Traditional Smear Research Articles

Development and Validation of Deep Learning-Based Infectivity Prediction in Pulmonary Tuberculosis Through Chest Radiography: Retrospective Study.

Pulmonary tuberculosis (PTB) poses a global health challenge owing to the time-intensive nature of traditional diagnostic tests such as smear and culture tests, which can require hours to weeks to yield results. This study aimed to use artificial intelligence (AI)-based chest radiography (CXR) to evaluate the infectivity of patients with PTB more quickly and accurately compared with traditional methods such as smear and culture tests. We used DenseNet121 and visualization techniques such as gradient-weighted class activation mapping and local interpretable model-agnostic explanations to demonstrate the decision-making process of the model. We analyzed 36,142 CXR images of 4492 patients with PTB obtained from Severance Hospital, focusing specifically on the lung region through segmentation and cropping with TransUNet. We used data from 2004 to 2020 to train the model, data from 2021 for testing, and data from 2022 to 2023 for internal validation. In addition, we used 1978 CXR images of 299 patients with PTB obtained from Yongin Severance Hospital for external validation. In the internal validation, the model achieved an accuracy of 73.27%, an area under the receiver operating characteristic curve of 0.79, and an area under the precision-recall curve of 0.77. In the external validation, it exhibited an accuracy of 70.29%, an area under the receiver operating characteristic curve of 0.77, and an area under the precision-recall curve of 0.8. In addition, gradient-weighted class activation mapping and local interpretable model-agnostic explanations provided insights into the decision-making process of the AI model. This proposed AI tool offers a rapid and accurate alternative for evaluating PTB infectivity through CXR, with significant implications for enhancing screening efficiency by evaluating infectivity before sputum test results in clinical settings, compared with traditional smear and culture tests.

Cytomorphological comparison of alcohol-formalin cell-block technique with conventional cytology in serous effusions in a low-resource setting.

Our study compared the diagnostic accuracy of the 10% alcohol-formalin cell-block (CB) technique against traditional smears (CS) in serous effusions over 1 year. CB outperformed CS by detecting 7 missed cases and diagnosing 177 benign, 5 suspicious and 26 malignant cases compared to CS's 180 benign, 9 suspicious and 19 malignant cases. Using histopathology as a gold standard, CB showed a sensitivity of 96.4%, specificity of 98.3% and diagnostic accuracy of 98.1%, significantly higher than CS's 79.3% sensitivity, specificity of 97.7% and 95.2% accuracy. Using a 10% alcohol-formalin method, CB also excelled in cytomorphological characterization, especially in background elements, cellularity and cellular architecture. CB offered improved diagnostic accuracy and allowed extra sections for additional tests. In resource-constrained settings, combining CS and CB enhances cytological assessment.

Comparison of microscopic and xpert MTB diagnoses of presumptive mycobacteria tuberculosis infection: retrospective analysis of routine diagnosis at Cape Coast Teaching Hospital

IntroductionTuberculosis is a global health problem that causes 1. 4 million deaths every year. It has been estimated that sputum smear-negative diagnosis but culture-positive pulmonary TB diagnosis contribute to 12.6% of pulmonary TB transmission. TB diagnosis by smear microscopy smear has a minimum detection limit (LOD) of 5,000 to 10,000 bacilli per milliliter (CFU/ml) of sputum result in missed cases and false positives. However, GeneXpert technology, with a LOD of 131–250 CFU/ml in sputum samples and its implementation is believe to facilitate early detection TB and drug-resistant TB case. Since 2013, Ghana health Service (GHS) introduce GeneXpert MTB/RIF diagnostic in all regional hospitals in Ghana, however no assessment of performance between microscopy and GeneXpert TB diagnosis cross the health facilities has been reported. The study compared the results of routine diagnoses of TB by microscopy and Xpert MTB from 2016 to 2020 at the Cape Coast Teaching Hospital (CCTH).MethodsThe study compared routine microscopic and GeneXpert TB diagnosis results at the Cape Coast Teaching Hospital (CCTH) from 2016 to 2020 retrospectively. Briefly, sputum specimens were collected into 20 mL sterile screw-capped containers for each case of suspected TB infection and processed within 24 h. The samples were decontaminated using the NALC-NaOH method with the final NaOH concentration of 1%. The supernatants were discarded after the centrifuge and the remaining pellets dissolved in 1–1.5 ml of phosphate buffer saline (PBS) and used for diagnosis. A fixed smears were Ziehl-Neelsen acid-fast stain and observed under microscope and the remainings were used for GeneXpert MTB/RIF diagnosis. The data were analyze using GraphPad Prism.Results50.11% (48.48–51.38%) were females with an odd ratio (95% CI) of 1.004 (0.944–1.069) more likely to report to the TB clinic for suspected TB diagnosis. The smear-positive cases for the first sputum were 6.6% (5.98–7.25%), and the second sputum was 6.07% (5.45–6.73%). The Xpert MTB-RIF diagnosis detected 2.93% (10/341) (1.42–5.33%) in the first and 5.44% (16/294) (3.14–8.69%) in the second smear-negative TB samples. The prevalence of Xpert MTB-RIF across smear positive showed that males had 56.87% (178/313) and 56.15% (137/244) and females had 43.13% (135/313) and 43.85% (107/244) for the first and second sputum. Also, false negative smears were 0.18% (10/5607) for smear 1 and 0.31% (16/5126) for smear 2.ConclusionIn conclusion, the study highlights the higher sensitivity of the GeneXpert assay compared to traditional smear microscopy for detecting MTB. The GeneXpert assay identified 10 and 16 positive MTB from smear 1 and smear 2 samples which were microscopic negative.

Clinical values of different specimen preparation methods for the diagnosis of lung cancer by EBUS-TBNA

Background and objectiveEBUS-TBNA has emerged as an important minimally invasive procedure for the diagnosis and staging of lung cancer. Our objective was to evaluate the effect of different specimen preparation from aspirates on the diagnosis of lung cancer.Methods181 consecutive patients with known or suspected lung cancer accompanied by hilar / mediastinal lymphadenopathy underwent EBUS-TBNA from January 2019 to December 2022. Specimens obtained by EBUS-TBNA were processed by three methods: Traditional smear cytology of aspirates (TSC), liquid-based cytology of aspirates (LBC) and histopathology of core biopsies.ResultsEBUS-TBNA was performed in 181 patients on 213 lymph nodes, the total positive rate of the combination of three specimen preparation methods was 80.7%. The diagnostic positive rate of histopathology was 72.3%, TSC was 68.1%, and LBC was 65.3%, no significant differences was observed (p = 0.29); however, statistically significant difference was noted between the combination of three preparation methods and any single specimen preparation methods (p = 0.002). The diagnostic sensitivity of histopathology combined with TSC and histopathology combined with LBC were 96.5 and 94.8%, the specificity was 95.0% and 97.5%, the PPV was 98.8% and 99.4%, the NPV was 86.4% and 81.2%, the diagnostic accuracy was 96.2% and 95.3%, respectively; The sensitivity and accuracy of above methods were higher than that of single specimen preparation, but lower than that of combination of three preparation methods.ConclusionWhen EBUS-TBNA is used for the diagnosis and staging of lung cancer, histopathology combined with TSC can achieve enough diagnostic efficiency and better cost-effectiveness.

PAP-test: Possibilities and Limitations

Cervical cancer (CC) progresses slowly, and the cytological screening increases the likelihood of early detection of precancerous lesions. Cytology of the cervix is one of the primary methods of effective CC diagnosis, which, thanks to early detection and timely treatment, leads to a stable decrease in morbidity and mortality from invasive CC. The results of many studies have shown that the specificity of the conventional Pap smear test is approximately 80–100%, its sensitivity ranges from 30% to 80%, and the rate of inadequacy of this method is from 5% to 25%. With traditional smear preparation, only a small percentage of collected cells end up on the slide, while abnormal cells may be discarded and not analyzed. When viewing the slide, cells that have dried and clumped together may interfere with the visualization of atypical cells. To overcome these limitations, in 1996, as an alternative to the traditional Pap test, liquid cytology was presented – the technology of preparing slides on which the cells are placed in a single layer. This technology outperformed the conventional Pap test with improved fixation, reduced obscuring factors, and standardized cell transfer. In liquid cytology samples are collected by fully immersing the cytobrush in a vial containing a preservative liquid, whereby the cells are preserved and fixed simultaneously, unlike conventional smears where the sample is applied to a glass slide and fixed separately. Today, two main methods of preparation based on liquid cytology are known: ThinPrep and SurePath. The results of cytology are described according to the Bethesda system. The Bethesda classification is widely accepted because it corresponds to the clinical presentation, reproduces the nature of the lesions, and is therefore treatmentoriented with a desirable follow-up procedure. The indisputable advantage of the Pap test by liquid cytology is the ability to perform both cytological and molecular studies, in particular HPV, in one sample. This capability facilitated the implementation of a two-step strategy when HPV testing is used as a triage test for ASC-US or low-grade squamous intraepithelial lesion cytology, or when cytology is used to triage HPV-positive women.

Cytodiagnosis of pleural effusions according to the International System for Reporting Serous Fluid Cytopathology: retrospective analysis of oncological dispensary experience

BACKGROUND: The International Serous Fluid Cytopathology Reporting System (TIS RSFC) was proposed in 2020 to standardize cytological reports and include information on perceived risk of malignancy in reports. It is necessary to analyze the use of TIS RSFC to determine the principles of rational practical implementation and possible improvement of this classification.
 AIM: To assess the possibility and results of the application of TIS RSFC (2020) in the cytodiagnosis of pleural effusions using the organizational technologies and resources of a regional oncological dispensary.
 METHODS: This observational, retrospective, crossover study carried out a comparative analysis of reports following cytological examination of pleural effusion with clinical and anamnestic information, histological, immunohistochemical results of 1507 patients of the Altai Regional Oncological Dispensary (Barnaul) from 2019 to 2021. The microscope slides were prepared by the traditional smear method, as well as by liquid cytology methods. Papanicolaou and Pappenheim staining methods were used. In certain cases, immunocytochemical tests were performed additionally.
 RESULTS: The following numbers of cytological reports corresponding to the TIS RSFC categories were formulated: non-diagnostic material, C I — 11 (0.7%); absence of malignant tumor cells, C II — 946 (62.8%); atypia of unknown significance, C III — 61 (4.0%); suspicion of a malignant process, C IV — 13 (0.9%); malignant process, C V — 476 (31.6%). Within category C V there were 37 (7.8%) cases of the primary tumor — mesothelioma; 398 (83.6%) cases of metastatic tumors, including 41 (8.6%) cases of non-epithelial tumors. Immunocytochemical tests of pleural fluid were performed in 273 (18.1%) cases. Risk of malignancy was 9.1% (1/11) for C I; 1.2% (11/946) — for C II; 59.0% (36/61) — for C III; 84.6% (11/13) — for C IV, and 100% — (476/476) for C V. Cytodiagnosis with immunocytochemistry in unclear cases was characterized by a sensitivity of 92.5%, a specificity of 100%, a positive predictive value of 100%, a negative predictive value of 88.5%, and an accuracy of 96.6%.
 CONCLUSIONS: The application of TIS RSFC (2020) in cytological tests of pleural fluid does not cause difficulties for specialists in cytological laboratory. If the required diagnostic accuracy of cytological tests is available, this system makes it possible to characterize the risk of malignancy and thus guide the oncologist in the case management. The liquid-based cytology and the addition of traditional cytological techniques with immunocytochemical tests increase the cytodiagnostic sensitivity.

CORONAVIRUS DISEASECOVID-19: NEW POSSIBILITIES OF DIAGNOSIS

The аim of research – to determinine the diagnostic expediency of using lung condensateas a bioenvironment for the detection of SARS-CoV-2 virus in children with coronavirusdisease COVID-19.Materials and methods. The study was conducted on the basis of infectious diseasesdepartments of the Chernivtsi Children’s Regional Clinical Hospital during December2021 to January 2022. Verifi cation of coronavirus disease COVID-19 was performed bypolymerase chain reaction with reverse transcriptase (set COVID-19 Multiplex RT-PCRin real time regime from Labsystems Diagnostics Oy) with simultaneous detection of threemajor genes ORF1ab, nucleus (E) and envelope (E). The material for the study werenasopharyngeal swabs and pulmonary expiratory. Results. We examined 32 hospitalized children diagnosed with COVID-19 with a meanage of 10,43 ± 0,72 (min = 3, max = 17). The share of boys was 34,4%, girls – 64,6%(p = 0,05), which indicates the practical absence of diff erences in gender. Biomaterialcollection – nasopharyngeal swabs and pulmonary expiration were performed on 6,71± 0,58 (min = 2, max = 16) day of the disease. SARS-CoV-2 virus RNA was detected in46,8% of patients, which almost coincided with the PCR results of 40,62% (p> 0,05).Estimating viral load, the mean value of cycles for PCR of nasopharyngeal smear was30,86 ± 1,39, and for pulmonary expiration – 32,39 ± 1,26. Taking into account theaverage values, depending on the detected gene, it was found that the number of cyclesfor the smear gene E constituted 30,06 ± 1,37 (min = 19, max = 38), the N gene – 30,93 ±1,33 (min = 20, max = 38) for the ORF1ab gene 31,6 ± 1,48 (min = 20, max = 40). Thenumber of cycles for the condensate gene E is 32,6 ± 1,24 (min = 25, max = 38); geneN – 33,36 ± 1,09 (min = 28, max = 39), for ORF1ab – 34,08 ± 1,06 (min = 28, max = 39).The results of the correlation analysis of paraclinical examination of children hospitalizedfor coronavirus disease COVID-19 showed that the use of PCR smear test, comparedwith Ig M, increased the risk of infection with a chance ratio (OR) of 2,27 (95% CI1,26-4,08), relative risk (RR) 1,47 (95% CI 1,01-2,15), absolute risk (R) 0,20. Whenreceiving a positive test result, the post-test probability of a positive result increased12,8%, with a negative one – the result decreased 7,5%. Estimating viral load for geneE, OR = 2,8 (95% CI 1,58-4,98), RR = 1,66 (95% CI 1,22-2,28), R = 0,25, for genes N,ORF1ab OR = 3,2 (95% CI 1,79-5,71), RR = 1,77 (95% CI 1,29-2,44), R = 0,28.Conclusions. At comparative analysis of PCR, performed in diff erentbioenvironmentsof children, the obtainedresults are evidence of better specifi city in the detection of thepathogen when using a traditional smear of the nasopharyngeal mucosa compared withthe use of pulmonary expiratory. However, the study of exhaled condensate can be usedto reduce the isolation time of patients.

Rapid detection of Mycobacterium tuberculosis based on antigen 85B via real-time recombinase polymerase amplification.

Tuberculosis (TB), as a common infectious disease, still remains a severe challenge to public health. Due to the unsatisfied clinical needs of currently available diagnostic vehicles, it is desired to establish a new approach for universally detecting Mycobacterium tuberculosis. Herein, we designed a real-time recombinase polymerase amplification (RPA) technology for identifying M. tuberculosis within 20min at 39°C via custom-designed oligonucleotide primers and probe, which could specifically target antigen 85B (Ag85B). Particularly, the primers F4-R4 produced the fastest fluorescence signal with the probe among four pairs of designed primers in the RPA assays. The optimal primers/probe combination could effectively identify M. tuberculosis with the detection limit of 4·0 copies per μl, as it could not show a positive signal for the genomic DNA from other mycobacteria or pathogens. The Ag85B-based RPA could determine the genomic DNA extracted from M. tuberculosis with high reliability (100%, 22/22). More importantly, when testing clinical sputum samples, the real-time RPA displayed an admirable sensitivity (90%, 95% CI: 80·0-96·0%) and specificity (98%, 95% CI: 89·0-100·0%) compared to traditional smear microscopy, which was similar to the assay of Xpert MTB/RIF. This real-time RPA based Ag85B provides a promising strategy for the rapid and universal diagnosis of TB.

Impact of multiple policy interventions on the screening and diagnosis of drug-resistant tuberculosis patients: a cascade analysis on six prefectures in China

BackgroundThe detection of drug-resistant tuberculosis (DR-TB) is a major health concern in China. We aim to summarize interventions related to the screening and detection of DR-TB in Jiangsu Province, analyse their impact, and highlight policy implications for improving the prevention and control of DR-TB.MethodsWe selected six prefectures from south, central and north Jiangsu Province. We reviewed policy documents between 2008 and 2019, and extracted routine TB patient registration data from the TB Information Management System (TBIMS) between 2013 and 2019. We used the High-quality Health System Framework to structure the analysis. We performed statistical analysis and logistic regression to assess the impact of different policy interventions on DR-TB detection.ResultsThree prefectures in Jiangsu introduced DR-TB related interventions between 2008 and 2010 in partnership with the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) and the Bill & Melinda Gates Foundation (Gates Foundation). By 2017, all prefectures in Jiangsu had implemented provincial level DR-TB policies, such as use of rapid molecular tests (RMT), and expanded drug susceptibility testing (DST) for populations at risk of DR-TB. The percentage of pulmonary TB cases confirmed by bacteriology increased from 30.0% in 2013 to over 50.0% in all prefectures by 2019, indicating that the implementation of new diagnostics has provided more sensitive testing results than the traditional smear microscopy. At the same time, the proportion of bacteriologically confirmed cases tested for drug resistance has increased substantially, indicating that the intervention of expanding the coverage of DST has reached more of the population at risk of DR-TB. Prefectures that implemented interventions with support from the Global Fund and the Gates Foundation had better detection performance of DR-TB patiens compared to those did not receive external support. However, the disparities in DR-TB detection across prefectures significantly narrowed after the implementation of provincial DR-TB polices.ConclusionsThe introduction of new diagnostics, including RMT, have improved the detection of DR-TB. Prefectures that received support from the Global Fund and the Gates Foundation had better detection of DR-TB. Additionally, the implementation of provincial DR-TB polices led to improvements in the detection of DR-TB across all prefectures.

Practical application of the cell block technique for the diagnostics of the tumors of the pancreas and of other localizations

Liquid-based material and traditional pap smears got during fine-needle biopsies of different tumors were analyzed. Cell-cycle blocks and monolayer pills were made from liquid-based material depending on the amount of cell structures. Original method using donor thrombocyte mass was implemented to create cell-cycle blocks, especially to condense and consolidate the sediment after centrifugation. After taking pancreas punctures different medical institutions in Vladivostok managed to form cell-cycle blocks in 71 cases from 2017 to 2019. In 9 cases (12.7%) the material was found to be diagnostically noninformative, in 15 cases (21.2%) – sufficient for morphological research, but inappropriate for immunohistochemistry. In 47 cases (66.1%) 206 immunohistochemical tests were made using 34 types of biomarkers.

An alternative method for smear preparation of fine-needle aspiration cytology of cystic thyroid lesions: Evaluation of sample adequacy.

Cystic thyroid lesions represent one of the most common causes of unsatisfactory fine-needle aspiration sampling. Thus, it is important to access the maximum number of follicular cells from cystic fluid in order to reduce unsatisfactory rates. We compared the traditional method of smearing with an alternative one. For each thyroid nodule, two smears were collected. Each smear was prepared using a distinct approach: either using the traditional technique or the alternative. Clinical data were taken from cytopathological request forms. The cytological aspects of the smears (eg, adequacy and number of cells) were observed during microscopy analysis. No cases were found to be suspicious for malignancy during ultrasound analysis (categories TR1 or TR2 according to ACR TI-RADS). Thirty-five cases were analyzed. For smears prepared using both the traditional and the alternative techniques, 20 and 4 cases, respectively, were unsatisfactory. In the 20 unsatisfactory traditional smear cases, 9 (45%) showed enough cells for diagnosis in cytospin and/or cell block samples; the four unsatisfactory alternative method cases showed the same. There was a statistical difference between the two methods of collecting a smear concerning sample adequacy (P < .001), but there was no statistical difference regarding the cellularity (P = .842). In our data, the alternative method of using only one slide and the needle tip had higher rates of adequate sampling. Since it is cost effective and does not change the cytological analysis, this proposed alternative method can be useful in cases of cystic thyroid lesions.

Values of different specimen preparation methods for the diagnosis of lung cancer by endobronchial ultrasound guided transbronchial needle aspiration

BackgroundEndobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) has been become an important procedure for the diagnosis and staging of lung cancer. Our research identified the effects of different pathological preparation on the diagnosis of lung cancer for specimens obtained by biopsy.MethodsPatients were clinically considered if lung cancer was accompanied by mediastinal or hilar lymph node enlargement between March 2014 and November 2017. Specimens obtained by EBUS-TBNA were treated by three methods: traditional smear cytology, liquid-based cytology (LBC) and histopathology.ResultsOf a total of 154 puncture sites from 153 patients, the total positive rate of combination for the three pathological treatment types (histopathology, direct traditional smear, and LBC) was 77.3%. The diagnostic positive rate for histopathology was 68.6%, direct traditional smear was 65.6%, and LBC was 60.4%; there was no significant differences among the three single pathological treatment types (P = 0.29), but there was a statistically significant difference between the combination of three treatments and any single pathological treatment type (P = 0.01). The diagnostic sensitivities of histopathology combined with traditional smear and histopathology combined LBC were 94.4 and 92.8%, respectively, the specificities and PPVs were both 100%, and the diagnostic accuracies were 95.5 and 94.2%, respectively; the sensitivities, specificities and diagnostic accuracies above were all higher than those of single specimen treatment and lower than those of the three combined.ConclusionWhen EBUS-TBNA is used for the diagnosis and staging of lung cancer, the use of histopathological sections combined with direct cytological smear should be sufficient and is the most economical choice.

Development and application of an optimized drop-slide technique for metaphase chromosome spreads in maize

ABSTRACTChromosome spreads are important for complex molecular cytogenetic studies. An adequate chromosome spreading method for identification and isolation of the maize B chromosome, however, has not been reported. We used the maize inbred lines, B73 and Mo17, the hybrid YD08 line and the landrace DP76 to develop an optimized chromosome spreading method. We investigated the effects of four treatment factors on the quality of metaphase chromosome spreads using a factorial analysis of variance. Optimal conditions for metaphase spreading were identified using regression analysis based on multifactor orthogonal design of four treatment factors with five levels for each factor. We developed optimal conditions for metaphase spreading as follows: nitrous oxide treatment for 2 h, glacial acetic acid fixation for 2 h, enzyme hydrolysis for 6.0 h, and a drop height of 35 cm for cell suspension. We obtained high quality metaphase chromosome spreads with large metaphase areas, large numbers of chromosomes, few chromosome overlaps and high frequency of intact metaphases. Our optimized drop-slide procedure was markedly better than the traditional flame smear technique. We identified 487 B chromosomes in three forms from maize landraces from Southwest China. We found no relation between the C-band number and B chromosome. Single B chromosomes also were isolated directly from a metaphase chromosome drop-slide using a micromanipulator. Our optimized method provides a simple, efficient and reproducible procedure for preparing high quality plant chromosome spreads.

Application of sputum cell DNA ploidy quantitative analysis technique in early non-invasive screening of lung cancer

Objective To investigate the application value of sputum cell DNA ploidy quantitative analysis technique in early non-invasive screening of lung cancer. Methods The clinical data of 84 patients with lung cancer (lung cancer group) and 84 patients with benign lung disease (lung benign disease group) who were admitted to the Second Affiliated Hospital of Xuzhou Medical University from April 2016 to May 2017 were retrospectively analyzed, and 80 healthy subjects were selected as the control group. The sputum samples of all subjects were collected, and 55 corresponding lavage fluid samples in the lung cancer group were also collected. A fully automated cell tumor screening analysis system was used to make DNA ploidy quantitative analysis in all specimens, and the results were compared with sputum smear and liquid-based thin-layer cytology results. Results The positive detection rates of routine smear, liquid-based thin-layer cytology and DNA ploidy quantitative analysis in lung cancer group were 4.76% (4/84), 29.76% (25/84) and 45.24% (38/84). The positive detection rate of liquid-based thin-layer cytology and DNA ploidy quantitative analysis was higher than that of routine smear, and the differences were statistically significant (χ 2 = 18.38, P 0.05). Conclusions DNA ploidy quantitative analysis technique of sputum cells can directly reflect the malignant transformation of early lung cancer patients compared with traditional smear method and liquid-based thin-layer technology. Its positive detection rate is higher than that of the conventional detection method, which can be used as a valuable reference index for early screening of lung cancer. Key words: Lung neoplasms; Sputum; DNA ploidy; Diagnosis

Efficiency enhancement on the solar steam generation by wick materials with wrapped graphene nanoparticles

Solar steam generation technology can utilize abundant and renewable solar energy for many applications. In this work, we proposed a low-cost high-efficiency solar steam generator by using wick materials with wrapped graphene nanoparticles, and the energy efficiency can reaches up to 80%. Instead of traditional smearing method, the chemical wrapping method was used for better coating the graphene nanoparticles on the wick materials. Through the SEM morphological results, the graphene nanoparticles are shown to be evenly wrapped across the fibres of the wick material, which have better dispersity and stability. The evaporation rate, instantaneous energy efficiency and the solar absorptivity of three wick materials with/without nanoparticles under different conditions were compared and analyzed. Among the three different wick materials, the fine fluffy cloth can provide more three-dimensional contact area for wrapping graphene nanoparticles and thus contribute to better evaporation. Additionally, the influence of two different reduction methods and different concentrations of graphene oxide solution on the energy efficiency was also analyzed. Our work offers a simple and effective way of using nanotechnology in practical application for better solar-to-heat conversion.

Management of cytologic material, preanalytic procedures and biobanking in lymph node cytopathology.

The range of pathologies that lymph node (LN) fine needle cytology (FNC) may encounter is extremely wide and ancillary techniques, in addition to traditional smears, are generally required to reach reliable cytologic diagnoses. Storing part of the cytologic material may be useful or necessary for molecular testing. The main difficulties concern the generally small size of the sample and the different methods of acquisition of LN-FNC. Therefore, the preanalytic phase is extremely important for LN-FNC. This article outlines the management of LN-FNC material, vials, technical devices (e.g.: additional smears, cytospin slides, LBC slides, cards, resins, etc.) and main ancillary techniques to assess their optimal application, taking into account the different diagnostic needs and cell storage.

Comparative Study between Genexpert and Smear Microscopy for the Diagnosis of Tuberculosis in Samples of Patients Suspected of Pulmonary Tuberculosis – the Case Study of General Hospital, Awo-Omamma, Imo State, Nigeria

Tuberculosis (TB), caused by Mycobacterium tuberculosis, has remained a major scourge of humanity all over the world, with the greatest mortality occurrences noted, in developing countries. The cannot-be-over- emphasized burden of TB in Nigeria is among the highest in Africa. The study on hand was therefore aimed at comparing Cepheid GeneXpert MTB/ RIF assay for direct detection of Mycobacterium tuberculosis Complex (MTBC) and Rifampicin (RIF) resistance with the traditional smear microscopy method-the ZN technique. Sensitivity and specificity of diagnostic yields were high points of comparison. A carefullydesigned cross-sectional study was drawn and executed at the General Hospital, Awo-Omamma, covering patients’ inflow from August, 2016 to May 2017. Amongst the numerous patients presenting, a total of 120 samples were collected from patients with highest pulmonary concerns, having been assessed prognostically. Sixty-two patients (51.67%) were males, fifty-eight (48.33%) were females and all having mean ages of 42.2+16 years. Thirty patients (25%) had chronic lung diseases. Out of the 120 samples examined, 36 samples (30.00%) were MTBC positive by Smear microscopy while 42 (35.00%) were positive by GeneXpert. Placing both methods (GeneXpert and Smear microscopy) side-by-side, GeneXpert gave 85% sensitivity and 98.5% specificity GeneXpert indeed detected 6 (7.2%) additional positive cases as compared to Smear microscopy. Only 5 clinical isolates of the entire patients were resistant to Rifampicin. The study therefore conduced that GeneXpert was a better and more reliable diagnostic tool compared to Smear microscopy and can significantly reduce false-negatives and very interestingly, rules out the unnecessary delays often experienced hitherto with Smear microscopy in treatment initiation.

Comparative Study between Genexpert and Smear Microscopy for the Diagnosis of Tuberculosis in Samples of Patients Suspected of Pulmonary Tuberculosis – the Case Study of General Hospital, Awo-Omamma, Imo State, Nigeria

Tuberculosis (TB), caused by Mycobacterium tuberculosis, has remained a major scourge of humanity all over the world, with the greatest mortality occurrences noted, in developing countries. The cannot-be-over- emphasized burden of TB in Nigeria is among the highest in Africa. The study on hand was therefore aimed at comparing Cepheid GeneXpert MTB/ RIF assay for direct detection of Mycobacterium tuberculosis Complex (MTBC) and Rifampicin (RIF) resistance with the traditional smear microscopy method-the ZN technique. Sensitivity and specificity of diagnostic yields were high points of comparison. A carefullydesigned cross-sectional study was drawn and executed at the General Hospital, Awo-Omamma, covering patients’ inflow from August, 2016 to May 2017. Amongst the numerous patients presenting, a total of 120 samples were collected from patients with highest pulmonary concerns, having been assessed prognostically. Sixty-two patients (51.67%) were males, fifty-eight (48.33%) were females and all having mean ages of 42.2+16 years. Thirty patients (25%) had chronic lung diseases. Out of the 120 samples examined, 36 samples (30.00%) were MTBC positive by Smear microscopy while 42 (35.00%) were positive by GeneXpert. Placing both methods (GeneXpert and Smear microscopy) side-by-side, GeneXpert gave 85% sensitivity and 98.5% specificity GeneXpert indeed detected 6 (7.2%) additional positive cases as compared to Smear microscopy. Only 5 clinical isolates of the entire patients were resistant to Rifampicin. The study therefore conduced that GeneXpert was a better and more reliable diagnostic tool compared to Smear microscopy and can significantly reduce false-negatives and very interestingly, rules out the unnecessary delays often experienced hitherto with Smear microscopy in treatment initiation.

Tuberculosis exposure, infection and disease in children: a systematic diagnostic approach.

The accurate diagnosis of tuberculosis (TB) in children remains challenging. A myriad of common childhood diseases can present with similar symptoms and signs, and differentiating between exposure and infection, as well as infection and disease can be problematic. The paucibacillary nature of childhood TB complicates bacteriological confirmation and specimen collection is difficult. In most instances intrathoracic TB remains a clinical diagnosis. TB infection and disease represent a dynamic continuum from TB exposure with/without infection, to subclinical/incipient disease, to non-severe and severe disease. The clinical spectrum of intrathoracic TB in children is broad, and the classification of clinical, radiological, endoscopic, and laboratory findings into recognized clinical syndromes allows a more refined diagnostic approach in order to minimize both under- and over-diagnosis. Bacteriological confirmation can be improved significantly by collecting multiple, high-quality specimens from the most appropriate source. Mycobacterial testing should include traditional smear microscopy and culture, as well as nucleic acid amplification testing. A systematic approach to the child with recent exposure to TB, or with clinical and radiological findings compatible with this diagnosis, should allow pragmatic classification as TB exposure, infection, or disease to facilitate timely and appropriate management. It is important to also assess risk factors for TB disease progression and to undertake follow-up evaluations to monitor treatment response and ongoing evidence supporting a TB, or alternative, diagnosis.Electronic supplementary materialThe online version of this article (doi:10.1186/s41479-016-0023-9) contains supplementary material, which is available to authorized users.

Stromal tissue as an adjunct tool in the diagnosis of follicular thyroid lesions by fine-needle aspiration biopsy.

Background:The stroma in fine-needle aspiration biopsy (FNAB) of thyroid lesions has not been well investigated.Design:We studied 256 consecutive cases of thyroid FNAB prepared with traditional smear technique. The stroma was categorized: Type 1a consisted of long (more than 3 mm), broad bands composed of mesh containing collagen fibrils thickened by entrapped blood components and follicular cells. Type 1b consisted of dense strands/bands. Type 2 was similar to Type 1a but with shorter (<2 mm) and looser stromal strands.Results:Types 1a and b showed straight/curved/circular branching patterns suggestive of incomplete frameworks of nodular/papillary architectures or fragments of capsule. Type 1b stroma likely represented thick/collagenized fibrous septae. Incomplete or complete rings of small encapsulated tumor were occasionally identified. These frameworks of stroma were frequently associated with multinodular goiters (MNGs) which are often hypocellular and follicular neoplasms/papillary thyroid carcinoma with increased cellularity. Type 2 was associated with microfollicles in encapsulated neoplasms or with macrofollicles in MNG. Follicular lesions of unknown significance (n = 41) either negative (n = 26) or positive (n = 15) for carcinoma in subsequent follow-up were frequently associated with stroma characteristic of MNG and carcinoma, respectively.Conclusion:The preservation of the in vivo architecture of Type 1 is likely due to its elasticity. Recognition of the stromal architecture will likely facilitate the diagnosis.