Biomedical subjects

Richard Lozano

Publications and source records attributed to Richard Lozano.

3 recordsLinked to original sources

PubMed2006

Comparison of computer-assisted and manual screening of cervical cytology.

OBJECTIVE: The Pap smear, introduced over 50 years ago, has significantly contributed to the reduction of mortality due to cervical cancer. The shortage of skilled cytotechnologists to screen and diagnose Pap slides has always been a concern, thus driving the goal to develop an automated system. This study evaluated the diagnostic performance of an automated computer imaging system for routine cervical cancer screening in a high-volume independent laboratory. METHODS: Validation and training were conducted upon installation of the computer imaging system. Following validation, data were evaluated comparing cytologic detection rates of a six-month cohort of slides screened with computer imaging assistance versus a historic control of manually screened slides. RESULTS: For each cytologic abnormal category, the Imager-assisted detection rates were significantly greater than the manually screened historic cohort. The Imager increased the detection of HSIL+ by 38% and LSIL by 46% compared to manual screening. There was an increase in the rate of ASC in the Imager cohort (6.5%) compared to manual screening (4.1%), however, the ASC rate decreased during the time of the study period suggesting learning affect. CONCLUSIONS: The results indicate that computer-imaging-assisted screening significantly increased the cytologic detection of cervical abnormalities compared to manual screening. The initial increase in ASC rates is partially due to a new stain protocol that may be corrected with additional experience. The implementation of the Imager, however, did not adversely affect the ASC:SIL ratio.

Adolescent↗

PubMed2004

Fluorouracil, doxorubicin, and streptozocin in the treatment of patients with locally advanced and metastatic pancreatic endocrine carcinomas.

PURPOSE: The role of systemic chemotherapy in the management of pancreatic endocrine carcinoma (islet cell carcinoma; PEC) is an area of considerable controversy. Response rates ranging from 6% to 69% have been reported for streptozocin-based chemotherapy. We retrospectively studied 84 patients with locally advanced or metastatic PEC who had been treated with fluorouracil, doxorubicin, and streptozocin (FAS) to determine the objective response rate, duration of progression-free survival (PFS), and duration of overall survival (OS). PATIENTS AND METHODS: Eligible patients had histologic or cytologic confirmation of their tumor and measurable disease on computed tomography or magnetic resonance imaging scans. Response to treatment was evaluated in this study using the new international criteria proposed by the Response Evaluation Criteria in Solid Tumors Committee. RESULTS: Sixty-one of the patients were male and 23 were female, with a median age of 54 years (range, 24 to 78 years). The response rate (RR) to FAS was 39%, with a median response duration of 9.3 months. The 2-year PFS rate was 41%, and the 2-year OS rate was 74%. The extent of liver metastatic disease correlated with a worse PFS (P = .01 by log-rank test) and a worse OS (P < .0001 by log-rank test). Analyses showed that metastatic replacement of more than 75% of the liver and prior chemotherapy were independently associated with inferior PFS. CONCLUSION: Patients with locally advanced or metastatic PEC who are treated with FAS may have a reasonable RR, and responders may experience longer PFS and OS. The volume of metastases in the liver is the most important predictor of outcome.

Adult↗

PubMed2003

Successfully integrating human papillomavirus testing into your practice.

Integrating human papillomavirus (HPV) testing into the practice of cervical cancer screening is a continuous process that begins and ends with education. An understanding of the basic science and clinical relevance are critical to proper implementation. One must have knowledge of one's own laboratory statistics, clinician awareness, and market forces before the final steps are taken. Additional logistical issues are often laboratory specific or state specific, but are addressed here.

Cytodiagnosis↗