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PubMed1984

Fluorescence polarization in gastric aspirate and in amniotic fluid and its relationship to the respiratory distress syndrome.

Fluorescence polarization of diphenylhexatriene (DPH), added to amniotic fluid can be used to estimate fetal lung maturity. In this study we estimated the fluorescence polarization (FP) value of gastric aspirates of newborns and of amniotic fluids and studied the relationship between the FP value and neonatal lung function. Gastric aspirates of 51 newborns and amniotic fluids of 13 cases were mixed with a DPH-phosphate buffered saline solution and incubated for 30 minutes at 37 degrees C. Fluorescence polarization was measured at 22 degrees C. The FP values of amniotic fluid are in accordance with results previously found. A highly significant negative correlation was present between the FP value in amniotic fluid and gestational age. The highest FP values were found in amniotic fluids of infants in whom respiratory distress developed. The FP values of gastric aspirates decreased also with gestational age. A rather poor negative correlation, however, was found between these FP values and gestational age. We also noticed that, before the 36th week of gestation, the FP values in gastric aspirates tend to be lower than those in amniotic fluids. Both high and low FP values were estimated in gastric aspirates of infants with RDS and of infants without respiratory problems. These results show that the measurement of the FP value in gastric aspirates of newborns is not an useful method to determine whether the infant will develop RDS or not.

Amniotic Fluid↗
PubMed2001

Successful management of tracheotomized patients with chronic saliva aspiration by use of constant positive airway pressure.

OBJECTIVE: Management of chronic aspiration of saliva is a challenge to clinicians. The purpose of this report is to review the clinical course of 3 patients with tracheotomy who we have followed for at least 1 year and who have received constant positive airway pressure (CPAP) as a primary treatment for ongoing aspiration of saliva. METHODS: Retrospective chart review. RESULTS: We present here 3 patients with chronic congestion and persistent hypoxemia in whom a diagnosis of chronic aspiration of saliva was established by use of radionuclide salivagram. Each of these children had tracheotomy for treatment of airway obstruction. In an attempt to decrease chronic aspiration of saliva, we instituted constant positive pressure via tracheotomy. Repeat radionuclide salivagram performed on CPAP demonstrated a marked decrease in saliva aspiration. All patients experienced improvement in clinical symptoms and required only rare subsequent hospitalizations for respiratory disease. CONCLUSION: We suggest, based on this case series, that CPAP administered via a tracheotomy is an acceptable means of managing chronic salivary aspiration and that it may decrease respiratory complications in such patients.

Adult↗
PubMed2006

Fine-needle aspiration biopsy for breast lesions: a comparison between two devices for obtaining cytological samples.

CONTEXT AND OBJECTIVE: Fine-needle aspiration biopsy has been accepted worldwide for breast lesions. However, some questions remain, including the appropriateness of the puncture method. The objective of this work was to compare aspirates obtained by the auto-vacuum device and by the syringe pistol holder. DESIGN AND SETTING: Randomized trial for validation of diagnostic method, at Hospital das Clínicas da Universidade Federal de Goiás and Hospital Araújo Jorge, Goiânia. METHODS: 351 patients presenting breast lumps underwent fine-needle aspiration biopsy, either with the auto-vacuum device or the syringe pistol holder. A single cytopathologist analyzed all of the cytology slides. The rates of insufficient material, cellularity, cell distortion and background hemorrhage were evaluated. RESULTS: The percentages of insufficient material were 16% and 22% (p = 0.18), for the auto-vacuum and pistol aspirates, respectively. Good cellularity was seen in 34% of auto-vacuum and 29% of pistol samples (p = 0.4). Cell distortion was seen in 31 and 26 cases, respectively (p = 0.7). Background hemorrhage occurred in 63 (35%) and 54 cases (31%) (p = 0.2), for auto-vacuum and pistol. The sensitivity was 88% and 86%; specificity 99% and 100%, positive predictive value 96% and 100%, negative predictive value 96% and 95% and total accuracy 76% and 75% for the auto-vacuum and pistol, respectively. CONCLUSION: The results obtained from the two fine-needle aspiration biopsy methods were equivalent. Therefore, the auto-vacuum device is a good option for obtaining aspirates for cytology.

Adult↗
PubMed1980

Percutaneous aspiration of retroperitoneal lymph nodes in ovarian cancer.

Nine percutaneous lymph node aspirations were performed on six patients with ovarian carcinoma. Two aspirations were performed for initial staging, while seven were done as part of the restaging evaluation. Seven of the aspirations were positive for tumor. Two aspirations were negative, one of which was surgically confirmed. In five instances the percutaneous aspiration saved the patient an operative procedure. Percutaneous lymph node aspiration is valuable when tissue is required to confirm metastatic disease during staging evaluation, especially with equivocal or atypical lymphograms. The procedure is also useful in assessing abnormal lymphograms that persist after therapy.

Adenocarcinoma↗
PubMed1986

Negative bone scans of joints after aspiration or arthrography: experimental studies.

It has long been suspected anecdotally that needle aspiration or contrast arthrogram before bone scan may cause a false-positive bone scan. This dictum often directs the sequence of events in the clinical workup of joint disease, yet data to support or refute this are lacking. This study was undertaken to generate such data. Fifty-six joints in mature dogs were examined, including hips, knees, elbows, and shoulders. The joints were examined in pairs; one joint was injected with Conray 60 for an arthrogram, and the contralateral joint was injected with an equal volume of normal saline to simulate a joint aspiration. Confirmation of needle placement and injection into the joints was made with fluoroscopic and digital subtraction imaging. Numbers of attempts required for aspiration and quantity of contrast material extravasated were noted for each joint. Baseline 99mTc-HDP or 99mTc-MDP bone scans were done before the experimental joint aspirations, with follow-up scans at 24 and 96 hr. The scans showed no significant change from baseline after either needle aspiration or arthrogram. When the diagnostic workup suggests the need for such a procedure, it should be performed. In contradiction to popular belief, joint aspiration and/or arthrogram did not affect a subsequent bone scan.

Animals↗
PubMed1995

Treatment of pelvic abscesses: value of one-step sonographically guided transrectal needle aspiration and lavage.

OBJECTIVE: The percutaneous treatment of pelvic abscesses has traditionally involved the placement of drainage catheters via a transgluteal, transrectal, or transvaginal route. These procedures are painful and prolonged. The goal of this study was to demonstrate the effectiveness of a one-step, single-puncture method for draining pelvic abscesses by use of a transrectal sonographically guided needle for aspiration and lavage instead of a two-step Seldinger technique for catheter placement. SUBJECTS AND METHODS: Thirty-three pelvic abscesses in 24 patients were drained by use of transrectal ultrasound guidance. All abscesses were initially seen on transrectal sonograms or CT scans and ranged from 2 to 11 cm in diameter. Abscesses were located in the prostate (n = five), seminal vesicles (n = five), pouch of Douglas (n = 21), and interloop (between bowel loops) (n = two). Causes of pouch of Douglas (cul-de-sac) abscesses included appendicitis (n = two), Crohn's disease (n = two), diverticulitis (n = three), trauma (n = six), HIV infection (n = two), complications of sigmoidectomy (n = one), complications of colectomy (n = one), pelvic inflammatory disease (n = two), and severe prostatitis (n = two). Interloop abscesses were attributable to HIV infection (n = one) and lymphoma (n = one). The procedure was performed without a cleansing enema or local anesthesia and required less than 30 min. An 18-gauge needle was inserted transrectally into the abscess cavity under transrectally guided sonography. The fluid collection was completely aspirated, and the cavity was lavaged with saline. Administration of antibiotics for 7-21 days, rather than prolonged catheter drainage, was used to treat residual infection. Resolution was documented after 7 days by sonography or CT examination. RESULTS: Transrectal aspiration was successful in treating 28 (85%) of the 33 pelvic abscesses in 21 (88%) of the 24 patients. Failure occurred in three patients, two with multiple abscesses and one with an enteric fistula for whom surgical drainage was subsequently required. The volume of aspirates ranged from 5 to 220 ml. There were no complications. CONCLUSION: Transrectal sonographically guided needle aspiration-lavage offers a one-step method for treating pelvic abscesses that does not require catheter placement or prolonged drainage. The procedure produces minimal discomfort and essentially no complications. Our results show that transrectal sonographically guided needle aspiration combined with antibiotic therapy is an effective treatment for pelvic abscesses.

Abscess↗
PubMed1997

The role of aspiration and contrast-enhanced arthrography in evaluating the uncemented hip arthroplasty.

OBJECTIVE: The purpose of this study was to determine the value of aspiration and contrast-enhanced arthrography in evaluating uncemented total hip arthroplasty components. A retrospective study was performed to determine the sensitivity, specificity, and accuracy of these procedures. MATERIALS AND METHODS: Preoperative aspiration of the hip joint and contrast-enhanced arthrography were performed by a skeletal radiologist in 33 hips with uncemented components before exploration or revision. In one patient, the hip aspiration yielded grossly purulent fluid and arthrography was not performed. Twenty-one uncemented acetabular components and 29 uncemented femoral components were evaluated by arthrography. The aspiration of the hip provided fluid for culture in 33 hips; in one hip, no fluid could be obtained. RESULTS: A preoperative diagnosis of infection based on growth on solid media was made in five hips (15%). An additional infection was determined to be present in the hip in which no fluid was obtained when purulent fluid was found at operation. On the basis of the operative findings, contrast-enhanced arthrography of the 21 acetabular components had a sensitivity of 50%, a specificity of 77%, and an accuracy of 68%. Arthrography of the 29 femoral components had a sensitivity of 63%, a specificity of 64%, and an accuracy of 63%. CONCLUSION: Aspiration of the hip joint before revision of uncemented hip arthroplasties was valuable because the diagnosis of infection was made preoperatively in five of six hips. However, contrast-enhanced arthrography was not valuable, with a low sensitivity and specificity for both uncemented acetabular and uncemented femoral components. Only a preoperative aspiration of the hip joint is recommended before revision of uncemented components.

Cementation↗
PubMed1999

Surveillance CT and the prompt use of CT-guided fine-needle aspiration in patients with head and neck cancer who have undergone surgery.

OBJECTIVE: The purpose of this study was to assess the usefulness of prompt CT-guided fine-needle aspiration in the evaluation of suspected tumor recurrence seen on surveillance images of patients who had undergone surgery for head and neck cancer. SUBJECTS AND METHODS: We reviewed 32 patients who had undergone CT-guided fine-needle aspiration after surgery for head and neck cancer. CT-guided fine-needle aspiration was performed with a 22-gauge spinal needle and a cytopathologist was present to assess the adequacy of the biopsy sample. As many as five needle passes were made. RESULTS: Of the 32 cases, pathologic findings revealed squamous cell carcinoma (n = 27), mucoepidermoid carcinoma (n = 2), neuroendocrine carcinoma (n = 1), papillary thyroid carcinoma (n = 1), and adenocarcinoma (n = 1). In 20 cases (62.5%) the results of CT-guided fine-needle aspiration were positive for tumor recurrence, whereas in 11 cases (34.4%) the results were negative. In one case (3.1%) the results were nondiagnostic. Of the 11 patients with negative findings on CT-guided fine-needle aspiration, two patients had a subsequent recurrence that was not at the biopsy site. There were no complications from the procedure. CONCLUSION: When a radiologist who is trained in head and neck imaging identifies with CT a possible early recurrence of tumor, the prompt use of CT-guided fine-needle aspiration is an effective way to diagnose these tumors so that appropriate treatment can be initiated.

Adult↗
PubMed2000

Cervical osteophytes impinging on the pharynx: importance of size and concurrent disorders for development of aspiration.

OBJECTIVE: This study evaluated the clinical significance of cervical osteophytes impinging on the pharynx in patients with dysphagia and the importance of concurrent disorders that may affect swallowing function. MATERIALS AND METHODS: On videofluoroscopy, anterior cervical osteophytes were found in 55 (32 men, 23 women; mean age, 69 years) of 3318 patients with dysphagia (1.7%). Coexisting diseases that affected swallowing function were found in 28 patients (stroke, n = 7; thyroidectomy, n = 7; tongue base or laryngeal cancer surgery, n = 5; other diseases, n = 9). Swallowing function was assessed with videofluoroscopy evaluating epiglottic tilting, laryngeal closure, impression of the hypopharynx, pharyngeal residue, and aspiration. RESULTS: With advancing age, the probability of aspiration (odds ratio, 1.07; p < 0.05) and of enlarging osteophytes (odds ratio, 1.26; p < 0.01) increased; the probability was higher for osteophytes at more than one vertebrae (odds ratio, 8.00; p < 0.01) and for concurrent diseases (odds ratio, 8.02; p < 0.01). Aspiration was found in 75% of patients with osteophytes larger than 10 mm and in 34% with osteophytes smaller than or equal to 10 mm. In 88% of patients with small osteophytes who aspirated, other diseases affected swallowing function. CONCLUSION: Aspiration is common in patients with dysphagia and cervical osteophytes larger than 10 mm. Aspiration is rare in patients with osteophytes smaller than or equal to 10 mm unless these patients suffer from other disorders that may affect swallowing.

Cervical Vertebrae↗
PubMedDate not supplied

[Sequential microbiological monitoring of tracheal aspirates in intubated patients admitted to a pediatric intensive care unit].

OBJECTIVE: To evaluate, sequentially, tracheal aspirates from patients admitted to a pediatric intensive care unit and to associate these pathogens with length of hospital stay, previous use of antimicrobial therapy and diagnoses of ventilator-associated pneumonia. METHODS: The study population consisted of patients admitted to a pediatric intensive care unit, between November 2002 and December 2003, on ventilator support. Three tracheal aspirates were collected serially from each patient. The first tracheal aspirate sample was obtained 6 hours after admission to the intensive care unit and the remaining samples were collected after 48 and 96 hours. RESULTS: One hundred patients aged from one day to 14 years were assessed. Positive tracheal cultures were observed to have increased in the three tracheal aspirate samples collected from each patient for Pseudomonas aeruginosa, from 6 to 22% (p = 0.002), and to have decreased for Staphylococcus aureus, from 23 to 8% (p = 0.009). Isolation of Candida spp increased for the subset that had received previous antimicrobial therapy (p < 0.05). Sixteen (23.5%) out of 68 patients admitted without pneumonia developed ventilator-associated pneumonia. Positive tracheal aspirate cultures were obtained in 10 out of 16 of these patients: six were positive for Staphylococcus aureus (three associated with Acinetobacter baumanii), two for Klebsiella spp (one associated with Enterobacter spp), one for Pseudomonas aeruginosa and one for Candida spp. CONCLUSION: Sequential evaluation of tracheal aspirates may be useful to track changes in bacterial flora at pediatric intensive care units.

Adolescent↗
PubMed2006

Field efficacy of the BG-Sentinel compared with CDC Backpack Aspirators and CO2-baited EVS traps for collection of adult Aedes aegypti in Cairns, Queensland, Australia.

In this study, we compared the efficacy of the newly available BG-Sentinel with an established "gold standard,", the CDC Backpack Aspirator, and a CO2-baited EVS trap for the collection of Aedes aegypti (L.) in Cairns, Australia. BG-Sentinels collected significantly more (P = 0.017) female Ae. aegypti (mean per collection, 1.92 +/- 0.39) than both the CDC Backpack Aspirator (1.00 +/- 0.35) and the EVS trap (0.71 +/- 0.27). Male-only and combined male-female Ae. aegypti collections for th BG-Sentinel and the CDC Backpack Aspirator were also greater than EVS trap collections. The CDC Backpack Aspirator and the BG-Sentinel captured proportionally fewer females compared with the EVS trap. The BG-Sentinel was the most Ae. aegypti specific collection method. The CDC Backpack Aspirator collected proportionally more bloodfed Ae. aegypti than the other methods, which collected a greater proportion of nullipars. The data presented here will aid researchers in deciding what Ae. aegypti sampling device best suits their needs. BG-Sentinels and CDC Backpack Aspirators should be considered as alternatives to human-bait collections for Ae. aegypti sampling.

Aedes↗
PubMed1986

Fine needle aspiration in studies of thyroglobulin (Tg). Iodothyronine and iodine contents of Tg from patients with multinodular euthyroid goitre.

Fine needle aspiration from the thyroid gland was performed in 10 patients with multinodular euthyroid goitre. This was done to evaluate the possibility of obtaining sufficient quantities of thyroglobulin by this procedure to allow biochemical characterization. For comparison aspiration from normal thyroid tissue was performed in seven subjects during operation for solitary thyroid lesions (cancer or cysts). The total amount of Tg in aspirate was, goitre 666 +/- 171 micrograms (mean +/- SE), normal 177 +/- 52 micrograms; purified Tg contained, goitre vs. normal: iodine 9.1 +/- 2.2 vs. 26 +/- 3.9; T4 0.86 +/- 0.39 vs. 4.0 +/- 0.7; T3 0.080 +/- 0.024 vs. 0.28 +/- 0.06 mol/mol Tg (all significantly different), compatible with iodine deficiency pattern in Tg from the patients with goitre. Similar values were obtained if iodine and iodothyronines were measured in crude aspirate (after alkaline ashing and pronase hydrolysis, respectively) and related to the amount of Tg in aspirate measured by radioimmunoassay; thus avoiding the cumbersome purification of Tg. Hence fine needle aspiration of the thyroid can be used to obtain Tg for biochemical analyses. This considerably facilitates Tg studies in humans for clinical or investigative purposes.

Adult↗
PubMed1989

Estrogen receptor enzyme immunoassay in fine-needle aspirates from human breast cancer.

An enzyme immunoassay was compared with a radioligand assay (isoelectric focusing) for estrogen receptor (ER) determination in 100 preoperative fine-needle aspirates from human breast cancer. A strong correlation (rs = 0.85) between the two estimates was found. However, ER estimates by enzyme immunoassay were 6 times higher than with isoelectric focusing, mainly due to an underestimation of ER content with the latter method in highly blood-contaminated or diluted samples. Enzyme immunoassay provided adequate ER measurement even at very high (50%) blood admixture. To study the reliability of ER measurement with enzyme immunoassay in fine-needle aspirates, a comparison was made with estimates in the corresponding surgical biopsies (65 cases). With DNA as reference parameter a significant correlation (rs = 0.68) was obtained. Excluding aspirates with low cellularity (less than 50,000 cells/ml), only one ER negative fine-needle aspirate was found among 47 ER positive surgical biopsies. A few ER positive aspirates corresponded to ER negative surgical biopsies possibly due to tumour heterogeneity or the fact that fine-needle aspiration sometimes may represent a better sampling technique than surgical biopsy.

Biopsy, Needle↗
PubMed2006

Fine needle aspiration biopsy of thyroid nodules in children and adolescents.

Thyroid nodules are uncommon in children and adolescents compared with adults, but the risk of malignancy is much higher. In adults, fine needle aspiration biopsy (FNAB) has been used extensively to select patients for surgical exploration with a high degree of reliability. The purpose of this study was to assess the utility of FNAB for the management of thyroid nodules in children and adolescents. We reviewed our experience with 60 FNABs of thyroid nodules in 51 children and adolescents. Of the 60 aspirates, 45 aspirates (74%) were diagnosed as "benign", 5 aspirates (8%) as "suspicious for malignancy", and 6 aspirates (10%) as "malignant", and 4 aspirates (7%) as "unsatisfactory". Thyroidectomy was performed in 17 patients, and 5 with a cytological diagnosis of "benign" revealed nodular hyperplasia in three and follicular adenoma in two; 5 with a cytological diagnosis of "suspicious" revealed nodular hyperplasia in one, follicular adenoma in two, and papillary carcinoma in two; and 6 with a cytological diagnosis of "malignant" revealed papillary carcinoma. One patient with a cytological diagnosis of "unsatisfactory" revealed papillary carcinoma. The diagnostic accuracy was 81% with 100% sensitivity and 63% specificity. The positive and negative predictive values of FNAB were 73% and 100%, respectively. We conclude that FNAB is a good screening test for thyroid nodules in children and adolescents because of its high sensitivity.

Adolescent↗
PubMedDate not supplied

Fine-needle aspiration of thyroid nodules: past, present, and future.

OBJECTIVE: To present a review of the traditional and more recent techniques and applications of thyroid fine-needle aspiration biopsy. METHODS: We describe the cytologic features and differential diagnoses of various thyroid lesions, outline recommendations for diagnostic categories, and discuss new techniques that have shown some promise in the diagnosis of thyroid nodule fine-needle aspiration specimens. RESULTS: Fine-needle aspiration biopsy of the thyroid has proved to be an excellent diagnostic tool in the initial management of thyroid nodules. Numerous studies have shown its high sensitivity and specificity in diagnosing malignant tumors of the thyroid, especially papillary thyroid carcinoma. As with other diagnostic tests, however, its effectiveness is highly dependent on the expertise of the operator performing the procedure and the adequacy of the specimen for interpretation of the cytomorphologic features. On-site evaluation of thyroid specimens promotes adequate specimen sampling and reduces the incidence of nondiagnostic specimens. Diagnostic reports on thyroid fine-needle aspiration should include patient demographics and pertinent clinical history, site and size of the thyroid nodule, mode of aspiration, number of needle passes, assessment of specimen adequacy, diagnosis, and recommendations. Although immunohistochemical and molecular markers have received considerable attention recently, additional studies are needed before they can be used to separate benign from malignant follicular thyroid lesions. CONCLUSION: Overall, fine-needle aspiration biopsy of thyroid nodules has proved to be sensitive, specific, and well accepted by patients because of minimal discomfort and complications.

Biopsy, Fine-Needle↗
PubMed2004

Comparison of needle core biopsy and fine-needle aspiration for diagnostic accuracy in musculoskeletal lesions.

CONTEXT: Needle core biopsy has been reported to be the choice of biopsy for musculoskeletal tumors. Fine-needle aspiration, on the other hand, has been widely accepted for nonmusculoskeletal tumors, but is only used in selected medical centers for musculoskeletal tumors. While fine-needle aspiration appears to have advantages to needle core biopsy in the aspects of simplicity and cost, the diagnostic accuracy should be the most critical parameter in determining the choice of biopsy. However, few studies comparing the diagnostic accuracy of these 2 biopsy methods have been performed. OBJECTIVE: This study was designed to compare the diagnostic accuracy of fine-needle aspiration and needle core biopsy in musculoskeletal tumors. DESIGN: Prospective study was performed in patients aged 10 years or older. Diagnostic accuracy was compared in 50 consecutive concurrent needle core biopsies and fine-needle aspirations of musculoskeletal lesions. RESULTS: For primary musculoskeletal lesions, fine-needle aspiration achieved a diagnostic accuracy rate of 88% for nature of lesion, 64% for specific diagnosis, 78% for histologic grading, and 74% for histologic typing. Needle core biopsy achieved an accuracy rate of 93% for nature of lesions, 83% for specific diagnosis, 83% for histologic grading, and 90% for histologic typing. Both biopsy methods have a higher diagnostic accuracy rate for high-grade tumors than for low-grade or benign lesions in determining the nature, specific diagnosis, and histologic grading. CONCLUSIONS: The needle core biopsy has a higher diagnostic accuracy than fine-needle aspiration in all aspects, including determining the nature of the tumor, establishing the histologic type and grade, and achieving a specific diagnosis.

Adolescent↗
PubMed1995

Continuous aspiration of subglottic secretions in preventing ventilator-associated pneumonia.

OBJECTIVE: To determine whether continuous subglottic aspiration prevents nosocomial pneumonia in mechanically ventilated patients. DESIGN: A randomized, controlled, blinded study. SETTING: Medical-surgical intensive care unit. PATIENTS: 190 patients who were admitted to the intensive care unit during a 33-month period and whose condition suggested the need for prolonged intubation (> 3 days). INTERVENTION: 76 patients were randomly allocated to receive continuous aspiration of subglottic secretions, and 77 control patients were allocated to receive usual care. MEASUREMENTS: The numbers of cases of ventilator-associated pneumonia, ventilated days, days in intensive care unit, and deaths were recorded. The amount of subglottic secretions aspirated daily and surveillance cultures in the subglottic secretions were also obtained periodically. Etiologic diagnosis was based on the quantitative culture of secretions obtained by protected specimen brush or bronchoalveolar lavage. RESULTS: The incidence rate of ventilator-associated pneumonia was 19.9 episodes/1000 ventilator days in the patients receiving continuous aspiration of subglottic secretions and 39.6 episodes/1000 ventilator days in the control patients (relative risk, 1.98; 95% CI, 1.03 to 3.82). This difference was due to a significant (P < 0.03) reduction in the number of gram-positive cocci and Haemophilus influenzae organisms in the patients receiving continuous aspiration. However, no differences were observed in the number of Pseudomonas aeruginosa or Enterobacteriaceae organisms. Episodes of ventilator-associated pneumonia occurred later in patients receiving continuous aspiration (12.0 +/- 7.1 days) than in the control patients (5.9 +/- 2.1 days) (P = 0.003). The same microorganisms isolated from protected specimen brush or bronchoalveolar lavage cultures in patients with ventilator-associated pneumonia were previously isolated from cultures of subglottic secretions in 85% of cases. No significant differences in outcome were found. CONCLUSIONS: The incidence of nosocomial pneumonia in mechanically ventilated patients can be significantly reduced by using a simple method that decreases the chronic microaspirations through the cuff of endotracheal tubes.

Aged↗
PubMed1977

Fine-needle aspiration cytology in the preoperative diagnosis of thyroid nodules.

Fifty consecutive patients were studied to assess the utility of fine-needle aspiration cytology for the diagnosis of hypofunctioning thyroid nodules. In two patients, cysts were evacuated and did not recur. Thirty-three patients underwent excisional biopsy; the aspiration biopsy result was not a criterion for surgery. Satisfactory aspiration specimens were obtained in 32 patients (97%). The diagnosis in nine aspiration specimens was malignant; of these seven (78%) were correct and there was one false-positive and one occult carcinoma unrelated to the clinically detected nodule. Five aspirations showed suspected malignancy; of these, two were carcinoma, one was an occult carcinoma, and two were benign. Eighteen aspirations were interpreted as benign; of these, 17 (94%) were correct and the one false-negative diagnosis was a well-differentiated follicular carcinoma. The procedure is useful in assessing the need for surgery in high-risk patients and in selecting patients for thyroid-suppression therapy.

Adult↗