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F Abdul-Karim

Publications and source records attributed to F Abdul-Karim.

6 recordsLinked to original sources

Adolescents with ASCUS: are they a high risk group?

Population demographics, risk behaviors, and compliance rates for the management of an ASCUS (atypical squamous cells of undetermined significance) diagnosis are not well studied in the adolescent population. From June 1994 to December 1996, 1,175 Papanicalou (pap) smears were performed in an urban adolescent clinic on patients age 12 to 18. Of these, 124 (10.5%) were diagnosed with ASCUS or ASCUS with a qualifying statement. A retrospective chart review (n=83) and telephone interview was performed on patients with ASCUS. Ninety-nine percent of enrollees were African American. Comparisons were made between those patients with normal pap smears and those with ASCUS. No statistically significant difference existed pertaining to age at pap smear, age at menarche, age at first coitus, and education level. A positive association was found in the ASCUS group for the presence of sexually transmitted diseases (P < 0.001), number of sexual partners (P < 0.0007), and pregnancy (P < 0.001). Of the 80% of patients who had an ASCUS diagnosis and were referred for colposcopy (n = 62), only 61% attended their appointment (n = 38). Thirty-nine percent of these patients were aware of an abnormal diagnosis after colposcopy. For those that attended colposcopy, 56% were accompanied by a parent. For those who were not compliant with attendance, none cited parental consent for the procedure as a barrier to obtaining treatment. Adolescent females in an urban setting with multiple sexual partners, history of sexually transmitted diseases, and prior pregnancy are at a greater risk for ASCUS on cervicovaginal smear when compared to their age-matched controls. In addition, the adolescent compliance rate for colposcopy is low. We, therefore, recommend that these adolescent females be observed diligently.

Adolescent↗

Interobserver reproducibility among neuropathologists and surgical pathologists in fibrillary astrocytoma grading.

UNLABELLED: Many of the problems associated with the current grading approaches for fibrillary astrocytomas center around the lack of consistency in grading. This study compares the diagnoses of five neuropathologists with five experienced surgical pathologists with regard to assigning astrocytoma grade. Thirty neoplastic and non-neoplastic lesions were sent to each of five neuropathologists and five surgical pathologists for placement into one of three grades as outlined by modified Ringertz schema. Grading criteria (Burger et al., 1985. Cancer 56:1106-1111) were distributed to all participants, who have been practicing for at least 5 years. An additional category for non-neoplastic or normal tissue was also provided. The diagnoses, based on the majority opinion of the neuropathologist group, included six low grade astrocytomas, 11 anaplastic astrocytomas, seven glioblastoma multiforme, and six normal/reactive lesions. Agreement by all neuropathologists was reached in 12 cases (40%). A discrepant diagnosis was obtained in one of five neuropathologists in 14 additional cases (46.7%). In the remaining four cases, two neuropathologists deviated from the majority opinion; in each of these cases, the diagnostic problem involved differentiating tumor from reactive gliosis. All five surgical pathologists agreed in six cases (20%). One discrepant diagnosis among the surgical pathologist group was seen in seven cases (23.3%). In the remaining 17 cases, two or more discrepant diagnoses were obtained (56.7%); discrepancies in these cases included differences in assignment of tumor grade and in distinguishing low grade astrocytoma from gliosis. IN CONCLUSION: (1) it is likely that experience with grading accounts for the better level of agreement among the neuropathologist group (kappa statistic 0.63) versus the surgical pathologist group (kappa statistic 0.36); (2) in most cases, the neuropathologists all agreed or had one discrepant diagnosis (86.7%) versus the surgical pathologist group (43.3%); (3) the discrepancies in diagnosis among both groups is likely related, in good part, to the limitations of the grading schema in fully enumerating the spectrum of such grading parameters as cytologic atypia and vascular proliferation.

Astrocytoma↗

Computed tomography-guided retroperitoneal biopsies.

A retrospective review was performed on consecutive patients who had a computed tomographic (CT) biopsy of the retroperitoneum at University Hospitals of Cleveland. Biopsies were performed using a 20-gauge Chiba needle (University Medical Instruments Corp, Ballston Spa, NY) and a 14-gauge Tru-Cut needle (Baxter Pharmaseal, Valencia, CA). The results included success rate, failure, and complications, and were determined by a review of patient charts, surgical results, and autopsy results. The 20-gauge needle aspirations were accurate in suggesting the diagnosis in 20 of 22 cases of metastatic disease and ten of 15 cases of lymphoma. Using the 20-gauge needle, it was not possible to make a specific diagnosis in any of the lymphoma patients or for unusual benign disorders. With the 14-gauge Tru-Cut needle, the correct diagnosis was made in 13 of 13 cases of metastatic disease, ten of 11 cases of lymphoma, and two of 2 cases of unusual benign disorders. It was also possible to make the specific diagnosis of the lymphoma type in ten of 11 cases. The only complication was a small subcutaneous hematoma following a biopsy with a 20-gauge Chiba needle.

Biopsy, Needle↗

Bartholin gland carcinoma.

Bartholin gland tumors are rare and management recommendations have been based on limited information. This report summarizes a 30-year clinical experience involving Bartholin gland carcinoma in 36 patients whose five-year survival rate was 84%. FIGO stages of the 36 tumors were stage I, nine; stage II, 15; stage III, ten; and stage IV, two. Cell types were: squamous, 27 (three nonkeratinizing with areas of a transitional component); adenomatous, six; adenoid cystic, two; and adenosquamous, one. Fourteen of 30 (47%) patients with lymph node dissections had nodal metastases and 11 remain disease-free. Disease recurred in nine patients (six local, two distant, one local and distant) and four were treated successfully. One of 14 (7%) patients receiving radiation and six of 22 (27%) patients not receiving radiation developed local recurrences. Wide excision (often necessitating a radical hemivulvectomy), ipsilateral inguinal lymphadenectomy, and adjunctive irradiation to the vulva and regional lymph nodes produced excellent results.

Adenocarcinoma↗

CT-guided liver biopsy: an update.

Computed tomography (CT)-guided liver biopsy has become an accepted part of the diagnostic evaluation of patients with benign and malignant hepatic disease The advantages of imaging guidance over blind percutaneous biopsy are now well established in the literature. Controversy continues to exist, however, over the safety and accuracy of the procedure, as well as over the proper choice of needle: large-caliber cutting needle versus small caliber aspiration needle. In 1984, our group reported the results in a preliminary set of 180 patients in whom CT-guided biopsy of focal liver lesions was performed. The study indicated that cutting-needle sampling could provide increased diagnostic accuracy over fine-needle aspiration in both benign and malignant hepatic disease without a significant increase in complications. This paper reports the results in a series of 179 new patients who underwent CT-guided liver biopsy using a variety of needles. Comparison is again made between fine-needle and cutting-needle biopsy with respect to diagnostic accuracy and safety. A detailed discussion of the proper choice of biopsy needle as well as of the causes of both biopsy failure and complications is provided.

Biopsy↗