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N R Padley

Publications and source records attributed to N R Padley.

5 recordsLinked to original sources
PubMed1992

Delay in the diagnosis of breast cancer: the effect of the introduction of fine needle aspiration cytology to a breast clinic.

Fine needle aspiration cytology (FNAC) was introduced to a District General Hospital Breast Clinic in 1984 and since that time the rate of surgical excision biopsy for benign breast disease has halved. The rate of benign to malignant breast operations fell from 2.0 to 0.7 over a 7-year period from 1982 to 1988. During this period the diagnosis of breast cancer was made at the first clinic appointment in 85% of women. However, a delay in diagnosis of more than 50 days occurred in 33 patients (6.9%) and there was little difference in the annual rate of delayed diagnosis despite the addition of FNAC as an extra diagnostic tool in the later years of the study. Eighty-five per cent of patients with a delayed diagnosis were under the age of 55 (mean and median age 47) years. FNAC is a useful adjunct in the management of patients with diagnostic breast problems, but even in combination with mammography is not always sufficiently sensitive to exclude malignancy, particularly in young women.

Adult↗
PubMed1984

Gall stones and mortality: a study of all gall stone related deaths in a single health district.

In a prospective study of gall stone related deaths in a single Health District, the biliary tract was examined at necropsy in 1701 cases and 8078 death certificates were searched. Gall stones were identified as the cause of death in only 21 cases (0.26%) but in 291 subjects found to have gall stones or cholecystectomy at necropsy, the mortality was 3.4%. The necropsy prevalence of gall stones in the adult population was 17.1% but nine out of 10 subjects with gall stones had not had a cholecystectomy and women were three times more likely to have had their gall stones removed than men. There were five postoperative deaths (mean age 60 years) with an operative mortality for cholecystectomy in the district of 1.2%. Death due to unoperated gall stones was identified in 16 subjects, most of whom were very elderly women (mean age 81) but carcinoma of the gall bladder was only found in one woman of 90 with gall stones. The prevalence of gall stones rose with age in both sexes but the cholecystectomy rate per head of population at-risk declined sharply in the seventh decade in women and the eighth decade in men. There are a large number of people with unoperated gall stones in the population but gall stone related deaths are very uncommon. The cholecystectomy rate in Britain, however, seems to be rising and it is suggested that if this trend continues there may be an increased number of deaths.

Adult↗
PubMed1981

Angiolymphoid hyperplasia with eosinophilia simulating lymphadenopathy.

A case of angiolymphoid hyperplasia (AHE) with eosinophilia presenting with recurrent inguinal swellings simulating lymphadenopathy is described. Tissue was examined by light microscopic techniques, electron microscopy and immunohistochemistry. Electron microscopy showed large numbers of cytoplasmic filaments and bizarre Weibel-Palade bodies in the atypical endothelial cells that characterize AHE. Factor VIII related antigen was demonstrated in a small proportion of these cells by immunoperoxidase staining. The absence of staining for lysozyme and alpha 1 antitrypsin does not support the concept that these cells are histiocytic in nature. The prominent lymphoid and plasma cell proliferative elements in this case showed a polytypic staining pattern for immunoglobulin. An unusual reticular staining pattern for IgE was observed in the lymphoid follicles. The nature and pathogenesis of AHE is discussed in the light of previous publications and the findings in this case.

Adult↗