The role of liquid-based cytology and ancillary techniques in pleural and pericardic effusions: An institutional experience

BACKGROUND: Fine-needle aspiration cytology (FNAC) of serous membrane effusions may fulfil a challenging role in the diagnostic analysis of both primary and metastatic disease. From this perspective, liquid-based cytology (LBC) represents a feasible and reliable method for empowering the performance of ancillary techniques (ie, immunocytochemistry and molecular testing) with high diagnostic accuracy. METHODS: In total, 3171 LBC pleural and pericardic effusions were appraised between January 2000 and December 2013. They were classified as negative for malignancy (NM), suspicious for malignancy (SM), or positive for malignancy (PM). RESULTS: The cytologic diagnoses included 2721 NM effusions (2505 pleural and 216 pericardic), 104 SM effusions (93 pleural and 11 pericardic), and 346 PM effusions (321 pleural and 25 pericardic). The malignant pleural series included 76 unknown malignancies (36 SM and 40 PM effusions), 174 metastatic lesions (85 SM and 89 PM effusions), 14 lymphomas (3 SM and 11 PM effusions), 16 mesotheliomas (5 SM and 11 SM effusions), and 3 myelomas (all SM effusions). The malignant pericardic category included 20 unknown malignancies (5 SM and 15 PM effusions), 15 metastatic lesions (1 SM and 14 PM effusions), and 1 lymphoma (1 PM effusion). There were 411 conclusive immunocytochemical analyses and 47 molecular analyses, and the authors documented 88% sensitivity, 100% specificity, 98% diagnostic accuracy, 98% negative predictive value, and 100% positive predictive value for FNAC. CONCLUSIONS: FNAC represents a primary diagnostic tool for effusions and a reliable approach with which to determine the correct follow-up. Furthermore, LBC is useful for ancillary techniques, such as immunocytochemistry and molecular analysis, with feasible diagnostic and predictive utility.

Critical analyses of the introduction of liquid-based cytology in a public health service of the state of São Paulo, Brazil

OBJECTIVE The aim of this study was to compare the performance of the current conventional Pap smear with liquid-based cytology (LBC) preparations. STUDY DESIGN Women routinely undergoing their cytopathological and histopathological examinations at Fundação Oncocentro de São Paulo (FOSP) were recruited for LBC. Conventional smears were analyzed from women from other areas of the State of São Paulo with similar sociodemographic characteristics. RESULTS A total of 218,594 cases were analyzed, consisting of 206,999 conventional smears and 11,595 LBC. Among the conventional smears, 3.0% were of unsatisfactory preparation; conversely, unsatisfactory LBC preparations accounted for 0.3%. The ASC-H (atypical squamous cells - cannot exclude high-grade squamous intraepithelial lesion) frequency did not demonstrate any differences between the two methods. In contrast, the incidence of ASC-US (atypical squamous cells of undetermined significance) was almost twice as frequent between LBC and conventional smears, at 2.9 versus 1.6%, respectively. An equal percentage of high-grade squamous intraepithelial lesions were observed for the two methods, but not for low-grade squamous intraepithelial lesions, which were more significantly observed in LBC preparations than in conventional smears (2.2 vs. 0.7%). The index of positivity was importantly enhanced from 3.0% (conventional smears) to 5.7% (LBC). CONCLUSIONS LBC performed better than conventional smears, and we are truly confident that LBC can improve public health strategies aimed at reducing cervical lesions through prevention programs.

The diagnostic and prognostic role of liquid-based cytology: are we ready to monitor therapy and resistance?

Here, we evaluate the diagnostic and prognostic role of liquid-based cytology (LBC) in different body lesions, including thyroid, lung, effusions and malignant breast lesions. LBC has gained consensus after being applied to both non-gynecologic and fine-needle aspiration cytology. Although some remain sceptical regarding the diagnostic efficacy of LBC, mainly when used alone, in recent years, good results have been obtained as long as it showed a high diagnostic accuracy. Here, we discuss the additional possibility of storing material for the application of ancillary techniques (immunocytochemistry–molecular analysis) with several diagnostic and prognostic advantages, which may pave the way for the challenging evaluation of both monitoring responses to treatment and resistance to targeted therapies in thyroid, lung, breast carcinoma or malignant effusions. Furthermore, it provides the use of several molecular spots as specific targets for personalized therapy.

High performance electromechanical actuators based on ionic liquid/poly(vinylidene fluoride)

Due to the increasing need of low voltage actuators, independent from electrochemical processes, electroactive actuators based on poly(vinylidene fluoride) composites with 10, 25 and 40 % of 1-ethyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide, [C2mim] [NTf2], ionic liquid are prepared by solvent casting and melting. We show that the charge structure of [C2mim] [NTf2] induces the complete piezoelectric -phase crystallization of the PVDF within the composite and decreases its crystallinity fraction significantly. [C2mim] [NTf2] also works as a plasticizer of PVDF, reducing the elastic modulus down to 12 % of the initial value. Moreover, the composites show significant displacement and bending under applied voltages of 2, 5 and 10 Vpp. The displacement and bending of the composite membranes are also evaluated as a function of [C2mim] [NTf2] content and sample thickness. Increasing amounts of ionic liquid result in larger deformations independently of the applied voltage.

Effect of ionic liquid anion and cation on the physico-chemical properties of poly(vinylidene fluoride)/ionic liquid blends

Poly(vinylidene fluoride), PVDF, has been blended with different ionic liquids (IL) in order to evaluate the effect of the different IL anions and cations on the electroative -phase, thermal, mechanical and electrical properties of the polymer blend. [C2MIM][Cl], [C6MIM][Cl], [C10MIM][Cl], [C2MIM][NTf2], [C6MIM][NTf2], [C10MIM][NTf2] have been selected and were introduced in the polymer at a weight percentage of 40 wt%. It was found that the incorporation of ILs into the PVDF matrix leads to an increase of the -phase content due to the strong electrostatic interactions between the dipolar moments of PVDF and the ILs. Further, the incorporation of ILs into PVDF strongly decreases the elastic modulus and increases the electrical conductivity of the blend with respect to the pure polymer matrix, all these effects being accompanied by a modification of the crystallization kinetics, as indicated by the modified spherulitic microstructure. Thus, novel PVDF/IL blends films with high transparency, excellent antistatic properties, and highly polar crystal form fraction were successfully achieved.

Effect of ionic liquid anion type in the performance of solid polymer electrolytes based on Poly(Vinylidene fluoride-trifluoroethylene)

The effect of different anions within the ionic liquid in the characteristics of solid polymer electrolytes (SPEs) based on P(VDF-TrFE) has been investigated. 1-ethyl-3-methylimidazolium acetate, [C2mim][OAc], 1-ethyl-3-methylimidazolium triflate, [C2mim][(CF3SO3)3], 1-ethyl-3-methylimidazolium lactate, [C2mim][Lactate], 1-ethyl-3-methylimidazolium thiocyanate, [C2mim][SNC] and 1-ethyl-3-methylimidazolium hydrogen sulphate [C2mim][HSO4] have been used in SPE prepared by thermally induced phase separation (TIPS). The polymer phase, thermal and electrochemical properties of the SPE have been determined. The thermal and electrical properties of the SPEs strongly depend on the selected IL, as determined by their different interactions with the polymer matrix. The room temperature ionic conductivity increases in the following way for the different anions: [SNC] > [CF3SO3)3] > [HSO4] > [Lactate] > [OAc], which is mainly dependent on the viscosity of the ionic liquid.

Electrochromic devices incorporating biohybrid electrolytes doped with a lithium salt, an ionic liquid or a mixture of both

The sol-gel method was employed in the synthesis of di-urethane cross-linked poly( caprolactone) (PCL(530)/siloxane biohybrid ormolytes incorporating either a mixture of lithium triflate (LiCF3SO3) and the ionic liquid (IL) 1-ethyl-3-methyl imidazolium tetrafluoroborate ([Emim]BF4), or solely with [Emim]BF4 or LiCF3SO3. The ormolyte doped with [Emim]BF4 is thermally more stable and exhibits higher ionic conductivity (4 x 10-4 and 2 x 10-3 S cm-1 at 36 and 98 ºC, respectively) than those containing the LiCF3SO3/[Emim]BF4 mixture or just LiCF3SO3. The three ormolytes were employed in the production of glass/ITO/ormolyte/WO3/ITO/glass electrochromic devices (ECDs) designated as ECD@Y with Y = Li-[Emim]BF4, [Emim]BF4 and Li. The three ECDs displayed fast switching speed (ca. 30 s). ECD@Li-[Emim]BF4 exhibited an electrochromic contrast of 18.4 % and an optical density change of 0.11 in the visible region, the coloration efficiency attained at 555 nm was 159 and 80.2 cm-2 C-1 in the “on” and “off” states, respectively, and the open circuit memory was 48 hours. In the “on” state the CIE 1931 color space coordinates were x = 0.29 and y = 0.30, corresponding to blue color.

Effect of the alkyl chain length of the ionic liquid anion on polymer electrolytes properties

New polymer electrolytes (PEs) based on chitosan and three ionic liquid (IL) families ([C2mim][CnSO3], [C2mim][CnSO4] and [C2mim][diCnPO4]) were synthesized by the solvent casting method. The effect of the length of the alkyl chain of the IL anion on the thermal, morphological and electrochemical properties of the PEs was studied. The solid polymer electrolytes (SPE) membranes were analyzed by differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), X-ray diffraction (XRD), scanning electron microscopy (SEM), energy dispersive X-ray (EDX), polarized optical microscopy (POM), atomic force microscopy (AFM), complex impedance spectroscopy (ionic conductivity) and cyclic voltammetry (CV). The obtained results evidenced an influence of the alkyl chain length of the IL anion on the temperature of degradation, birefringence, surface roughness and ionic conductivity of the membranes. The DSC, XRD and CV results showed independency from the length of the IL-anion-alkyl chain. The PEs displayed an predominantly amorphous morphology, a minimum temperature of degradation of 135 °C, a room temperature (T = 25 °C) ionic conductivity of 7.78 × 10−4 S cm−1 and a wide electrochemical window of ∼ 4.0 V.

Gellan gum-Ionic liquid membranes for electrochromic device application

Biopolymer-based materials have been of particular interest and they are alternatives to synthetic polymers based on the decreasing oil resources. The polymer electrolytes were doped with choline-based IL N,N,Ntrimethyl- N-(2-hydroxyethyl)ammonium bis(trifluoromethylsulfonyl)imide ([N1 1 1 2(OH)][NTf2]), or Er (CF3SO3)3 or both. The polymer electrolytes were employed in the production of glass/ITO/WO3/electrolyte/ CeO2–TiO2/ITO/glass electrochromic devices (ECDs). The lowest onset temperature for the degradation of all the SPEs is at ~130 °C for the Gellan Er (CF3SO3)3 (10:1) this temperature range of stability is wide enough for a material to be applied as an electrolyte/separator component in electrochemical devices. The three ECDs displayed fast switching speed (ca. 15 s). Gellan [N1 1 1 2(OH)][NTf2] Er (CF3SO3)3 (5:1:10) exhibited an electrochromic contrast of 4.2% in the visible region, the coloration efficiency attained at 555 nm was 3.5 and 0.90 cm-2 C-1 in the “colored” and “bleached” states, respectively, and the open circuit memorywas 48 h. Preliminary tests performed with a prototype electrochromic device (ECD) incorporating WO3 as cathodic electrochromic layer, are extremely encouraging.

MMP-9/RECK imbalance: a mechanism associated with high-grade cervical lesions and genital infection by Human Papillomavirus (HPV) and Chlamydia trachomatis

"Manuscript"

Human papillomavirus (HPV) screening and cervical cancer burden. A Brazilian perspective

This review tackles the issues related to disease burden caused by cervical cancer (CC) and its precursor (CIN) lesions in Brazil. A special focus is given to new technologies with potential to interfere with the development of CC by reducing the high-risk human papillomavirus (hr-HPV)-induced lesions that remain a major public health burden in all developing countries where organized screening programs do not exist. Globally, 85 % of all incident CC and 50 % of CC deaths occur in the developing countries. Unfortunately, most regions of Brazil still demonstrate high mortality rates, ranking CC as the second most common cancer among Brazilian women. Recently, CC screening programs have been tailored in the country to enable early detection of CC precursor lesions and thereby reduce cancer mortality. A combination of HPV testing with liquid-based cytology (LBC) seems to be a promising new approach in CC screening, with high expectation to offer an adequate control of CC burden in this country.

HPV DNA testing with cytology triage in cervical cancer screening: Influence of revealing HPV infection status

BACKGROUND: Knowledge of cervical human papillomavirus (HPV) status might influence a cytotechnician's assessment of cellular abnormalities. The authors compared original cytotechnicians' Papanicolaou (Pap) readings for which HPV status was concealed with Pap rereads for which HPV status was revealed separately for 3 screening populations. METHODS: Previously collected cervical Pap smears and clinical data were obtained from the Canadian Cervical Cancer Screening Trial (study A), the Democratic Republic of Congo Community-Based Screening Study (study B), and the Brazilian Investigation into Nutrition and Cervical Cancer Prevention (study C). Smears were reread with knowledge of HPV status for all HPV-positive women as well as a sample of HPV-negative women. Diagnostic performance of Pap cytology was compared between original readings and rereads. RESULTS: A total of 1767 Pap tests were reread. Among 915 rereads for HPV-positive women, the contrast between "revealed" and "concealed" Pap readings demonstrated revisions from negative to positive results for 109 women (cutoff was atypical squamous cells of undetermined significance or worse) and 124 women (cutoff was low-grade squamous intraepithelial lesions [LSIL] or worse). For a disease threshold of cervical intraepithelial neoplasia of grade 2 or worse, specificity significantly declined at the atypical squamous cells of undetermined significance cutoff for studies A (86.6% to 75.3%) and C (42.5% to 15.5%), and at the LSIL cutoff for study C (61.9% to 37.6%). Sensitivity remained nearly unchanged between readings, except in study C, in which reread performance was superior (91.3% vs 71.9% for the LSIL cutoff). CONCLUSIONS: A reduction in the diagnostic accuracy of Pap cytology was observed when revealing patients' cervical HPV status, possibly due to a heightened awareness of potential abnormalities, which led to more false-positive results. Cancer (Cancer Cytopathol) 2015. (c) 2015 American Cancer Society.

Recommendations on quality control and quality assurance in cervical cytology

Objective: We aimed to critically evaluate the importance of quality control (QC) and quality assurance (QA) strategies in the routine work of uterine cervix cytology. Study Design: We revised all the main principles of QC and QA that are already being implemented worldwide and then discussed the positive aspects and limitations of these as well as proposing alternatives when pertinent. Results: A literature review was introduced after highlighting the main historical revisions, and then a critical evaluation of the principal innovations in screening programmes was conducted, with recommendations being postulated. Conclusions: Based on the analysed data, QC and QA are two essential arms that support the quality of a screening programme.

Vapor - liquid equilibrium of systems containing perfluoromethyl-cyclohexane and hydrocarbons

Vapor - liquid equilibrium data for the binary systems: Perfluoromethylcyclohexane + n-Hexane and Perfluoromethylcyclohexane + 1-Hexene were determined at 93.3 KPa and 328.15 K. The vapor pressure for the pure components were also measured to calculate the Antoine constants. The data were correlated by using the Van-Laar, Margules, Wilson, NRTL and UNIQUAC equations. UNIFAC group-contribution parameters between CH, and CF,, and CH,=CH and CF, were also calculated.