RESUMO
One hundred fifty thousand cells in a vaginal, ectocervical and endocervical smears from 25 patients with poorly to moderately differentiated squamous cancer of the uterine cervix were evaluated to determine the numerical composition of cellular clusters, the sizes of the clusters and the cellular types contained. The study is a baseline assessment for the design of automated cytology devices for which monocellular layers or individual cells are of importance. The evaluation indicates that the majority of cells appear in actual or facultative clusters, and that dispersement or breaking up of these clusters can yield improved machine-readable samples.
Assuntos
Carcinoma de Células Escamosas/patologia , Neoplasias do Colo do Útero/patologia , Esfregaço Vaginal , Agregação Celular , Contagem de Células , Separação Celular , Colo do Útero/patologia , Feminino , HumanosAssuntos
Colo do Útero/patologia , Displasia do Colo do Útero/patologia , Neoplasias do Colo do Útero/patologia , Vagina/patologia , Adulto , Contagem de Células , Células Epiteliais , Epitélio/patologia , Eritrócitos , Feminino , Histiócitos , Humanos , Leucócitos , Linfócitos , Pessoa de Meia-Idade , Estatística como AssuntoAssuntos
Febre de Causa Desconhecida/etiologia , Idoso , Regulação da Temperatura Corporal/fisiologia , Diagnóstico Diferencial , Febre de Causa Desconhecida/fisiopatologia , Idoso Fragilizado , Instituição de Longa Permanência para Idosos , Humanos , Casas de Saúde , Guias de Prática Clínica como Assunto , Valores de ReferênciaRESUMO
Conventional laboratory investigations of haemostasis like prothrombin time and activated partial thromboplastin time are not useful in predicting and managing intra-operative bleeding complications. In order to establish a possible "perioperative reference range" for thrombin generation prothrombin fragment F1+2 (F1+2) and fibrin degradation (D-dimer) markers, we measured F1+2 and D-dimer concentrations before surgery (but after induction of anaesthesia), 30 minutes into surgery, 10 minutes after the event expected to induce the maximal activation of the haemostatic systems, 90 minutes after surgery and on postoperative days 1 and 2 in 226 consecutive patients. Samples were collected from arterial lines. Twenty patients developed a clinically defined, intraoperative disorder of haemostasis, 206 did not. Patients with an intraoperative disorder of haemostasis had significantly higher preoperative F1+2 and D-dimer concentrations. Preoperative values for F1+2 and D-dimer concentrations above the 75th percentile of patients without an intraoperative disorder of haemostasis indicated a 2.70 to 2.88 fold risk of developing an intraoperative disorder of haemostasis (odds ratios were 3.04, 3.12 and 3.29 for D-dimer, ELISA, F1+2, and D-dimer latex tests, respectively with 95% confidence intervals from 1.20 to 8.46) with negative predictive values of 94%, but positive predictive values of only 16% to 26%. These data suggest that preoperative determination of molecular markers might be helpful in identifying a group of patients at high risk for intraoperative disorder of haemostasis by exclusion of low risk patients. Validation of such an approach requires a prospective trial.