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PubMed1993

The influence of clinical history on visual search with single and multiple abnormalities.

RATIONALE AND OBJECTIVES: Facilitation of detection by clinical history generally has been found with a single abnormality per image but not with multiple abnormalities. Multiple abnormalities per image can occasion a "satisfaction-of-search" effect in which detection of one lesion is reduced in the presence of other distant lesions. Our experiment studied the combined effect of multiple abnormalities and clinical history on accuracy. METHODS: Detection of native lesions was measured 1) with histories suggestive of the native abnormality; 2) with these histories and added simulated pulmonary nodules; and 3) with the same added nodules and histories suggestive of metastatic disease. These conditions also were compared with those of a previous experiment that were similar but included no history. RESULTS: Detection was substantially improved for appropriately prompted abnormalities even in the presence of a pulmonary nodule. In fact, satisfaction of search was not found in the presence of an appropriate history. Detection of unprompted abnormalities was unchanged when prompts indicated other abnormalities actually present. Prompted abnormalities were detected earlier in search. CONCLUSIONS: History appears to direct perceptual resources to the prompted abnormalities, thereby alleviating satisfaction of search. The presence of nodules yielded a small but consistent reduction in total search time for searches involving false responses, suggesting that satisfaction of search may depend more on reduction in search time than had been indicated by previous research.

Diagnostic Errors↗
PubMed2006

Pedicle rotation in scoliosis: a marker for occult intrathecal abnormalities.

STUDY DESIGN: The Perdriolle method was used to assess retrospectively radiographic pedicle rotation for association with occult intrathecal abnormalities in patients with scoliosis. OBJECTIVE: To determine if pedicle rotation can be predictive of underlying intrathecal abnormalities. SUMMARY OF BACKGROUND DATA: Scoliosis associated with intrathecal abnormalities is thought to produce less rotation than true idiopathic scoliosis. No supporting evidence was found in the literature. METHODS: A consecutive series of patients with a presenting diagnosis of idiopathic scoliosis were reviewed for anteroposterior radiographs and spinal magnetic resonance imaging (MRI). A blinded single examiner evaluated radiographic curve parameters. MRI reports were reviewed for the presence or absence of intrathecal abnormalities. RESULTS: A total of 78 MRIs included 15 intrathecal abnormalities and 63 normals. The abnormal MRI group had more males and apex left curves. Primary curve in the intrathecal abnormality group had a mean of 9.6 degrees of apical vertebrae rotation compared to 17.7 degrees in idiopathic curves (average 37 degrees and 40 degrees Cobb angles, respectively). Of angulation, 1 degrees correlated with 0.21 degrees and 0.34 degrees of rotation in intrathecal abnormality versus no abnormality groups, respectively. CONCLUSIONS: Curves with occult intrathecal pathology had significantly less rotation than those without. Pedicle rotation assessment is a useful adjuvant for identifying scoliosis with intrathecal abnormalities.

Adolescent↗
PubMed2005

Abnormal intrahepatic portal vasculature in native and allograft liver biopsies: a comparative analysis.

Abnormal portal vessels in small portal tracts can be seen in association with various causes of portal hypertension, such as noncirrhotic portal hypertension (NCPH) and cirrhosis. Very little has been reported about the presence of abnormal portal vessels in livers with normal portal pressure. Little attention has also been given to the presence of abnormal vessels in liver allografts outside the setting of transplant vasculopathy/chronic rejection. This study reports on the portal vasculature abnormalities, many similar to those described in NCPH, encountered in routine native liver biopsies (n = 46) and allograft liver biopsies (n = 48). A classification scheme for the abnormal portal vasculature was adapted from the literature, and the portal vessels were divided into five groups (types 0-IV). Abnormal vessels were present in greater than 25% of the portal tracts in 88% of all the biopsies studied; there was no significant difference between the native and allograft biopsies. In the allograft biopsy group, there were correlations between vascular abnormalities and severity of a concurrent acute cellular rejection episode, the presence of prior rejection episodes, and length of time after transplant. Biopsies from patients with viral hepatitis C infection (HCV) showed more type IV lesions (absent or sclerosed portal vessels) with fragmentation when compared with biopsies obtained for other reasons. The number of portal tracts with abnormal portal veins and fragmented vessels correlated positively with increasing fibrosis. This is the first study to demonstrate the presence of abnormal portal vessels, some of the type seen in NCPH, in a significant number of both native and allograft liver biopsies in patients without evidence of portal hypertension. Abnormal portal vasculature tends to be associated with HCV and increased fibrosis, and, within the transplant group, with the severity of rejection, presence of prior rejection episodes, and increased time posttransplantation.

Biopsy↗
PubMed1986

Growth factor and cytogenetic abnormalities in cultured nevi and malignant melanomas.

It has been proposed that benign nevi that fail to differentiate normally may undergo stepwise growth and morphologic changes resulting in progression toward dysplastic nevi, which in some cases progress into malignant melanoma. In this study, we sought to determine the relationship between production of endogenous growth factors and the appearance of chromosomal abnormalities in cultured nevi and melanomas. Newly established cultures from 8 nevi with benign histology and 6 malignant melanomas, and 2 malignant melanoma cell lines were studied. Assays for mitogenic growth factors were based on stimulation of [3H]thymidine incorporation into DNA in Hs0294 malignant melanoma cells, produced by serum-free conditioned medium from nevus or melanoma cultures. Karyotypes were examined in cultures of an equivalent passage. Three of the 8 nevus cultures were mitogen-negative and displayed normal karyotypes; one nevus culture was mitogen-positive and had a normal karyotype, although the biopsied tissue demonstrated histologic evidence of benign melanocytic proliferation; one was mitogen-negative initially, but had an extra chromosome 8 in 2 of 50 cells; 3 were mitogen-positive and chromosomally abnormal. Each of the cultures in this latter group exhibited reciprocal translocation (rcpt) as the only identifiable abnormality [rcpt(6;15), rcpt(10;15), rcpt(15;20)], or a constitutional rcpt(4;5). Thus, there was direct correlation between growth factor production and chromosome abnormality in 6 of 8 benign nevus cultures. In the newly established melanoma cultures there was also concordance between growth factor and chromosomal status; conditioned media from 4 of 6 were mitogen-positive by at least one assay, and all 4 of the mitogen-positive cultures had chromosomally abnormal cell populations. Of the 2 melanoma cultures negative for growth factors, one was also negative for chromosome abnormality; the other had chromosomal change consisting of increased polyploidy. Both melanoma cell lines had abnormal karyotypes and were mitogen-positive. Though numerous chromosome changes were noted in the karyotypically abnormal melanoma cells, 6 of the 8 cultures exhibited abnormalities in chromosomes 1, 6, and/or 7. These data suggest that steps in the progression from benign nevi toward dysplastic nevi or malignant melanoma include: proliferation resulting from altered production of endogenous mitogenic growth factors; and development of specific chromosomal abnormalities.

Cells, Cultured↗
PubMed1990

Cytogenetic analysis of 147 cases of non-Hodgkin's lymphoma: non-random chromosomal abnormalities and histological correlations.

A prospective cytogenetic study of patients with non-Hodgkin's lymphoma (NHL) presenting to one institution was commenced in 1983 as part of a larger study including histology, immunophenotyping, cytokinetics and survival. 175 patients were studied over 5 years and G-banded karyotypes were successfully obtained in 147. Chromosome abnormalities were detected in 135 cases (92%) with the commonest abnormality being t(14;18)(q32;q21) in 69 cases. Other non-random translocations were much less frequent, i.e. t(11;14) in seven cases and t(8;14) in four cases. Other specific structural changes included partial deletions of 6q (breakpoints ranging within q13-q23), 3q (breakpoints ranging within q21-q27), 1q and 10q22. Chromosome regions highlighted as being frequently involved in structural abnormalities were 11q13-q25, 1p22-p36, 3q21-q27 and 6q13-q23. Several specific recurring breakpoints were identified and these included 14q32, 18q21, 1p36 and 6q21. Frequently occurring numerical abnormalities were gains of chromosomes 3, 7, X and 12. Correlation with histological type showed, as expected, that t(14;18) was present in 89% of follicular lymphoma but also occurred in 30% of diffuse lymphoma. Abnormalities of 11q were correlated with the diffuse histologies as a group, whereas both numerical and structural abnormalities of chromosome 3 correlated with the diffuse large cell lymphoma (DLCL) subtype, and t(11;14) with diffuse small cleaved cell lymphoma (DSCCL). Although not statistically significant, abnormalities of 6q occurred twice as frequently in DLCL than in any other variety. However, several other commonly occurring abnormalities, such as extra copies of chromosomes 7, X, 12 and most of the structural abnormalities of 1p, did not correlate with any histological type. Therefore this large cytogenetic study has confirmed some previously reported correlations between specific chromosome abnormalities and histological subtypes of non-Hodgkin's lymphoma and has also identified some new correlations which may prove useful in the investigation of the biological basis of the disease.

Chromosome Aberrations↗
PubMed2005

Laboratory performance measures: evidence against low-risk women explaining low detection rates of high-grade abnormalities.

OBJECTIVE: When a laboratory has a low reporting rate of high-grade abnormality for its cervical cytology specimens, the question arises whether this is due to the laboratory screening a low-risk group of women. This study was undertaken to explore the hypothesis that a low-risk group of women were screened by Victorian laboratories not meeting the recommended minimum standard for the detection of high-grade abnormalities. METHODS: A cohort of 28 094 women was established comprising women whose cervical cytology was reported in 2000 by laboratories not meeting the recommended standard of 0.5% high-grade abnormalities in their reporting of community smears. Outcome measures included the prevalence of high-grade abnormality on the next cytology test for the women, the positive predictive value of the cytology reports of high-grade abnormality, and the standardized incidence ratio for a later diagnosis of cervical cancer. RESULTS: The prevalence of high-grade abnormality was 0.36% on the index cytology compared with 0.68% on the first subsequent cytology report. Sixty-nine per cent (60/87) of the index cytology reports of high-grade abnormality were confirmed as high-grade abnormalities on histology, compared with 70.8% (121/171) for the first subsequent reports of high-grade abnormality. During 70 015 person-years at risk, nine cases of cervical cancer were observed compared with 5.21 expected cases, giving a standardized incidence ratio of 1.73 (95% CI 0.79-3.28). CONCLUSIONS: These results do not support a hypothesis that the low detection rate for high-grade abnormalities is due to the women comprising a low-risk group for cervical neoplasia.

Adolescent↗
PubMed1992

Electromyographic abnormalities in the urethral and anal sphincters of women with idiopathic retention of urine.

Previous concentric needle studies of the urethral sphincter in women with idiopathic urinary retention have found evidence of denervation and reinnervation as well as abnormal patterns of muscle fibre discharge--complex repetitive discharges (CRDs). In order to test the hypothesis that these abnormalities represented a more widespread disease process of pelvic floor function, we carried out an electromyographic (EMG) study of both anal and urethral sphincters in 18 women with idiopathic urinary retention. The urethral sphincter EMG was abnormal in 15 patients. These abnormalities included polyphasic and long duration potentials. Complex repetitive discharges were identified in 8 women. However, abnormalities of the anal sphincter were found in 14 of the 15 patients with abnormal urethral sphincter EMGs, polyphasic and abnormally long duration potentials being found in the anal sphincters of all 14 patients. In addition, 7 of the 8 women who had complex repetitive discharges in the urethral sphincters had similar complex repetitive discharges in their anal sphincters. Women with complex repetitive discharges had a significantly greater proportion of abnormal potentials than women with no such repetitive discharges. These results support the previous findings of electromyographic urethral sphincter abnormalities in women with idiopathic urinary retention, but also suggest that these abnormalities reflect a widespread disease process involving the pelvic floor in such patients.

Adult↗
PubMed1989

How much difference does chromosome banding make? Adjustments in prevalence and mutation rates of human structural cytogenetic abnormalities.

A collaborative analysis was undertaken of 226 karyotypes with structural chromosome abnormalities diagnosed primarily with low level banding resolution, about 300 to 400 bands per karyotype. We estimate that in this series, use of low level banding was required to detect about 78% of pericentric inversions, about 51% of reciprocal translocations, about 47% of all balanced translocations, about 35% of unbalanced rearrangements other than rings, Robertsonian translocations and extra structurally abnormal chromosomes, about 11% of all unbalanced rearrangements, and about 35% of all structural abnormalities. Adjustment factors derived from these figures were applied to prevalence and mutation rates of structural mutation rates derived from published large scale studies of livebirths. Had low level banding been used in these earlier studies we estimate that the rate of all structural abnormalities would have been about 60% higher than those reported (3.8 per 1000 vs. 2.3 per 1000 in the original studies). The increase is much higher for balanced abnormalities, 75% (3.4 per 1000 vs. 1.9 per 1000), than for unbalanced abnormalities, 5% (0.42 per 1000 vs. 0.405 per 1000). The increase in mutation rates for de novo cytogenetic abnormalities was similarly, considerably higher after such adjustment: the rates per 100,000 gametes increased from 18.0 to 35.0 for balanced rearrangements, from 8.2 to 10.1 for unbalanced abnormalities and from 26.2 to 45.1 for all abnormalities. These estimates illustrate the difference even low level banding makes to detection of structural cytogenetic abnormalities and why contemporary studies using such methods cannot be compared with earlier large scale population studies or livebirths without some type of adjustment such as those suggested here.(ABSTRACT TRUNCATED AT 250 WORDS)

Birth Rate↗
PubMed1998

Can women at risk of cervical abnormality be identified?

OBJECTIVE: To determine if use of a detailed risk factor profile accurately predicts the presence of cytological abnormality of the cervix or improves the appropriateness of referral for colposcopic assessment when women are found to have these abnormalities. DESIGN: Cross-sectional survey. SETTING: Family planning clinic. POPULATION: 1219 consecutive women, aged between 15 and 19 years, attending for contraceptive advice. Variables included age, social class, educational status, hormonal and obstetric history, smoking and alcohol habits, history of sexually transmitted diseases, the age of first intercourse, number of sexual partners, duration of each relationship, frequency of intercourse, contraception used and the age of each partner. MAIN OUTCOME MEASURES: Presence or absence of cytological abnormality and the presence or absence of histological abnormality in those with cytological abnormality referred for colposcopic assessment. RESULTS: Univariate analysis confirmed many of the known associations of cervical abnormality. Discriminant analysis identified five independent significant predictors of cytological abnormality and four independent predictors of dyskaryotic cytology. At best models, derived from identified variables correctly predicted 10.1% of individuals with cytological abnormality and 13.5% of those with dyskaryotic cytology. Of those referred for colposcopic assessment because of abnormal cytology, models were able to predict 23.5% of those with histological evidence of cervical intraepithelial neoplasia. CONCLUSIONS: Despite the availability of detailed information regarding the known correlates of cervical neoplasia in this age group, it was not possible to identify the majority of women with cervical abnormality. It is concluded that the strength of these associations is not sufficient to allow useful prediction of membership of a high risk group.

Adolescent↗
PubMed2005

Economic modelling of antenatal screening and ultrasound scanning programmes for identification of fetal abnormalities.

OBJECTIVE: Within the framework of a health technology assessment and using an economic model, to determine the most clinically and cost effective policy of scanning and screening for fetal abnormalities in early pregnancy. DESIGN: A discrete event simulation model of 50,000 singleton pregnancies. SETTING: Maternity services in Scotland. POPULATION: Women during the first 24 weeks of their pregnancy. METHODS: The mathematical model was populated with data on uptake of screening, prevalence, detection and false positive rates for eight fetal abnormalities and with costs for ultrasound scanning and serum screening. Inclusion of abnormalities was based on the relative prevalence and clinical importance of conditions and the availability of data. Six strategies for the identification of abnormalities prenatally including combinations of first and second trimester ultrasound scanning and first and second trimester screening for chromosomal abnormalities were compared. MAIN OUTCOME MEASURES: The number of abnormalities detected and missed, the number of iatrogenic losses resulting from invasive tests, the total cost of strategies and the cost per abnormality detected were compared between strategies. RESULTS: First trimester screening for chromosomal abnormalities costs more than second trimester screening but results in fewer iatrogenic losses. Strategies which include a second trimester ultrasound scan result in more abnormalities being detected and have lower costs per anomaly detected. CONCLUSIONS: The preferred strategy includes both first and second trimester ultrasound scans and a first trimester screening test for chromosomal abnormalities. It has been recommended that this policy is offered to all women in Scotland.

Chromosome Aberrations↗
PubMedDate not supplied

EEG abnormalities in children with a first unprovoked seizure.

We examined EEG findings from an ongoing study of 347 children with a first unprovoked seizure. EEGs were available in 321 (93%), and 135 (42%) had an abnormal EEG. EEG abnormalities included focal spikes (n = 77), generalized spike and wave discharges (n = 28), slowing (n = 43), and nonspecific abnormalities (n = 7). Abnormal EEGs were more common in children with remote symptomatic seizures (60%) than in those with idiopathic seizures (38%) (p < 0.003), more common in partial seizures (56%) than in generalized seizures (35%) (p < 0.001), and more common in children age > 3 years (52%) than in younger children (12%) (p < 0.001). Records including both awake and sleep tracings were available in 148 (46%) cases. For 122 (38%) only awake tracings and for 51 (16%) only sleep tracings were available. Fifty-nine (40%) of the 148 patients with both an awake and asleep tracing had abnormal EEGs. Of 50 such EEGs with epileptiform abnormalities, 15 (30%) demonstrated the abnormality either only while awake (n = 8) or only while asleep (n = 7). Of 17 patients with EEG slowing, 8 showed slowing only in the awake tracing and 9 showed slowing in both the awake and asleep tracing. Children with even a single unprovoked seizure have a high incidence of EEG abnormalities. Obtaining a combined awake and sleep EEG significantly increases the yield of EEG abnormalities. In children with an idiopathic first seizure, EEG abnormalities are associated with an increased risk of seizure recurrence.

Adolescent↗
PubMed2006

Magnetic resonance imaging abnormalities in right ventricular outflow tract tachycardia and the prediction of radiofrequency ablation outcome.

BACKGROUND: Recent reports have shown abnormalities on cardiac magnetic resonance imaging (MRI) in patients with right ventricular outflow tract (RVOT) tachycardia. OBJECTIVES: OBJECTIVES of this study were to demonstrate abnormalities on MRI and signal-averaged ECG (SAECG) in patients with RVOT tachycardia and their correlation with the outcome of radiofrequency (RF) ablation. METHODS: We studied 41 patients with symptomatic RVOT tachycardia and 15 controls. SAECG and cardiac MRI were performed on every subject. An evaluation of structural abnormality, chamber size, function, and wall motion abnormality of the left and right ventricle was performed by MRI. Focal wall thinning was evaluated by the black blood technique and fatty infiltration was evaluated by the T1 image with and without fat suppression. RESULTS: MRI abnormalities were demonstrated in 24 (58.5%) patients with RVOT tachycardia. The abnormalities included localized wall bulging in 22 (53.7%), focal wall thinning in 10 (24.4%), and fatty replacement in 9 (22%) patients. MRI abnormality was found in only one patient in the control group (P < 0.001). Late potentials from SAECG were demonstrated in six (10.7%) patients but none in the controls (P = 0.117). Among 29 patients who underwent RF ablation, 3 patients had a failed procedure and 3 having arrhythmia recurrence needed repeated ablation. MRI abnormalities and late potentials were associated with an unfavorable outcome of RF ablation. CONCLUSIONS: MRI abnormalities were frequently found in patients with RVOT tachycardia. MRI abnormalities and late potentials can predict outcomes of RF ablation.

Catheter Ablation↗
PubMed2000

Role of ERCP in asymptomatic orthotopic liver transplant patients with abnormal liver enzymes.

OBJECTIVE: The safety and efficacy of endoscopic retrograde cholangiopancreatography (ERCP) in the evaluation and management of biliary tract complications after orthotopic liver transplantation (OLT) have been previously demonstrated. However, the role of ERCP in evaluating asymptomatic OLT patients with abnormal liver enzymes with a previously normal biliary tree remains poorly defined. We sought to assess the utility of ERCP in this subset of patients. METHODS: A retrospective analysis of-asymptomatic OLT patients with abnormal liver enzymes evaluated by ERCP was undertaken. In addition to ERCP, all these patients had a diagnostic abdominal Doppler ultrasound, and a percutaneous liver biopsy. All patients had choledochocholedochostomy at the time of transplant and normal T-tube cholangiograms 3 months postoperatively. A radiologist, blinded to clinical findings, interpreted the ultrasound as normal, biliary dilation, or vascular abnormalities. The same radiologist interpreted ERCP findings. A pathologist, blinded to clinical findings, graded liver biopsies as normal, diagnostic, or abnormal but nondiagnostic. RESULTS: Twenty-two patients underwent 23 ERCPs. Twenty-two of the 23 ERCPs were normal (96%), and one abnormal ERCP finding did not explain the liver enzyme abnormality. Liver biopsy was diagnostic in 13 of 22 (57%) and in each case the ERCP was normal. The remaining 10 liver biopsies were abnormal but nondiagnostic. Ultrasound was abnormal in five of 22 cases, but in the three cases suggesting biliary dilation, the ERCP was interpreted as normal. CONCLUSION: Routine use of ERCP in evaluation of asymptomatic OLT patients with liver function test abnormalities and normal cholangiograms at 3 months was not diagnostically useful. In this subset of patients, liver biopsy was usually abnormal and frequently diagnostic and should be the initial invasive diagnostic procedure.

Adult↗
PubMed2006

Abnormal hepatic biochemistries in patients with inflammatory bowel disease.

OBJECTIVES: The relationship between abnormal hepatic biochemistries and inflammatory bowel disease (IBD) is unclear. We determined the prevalence of abnormal hepatic biochemistries and chronic liver disease in a cohort of IBD patients, and we compared patients with normal and abnormal liver biochemistries. METHODS: Patients with IBD evaluated at our institution between January 1, 2000 and December 31, 2000 were identified. Data on gender, age, IBD subtype, extent and activity, medications, liver disease history, liver biochemistries, and vital status were collected. The chi(2) test, Student's t-test, and Cox proportional regression were used. RESULTS: We identified 544 patients with available hepatic biochemistries. Abnormal hepatic biochemistries were found in 159 (29%). Defined chronic liver disease was present in 5.8% of patients (primary sclerosing cholangitis in 4.6%). The prevalence of abnormal hepatic biochemistries was 27% for those with active IBD and 36% for those in remission (P= 0.06). Patients with abnormal hepatic biochemistries were less frequently on 5-aminosalicylates (35%vs 51%, P < 0.001), and a smaller proportion was alive at last follow-up (90.4%vs 98.5%, P < 0.0001). The age-adjusted risk of death was 4.8 times higher in patients with abnormal hepatic biochemistries, after excluding patients with any diagnosis of liver disease. CONCLUSIONS: Abnormal hepatic biochemistries were present in nearly one-third of our patients, and surprisingly, they were not associated with IBD activity. Abnormal hepatic biochemistries and chronic liver disease appeared to have a negative impact on vital status. Persistently abnormal hepatic biochemistries should be evaluated, and not attributed to IBD activity.

Adolescent↗
PubMed2005

Relationship between radiographic abnormalities of lumbar spine and incidence of low back pain in high school rugby players: a prospective study.

The purpose of this study was to examine the relationship between prevalent radiographic abnormalities of the lumbar spine and the incidence of low back pain in high school rugby players. Three hundred and twenty-seven incoming high school rugby players (15-16 years of age) were recruited between 1986 and 1994. All of them underwent athletic physical examination before participation in high school athletics. The relationship between prevalent radiographic abnormalities of the lumbar spine in the pre-participation athletic physical examination and the incidence of low back pain during a 1-year period after the start of participation in athletics was analyzed. Radiographic abnormalities assessed were spondylolysis, disc space narrowing, spinal instability, Schmorl's node, balloon disc, and spina bifida occulta. The frequency of respective radiographic abnormalities was 15.6%, 13.1%, 32.7%, 14.1%, 11.6%, and 30.6%. Two hundred and forty-three players (74.3%) had at least one of these radiographic abnormalities. The incidence of low back pain was 44.0% in players with no such radiographic abnormalities and 41.2% in those with at least one radiographic abnormality. The incidence of low back pain in players with the respective radiographic abnormalities was 72.5%, 46.5%, 46.7%, 39.1%, 34.2%, and 41.0%, and only players with spondylolysis had a significantly higher incidence of low back pain than those with no radiographic abnormalities. This study shows that a radiographic abnormality, specifically spondylolysis, is a significant radiological risk factor for low back pain in high school rugby players.

Adolescent↗
PubMedDate not supplied

Coagulation abnormalities in 22 cats with naturally occurring liver disease.

Twenty-two cats with liver disease were evaluated for coagulation abnormalities including alterations in prothrombin time, activated partial thromboplastin time, thrombin time, factor VII activity, and platelet count. The purpose of the study was to determine the prevalence of coagulation abnormalities in this population of cats, classify abnormalities according to underlying pathogenesis, and determine if serum biochemical parameters typically used as indicators of liver disease showed any correlation with the coagulation abnormalities present. Study results indicated that at least 1 coagulation abnormality was present in 82% of the cats. Prolongation of prothrombin time was most common (16/22 cats) and factor VII activity was below reference range (< 60%) in 15 cats. When classified according to underlying pathogenesis, vitamin K deficiency was the most common abnormality found (11/22). Other abnormalities were less common and included hepatic synthetic failure (3/22), indeterminate (3/22), and disseminated intravascular coagulation (1/22). Increase in alkaline phosphatase (ALP) activity was the only biochemical abnormality that showed statistically significant correlation with coagulation abnormalities (P = .023). Cats with marked increases in ALP activity were more likely to have coagulation abnormalities than those with only mild increases in ALP activity.

Animals↗
PubMed1993

Breathing abnormalities in sleep in achondroplasia.

Overnight sleep studies were performed in 20 subjects with achondroplasia to document further the respiratory abnormalities present in this group. Somatosensory evoked potentials (SEPs) were recorded in 19 of the subjects to screen for the presence of brainstem abnormalities, which are one of the potential aetiological mechanisms. Fifteen children aged 1 to 14 years, and five young adults, aged 20 to 31 years were included. All had upper airway obstruction and 15 (75%) had a pathological apnoea index (greater than five per hour). Other sleep associated respiratory abnormalities, including partial obstruction, central apnoea, and abnormal electromyographic activity of accessory muscles of respiration, also showed a high prevalence. SEPs were abnormal in eight (42%), but there was no correlation between abnormal SEPs and apnoea during sleep, either qualitatively or quantitatively. A high prevalence of both sleep related respiratory abnormalities and abnormal SEPs in young subjects with achondroplasia was demonstrated. However, the sleep related respiratory abnormalities do not always result in significant blood gas disturbances or correlate with abnormal SEPs in this group.

Achondroplasia↗
PubMed1983

Natural history of cervical epithelial abnormalities in patients with vulval warts. A colposcopic study.

The natural history of intraepithelial abnormalities of the cervix associated with human papillomavirus infection was investigated in a prospective study of 50 women with vulval warts, of whom 28 had colposcopic evidence of a cervical epithelial abnormality and 22 a normal cervix. Of the 28 with a cervical abnormality, 26 were re-examined by colposcopy after three months; the epithelial abnormality had persisted in 23 women. Nineteen women who had initially shown abnormality by colposcopy were re-examined six months after their first attendance; the epithelial abnormality had persisted in 14 women. Of the 22 women who initially had a normal cervix, 19 were re-examined after three months; the cervix remained normal in 18, but an epithelial abnormality had developed in one. Fourteen women who initially had a normal cervix were re-examined six months after their first attendance; the cervix was still normal in 11, but an epithelial abnormality had developed in three. Colposcopically directed biopsy specimens were obtained from 21 women who showed an epithelial abnormality; of these, evidence of wart virus infection was present in four, cervical intraepithelial neoplasia in two, both conditions in 13, and no abnormality in two. It is concluded that lesions of the cervix associated with wart virus infection show little evidence of short term regression.

Adult↗