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E Molodysky

Publications and source records attributed to E Molodysky.

6 recordsLinked to original sources

Urethritis and cervicitis.

BACKGROUND: With sexually transmitted diseases (STDs) no longer on the decline, it is prudent to assume that all cases of non specific urethritis and cervicitis are caused by sexually transmitted infection. Specific infections of the urethra and cervix due to chlamydia and other non gonococcal organisms are common and because they are often not apparent clinically, are underdiagnosed. OBJECTIVE: The aim of this paper is to provide a realistic approach to the management of urethritis and cervicitis by encouraging the performance of investigations and the instigation of treatment at the first consultation. DISCUSSION: A knowledge of the patient's sexual history combined with a working knowledge of the new DNA based technologies should provide for the early assessment of and intervention with patients who are at risk of at least one STD infection.

Adolescent↗

Cervical cytopathology reporting systems. Helping or hindering patient management?

OBJECTIVE: When a Pap smear is reported, the general practitioner needs to know whether it was technically satisfactory and, if abnormal, what kind of abnormality was found, in order to arrange appropriate management. A random survey of non hospital based cytology reporting laboratories in NSW was undertaken to determine the efficiency of this process. METHOD: This study examines the types of cytopathology reporting protocols used, the means provided by the laboratory to assist general practitioners in assessing the quality of their Pap smears and what, if any, management advice was given to general practitioners. RESULTS: Not only do different laboratories use different terminologies to report on Pap smears, but the majority use terms from at least two different reporting systems. Seven of the 10 laboratories provided feedback on the adequacy of the Pap smears while only 4 of the 10 laboratories provided management advice. CONCLUSIONS: If the 1993 National Health and Medical Research Council recommendations are followed, cytopathology reporting will be primarily Bethesda based with the pathology laboratories providing feedback on technical aspects of Pap smears taking as well as management advice.

Carcinoma in Situ↗

Sampling techniques for cervical cancer prevention.

The principal goal of Pap smear screening is to detect those abnormalities of the cervix that require definitive diagnostic intervention. Any mainstream screening of the population should also seek to increase the participation of women belonging to groups with special needs, such as Aboriginal and Torres Strait Islander women, women of non English speaking background, women with disabilities and older unscreened women. As it is not always possible to obtain endocervical cells, the importance of a Pap smear for individual women is questioned. This article examines the various sampling techniques and choice of instruments. Though the literature is not entirely supportive of a particular cytological sampling technique, the overall evidence supports the use of the spatula/cytobrush combination.

Female↗

Fourier transform infrared spectroscopy of dysplastic, papillomavirus-positive cervicovaginal lavage specimens.

To assess the utility of a new, rapid, economical procedure that may prove valuable in cervical screening, Fourier transform infrared (ir) spectroscopy was performed on 25 cervicovaginal lavage specimens from women referred for colposcopy on the basis of a cytological abnormality detected on their Pap smear and whose lavage specimen was positive for human papillomavirus. Of the 18 classed as CIN I or less by histopathology, 11 showed band frequencies that deviated only slightly from spectra that characterize normal cervical cells and 3 of 5 "atypia" specimens had spectra identical to normal. Two of 3 classed as CIN II had spectra only slightly more abnormal to these 11. In the case of 2 graded as CIN I, several bands were similarly altered in the direction of the pattern seen for 4 CIN III specimens. A further CIN I sample gave a spectrum that was even further shifted toward the latter and the remaining CIN I sample had a pattern that matched the 4 CIN IIIs. The most obvious change in each of the CIN IIIs was an additional peak at 972 cm-1 and this has been suggested as a key indicator for malignancy. One of the 3 CIN IIs had this peak. Other characteristic spectral changes were seen as well in the CIN III samples. High-risk HPV18 was present in 3 of the CIN III samples, as well as in one specimen classed as atypia, but having an abnormal ir spectrum. Low-risk HPV 6 or 11 was seen along in samples with a normal or slightly abnormal ir spectrum, but never in those that showed an ir pattern that was abnormal. The current study has therefore shown complete concordance between ir spectral findings and histopathology result in the case of CIN III specimens, but less precise matching for other grades of CIN. The spectral differences revealed by ir spectroscopy are likely to characterize molecular abnormalities in cervical cells during progression to cancer and may therefore have potential in assisting with clinical decision making. More studies will, however, be required to establish the place of this technique in cervical screening.

Colposcopy↗

Teaching ethics in the context of general practice.

This paper describes the teaching in medical ethics provided by the Department of General Practice during the fifth year of the undergraduate medical course at the University of Sydney. The objectives of the sessions are to raise awareness of the complex nature of decision-making, to encourage students to determine their own moral viewpoints on common controversial issues, and to provide a framework for managing common ethical dilemmas. This framework is considered in the light of ethical problems which may have arisen during the two-week general practice attachment experienced by students prior to the ethics session. Feedback from students on the sessions is largely positive, although a number complain that simple answers to common problems are not provided.

Education, Medical, Undergraduate↗

Simple microwave and thermal cycler boiling methods for preparation of cervicovaginal lavage cell samples prior to PCR for human papillomavirus detection.

Sample preparation is an important step in the detection of viral DNA by the polymerase chain reaction (PCR) technique. The method used should achieve release of cellular DNA with the minimum of manipulation steps so as to reduce the possibility of contamination. The present report demonstrates that either microwaving or 20 min of boiling in the heating block of a thermal cycler lead to satisfactory results in the detection by PCR of human papillomavirus in cervicovaginal epithelial cell specimens obtained by lavage. Since each of these methods uses only one step the possibility of contamination is greatly reduced compared to the widely used proteins K/nonionic detergent extraction procedure.

Carcinoma in Situ↗