Biomedical subjects
Publications and source records attributed to V F Colón.
Wilson's disease, an autosomal recessive disorder of copper metabolism, most often becomes apparent in adolescence and may present with a multitude of signs and symptoms. Early diagnosis and treatment can prevent irreversible damage to the liver and the central nervous system. The diagnosis is confirmed by hepatic biopsy and quantitation of copper in the tissues. Treatment is chelation of excess copper. If untreated, Wilson's disease is fatal.
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An important factor in assessing the adequacy of cervical cytologic preparation is the presence of endocervical cells in the Pap smear. A study in a university based family practice center compares the percentage of "adequate" smears obtained by using the standard Ayre spatula and cotton tipped applicator with the yield obtained while using a new extended tip cervical spatula. A significant increase in the percentage of slides with endocervical cells is found where extended tip spatulas are used for harvesting cervical and endocervical cells.
Scrapings of the conjunctiva should be obtained as part of the evaluation of the inflamed eye. Conjunctival specimens are obtained by a simple technique using readily available materials. Anesthesia is usually not required. Viral or fungal elements, as well as bacteria, can be identified. Cytologic studies reveal the character of exudates and premalignant or malignant lesions. Adenovirus and herpes simplex produce characteristic cellular changes and inclusion bodies.
Properly collected urine samples examined by qualified cytologists can aid in the diagnosis and management of various infectious and inflammatory renal parenchymal diseases. Patients with proteinuria, hematuria or bacteriuria will benefit most from renal cytologic examination. Exfoliative cells from renal parenchymal tumors often do not communicate with the collecting system. Some disseminated neoplasms, such as lymphoma or myeloma, can be diagnosed and followed by cytologic study.
Urinary tract cytology is an excellent means of detecting urinary tract neoplasia. It is not a good localizing technique but is an exceptionally useful diagnostic tool for monitoring high-risk patients. The closer the lesion is to the collecting point, the higher the degree of diagnostic accuracy. Thus, cells from a bladder cancer are more frequently seen than malignant cells from the ureter or renal pelvis. Properly collected urine specimens examined by qualified cytologists can also aid in the diagnosis of infections and inflammatory diseases.
Fine-needle aspiration is a rapid, safe and accurate technique for diagnosing a variety of radiologically evident or palpable lesions. Cellular material is obtained from suspicious areas with an 18- to 23-gauge needle. The technique can be applied to lesions of the breast, prostate, thyroid and subcutaneous tissue, as well as to many pulmonary and intra-abdominal lesions.
The primary purpose of sputum cytology is to detect preinvasive and invasive malignancy. Candidates for the screening procedure include long-time smokers with productive cough, patients chronically exposed to asbestos, patients with hemoptysis, persistent cough and/or weight loss, and asymptomatic patients with x-ray lesions or unexplained pleural effusions. The procedure is inexpensive and highly diagnostic. Five consecutive specimens produced by deep coughing are required for adequate evaluation.
The United States government, in its desire to deliver broad health care coverage to its citizens, has looked to several of the established socialized health care systems for direction. There are definitely good points in each system, and the Canadian system, in particular, has done quite well in providing services within a limited federal budget. On the other hand, the unlimited access to care has led to increased demands for health care services, overperformance of services, and excessive utilization of facilities. There are major technological constraints now emerging and the fiscal integrity of the system is shaky. There is a notable decrease in research and voluntary faculty participation at university levels. Financial constraints are becoming more severe and it appears that demand vis-a-vis the resources available will soon force stringent readjustments in Canadian health care delivery and funding. Health care plan administrators concede that unless more dollars are invested in the system, the current level of health care delivery cannot be maintained.
Cervical Pap smears should be initiated at the time a woman becomes sexually active or by 21 years of age. Additional sites for obtaining specimens include the vulva, vaginal wall, vaginal pool, cervix and endometrium, each serving a specific purpose. The primary use of vaginal pool cytology is to detect an abnormal endometrium or an extrauterine malignancy. Meticulous technique and knowledge of the types of yield from specific sites are required in order to obtain accurate cytologic information.
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