the Dr. Jose N. Rodriguez Memorial Hospital and Sanitarium (DJNRMHS). @*Methods@#This is a descriptive, retrospective, single-center study conducted at the DJNRMHS, a tertiary government hospital and one of the last remaining sanitaria in the country located in northern Metro Manila in the Philippines. The study reviewed and included all the patient records from the years 2017-2019 which included skin biopsy results and slit-skin smear with AFS. Leprosy patients were then classified based on the following classifications: World Health Organization (WHO) and Ridley-Jopling classifications; and the concordance of clinical diagnosis vs the histopathologic findings and clinical diagnosis vs AFS results were determined using kappa testing.

Realização periódica do Papanicolau: uma contribuição de empoderamento através de oficina / Periodic realization of Papanicolaou: a contribution to the empowerment of women / Realización periódica de Papanicolaou: una contribución al empoderamiento de la mujer

Objetivo: desenvolver uma oficina como forma de contribuição ao empoderamento de mulheres para a realização periódica do Papanicolau. Método: qualitativo, exploratório e descritivo, tipo pesquisa participante, em uma unidade de saúde, com mulheres entre 25 a 59 anos, através de entrevista semiestruturada coletiva, durante uma oficina ocorrida em fevereiro de 2023, analisada por meio da Análise Temática de Conteúdo. Resultados: a oficina mostrou-se como um dispositivo que potencializa o empoderamento feminino, interferindo no processo saúde-doença. Desvelou-se ainda como ferramenta de dialogicidade e escuta ativa, na compreensão dos determinantes que se configuram como empecilhos na realização periódica do Papanicolau. Considerações finais: como forma de romper barreiras, ao tratar-se da periodicidade do Papanicolau, a oficina é uma ferramenta eficiente e incentivadora de promoção à participação ativa, à autonomia, à autoestima e ao empoderamento social por meio do processo educativo

Objective: develop a workshop as a way of contributing to the empowerment of women to carry out regular Pap smears. Method: qualitative, exploratory and descriptive, participant research type, in a health unit, with women between 25 and 59 years old, through collective semi-structured interviews, during a workshop, analyzed through Thematic Content Analysis. Results: the workshop proved to be a device that enhances female empowerment, interfering in the health-disease process. It also revealed itself as a tool for dialogue and active listening, in understanding the determinants that constitute obstacles in the periodic performance of the Pap smear. Final considerations: as a way of breaking down barriers, when it comes to the frequency of the Pap smear, the workshop is an efficient and encouraging tool to promote active participation, autonomy, self- esteem and social empowerment through the educational process

Objetivos: desarrollar un taller como forma de contribuir al empoderamiento de las mujeres para la realización periódica de Papanicolaou. Método: investigación cualitativa, exploratoria y descriptiva, tipo participante, en una unidad de salud, con mujeres entre 25 y 59 años, a través de entrevistas colectivas semiestructuradas, durante un taller, analizadas mediante Análisis de Contenido Temático. Resultados: el taller resultó ser un dispositivo que potencia el empoderamiento femenino, interfiriendo en el proceso salud-enfermedad. También se reveló como una herramienta de diálogo y escucha activa, en la comprensión de los determinantes que constituyen obstáculos en la realización periódica del Papanicolaou. Consideraciones finales: como una forma de romper barreras en cuanto a la frecuencia de la prueba de Papanicolaou, el taller es una herramienta eficiente y alentadora para promover la participación activa, la autonomía, la autoestima y el empoderamiento social a través del proceso educativo

Human papillomavirus DNA testing with the urine sample is not yet available: the accuracy of two distinct kits

SUMMARY OBJECTIVE: The aim of this study was to assess the results and efficiency of two real-time polymerase chain reaction procedures for detecting human papillomavirus utilizing urine samples. METHODS: This study comprised 151 patients who had previously tested positive for human papillomavirus in their cervical samples. Two different commercial real-time polymerase chain reaction techniques were used for identification and genotyping human papillomavirus in urine specimens. The urine samples of 151 patients were evaluated via the Roche Cobas test, and the urine samples of 91 patients were also evaluated via the Qiagen test. RESULTS: The overall consistency of urine and cervical swab specimens for the identification of human papillomavirus in Roche Cobas and Qiagen tests were 44.8 and 44%, respectively. The rates of positive human papillomavirus results from urine samples were 57 and 70.3%, respectively. The overall concordance among Roche Cobas and Qiagen tests utilizing urine samples for human papillomavirus type 16/18 was 84.3% with a kappa value of 0.675, and for other high-risk-human papillomavirus, it was 75.60% with a kappa value of 0.535. Roche Cobas showed high concordance with Qiagen test. CONCLUSION: human papillomavirus positivity was not detected in all urine samples. It is still inappropriate to recommend the use of urine liquid biopsy for the accurate and reliable detection of human papillomavirus. Due to the lack of a standardized tool, the utilization of urine samples as a screening human papillomavirus test remains a challenge.

Changes of lymphocyte subsets in smear-negative pulmonary tuberculosis

Background and Aims: The host immune system plays an important role in the pathogenesis and defense mechanism of Mycobacterium tuberculosis (Mtb). This study aimed to explore the different changes in the immune system between smear-negative pulmonary tuberculosis (PTB) and smear-positive PTB patients. Materials and Methods: A total of 85 active PTB patients and 50 healthy adults were enrolled. The participants were divided into smear-negative PTB, smear-positive PTB, and control groups. Chest computed tomography (CT) and lymphocyte subgroup counts in peripheral blood were measured in all participants. Results: There were higher numbers of CD4 + T-cells, NK cells, and pulmonary cavities in the smear-positive PTB group, whereas the numbers of B-ells were significantly increased in the smear-negative PTB group. Conclusions: Smear-negative PTB showed fewer pulmonary cavities, mild inflammatory response, lower numbers of immune cells, and higher numbers of B- cells.

A comparative study of conventional cytology and cell block in the diagnosis of pleural effusion with special reference to immunohistochemistry

Background: Body cavity fluids are evaluated by cell block (CB) technique. In conventional cytological smears (CS), appropriate identification of the cells as either reactive mesothelial cells or malignant cells is a diagnostic problem. In CB method, there is increase in cellularity, so it gives more morphological details of cells and improving the sensitivity of diagnosis. Sections obtained by CB method are also can be stored for future study like immunohistochemistry (IHC). Aims and Objectives: The aim of the study was to determine the diagnostic efficacy of CB technique over conventional CS and to study of IHC in CB of malignant pleural effusion. Materials and Methods: This will be institution-based, cross-sectional, and observational study. The pleural fluid (except blood and pus) obtained by thoracocentesis from both male and female patient (>18 years of age) 100 cases was included in the study. Pleural fluid mixed with blood/pus, fluid from cystic lesion, and inadequate sample (<15 ml vol.) were excluded in the study. Results: Association between architectural pattern in CB versus architectural pattern in cytology smear showed statistically significant value Chi-square: 201.7417, P < 0.0001. Conclusion: We may conclude that CB technique is better than conventional cytology smear technique especially in case of malignant pleural effusion. It increases true positive cases and decreases false negative cases. It also increases cellularity, maintain architectural pattern, and cellular morphology.

Factores que favorecen el tamizaje de cáncer de cuello uterino en mujeres de 12 a 49 años: Sub-análisis de la Encuesta Demográfica y de Salud Familiar 2019, Perú

Introducción: La prueba de Papanicolau ayuda a detectar de manera oportuna en la intervención de rutina el cáncer de cuello uterino. Objetivo: Analizar factores asociados al tamizaje para cáncer de cuello uterino en mujeres de 12 a 49 años en Perú durante el año 2019. Metodología: Se realizó un estudio observacional, analítico-transversal de un análisis secundario de datos de la Encuesta Demográfica y de Salud Familiar del 2019. Muestreo bietápico, probabilístico, equilibrado y estratificado. Se utilizó estadística descriptiva y analítica (nivel de inferencia p<0.05). Para el análisis bivariado y multivariado se utilizaron razones de prevalencia con intervalo de confianza de 95% y p<0.05. Resultados: La frecuencia de tamizaje de cáncer de cuello uterino en las regiones políticas con menores valores de prevalencia fueron Pasco (0,52%) y Tumbes (0,55%). Discusión: Los factores asociados al tamizaje de cáncer de cuello uterino son la edad, tener pareja, nivel educación superior, nivel socioeconómico pobre, residir en área rural, tener seguro de salud, edad de inicio de relaciones sexuales y haber escuchado del cáncer de cuello uterino.

Introduction: The Papanicolaou test smear helps detect cervical cancer in a timely manner in routine intervention. Objective: To analyze factors associated with screening for cervical cancer in women aged 12 to 49 years in Peru in 2019. Methods: An observational, analytical-cross-sectional study of a secondary analysis of data from 2019 Demographic and Family Health Survey was carried out. Two-stage, probabilistic, balanced, and stratified sampling. Descriptive and analytical statistics were used (level of inference p<0.05). For the bivariate and multivariate analysis, prevalence ratios were used with a 95% confidence interval and p<0.05. Results: The frequency of cervical cancer screening in the political regions with the lowest prevalence values were Pasco (0.52%) and Tumbes (0.55%). Discussion: The factors associated with cervical cancer screening are age, having a partner, higher education level, poor socioeconomic level, residing in a rural area, having health insurance, age at the start of sexual relations, and having heard of cervical cancer.

Factores socioculturales que influyen en las usuarias de 50 años para la toma de Papanicolaou de un Hospital Nasca

Objetivo: El objetivo del presente estudio fue determinar los factores socioculturales en usuarias de 50 años para la toma de Papanicolaou en el hospital Ricardo Cruzado Rivarola de Nasca durante el periodo Diciembre 2021 - Febrero 2022. Materiales y métodos : Realizamos un estudio observacional, analítica, y prospectivo. La población de estudio está constituida por 80 usuarias de 50 años que acuden al hospital Ricardo Cruzado Rivarola para controles de Papanicolaou al consultorio de Ginecología-Obstetricia. La muestra estuvo conformada por 67 usuarias, seleccionadas por muestreo no probabilístico por conveniencia. Resultados: Para el primer análisis, en la regresión simple, se encontró que las mujeres con nivel de conocimientos altos tenían 153% mayor frecuencia de haberse realizado alguna vez un pap y las mujeres con nivel de conocimientos altos tenían 384% mayor frecuencia de haberse realizado alguna vez un PAP, en comparación a quienes tenían un nivel de conocimientos bajo. Luego, en la regresión múltiple se observó que las mujeres con nivel de conocimientos altos tenían 382% mayor frecuencia de haberse realizado alguna vez un PAP, en comparación a quienes tenían un nivel de conocimientos bajo. Conclusiones: El nivel de conocimiento sobre el PAP influye de una manera relevante al haberse realizado un PAP; pero además las mujeres que tuvieron mayor educación fueron las que tuvieron mayor frecuencia de haberlo realizado. Esto sumado a la cantidad de hijos; posiblemente porque en los círculos de mujeres con hijos uno de los temas a tratar es sobre la salud materna y dentro ellos el PAP.

Objective: The objective of this study was to determine the sociocultural factors in 50-year-old users for pap smears at the Ricardo Cruzado Rivarola de Nasca Hospital during the period December 2021 - February 2022. Material and methods: Observational, analytical, and prospective study. The study population is made up of 80 50-year-old users who attend the Ricardo Cruzado Rivarola Hospital for PAP tests at the gynecology-obstetrics office and the sample is 67 users, selected by non-probabilistic sampling for convenience. Results: For the first analysis, in simple and multiple regression, it was found that women with high levels of knowledge had a 384% and 382% higher frequency of having ever undergone a PAP test compared to those with low levels of knowledge. Conclusions: The level of knowledge about the PAP has a relevant influence on having carried out a PAP; but also the women who had a high level were the ones who had the highest frequency of having done it. This added to the number of children; possibly because in the circles of women with children one of the topics to be discussed is about maternal health and within them the PAP.

Atitudes e crenças de médicos ginecologistas- -obstetras e de pacientes do Hospital Universitário de Brasília sobre o rastreamento cervical e o exame pélvico / Attitudes and beliefs of obstetrician-gynecologists and patients at the University Hospital of Brasília about cervical screening and pelvic examination

Objetivo: Avaliar as atitudes e crenças de pacientes e médicos ginecologistas-obstetras sobre o rastreamento cervical e o exame pélvico no Hospital Universitário de Brasília (HUB). Métodos: Foram realizadas entrevistas com pacientes que aguardavam por uma consulta previamente agendada no ambulatório de ginecologia e com médicos ginecologistas-obstetras que atuavam no HUB. Cada grupo respondeu a um questionário que enfocava a realização do rastreamento cervical e do exame pélvico (EP). Resultados: No total, 387 pacientes responderam ao questionário. Dessas, apenas 4,13% sabiam que, de acordo com as diretrizes brasileiras, o rastreamento cervical deveria ser iniciado aos 25 anos de idade, 5,17% sabiam que ele deveria ser encerrado aos 64 anos e 97,93% esperavam um intervalo menor do que o trienal recomendado. Após serem informadas sobre as diretrizes, 66,93% acreditavam que o início aos 25 anos é tardio, 61,5%, que o encerramento aos 64 anos é precoce, 88,37%, que o intervalo trienal é muito longo e 94,06% ficaram com receio de que problemas de saúde pudessem aparecer nesse intervalo. Dos 44 médicos que responderam ao questionário, embora a maioria concordasse com as diretrizes, somente 31,82%, 38,64% e 34,1% as seguia com relação à frequência, à idade de início e à idade de encerramento, respectivamente. Quanto ao EP, aproximadamente metade dos participantes de cada grupo considerava que o exame deveria ser realizado nas consultas regulares com o ginecologista. Conclusão: Foi observada uma discrepância entre as expectativas das pacientes e as diretrizes para o rastreamento de câncer cervical. A maior parte das pacientes não as conhecia e, quando informadas, não concordava com elas. Quanto aos médicos ginecologistas- obstetras, a maioria não as seguia, apesar de conhecê-las. Quanto ao EP, grande parte dos médicos e pacientes considerava-o importante e acreditava que ele deveria ser realizado de forma rotineira nas consultas ginecológicas.

Objective: Evaluate the attitudes and beliefs of patients and obstetrician-gynecologists about cervical screening and pelvic examination in the University Hospital of Brasília (HUB). Methods: Face-to-face interviews with patients waiting for a previously scheduled consultation at the gynecology outpatient clinics and attending obstetrician-gynecologists at the HUB. Each group answered a questionnaire addressing cervical screening and pelvic examination (PE). Results: 387 patients answered the questionnaire. Of these, only 4.13% were aware that, according to Brazilian guidelines, cervical screening should begin at age 25, 5.17% that it should stop at age 64 and 97.93% expected a shorter interval than the recommended triennial. After being informed of the guidelines, 66.93% believed that starting at age 25 is late, 61.5% that stopping at 64 is early, 88.37% that the triennial interval is too long, and 94.06% would be afraid that health problems could appear during the interval. Of the 44 participating physicians, although most agreed with the guidelines, only 31.82%, 38.64% and 34.1% followed them regarding frequency, starting and stopping age, respectively. As for EP, approximately half of the participants in each group believed that it should be performed in regular consultations with the gynecologist. Conclusion: There was a discrepancy between patients' expectations and cervical screening guidelines. Most patients didn't know and, when informed, didn't agree with them. As for Ob-Gyn physicians, most did not follow these guidelines, despite knowing them. As for pelvic exam, most physicians and patients considered it important and believed it should be routinely performed during gynecological consultations.

Auramine-O Staining vs Ziehl Neelsen Staining: Advantages and Disadvantages

Background: Tuberculosis (TB) caused by Mycobacterium tuberculosis (Mtb) is still a major public health concern around the world. Prompt detection of active tuberculosis cases helps in timely therapeutic intervention and reduces community transmission. Despite limited sensitivity, conventional microscopy is still used to diagnose pulmonary tuberculosis in high-burden nations such as India. This study, therefore, was aimed at assessing the diagnostic performance of microscopy by Ziehl Neelsen (ZN) and auramine (AO) staining in the diagnosis of pulmonary tuberculosis. Materials and methods: A prospective comparative study was done on the sputum samples of 2,395 adult patients from November 2018 to May 2020 suspected of having pulmonary tuberculosis visiting the Designated Microscopic Centre of SGT Medical College, Budhera, Gurugram. Each sample was subjected to ZN staining, and AO staining as per NTEP guidelines. Results: Out of the 2,395 samples studied, 161 (6.76%) and 224 (9.35%) were positive by ZN and AO staining methods respectively. Pauci-bacillary cases detected by AO were more than ZN staining. There were 63 more sputum samples detected by AO staining which were missed by ZN microscopy. Conclusion: When compared to conventional ZN staining, the auramine staining technique is more sensitive and takes less time to diagnose pulmonary tuberculosis

COMPARATIVE STUDY OF AUTOMATED CELL COUNTER HISTOGRAM AND PERIPHERAL BLOOD SMEAR IN DIAGNOSIS OF ANEMIA

Introduction: Over the past few years, complete blood count, RBC histogram and peripheral blood smear have become the important diagnostic tools to diagnose various haematological conditions. Major public health burden worldwide is anemia with high prevalence in developing countries like India1. Red blood cell and histogram are indispensable for diagnosis and management of anemia2. The major diagnostic tool for work up of most commercial laboratories has been analysing the blood film routinely. The aim AIM: of the study is to compare between automated cell counter histogram and peripheral smear finding in diagnosis of anemia. Material and method: A prospective comparative study of RBC histogram and peripheral blood smear in diagnosis of anemia was done on 100 patients of HB<14gm%, over six month time span (June2022-Nov2022) in the central laboratory of Saraswathi Institute of Medical Sciences Hapur, (UP) India. This study included all the age groups. All cases of anemia that have undergone blood transfusion is excluded from this study. In Result: our study it was observed that on peripheral blood smear, the most common type of anemia was microcytic hypochromic anemia followed by normocytic normochromic anemia, when we compared with automated cell counter generated histogram most common type of anemia was normocytic normochromic followed by microcytic hypochromic anemia. In our study female population were more than males. The mean age was(32.4yr). Automated cell counters generated CBC histograms and peripheral blood smears Conclusion: plays a major role in diagnosis and management of red cell disorder. Our study observed that histogram patterns and their confirmation by peripheral blood smear along with clinical history gives accurate and confirmed diagnosis of various haematogical conditions. There is much improvement in accuracy and precision 3 reducing the subjective errors .

Intervención educativa basada en metodologías B-learning para mejorar las citologías cervicales: experiencias de enfermeras / Intervenção educacional através do B-learning para melhorar a citologia cervical: experiências de enfermeiras / Educational intervention through B-learning to improve cervical cytology: experiences of nurses

Resumen Objetivo analizar las experiencias de enfermeras en la toma de las citologías cervicales y otros factores organizacionales durante una intervención educativa asistida por metodologías B-learning. Método estudio cualitativo realizado en San Luis Potosí, México. Participaron 15 enfermeras. La recolección de datos se hizo a través de entrevistas semiestructuradas con base en una sistematización de experiencias. Para el análisis de la información se utilizó el programa Taguette y como referente teórico las metodologías B-learning. Resultados se identificaron debilidades en factores relacionados con la accesibilidad de las usuarias al servicio, insumos, infraestructura, bioseguridad, capacitación del personal de salud, entrega de resultados a las pacientes y conocimiento del programa por parte de las usuarias. Conclusiones e implicaciones para la práctica el cáncer cervical es un problema de salud pública. La citología cervical es la prueba de tamizaje más utilizada; sin embargo, existen limitantes en la calidad, por lo que se proponen acciones para mejorar los conocimientos y habilidades del personal de enfermería que tiene como función la toma. La intervención educativa fue efectiva para fomentar el aprendizaje integral sobre la toma de las citologías cervicales y permitió al personal de enfermería compartir sus experiencias.

Resumo Objetivo analisar as experiências das enfermeiras na realização de esfregaços cervicais e outros fatores organizacionais durante uma intervenção educacional assistida por metodologias de b-learning. Método estudo qualitativo realizado em San Luis Potosí, México. Participaram 15 enfermeiras. A coleta de dados foi feita por meio de entrevistas semiestruturadas a partir de uma sistematização de experiências. Para a análise das informações, utilizou-se o programa Taguette e metodologias de b-learning como referencial teórico. Resultados foram identificadas fragilidades em fatores relacionados com a acessibilidade dos usuários ao serviço, insumos, infraestrutura, biossegurança, capacitação da equipe de saúde, entrega de resultados aos pacientes e conhecimento do programa pelos usuários. Conclusões e implicações para a prática o câncer do colo do útero é um problema de saúde pública. A citologia cervical é o teste de triagem mais utilizado; no entanto, existem limitações na qualidade, por isso são propostas ações para aprimorar os conhecimentos e habilidades das enfermeiras que estejam desempenhando essa função. A intervenção educacional foi eficaz para promover o aprendizado integral sobre a realização do esfregaço cervical e permitiu que as enfermeiras compartilhassem suas experiências.

Abstract Objective to analyze the nursing staff's experiences in taking cervical smears and other organizational factors during an educational intervention assisted by B-learning methodologies. Method a qualitative study was carried out in San Luis Potosí, Mexico, with 15 nurses. Data collection was done through semi-structured interviews based on a systematization of experiences. The Taguette program and B-learning methodologies as theoretical references were used to analyze the information. Results weaknesses were identified in factors related to the accessibility of users to the service, supplies, infrastructure, biosafety, training of health personnel, delivery of results to patients, and knowledge of the program by the users. Conclusions and implications for practice cervical cancer is a public health problem. Cervical cytology is the most widely used screening test; however, there are limitations in quality, so actions are proposed to improve the knowledge and skills of the nursing staff in their functions. The educational intervention effectively promoted comprehensive learning about taking cervical smears and allowed the nursing staff to share their experiences.

Analysis of the role of molecular diagnostic technology in improving the bacteriological diagnostic rate of tuberculosis / 中华传染病杂志

Objective:To analyze the relevant factors of bacteriological diagnosis rate in pulmonary tuberculosis in Zhejiang Province, and to provide basis for the control of tuberculosis.Methods:The results of etiology detection of pulmonary tuberculosis in Zhejiang Province from 2015 to 2020 were collected from the China Tuberculosis Information Management System. Positive detection of etiology of pulmonary tuberculosis cases was analyzed. Joinpoint regression model was constructed to evaluate the annual trend of the positive rate of etiology, and linear regression model was used to analyze the influence of new diagnostic technology on the positive detection rate of etiology in smear-negative pulmonary tuberculosis cases.Results:From 2015 to 2020, the positive rate of etiology of pulmonary tuberculosis in Zhejiang Province increased from 38.66%(10 588/27 385) to 64.12%(14 275/22 262), with an average annual growth rate of 8.80%. All of the 11 prefecture cities in Zhejiang Province showed an increasing trend of the positive rate of etiology. The average annual growth rates in Wenzhou City and Lishui City were 10.27% and 11.21%, respectively, and the positive rates of etiology in Jinhua City and Lishui City were 70.13%(2 007/2 862) and 73.34%(707/964) in 2020, respectively. From 2015 to 2020, smear-negative cases accounted for 61.66%(92 935/150 733) in Zhejiang Province, and the further detection rate by culture and molecular test increased from 0.13%(22/16 650) to 84.74%(11 384/13 434). The positive rate of bacteriological tests in smear-negative pulmonary tuberculosis patients increased from 0.04%(6/16 650) to 41.28%(5 546/13 434). If the culture and molecular detection rate increased to 100.00%, the linear regression model predicted positive rate of etiology could increase to 44.20%. Thus, the positive rate of etiology of pulmonary tuberculosis in Zhejiang Province would reach 66.00%. Up to 2020, 95.56%(86/90) and 92.22%(83/90) of tuberculosis designated hospitals were equipped with molecular and liquid diagnostic equipments, respectively, and the detection positive rates of molecular and liquid diagnostics in the etiology positive pulmonary tuberculosis cases were 71.24%(10 169/14 275) and 53.44%(7 629/14 275), respectively.Conclusions:The implementation and promotion of the new diagnostic techniques for tuberculosis, especially the molecular diagnostic techniques, could significantly improve the positive rate of etiology of pulmonary tuberculosis etiology. Methods and strategies of etiological diagnosis of tuberculosis should be paid more attention in prevention and control of tuberculosis.

Application of artificial intelligence assists bone marrow cytomorphology analysis in the diagnosis and treatment of acute myeloid leukemia / 中华检验医学杂志

Objective:To investigate the value of artificial intelligence (AI) cytomorphologic analysis system in the cytomorphological diagnosis and therapeutic evaluation of acute myeloid leukemia (AML).Methods:Bone marrow smear samples were collected from 150 patients with newly diagnosed and treated acute myeloid leukemia who were inpatients and outpatients at the Department of Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from June 1, 2021 to July 31, 2022 for retrospective analysis. Among them, there were 50 patients in the newly diagnosed group, including 28 males and 22 females, with the onset age of 43.5(32.3,58.8)years. There were 100 patients in the post-treatment group, including 36 males and 64 females, with the onset age of 34.5(23.0,47.0)years. The results from cytomorphology expert were used as the gold standard and the Python 3.6.7 was used for analysis to evaluate the accuracy, sensitivity, and specificity of the AI cytomorphologic analysis system for blast cell recognition in AML diagnosis and treatment.Results:The proportion of blasts in AI analysis of 50 samples in the newly diagnosed group was≥20%, which met the diagnostic criteria of AML. AI analysis of blasts had an accuracy of 90.3%, sensitivity of 85.5%, and specificity of 98.0%. The correlation coefficient between AI and the proportion of blasts analyzed by experts was positively correlated( r=0.882, P<0.001). Meanwhile, in the post-treatment group, the sensitivity and specificity of AI analysis of blasts were 89.7% and 99.2%, respectively. The correlation coefficient between AI and the proportion of blasts analyzed by experts was positively correlated( r=0.957, P<0.001). According to AI analysis data, there are 8 samples in this group whose AI efficacy evaluation results on AML are inconsistent with expert analysis. Conclusion:AI cytomorphologic analysis system has high accuracy, sensitivity and specificity for blast cell recognition in AML morphological diagnosis and therapeutic evaluation.

Studies on the effect of ultrasound on properties and bonding strength of dentin smear layer / 口腔医学

Objective@# To explore the effect of ultrasound on dentin smear layer's surface and bonding strength of the universal resin adhesive under self-etching mode. @*Methods@# Forty mandibular third molars without caries were randomly divided into two groups; one was polished with silicon carbide sandpaper; the other was polished with silicon carbide sandpaper followed by ultrasonic treatment. Scanning electron microscope (SEM) was used to observe surface of the dentin. Treated teeth were bonded with two universal resin adhesives, Clearfil Universal Bond (pH=2.3) and All-Bond Universal (pH=3.1), and the penetration of the bonding interface was observed with a confocal laser scanning microscope (CLSM) after Rhodamine B staining. Finally, the micro tensile bond strength test was conducted to test the adhesion. @*Results@# The SEM showed that after polishing with silicon carbide sandpaper, the smear layer of the dentin surface was scratched, and dentin tubules were almost completely blocked, with no obvious dentin tubules exposed. After ultrasonic treatment, the scratches were reduced, and a large number of dentin tubules were exposed. CLSM showed that both adhesives could penetrate the dentin along the dentin tubules more deeply after ultrasound treatment. Micro tensile bond strength tests showed that ultrasonic treatment could enhance the bonding strength of two universal resin adhesives. However, there was no statistical difference in bonding strength between these two universal resin adhesives under the same treatment. .@*Conclusion@# Ultrasound can partially remove the smear layer on dentin's surface, expose dentin tubules, and increase universal resin adhesives' penetration depth and bonding strength under self-etching mode

The effect of sonic activated device used for different time on intracanal smear layer removal: An SEM analysis / 口腔医学

Objective @#To observe the clearance of smear layer on the root canal wall in different action time by scanning electron microscope (SEM), and to determine the optimal amount of time using sonically activated irrigation to wash root canal in clinic. @*Methods@# Fifty-six ex vivo human anterior teeth with single straight root canal were selected. After routine mechanical preparation, they were divided into two experimental groups according to different irrigating agents: saline group and EDTA group. Each group was assisted by VDW sonic activation EDDY. The saline group was divided into three subgroups according to the irrigating time: 5 s, 30 s and 50 s; EDTA group was divided into six subgroups according to the irrigating time: 5 s, 10 s, 20 s, 30 s, 40 s and 50 s. The control group did not undergo root canal irrigation. After irrigation, the root was cut longitudinally. The smear layer of crown, middle and apical of root canal wall was observed by SEM.@* Results@# After irrigating for 30 seconds, there was a significant difference between the normal saline group and the control group and the 5 second group (P<0.05), and there was no difference in the middle and apical part (P>0.05). After 50 seconds, there was a significant difference in the score of the smear layer between the apical area and the other groups (P<0.05). After irrigating for 5 seconds or 10 seconds in EDTA group, there was a significant difference between the scores of the crown and middle area of the root canal and the control group (P<0.05), and there was no significant difference in the apical area (P>0.05). There was a significant difference between the 20-40 second group and the first two groups (P<0.05). There was a significant difference between the 50 second group and the other groups (P<0.05). Comparing the cleaning effect on the smear layer after 50 seconds of irrigating between the two experimental groups, the whole root canal showed significant statistical difference (P<0.05). @*Conclusion @#The EDTA-assisted sonic activated device used for 50 seconds has the best cleaning effect.

Effect of thymopentin combined with levofloxacin for retreatment smear positive pulmonary tuberculosis / 中国热带医学

@#Abstract: Objective　To analyze the effect of adjuvant to levofloxacin in the treatment of retreatment smear positive pulmonary tuberculosis, as well as its effect on respiratory function, immune function and inflammatory factors. Methods　One hundred cases of retreatment smear positive pulmonary tuberculosis patients admitted to Rudong County People's Hospital in Nantong city in Jiangsu province from 2017 to 2021 were randomly divided into a control group (n=50) and an observation group (n=50) according to random number table method. Both groups received conventional treatment (3 months of isoniazid, rifampicin, ethambutol, pyrazinamide / 6 months of isoniazid, rifampicin, ethambutol), with levofloxacin added to the control group, and thymopentin added to the observation group for the first three months in addition to routine treatment. The treatment effect of the two groups were compared. Results　The sputum smear conversion rate of the observation group was significantly higher than that of the control group after 3 months and 5 months of treatment (χ2=7.142, P<0.05; χ2=6.250, P<0.05). The cavity absorption time and lesion absorption time in the observation group were significantly lower than those in the control group (t=4.006, P<0.05; t=5.165, P<0.05). The turning time of bacteriological culture in the observation group was significantly lower than that in the control group (t=4.220,P<0.05). After 3 months of treatment, CD4+, CD3+, CD4+/CD8+ of the observation group were higher than those of the control group, the differences were statistically significant (t=8.885, P<0.05; t=6.274, P<0.05; t=4.357, P<0.05). After 3 months of treatment, the IFN-γ (interferon-γ) of the observation group was higher than that of the control group (t=8.892, P<0.05), whereas the , IL-10 (interleukin-10) was significantly lower than that in the control group (t=5.986, P<0.05). After 3 months of treatment, forced vital capacity (FVC), forced expiratory volume in one second (forced expiratory volume in one second, FEV 1) and the one-second rate (forced expiratory volume in one second / forced vital capacity, FEV1/FVC) in the observation group were significantly higher than those in the control group (t=11.223, P<0.05; t=10.128, P<0.05; t=4.464, P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (χ2=0.378, P>0.05). Conclusions　Thymopentin combined with levofloxacin had a significant application effect in the treatment of retreatment smear positive pulmonary tuberculosis, s, which led to improved inflammatory reaction, respiratory function and immune function. Additionally, it can increase sputum smear conversion rate and accelerate patient recovery, improving overall treatment efficacy, with a relatively high clinical application value.

Diagnostic efficacy of joint detection of Xpert MTBRIF, TB-RNA and TB-DNA in bronchoalveolar lavage fluid for smear-negative pulmonary tuberculosis / 中国热带医学

@#Abstract: Objective　To investigate the diagnostic value of joint detection of Mycobacterium tuberculosis rifampicin resistance gene (Xpert MTB/RIF), Mycobacterium tuberculosis ribonucleic acid (TB-RNA) and Mycobacterium tuberculosis deoxyribonucleic acid (TB-DNA) in bronchoalveolar lavage fluid for smear-negative pulmonary tuberculosis. Methods A total of 806 patients with suspected smear-negative pulmonary tuberculosis admitted to our hospital from May 2020 to July 2022 were selected, 506 patients diagnosed as bacterial negative pulmonary tuberculosis by clinical, X-ray and sputum samples were classified as bacterial negative pulmonary tuberculosis group, and the other 300 patients with non-tuberculous pulmonary disease were classified as non-tuberculous pulmonary disease group. XpertMTB/RIF, TB-RNA and TB-DNA in bronchoalveolar lavage fluid of all patients were detected. With clinical, X-ray and sputum specimen examination of mycobacterium tuberculosis as the gold standard, the diagnostic efficacy of alveolar lavage solution Xpert MTB/RIF, TB-RNA and TB-DNA alone and in combination was analyzed. Results The positive detection rates of Xpert MTB/RIF, TB-RNA and TB-DNA in bronchoalveolar lavage fluid of the smear-negative pulmonary tuberculosis group and the non-tuberculosis pulmonary disease group were 69.96% (354/506) and 2.67% (8/300), 61.46% (311/506) and 5.00% (15/300), and 63.64% (322/506) and 8.00% (24/300), respectively. The rates in the smear-negative pulmonary tuberculosis group were higher than those in the non-tuberculosis lung disease group, and the differences were statistically significant (χ2=342.005, 246.930, 235.687, P<0.01). Compared with the gold standard, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of Xpert MTB/RIF in the diagnosis of smear-negative pulmonary tuberculosis were 69.96%, 97.33%, 80.15%, 97.79% and 65.77%, respectively; those values of TB-RNA were 61.46%, 95.00%, 73.95%, 95.40% and 59.38%, respectively; those values of TB-DNA were 63.64%, 92.00%, 74.19%, 93.06% and 60.00%, respectively; those values of combined diagnosis with Xpert MTB/RIF, TB-RNA and TB-DNA were 61.26%, 100.00%, 75.68%, 100.00% and 60.48%, respectively; the specificity and positive predictive value of combined detection were higher than those of single detection (P<0.05). Conclusions The joint detection of Xpert MTB/RIF, TB-RNA and TB-DNA in bronchoalveolar lavage fluid can improve the diagnostic efficacy of smear-negative pulmonary tuberculosis and is worthy of clinical promotion and application.

Comparison between the Mycob.T scanner system and manual microscopy in detecting acid-fast bacilli in sputum specimens / 上海预防医学

ObjectiveTo compare the efficacy between the Mycob.T scanner system and manual microscopy for detecting acid-fast bacilli in sputum specimens. MethodsBetween January and November 2020， a total of 1 519 sputum samples from suspected primary tuberculosis patients from 5 designated tuberculosis hospitals in Shanghai were examined by Smear and BACTEC MGIT 960 liquid culture （liquid culture） methods. Each specimen was subiected to 2 direct smear slides. One slide was stained by Z-N method and examined with manual microscopic method. Another slide was stained and scanned by the Mycob.T system. The efficacy of manual microscopy and the Mycob.T scanner system for detecting acid-fast bacilli in sputum specimens was compared based on the result of liquid culture. Results of the repetitive scanning by the Mycob.T scanner system and the recheck of the manual microscopy were analyzed. ResultsThe average positive rate by the Mycob.T scanner system was 14.4% （219/1 519） while the average positive rate by manual microscopy was 16.3% （248/1 519）. No significant difference was observed （χ2=2.13， P=0.145）. Based on liquid culture confirmation results， the sensitivity of manual microscopy （60.36%） was higher than that of the Mycob.T scanner system （52.94%）， and the difference is statistically significant （χ2=4.38， P=0.036）. Both methods had high specificity （98.94%）. The concordance of the Mycob.T scanner system and manual microscopy was 95.46%， with the kappa value of 0.826. The results of repeatability test of the Mycob.T scanner system and the recheck results of the manual microscopy showed that the coincidence rate of scanning by the Mycob.T scanner system was 99.5% （436/438）， and the recheck coincidence rate by the manual microscopy was 98.6% （432/438）. ConclusionThe Mycob.T scanner system have high specificity for detecting acid-fast bacilli in sputum samples and good consistency with the results of manual microscopy. Compared with manual microscopic examination， the Mycob.T scanner system can greatly alleviate the work intensity.

Effect of Glycolic Acid, Maleic Acid, and EDTA in the Removal of Smear Layer from Root Canal Dentin

ABSTRACT Objective: To assess the efficacy of 5% Glycolic Acid (GA), 17% ethylenediaminetetraacetic acid (EDTA) and 7% maleic acid (MA), in removing the smear layer (SL). Material and Methods: For the experiment, forty single-rooted human teeth were selected. To perform the chemo‑mechanical preparation, the root canals were instrumented to an apical size of #30, along with simultaneous irrigation of 2.5% NaOCl. The samples were allotted to the experimental groups based on the final irrigating solution (n=10): (1) The GA group: 05%, (2) the EDTA group: 17%, (3) the MA group: 7%, and (4) the control group: Distilled water. The teeth were evaluated for the presence or absence of SL using SEM. Results: Comparing the 5% GA, 7% MA and 17% EDTA groups, no statistically significant differences were found at the coronal and middle thirds (p>0.05). However, in the apical third, MA had greater efficacy than EDTA (p=0.002) and GA (p=0.041), with a significant difference in the SL removal, while there was no significant difference between the latter (p=0.148). Conclusion: Thus, it was concluded that 7% maleic acid as a final irrigating solution is more efficacious than 17% EDTA and 5% glycolic acid in eliminating the smear layer from the apical portion of the root canal.

Cervical Cancer Screening with DNA-HPV Testing and Precancerous Lesions Detection: A Brazilian Population-based Demonstration Study / Rastreamento do câncer do colo do útero com teste de DNA-HPV e detecção de lesões precursoras: um estudo de demonstração de base populacional brasileiro

Abstract Objective To evaluate the rates of precancerous lesions, colposcopy referral, and positive predictive value (PPV) by age groups of a population-based screening with DNA-HPV testing. Methods The present demonstration study compared 16,384 HPV tests performed in the first 30 months of the program with 19,992 women tested in the cytology screening. The colposcopy referral rate and PPV for CIN2+ and CIN3+ by age group and screening program were compared. The statistical analysis used the chi-squared test and odds ratio (OR) with 95% confidence interval (95%CI). Results The HPV tests were 3.26% positive for HPV16-HPV18 and 9.92% positive for 12 other HPVs with a 3.7 times higher colposcopy referral rate than the cytology program, which had 1.68% abnormalities. Human Papillomavirus testing detected 103 CIN2, 89 CIN3, and one AIS, compared with 24 CIN2 and 54 CIN3 detected by cytology (p < 0.0001). The age group between 25 and 29 years old screened by HPV testing had 2.4 to 3.0 times more positivity, 13.0% colposcopy referral, twice more than women aged 30 to 39 years old (7.7%; p < 0.0001), and detected 20 CIN3 and 3 early-stage cancer versus 9 CIN3 and no cancer by cytology screening (CIN3 OR= 2.10; 95%CI: 0.91 -5.25; p = 0.043). The PPV of colposcopy for CIN2+ ranged from 29.5 to 41.0% in the HPV testing program. Conclusion There was a significant increase in detections of cervix precancerous lesions in a short period of screening with HPV testing. In women < 30 years old, the HPV testing exhibited more positivity, high colposcopy referral rate, similar colposcopy PPV to older women, and more detection of HSIL and early-stage cervical cancer.

Resumo Objetivo Avaliar as taxas de lesões pré-cancerosas, encaminhamento para colposco pia e valor preditivo positivo (VPP) por faixas etárias de rastreamento populacional com teste DNA-HPV. Métodos O presente estudo de demonstração comparou 16.384 testes de HPV realizados nos primeiros 30 meses do programa com 19.992 mulheres testadas no rastreio citológico. Os programas foram comparados por taxa de encaminhamento de colposcopia e VPP para NIC2+ e NIC3+ por faixa etária. A análise estatística utilizou o teste de qui-quadrado e odds ratio (OR, na sigla em inglês) com intervalo de confiança (IC) de 95%. Resultados Os testes de HPV foram 3,26% positivos para HPV16-HPV18 e 9,92% positivos para 12 outros HPVs, com uma taxa de encaminhamento de colposcopia 3,7 vezes maior do que o programa de citologia, que teve 1,68% de anormalidades. O teste de HPV detectou 103 NIC2, 89 NIC3 e um AIS, em comparação com 24 NIC2 e 54 NIC3 detectados por citologia (p < 0,0001 ). O rastreio por teste de HPV no grupo etário 25 a 29 anos teve 2,4 a 3,0 vezes mais positividade, 13,0% de encaminhamento para colposcopia, 2 vezes mais que mulheres de 30 a 39 anos (7,7%; p < 0,0001 ), e detectou 20 NIC3 e 3 cânceres em estágio inicial versus nove NIC3 e nenhum câncer pelo rastreio citológico (NIC3 OR= 2,10; 96%CI: 0,91 -5,25; p = 0,043). O VPP da colposcopia para NIC2+ variou de 29,5 a 41,0% no programa de teste de HPV. Conclusão Houve um aumento significativo na detecção de lesões pré-cancerosas do colo do útero em um curto período de rastreamento com teste de HPV. Em mulheres < 30 anos, o teste de HPV exibiu mais positividade, alta taxa de encaminhamento para colposcopia com VPP semelhante a mulheres mais velhas, e mais detecção de HSIL e de câncer cervical em estágio inicial.