The Pap Test and Bethesda 2014

2015 ◽  
Vol 59 (2) ◽  
pp. 121-132 ◽  
Author(s):  
Ritu Nayar ◽  
David C. Wilbur
Keyword(s):  
Pap Test ◽  
Cost Effective ◽  
Multiple Organ ◽  
Cervical Cytology ◽  
Effective Management ◽  
Organ Systems ◽  
Significant Research ◽  
History Of ◽  
Bethesda System ◽  
The Bethesda System

The history of ‘The Bethesda System' for reporting cervical cytology goes back almost 3 decades. This terminology and the process that created it have had a profound impact on the practice of cervical cytology for laboratorians and clinicians alike. The Bethesda conferences and their ensuing output have also set the stage for standardization of terminology across multiple organ systems, including both cytology and histology, have initiated significant research in the biology and cost-effective management for human papillomavirus-associated anogenital lesions, and, finally, have fostered worldwide unification of clinical management for these lesions. Herein, we summarize the process and rationale by which updates were made to the terminology in 2014 and outline the contents of the new, third edition of the Bethesda atlas and corresponding website.

Pap Test Reporting Rates for Conventional Smear and Liquid-Based Cervical Cytology from the Largest Academic Women's Hospital in China: Analysis of 1,248,785 Pap Test Reports

2015 ◽  
Vol 59 (6) ◽  
pp. 445-451 ◽  
Author(s):  
Xiang Tao ◽  
R. Marshall Austin ◽  
Hao Zhang ◽  
Lihong Zhang ◽  
Jianan Xiao ◽  
...  
Keyword(s):  
Cervical Screening ◽  
Pap Test ◽  
Major Change ◽  
Cervical Cytology ◽  
Pap Smears ◽  
Pap Tests ◽  
Bethesda System ◽  
Liquid Based Cytology ◽  
The Bethesda System ◽  
Reporting Rates

Objective: The Obstetrics and Gynecology Hospital of Fudan University (OGHFU) in Shanghai is the largest academic women's hospital in China. Between 2009 and 2014, the use of liquid-based cytology (LBC) significantly increased while gradually adopting the Bethesda System (TBS), and in 2012 local regulations mandated that pathologists replace technicians to sign out Pap tests. Design: A retrospective OGHFU database search documented all Pap test reports between 2009 and 2014 by specimen type, either LBC or conventional Pap smears (CPS), and final reporting category. A total of 1,224,785 Pap reports were analyzed to document variations in Pap test reporting during a period of major change in cervical screening in China. Results: LBC gradually replaced CPS, which declined from over 65% of Pap tests in 2010 to 6.4% in 2014. Of 514,811 Pap reports using the traditional class system, class I (negative) reports accounted for 98.3% of results. With the introduction of TBS reporting, pathologist reviews and substantial replacement of CPS by LBC, the laboratory abnormal Pap test rate increased significantly to almost 5%. Conclusions: Changes in cervical cytology reporting between 2009 and 2014 in China's largest academic women's hospital reflected both increased use of LBC and the introduction of pathologist TBS reporting. Abnormality rates increased significantly and fell within CAP benchmark ranges.

scholarly journals Correlation Between Cervical Cytology and Histopathological Cervical Biopsy Findings According to the Bethesda System / Stepen Korelacije Cervikalne Citologije Po Bethesda Klasifikaciji Sa Patohistološkim Nalazima Cervikalne Biopsije

2014 ◽  
Vol 15 (4) ◽  
pp. 205-216
Author(s):  
Gordana M Sosic ◽  
Goran Babic ◽  
Aleksandra Dimitrijevic ◽  
Slobodanka Mitrovic ◽  
Mirjana Varjacic
Keyword(s):  
Pap Smear ◽  
Screening Program ◽  
Pap Test ◽  
High Sensitivity ◽  
Diagnostic Procedures ◽  
Cervical Cytology ◽  
Screening Programs ◽  
Gynecology And Obstetrics ◽  
Bethesda System ◽  
The Bethesda System

ABSTRACT The Pap test (Pap smear) is a morphological cytodiagnostic test that reveals premorbid and early stages of cervical cancer through the use of cervicovaginal cytology. The present study was conducted at the Department of Gynecology and Obstetrics, Clinical Center Kragujevac, from January 01, 2013, to December 1, 2013, with patients who were part of the national screening program and who used a secondary cytological examination (Pap test) performed using a conventional method. The patients were grouped according to the results of a Pap smear and histopathological findings. The classification of cytological smears was performed in accordance with the Bethesda system. The hypotheses established in this study were statistically tested. The greatest number of cytological findings was NILM. However, the most frequent abnormal cytological findings in terms of percentage were ASC-US. After secondary cervical findings of 8.1% of the total number of women, biopsies were performed. In 68.57% of the biopsies performed, CIN was present in all of them, with the most frequent ones being LSIL (50.6%), HSIL (10.4%) and CA Invasiva (0.5%). This study, using the X2 test, confirmed that cervical cytology and biopsy results are dependent features (sig. = 0.036), between which there is a medium association (Cramer’s V = 0.176). In the ASC-US cytological findings, small percentages of CIN1 and CIN2 were detected. Cervical cytology in this study presented high sensitivity, specificity, positive and negative predictive value. As a relatively inexpensive, painless and easily approachable method, cervical cytology fully substantiates its implementation in diagnostic procedures as well as in organized screening programs.

Incidence of Atypical Glandular Cells of Uncertain Significance in Cervical Cytology Following Introduction of the Bethesda System

1997 ◽  
Vol 67 (1) ◽  
pp. 51-55 ◽  
Author(s):  
Gary L. Eddy ◽  
Serdar H. Ural ◽  
Kenneth B. Strumpf ◽  
Martha A. Wojtowycz ◽  
Pamela S. Piraino ◽  
...  
Keyword(s):  
Cervical Cytology ◽  
Uncertain Significance ◽  
Glandular Cells ◽  
Atypical Glandular Cells ◽  
Bethesda System ◽  
The Bethesda System

Abstract 12563: Retrospective Analysis of Cardiovascular Events With the Use of Immune Checkpoint Inhibitors

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Tushar Tarun ◽  
Brian P Bostick ◽  
Deepa Baswaraj ◽  
Nishchayjit Basra ◽  
Meeshal Khan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Retrospective Analysis ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Multiple Organ ◽  
Fulminant Myocarditis ◽  
Organ Systems ◽  
History Of

Introduction: Immune checkpoint inhibitors have emerged as a promising, novel therapy for multiple malignancies. Immune-related adverse reactions pose a serious concern with use of these agents and reportedly involve multiple organ systems, notably cardiotoxicity. Early identification and management of these adverse events is essential in the prevention of morbidity and mortality. Hypothesis: Immune checkpoint inhibitors cause multiple cardiotoxic effects, and patients with prior cardiac history have a higher likelihood of cardiotoxicity. Methods: 1. A retrospective analysis of 150 patients was performed who had received immunotherapy with either the cytotoxic T lymphocyte associated antigen 4 inhibitors (CTLA4) or with the programmed cell death inhibitors (PD1) or programmed death-ligand 1 (PD-L1) inhibitors for a period of two years at a Tertiary health Care from 7/1/2016-6/30/2018. 2. Patients' cardiac diagnoses prior to the initiation of therapy were noted and included, including history of heart failure, coronary artery disease, atrial fibrillation, and sudden cardiac arrest. 3. Patients’ clinic visits and hospitalizations with admitting and discharge diagnosis, electrocardiogram, echocardiogram, troponin T, and NT-proBNP were reviewed. Results: 6% of patients had new onset heart failure (both preserved and reduced), 1.3% had evidence of myocardial infarction, 2% had new atrial fibrillation with rapid ventricular rate, and 0.6% had fulminant myocarditis. Of patients with new cardiac events, 60% had a history of cardiac disease, which was significantly higher than in patients without (p< 0.05). There were no age or sex differences between the groups with and without cardiotoxicity. Conclusion: Immunotherapy with immune checkpoint inhibitors have broadened the horizon for treatment of multiple solid and hematological malignancies. Nonetheless, new adverse effects on multiple organ systems, specifically cardiac involvement, occur with these therapies, which are important and potentially detrimental toxicities. Patients with a history of prior cardiovascular disease have higher likelihood to develop cardiotoxicity.

scholarly journals Correlation of lateral placental location with development of preeclampsia

2020 ◽  
Vol 9 (3) ◽  
pp. 1017
Author(s):  
Anjali Gupta ◽  
Priyanka Bansal ◽  
Jyotsna Sen ◽  
Savita Rani Singhal
Keyword(s):  
Prospective Observational Study ◽  
Previous History ◽  
Antenatal Clinic ◽  
Severe Anaemia ◽  
Multiple Organ ◽  
Clinical Syndrome ◽  
Chronic Hypertension ◽  
Singleton Pregnancy ◽  
Organ Systems ◽  
History Of

Background: Preeclampsia is a complex clinical syndrome which involves multiple organ systems and remains the principle cause of maternal and perinatal morbidity and mortality. Preeclampsia is a disease of trophoblastic tissue. Placental abnormality is one of the initial events in patients who are destined to develop pregnancy induced hypertension subsequently. Objective of this study was to evaluate the association of laterally located placenta on ultrasound with development of preeclampsia.Methods: This prospective observational study was conducted on 200 antenatal women with singleton pregnancy at 18-24 weeks of gestation who attended antenatal clinic of obstetrics and gynaecology, PGIMS Rohtak from October 2017 to October 2018. Detailed antenatal transabdominal ultrasound along with placental location was done between 18-24 weeks of gestation in women who fitted into inclusion criteria. All the antenatal women belonged to 18-24 weeks of gestation were included in the study except those women with chronic hypertension, diabetes mellitus, renal disease, severe anaemia, thyrotoxicosis, low lying placenta, previous history of preeclampsia or eclampsia.Results: Out of 200 antenatal women, 84 had lateral placenta while 116 had central placenta. Out of these 84 women who had lateral placenta, 55 women (65.5%) developed preeclampsia and out of 116 (58%) women who had central placenta, 28 women (24.1%) developed preeclampsia.Conclusions: From the above study, we concluded that women with laterally located placenta by ultrasound at 18-24 weeks of gestation have greater risk of developing preeclampsia.

Normal-Appearing Endometrial Cells in Pap Tests of Women Aged Forty Years or Older and Cytohistological Correlates

2015 ◽  
Vol 59 (2) ◽  
pp. 175-179 ◽  
Author(s):  
Narges Izadi-Mood ◽  
Soheila Sarmadi ◽  
Sanaz Sanii ◽  
Hossein Sadidi
Keyword(s):  
Pap Test ◽  
Clinical Indicators ◽  
Endometrial Sampling ◽  
Pap Tests ◽  
Endometrial Cells ◽  
Lower Genital Tract ◽  
Bethesda System ◽  
Clinically Significant ◽  
The Bethesda System

Objective: The Bethesda System 2001 for reporting cervical cytology recommends reporting benign-appearing, exfoliated endometrial cells in women aged 40 years or older. The objective of this study was to determine the significance of normal endometrial cells in conventional Papanicolaou (Pap) tests of women aged 40 years and older and to correlate this finding with histological follow-up. Study Design: Over a period of 5 years, all Pap tests showing endometrial cells in women aged ≥40 years were identified. Histological follow-up and outcome were evaluated. Results: Out of 17,275 Pap tests, 199 (1.15%) showed benign endometrial cells. Forty-seven of these 199 patients had subsequent tissue sampling by surgical procedures including endometrial curettage (n = 31), lower genital tract biopsy (n = 30) and hysterectomy (n = 2). Overall, out of 47 cases, 3 (6.4%) had significant endometrial pathology including 2 simple hyperplasias without atypia and 1 complex hyperplasia with atypia. Conclusion: The incidence of clinically significant endometrial lesions associated with the presence of endometrial cells in Pap tests of women aged 40 years and older was very low. Considering this finding, women aged between 40 and 50 years with benign endometrial cells in a Pap test should undertake endometrial sampling only when additional clinical indicators are recognized.

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