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PubMed2026

Is random biopsy necessary for normal esophageal mucosa during chromoendoscopy? Evidence from a population-based cohort study.

BACKGROUND: Esophageal squamous intraepithelial neoplasia could be detected in normally stained mucosa under Lugol's chromoendoscopy. We aim to determine whether an active biopsy should be performed on such mucosa. METHODS: This study was based on a population-based screening cohort where participants underwent Lugol's chromoendoscopy with biopsies taken from abnormal-unstaining areas and normally stained standard site. A total of 641 participants with esophageal squamous intraepithelial neoplasia or more severe lesions were included in the analysis. The cumulative incidence of high-grade intraepithelial neoplasia/esophageal squamous cell carcinoma (HGIN/ESCC) and ESCC-specific mortality were compared between participants biopsied from iodine unstained and stained areas. Additionally, paired eligible tissues were utilized for comparative genomic analysis. RESULTS: For participants diagnosed with low-grade intraepithelial neoplasia (LGIN), HGIN, and ESCC, 292 (54.8%), 11 (14.9%), and 1 (2.9%) cases, respectively, were biopsied from normal-staining mucosa. Over a median 9.5-year follow-up, no incident HGIN/ESCC cases were identified among individuals with LGIN diagnosed from normal-staining esophageal mucosa. In contrast, LGIN cases detected in unstained lesions exhibited a cumulative incidence of HGIN/ESCC of 15.8 (95% CI, 11.4-21.0) per 100 persons. No ESCC-related deaths occurred in patients having normal-staining lesions, irrespective of pathological grade. Contrastingly, cumulative ESCC-specific mortality per 100 persons for LGIN, HGIN, and ESCC patients of unstained lesions were 2.1 (95% CI, 0.7-4.8), 14.3 (95% CI, 6.7-25.4), and 36.4 (95% CI, 20.4-54.9), respectively. Genomic analysis revealed minimal copy number variants in normally stained lesions compared to substantial alterations in unstained lesions. CONCLUSIONS: Random biopsies of normally stained esophageal mucosa under Lugol's chromoendoscopy should be unnecessary for population-level ESCC screening.

Humans↗
PubMedDate not supplied

[Aberrant pancreas: description of a clinical case and review of the literature].

Aberrant pancreas is a rare finding pathology. Authors reviewed this problem after their personal observation of a specific case, pointing out the behaviour of the disease, particularly the difficult for a careful preoperative diagnosis. They also point out the necessity to make a diagnosis of "suspect" in presence of a symptomatology with the referred characters and when there aren't instrumental findings for evident pathologies.

Adolescent↗
PubMedDate not supplied

[Problems of ethics, deontology and esthetics in pathology practice].

Relationships between pathologists on the one hand and clinicians, patients asking for histological slides, relatives of the deceased persons on the other are extremely complicated and need special attention. Pathology service should not be considered as second-rate. Ethic problems in the pathology service are not yet properly dealt in the literature.

Esthetics↗
PubMed1997

Impulsivity in pathological gambling: the antisocial impulsivist.

The construct of impulsivity has to date remained relatively unexplored in the pathological gambling literature. This is in spite of recent claims suggesting that impulsivity may be an important feature characterizing a subgroup of pathological gamblers who are claimed to suffer from a Multi-Impulse Personality Disorder. The present study examined the potential role of impulsivity using the Eysenck Impulsivity Scale among 115 pathological gamblers. Results indicate that heightened impulsivity is associated with the degree of severity of psychological and behavioural change in pathological gamblers. However, the findings also indicate that impulsivity closely mirrors components contained in Eysenck Personality Questionnaire Psychoticism Scale, the California Personality Inventory Socialization Scale and DSM-III Antisocial Personality Disorder. This is manifest both in terms of high intercorrelations between the measures of psychopathy and impulsivity and in their predictive relationship to the level of psychological distress suggesting a uniform impulsivity/psychopathy construct. Thus, the research supports a model of pathological gambling in which the severity of associated behavioural and psychological disturbance is mediated by a impulsivity/ psychopathy construct.

Adolescent↗
PubMedDate not supplied

[Adenomyomatosis of the gallbladder. Personal experience and analysis of the literature].

Gallbladder adenomyomatosis is a pathological condition due to parietal thickening and intramural diverticulosis. Though it has always been considered a hyperplastic benign disease, the possibility of malignant transformation is currently admitted. Through an analysis of their personal experience and of the relevant literature, the authors draw attention to anatomical and clinical features, diagnostic interpretations and up-to-date trends in the therapy of this condition. Over the period from 1990 to 2001, 13 patients with adenomyomatosis of the gallbladder were observed, amounting to 4% of all cholecystectomies performed over the same period. According to the extent of the disease three forms have been identified: diffuse (26%), segmental (26%) and localized (48%). The clinical presentation appears to be mainly conditioned by the frequent association with gallstones (84%), and for this reason ultrasonographic features were commonly interpreted as being signs of chronic inflammation or suspected neoplasia, though retrospective ultrasound evaluation revealed pathognomonic signs of gallbladder adenomyomatosis. Indications to surgery were therefore mainly based upon the presence of stones and chronic inflammation. Cholecystectomy is currently also indicated in symptomatic cases of non-lithiasic gallbladder adenomyomatosis, whereas there appears to be no such clear-cut rule for the treatment of asymptomatic cases. Nevertheless, prophylactic laparoscopic cholecystectomy may be justified considering the evolution, the uncertain nature of the disease and the difficult differential diagnosis versus malignant lesions.

Adenomyoma↗
PubMed1982

Personality styles, manifest needs, and the perception of time in college women.

Reports the continued development of a multivariate theory of personality styles and a scale, the Multivariate Personality Inventory, designed to measure these styles in both pathological and normal populations. In a sample of college women, theory-generated predictions of the manifest needs of each personality style were examined with the Edwards Personal Preference Schedule. Results supported the validity of the Multivariate Personality Inventory in regard to the need profile of each personality style group. To examine the relationship between the personality styles and behavior, a series of time estimation measures also were employed.

Adult↗
PubMed2000

Dealing with doubt. How patients account for non-specific chronic low back pain.

OBJECTIVE: To explore the ways that persons with long standing chronic low back pain respond to the problem of medical doubt about the presence of organic pathology. METHOD: Qualitative analysis of accounts provided by 12 persons attending a back pain rehabilitation clinic in NW England. RESULTS: Subjects rejected the notion that they were culpable for their pain. They were not culpable for the onset of their pain. They argued that despite their cooperation, no sensible explanation of their pain was forthcoming from health professionals. Finally, they asserted that medical scepticism had been damaging and dispiriting. CONCLUSION: Patients dealt with clinical doubt by stressing their own expertise. They constituted their beliefs about the cause and trajectory of their pain and disability as accurate accounts of their disability. They resisted the suggestion that there might be psychological factors involved in their ill-health by locating culpability among clinicians, who were confused or uncertain about diagnosis and treatment.

Adult↗
PubMed2002

Influence of war circumstances on tumor morphological characteristics in patients with breast cancer.

The influence of war circumstances on tumor morphological characteristics in patients with breast cancer has not been studied up to now. The aim of this study is to investigate if war circumstances have influenced breast cancer incidence. The study covered both the patients in which during a period of observation a breast cancer was diagnosed as well as those who died of the same disease in the same period. Three sources of data were used: 1) The archives of the Oncology and Radiotherapy Center of the University Hospital "Split" (UHS): hospital data of 768 patients were reviewed. The war sample consisted of 380 patients aged 59.4+/-12.1 (31 to 86) (including 5 males), whereas the pre-war sample was made up of 388 patients aged 58.4+/-12.7 (19 to 88) (including 3 males); 2) Register of death of the Pathology Department of UHS with 162 analyzed persons whose death was caused by breast cancer in the six-year period between 1988 and 1993. The list of 162 dead patients included 79 people who died from breast cancer diagnosed in that period (1988-1993) and another 83 people that had been diagnosed before that period; 3) The biopsy register of the Pathology Department of UHS with 851 breast biopsies performed between 1988 and 1993. Breast cancer is predominantly a female illness (99.1%). The war circumstances influenced the of T, N and M rate. The rate of N2, N3, Ml were conspicuously higher in the war period. There were significantly more malignant histological diagnoses found in new patients and also significantly more patients died due to breast cancer. Stress and other war circumstances undoubtedly have a negative impact on the numerous markers of breast cancer which we have proved in this study.

Adult↗
PubMed1989

[The psychotic component of so-called normal parents].

Working with very young children who are placed, on a part-time basis, in a facility affording associated psychoanalytical treatment, points up special parent-child relationships. For children showing personality structures of a psychotic nature, these relationships coincide with the psychic core of the parent's personality structure. This is a very real pathological "meeting of the minds" that partoof the therapeutic treatment is based on.

Child Development Disorders, Pervasive↗
PubMed1993

Delivery systems for the care of persons with HIV infection and AIDS.

HIV infection and AIDS are pathologic conditions that more than any other disease require the concerted, cooperative efforts of the health care profession and the community. This article discusses the development of delivery systems for the care of persons with HIV infection and AIDS, highlights what systems have been successful, and indicates the areas in which further research and development are needed. Topics discussed include the costs of care; identifying and meeting the specific health care needs of the HIV-infected population; and long-term, community-based, hospice, and hospital care.

Acquired Immunodeficiency Syndrome↗
PubMed1982

Effect of experimental anxiety on behaviour.

One of the variables capable of significantly affecting personality behaviour under normal conditions and in pathology is anxiety. The theses submitted here are supported by arguments derived from the results of experiments carried out at the Institute of Experimental Psychology, Slovak Academy of Sciences, Bratislava. Anxiety significantly affects the activity of cognitive processes. Cognitive processes are often affected by anxiety indirectly through enhanced uncertainty, limitation of choice of responses, or inadequate reactions. The personality of an anxious S is characterized by such patterns of behaviour that may contribute, in the form of risk factors, to the onset of cardiac disorders.

Adolescent↗
PubMed1983

[Dynamics of intellectual mnestic disorders in alcoholism].

Thirty alcoholic patients with remissions and one hundred alcoholics with relapses were followed up for three years using cross-section and longitudinal psychological examinations. The development of the psychic defect was shown to be related to the degree of personality degradation and the character of organic cerebral pathology. The patients with remissions displayed a greater reversibility of intellectual and mnemonic derangements; there was improvement in their memory and concentration levels as well as combinative abilities; their personal attitude to the study situation changed favourably. The patients with relapses in the course of disease were characterized by deteriorated capacities for memorization, analytic and synthetic mental processes as well as by increased exhaustibility, anxiety, and affective instability. Intellectual and mnemonic disorders in patients with alcoholic dementia were the least reversible.

Alcohol Amnestic Disorder↗
PubMed1988

[Disorders of purine metabolism as an etiological factor in renal pathology].

Of 3200 patients admitted to the nephrology department within several years, hyperuricemia was detected in 696. Excluding from this number persons with signs of chronic renal insufficiency (146 persons) and patients who were treated by diuretics (89), the frequency of hyperuricemia was 16.2% which exceeded almost 2-fold (9.2%) the value determined during the examination of 594 healthy persons. The authors discussed a possibility of early development of renal pathology in purine metabolic derangement with hyperuricosuric and hyperuricemic stages characterized by certain clinical peculiarities, including a possibility of development of immune complex nephritis.

Arthritis, Gouty↗
PubMedDate not supplied

Pathological grief: diagnosis and explanation.

Pathological grief deserves a place in the diagnostic nomenclature. Because posttraumatic stress disorder requires an event beyond the range of usual experience and bereavement is virtually a universal experience, a new diagnosis of signs and symptoms precipitated by a loss event is needed. Many varieties of pathological grief have been noted in clinical research studies, and multiple diagnoses of pathological grief would make research difficult. The authors advance a solution in a personality-based explanation of abnormal responses to loss events; this allows for a single diagnosis of pathological grief. The authors also present a predictive model to partially explain pathological grief by antecedent trait combinations. The hypothesis is that persons with a preloss combination of both contradictions in relational schemas about the deceased and tendencies toward excessive control to stifle unwanted affect will tend to have unsuccessful processes of mourning. Types of contradictions and overcontrol may vary, yielding personality-based varieties of response within a single diagnostic category.

Adaptation, Psychological↗
PubMed1998

Adjustable silicone gastric banding: complications in a personal series.

BACKGROUND: Morbid obesity is a very severe pathology, deriving partly from a psychological disturbance of nutritional behavior. Besides a behavioral therapeutic approach, surgery appears to be necessary to resolve associated diseases by causing a satisfactory weight loss. Adjustable gastric banding is a less-invasive, potentially reversible procedure that guarantees an optimal quality of life. METHODS: The authors have performed Kuzmak's gastric banding since 1992, with the lap-band approach since 1995; 183 patients were submitted to surgery, and 68 of these were operated by the laparoscopic approach. Average body mass index was 45.5 kg/m2. The complications were always under control and have decreased since the introduction of the recent lap-band. RESULTS: Gastric banding is still a very young procedure and it is difficult to state definitive results yet. Preliminary results, according to our experience are satisfactory in terms of weight loss, without metabolic changes and without mortality. CONCLUSIONS: Our experience is encouraging if patient selection is accurate and rigid.

Adolescent↗
PubMed2006

Traveling the tau pathway: a personal account.

Studies of the tau protein and its pathological fate as a neurofibrillary tangle have been a pillar of Alzheimer's disease research. The understanding of the fundamental position that tau occupies in the disease cascade is a tribute to an international group of scientists who brought rigor, candid assessments of data, and critical thinking to the problem. The tau pathway winds its way from astute clinical observations to pathological correlations, from molecular and cellular experiments to mining informatic data, and from animal behavior to the biophysics of protein structure. For most the vindication of this tireless effort will come from tau-based therapies; but for others the remarkable biology revealed by the Alzheimer disease process has been its own reward.

Alzheimer Disease↗
PubMedDate not supplied

The multiple tumor syndrome. Personal experience.

The multiple tumor syndrome is an unusual pathologic condition, which consists in association of multiple malignancies in the same patient. Seven cases are discussed: two women, five men, aged 32-70 years. The period between the two neoplasias was 2-23 years (in 6 cases). In one case the two malignancies appeared concomitantly. The hematological malignancies were: multiple myeloma: 2 cases; chronic granulocytic leukemia: 2 cases; chronic lymphatic leukemia: 3 cases. In four cases, the solid tumor followed the hematological malignancy at variable periods (2 and 4 years). In other two cases, the solid tumors preceded the hematological malignancy with 2 years, 23 years respectively. The solid tumors were genital cancers, malignant melanoma, spino-cellular carcinoma, thyroid cancer, hemangiosarcoma. In a single case the second tumor was a hematological malignancy too (NHL-diffuse lymphocytic lymphoma). Possible implications of previous therapy and environmental factors are discussed.

Adult↗