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Biomedical subjects

H S Mitchell

Publications and source records attributed to H S Mitchell.

15 recordsLinked to original sources
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↗
PubMed2004

Contraception choice for HIV positive women.

UNAIDS/WHO estimates that 42 million people are living with HIV/AIDS worldwide and 50% of all adults with HIV infection are women predominantly infected via heterosexual transmission. Women with HIV infection, like other women, may wish to plan pregnancy, limit their family, or avoid pregnancy. Health professionals should enable these reproductive choices by counselling and appropriate contraception provision at the time of HIV diagnosis and during follow up. The aim of this article is to present a global overview of contraception choice for women living with HIV infection including effects on sexual transmission risk.

Adolescent↗
PubMed2001

Longitudinal analysis of histologic high-grade disease after negative cervical cytology according to endocervical status.

BACKGROUND: There is concern that Papanicolaou (Pap) smears without an endocervical component may be associated with the incomplete detection of abnormalities. METHODS: Four cohorts of women with initial negative Pap smear reports and an additional Pap smear obtained within 36 months were established from a statewide database. The endocervical status of the entry smear and subsequent smears, respectively, among the cohort women was as follows: Cohort A: present and present; Cohort B: absent and present; Cohort C: present and absent; and Cohort D: absent and absent. The subsequent incidence of histologic high-grade disease was calculated for each cohort. RESULTS: No significant differences were evident in the incidence of histologic high-grade disease between Cohorts A and B (standardized incidence ratio for Cohort B compared with Cohort A = 0.89; 95% confidence interval, 0.67-1.12). Cohorts C and D had significantly less high-grade disease compared with Cohorts A and B. CONCLUSIONS: The findings of the current study indicate that early repeat testing of women whose Pap smears are negative but lack an endocervical component is not justified because no higher rate of histologic high-grade abnormality was evident on longitudinal follow-up even when later smears included an endocervical component.

Adenocarcinoma↗
PubMed1996

Cancer diagnosis after a report of negative cervical cytology.

OBJECTIVES: 1. To determine the annual rate of interval squamous cancer of the cervix after a negative Papanicolaou smear report. 2. To evaluate the proportion of women with cervical cancer who received negative cervical smear reports during the three years before the cancer diagnosis. DESIGN AND SETTING: Objective 1. A prospective study of the incidence of squamous cervical cancer from 1990 to 1993 among women who received negative cervical smear results in Victoria in 1990. Objective 2. A retrospective audit of preceding cervical smear results from 1990 to 1993 in women diagnosed with cervical cancer in Victoria in 1993. RESULTS: The average interval cervical rate was 2.54 squamous cancers per 100000 women per year (95% confidence interval, 1.75-3.67) during the first three years after a negative smear report. The interval cancer rate did not vary by age group nor by the endocervical status of the negative smear report. Of the 233 cases of cervical cancer diagnosed during 1993, 56 women (24%) had negative cervical cytology reported during the preceding three years. The frequency of preceding negative cervical cytology was greater for non-squamous cancer (22 women [33%] from 66 cases) than for squamous cancer (34 women [20%] from 167 cases. CONCLUSION: The rate of interval cancer diagnosis is very low compared with expected rates in the absence of screening, indicating the effectiveness of the cervical screening program in Victoria.

Carcinoma, Squamous Cell↗
PubMed1988

Subclinical penile human papillomavirus infection and dysplasia in consorts of women with cervical neoplasia.

Fifty men whose sexual partners were 50 women with histologically proved cervical intraepithelial neoplasia (CIN) grade III (severe dysplasia or carcinoma in situ) were studied. A further 25 men whose current regular sexual partners were 25 women with chlamydial cervicitis were recruited as controls. If either of the partners in either group had genital condylomata acuminata or a known history of similar lesions, the couple was excluded from the study. Abnormal penile epithelium, which was detected by colposcopy after application of 5% acetic acid to the penile skin, was reported in 25 men in the study group compared with three in the control group. Histologically proved subclinical penile infection with human papillomavirus (HPV) was present in 23 men in the study group compared with three in the control group (p less than 0.01). Of the 50 men in the study group, four had histologically proved severe penile dysplasia or carcinoma in situ with evidence of HPV infection, the disease being subclinical in each case and diagnosed on histology of a specimen obtained by colposcopically directed biopsy. HPV DNA was detected on filter hybridisation of penile scrapes from 15 of the 23 men in the study group with histologically proved penile HPV infection, HPV16 DNA being detected in 10 of them. HPV DNA was detected on DNA-DNA hybridisation of biopsy material in seven of 18 men with histologically proved penile HPV infection. Five of these biopsy specimens were positive for HPV16 DNA. Only one man in the control group had HPV DNA detected in a penile scrape. This patient had histologically proved subclinical penile HPV infection. Such lesions may represent an important male reservoir of HPV types implicated in genital squamous carcinogenesis in both sexes.

Adult↗
PubMed1978

Nutritional improvement in Hokkaido orphanage children--1960-1970.

In 1960, a survey showed Japanese orphanage children to be shorter in stature than Japanese children in general. In 1964, food budgets for orphanages were increased and, on Hokkaido, 180 gm. milk per day was made available for each child. In 1968, a further improvement in the diet was made by providing for an egg a day for each child, plus more liberal money allowances. Data from surveys in 1965 and 1970 on food served to these children reflected the improvements, as compared with 1960, Figures on the stature of the orphanage children were also compared. By 1970, the only orphanage children falling below the national mean were the teen-age boys and, to a lesser extent, the adolescent girls. Weight differences in all three surveys were less striking.

Adolescent↗