Paediatric nasopharyngeal cytology: a new diagnostic opportunity?

The purpose of this investigation was to describe the first application of nasopharyngeal cytology (NPC), a new cytological technique to collect cellular material from the nasopharyngeal surface non-invasively in children with chronic adenoiditis associated with recurrent acute otitis media and/or otitis media with effusion. Cellular material was collected transorally using an extra-thin flexible wire nasopharyngeal swab and then examined under a light microscope. The diagnostic accuracy of NPC in detecting the presence of allergy and pathogens (compared to microbiological evaluation of nasopharyngeal aspirates, NPAs) was assessed. NPC was performed on 121 children (mean age 69.4 ± 15.5 months). Inflammatory cells and pathogens were detected in 61.1 % and 44.2 % of patients, respectively. The specificity of nasopharyngeal eosinophils in detecting allergy was good (91.9 %), as was the specificity of mast cells, but the sensitivities were less. The NPAs revealed bacterial colonisation in 84.7 % of the patients, and Streptococcus pneumoniae was the most frequently isolated (60.0 %). NPC revealed the presence of bacteria in 94.9 % of patients, including bacillary species in 33.9 %. NPC was highly sensitive in detecting pathogens (96.0 %). Its specificity in detecting bacillary species was fairly good (75.0 %), but the corresponding values of the specificity of NPC in detecting pathogens and its sensitivity in detecting bacillary species were poor. Our findings suggest the need for more structured studies that can test the real effectiveness and usefulness of NPC in defining nasopharyngeal cytological patterns in children with chronic nasopharyngeal diseases by comparing it with established diagnostic techniques.

Perceptual and response bias in unilateral neglect: two modified versions of the milner landmark task.

Perceptual and response bias in estimating the proportion of the two segments of prebisected lines were disambiguated in a group of 121 patients suffering from left neglect by means of two variants of the Milner Landmark task (Milner et al., 1993). The first variant, LANDMARK-V, required a verbal response; the second variant, LANDMARK-M, required manual pointing. The paper reports and discusses the results obtained on each task and their correlations, as well as the relationships between either kind of bias and the intrahemispheric location of the lesion. It is argued that besides their usefulness as a diagnostic tool the proposed variants of the Milner Landmark task provide results that are worth further investigation in their own right.