Do proficiency test results correlate with the work performance of screeners who screen Papanicolaou smears?

We rescreened Papanicolaou smear slides from 40,245 women, which had been examined by 81 cytology screeners, scored the screeners' work performance, and compared these scores with the results of the screeners' performance on glass slide and computer-based proficiency tests. All diagnoses (i.e.

Quality assurance in molecular genetic testing laboratories.

Context: Specific regulation of laboratories performing molecular genetic tests may be needed to ensure standards and quality assurance (QA) and safeguard patient rights to informed consent and confidentiality. However, comprehensive analysis of current practices of such laboratories, important for assessing the need for regulation and its impact on access to testing, has not been conducted.

Objective: To collect and analyze data regarding availability of clinical molecular genetic testing, including personnel standards and laboratory practices.

Future directions for research in laboratory medicine: the findings of a Delphi survey of stakeholders.

In July 1995, we asked 101 experts to anticipate future areas for research in clinical laboratory medicine using a modified Delphi survey approach. The panel included academicians, clinical laboratory professionals, laboratory managers, practicing physicians public health officials, hospital administrators, and representatives of manufacturing industries, managed care organizations, commercial laboratories, and government health agencies. The participants predicted fewer laboratories, more automation, and fewer skilled staff needed in the future.

An evaluation of partner notification for HIV infection in genitourinary medicine clinics in England.

Objective: To evaluate the feasibility and effectiveness of a standardized HIV partner notification programme within genitourinary medicine clinics in England.

Design: A prospective survey of HIV partner notification activity over a 12-month period.

Setting: Nineteen genitourinary medicine clinics in England.

Ethnic differences in women with HIV infection in Britain and Ireland. The study group for the mrc collaborative study of HIV infection in women.

Objective: To examine ethnic differences in the socio-epidemiological and clinical characteristics of a cohort of women with HIV infection in Britain and Ireland.

Design And Methods: Analysis of baseline data (ethnic group, sexual history, likely route of HIV infection, reasons for HIV testing and first AIDS-defining disease) from 400 women with HIV infection recruited into a cohort study from 15 genitourinary medicine/HIV clinics in Britain and Ireland.

Results: Sixty-five per cent of women were white and 29% black African.

Lead poisoning among household members exposed to lead-acid battery repair shops in Kingston, Jamaica.

To investigate the risk of lead poisoning among household members exposed to 'backyard' battery repair shops (BBRS) in Kingston, Jamaica, environmental and blood lead (PbB) were measured at 24 households (112 individuals) with a BBRS worker or located at a BBRS premises and at 18 neighbourhood control households (74 individuals). Elevated PbB (greater than or equal to 25 micrograms per decilitre [micrograms/dl]) was common among subjects of all ages living at BBRS premises, especially among children less than age 12, 43% of whom had PbB greater than 70 micrograms/dl. Potentially hazardous soil and house dust lead levels were also common at BBRS premises, where 84% of yards had soil lead levels above 500 parts per million (geometric mean 3388 parts per million [ppm] at BBRS premises households with a BBRS worker).

Lead exposure among lead-acid battery workers in Jamaica.

To assess lead exposure in the Jamaican lead-acid battery industry, we surveyed three battery manufacturers (including 46 production workers) and 10 battery repair shops (including 23 battery repair workers). Engineering controls and respiratory protection were judged to be inadequate at battery manufacturers and battery repair shops. At manufacturers, 38 of 42 air samples for lead exceeded a work-shift time-weighted average concentration of 0.

A large outbreak of acupuncture-associated hepatitis B.

An epidemiologic investigation of an acupuncturist's practice in Rhode Island identified 35 patients who were infected with hepatitis B virus during 1984. Of 366 patients seen by the acupuncturist during 1984, 316 (86%) completed questionnaires and submitted serum for hepatitis B serology. Use of tests for immunoglobulin M antibody to hepatitis B core antigen (IgM anti-HBc) identified 17 case-patients who otherwise may have gone undetected.

A retrospective cohort mortality study of workers exposed to formaldehyde in the garment industry.

In order to assess the possible human carcinogenicity of formaldehyde we conducted a retrospective cohort mortality study of workers exposed for at least three months to formaldehyde in three garment facilities which produced permanent press garments. A total of 11,030 workers contributing 188,025 person-years were included in the study. Vital status was successfully ascertained through 1982 for over 96% of the cohort.

Screening for Chlamydia trachomatis infection in a sexually transmitted disease clinic: comparison of diagnostic tests with clinical and historical risk factors.

Of 212 consecutive male patients and 212 consecutive female patients attending a sexually transmitted disease (STD) clinic, 36 (17%) men and 28 (13%) women had urethral or cervical cultures positive for Chlamydia trachomatis. When compared with culture, the direct fluorescent antibody test (MicroTrak, Syva Co., Palo Alto, CA) had a sensitivity of 75% and a specificity of 97% in men; for women the sensitivity and specificity were 68% and 82%, respectively.

Proportionate mortality study of workers in the garment industry exposed to formaldehyde.

In order to evaluate the human carcinogenicity of formaldehyde, we conducted a proportionate mortality study of garment workers engaged in the production of shirts from formaldehyde-treated cloth. This study included three plants, and was based upon 256 deaths identified from a death-benefit insurance fund. No deaths due to nasal cancer were observed, and the mortality from respiratory cancer (11 cases, PMR = 95) was slightly less than expected.

Case-control study of Mastomys natalensis and humans in Lassa virus-infected households in Sierra Leone.

Lassa virus infection and antibodies were studied in households where Lassa fever cases occurred, and compared to those in nearest neighbor houses and "far" houses located across the village from case houses. Seventy-nine percent of all rodents caught in the houses were Mastomys, the natural reservoir of Lassa virus. Rodent infection was not randomly distributed, but rather focal.

Keratoconjunctivitis associated with adenovirus type 37: an extended outbreak in an ophthalmologist's office.

An outbreak of epidemic keratoconjunctivitis occurred in three clusters among patients of an ophthalmologist during 1977-1978. Cases in the third cluster and possibly one case in the first were caused by infection with adenovirus type 37. Among 83 infected patients, the mean interval between a visit to the ophthalmologist's office and the onset of symptoms was 11 days.

Nasal cancer in a worker exposed to formaldehyde.

Formaldehyde has not been established as a human carcinogen. Toxicological studies have, however, demonstrated that formaldehyde causes squamous cell carcinoma of the nasal cavity in rats. A case of squamous cell carcinoma of the nasal cavity occurred in a 57-year-old man who had 25 years of occupational exposure to low concentrations of formaldehyde in the textile-finishing industry.

Nosocomial herpetic infections in a pediatric intensive care unit.

A series of acute herpetic infections occurred among nurses and patients in a pediatric intensive care unit (PICU). Epidemiologic study revealed two separate time clusters of infections, one in early summer and another six weeks later. Restriction endonuclease analysis of DNA extracted from virus isolates showed that each time cluster was associated with a different genetic strain of herpes simplex virus (HSV) type 1 and provided evidence of cross infection between patients and nurses.

Fatal Guillain-Barré syndrome after the national influenza immunization program.

Fifty-eight fatal cases of Guillain-Barré syndrome (GBS) were reported during the 1976 to 1977 National Influenza Program: Thirty-two (58%) of these patients had received the A/New Jersey influenza vaccine. The mean interval from vaccination to onset was 3.9 weeks, and the incidence of preceding illness in vaccinated or unvaccinated patients was similar.