Assuntos
Clínicos Gerais/estatística & dados numéricos , Hemofilia A/psicologia , Serviços Preventivos de Saúde/estatística & dados numéricos , Adolescente , Adulto , Idoso , Nível de Saúde , Hemofilia A/complicações , Hemofilia A/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Encaminhamento e Consulta , Índice de Gravidade de Doença , Inquéritos e Questionários , Adulto JovemAssuntos
Biologia Celular/normas , Detecção Precoce de Câncer/normas , Laboratórios/normas , Programas de Rastreamento/normas , Guias de Prática Clínica como Assunto , Neoplasias do Colo do Útero/diagnóstico , Alphapapillomavirus/isolamento & purificação , Automação Laboratorial/normas , Biologia Celular/organização & administração , Colo do Útero/patologia , Colo do Útero/virologia , Colposcopia/métodos , Feminino , Humanos , Armazenamento e Recuperação da Informação/legislação & jurisprudência , Armazenamento e Recuperação da Informação/normas , Laboratórios/organização & administração , Auditoria Médica , Pessoal de Laboratório Médico/educação , Pessoal de Laboratório Médico/organização & administração , Pessoal de Laboratório Médico/normas , Manejo de Espécimes/normas , Reino Unido , Neoplasias do Colo do Útero/virologia , Recursos HumanosRESUMO
BACKGROUND: Periodontal treatment may be a useful adjunct to medical management of diabetes; however, oral health has not been integrated into multidisciplinary diabetes care in Australia. This study aimed to understand the needs of patients and staff at a diabetes clinic to inform a prototype of integrated dental and diabetes care. METHODS: Quantitative and qualitative data were collected from patients and staff at West Moreton Diabetes Clinic (WMDC) between September-October 2019. Clinical information, survey responses and dental screening results were analysed for 41 patients. Semi-structured interviews were held with six patients and a focus group with seven staff. RESULTS: Most patients (83%) had not seen a dentist in the previous year. Of the 37 patients with remaining natural teeth, 84% required periodontal assessment and 46% had multiple carious lesions. Unmet treatment needs and rates of access were similar for private and public dental patients. Staff and patients reported high levels of support for incorporation of dental care at WMDC. CONCLUSIONS: Integrating oral health into diabetes management is well-supported by patients and staff to address significant unmet dental needs for both public and private dental patients. Incorporating dental screening/services within diabetes clinics may increase uptake and improve awareness of its importance in diabetes management.
Assuntos
Diabetes Mellitus , Saúde Bucal , Austrália , Assistência Odontológica , Diabetes Mellitus/terapia , HumanosRESUMO
The cytological and histological findings of a case of breast carcinoma with osteoclast-like giant cells are presented. A fine needle aspiration specimen demonstrated the characteristic combination of malignant epithelium and reactive multinucleated cells and enabled identification of this rare variant of breast cancer. Immunocytochemical studies using the monoclonal antibody KP1[CD68] support a histiocytic origin for the osteoclast-like cells.
Assuntos
Neoplasias da Mama/patologia , Células Gigantes , Osteoclastos/patologia , Idoso , Idoso de 80 Anos ou mais , Biópsia por Agulha , Feminino , Humanos , Imuno-HistoquímicaRESUMO
Urinary incontinence affects 50%-80% of residents in nursing homes, presenting a challenge to the health care team. Assessment of urinary incontinence is crucial to selecting appropriate treatment. This article addresses the scope of the problem, incontinence assessment, and treatment specific to nursing home residents.
Assuntos
Incontinência Urinária , Instituição de Longa Permanência para Idosos , Humanos , Casas de Saúde , Exame Físico , Incontinência Urinária/etiologia , Incontinência Urinária/terapiaRESUMO
The cervical cytology and histology specimens from 200 patients referred to colposcopy with borderline nuclear abnormality were reviewed. Human papillomavirus (HPV)-associated changes were identified in 103 of 200 (53%) referral smears and in 139 of 150 (91%) biopsy specimens. Cervical intraepithelial neoplasia (CIN) was less frequently diagnosed on review compared with the original histopathology reports (30.7% vs 45.4%); the discrepancy was largely attributable to a lower incidence of CINI. There was agreement in the grading of borderline nuclear abnormality in 161 of 200 referral smears following review. Twenty-three smears were upgraded to mild dyskaryosis, whereas 16 were reclassified as negative.
Assuntos
Colo do Útero/patologia , Esfregaço Vaginal , Feminino , Humanos , Papillomaviridae , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/patologia , Infecções Tumorais por Vírus/diagnóstico , Infecções Tumorais por Vírus/patologia , Doenças do Colo do Útero/diagnóstico , Doenças do Colo do Útero/patologia , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/patologia , Displasia do Colo do Útero/diagnóstico , Displasia do Colo do Útero/patologiaRESUMO
A case of cervical adenocarcinoma arising in diffuse mesonephric hyperplasia is presented. The hyperplastic and neoplastic tubules showed focal endocrine cell differentiation. Endocrine cells stained with the Grimelius technique, and were immunoreactive for chromogranin and serotonin. Antisera to additional specific hormones were negative. The natural history of this rare tumor is uncertain; the patient presented in this report is free of disease at 10-year follow-up.
Assuntos
Mesonefroma/patologia , Neoplasias do Colo do Útero/patologia , Adulto , Diferenciação Celular , Colo do Útero/patologia , Cromograninas/análise , Feminino , Humanos , Histerectomia , Técnicas Imunoenzimáticas , Queratinas/análise , Mesonefroma/cirurgia , Serotonina/análise , Coloração e Rotulagem , Neoplasias do Colo do Útero/cirurgia , Útero/patologia , Vimentina/análiseRESUMO
Immunoglobulin heavy chain (IgH) gene rearrangement analysis was performed on 27 fine needle aspiration (FNA) specimens (13 reactive hyperplasia, 11 B cell non-Hodgkin's lymphoma (B-NHL), one Hodgkin's disease and two suspicious of non-Hodgkin's lymphoma). Satisfactory amplification was achieved in 23/27 cases. A polyclonal pattern was seen in 14 cases (11 reactive hyperplasia, one B-NHL, one suspicious of lymphoma, one Hodgkin's disease). A monoclonal band was seen in nine cases (eight B-NHL, one reactive hyperplasia). Amplification was unsuccessful in four cases. Clonal analysis by PCR-based IgH gene rearrangement analysis can be successfully applied to FNA material and can be useful in diagnosis, but the results must be interpreted in conjunction with morphology and other ancillary information.
Assuntos
Clonagem Molecular , Rearranjo Gênico de Cadeia Pesada de Linfócito B , Reação em Cadeia da Polimerase , Biópsia por Agulha/métodos , Doença de Hodgkin/genética , Doença de Hodgkin/patologia , Humanos , Linfoma de Células B/genética , Linfoma de Células B/patologia , Pseudolinfoma/genética , Pseudolinfoma/patologiaRESUMO
It has been suggested that the coagulation defect in haemophilia A protects these patients from coronary artery disease. We report two patients with severe haemophilia, who each had severe atheroma localised to the coronary arteries. Both patients had received only small amounts of factor VIII concentrates in their lifetime because of various social reasons. In one case death resulted from myocardial infarction secondary to an occlusive thrombus in a coronary artery. The implications of these findings to the pathogenesis of vascular disease are discussed.