Objectives. To evaluate the association of pre-visit anxiety with pre-and post-visit knowledge, satisfaction, and adherence to colposcopy follow-up visits.Methods. A group of 122 women presenting for colposcopy between July 1999 and May 2000 were studied. Immediately prior to their appointment, 98% of eligible patients participated in a self-administered questionnaire. Patients were sent a follow-up questionnaire within two weeks of the appointment. Statistical analyses included Chi-Square and Fisher's exact tests for categorical variables.Results. The mean follow up was 112 days (SE 9.47). Although the mean fear score was 7.3 (SE 3, range 1-10) and mean anxiety score was 7.8 (SE 2.8, range 1-10), there was no significant association with pre-visit fear and adherence to follow up. Pre-evaluation knowledge was positively associated with fear, anxiety, post-visit knowledge, and adherence to follow up.Conclusions. Pre-visit intervention may improve adherence and reduce anxiety associated with colposcopy.
Review of histopathologic material diagnosed at outside institutions is generally recognized as an important aspect of quality assurance and risk management. However, review of external cytology specimens is usually undertaken (if at all) only for fine-needle aspiration material. Because of anecdotal observations that colposcopic biopsies, loop electrosurgical excision procedures, and conizations often did not reflect the level of cervical disease predicted by Papanicolaou smears read at outside institutions, we decided to study the cyto/histopathologic correlation rates for outside and in-house Papanicolaou smears. Thirty-seven outside and 35 in-house control smear diagnoses were compared with subsequent tissue specimens at our hospital over a 22-month period. Cases diagnosed on outside smears as squamous intraepithelial lesions (SILs) yielded tissue diagnoses of low-grade SIL or higher in 11 of 22 cases (50%), while in-house SIL smear diagnoses correlated with the tissue diagnosis in 11 of 16 cases (69%). Although the numbers are too small for statistical significance, the results suggest that larger studies might provide interesting answers and might suggest that Papanicolaou smears be added to the list of pathologic specimens to be reviewed at referral institutions before expensive diagnostic and therapeutic maneuvers are undertaken.A t the University of Maryland Medical Center, outside slides (OS) from biopsy specimens diagnosed in other pathology departments are routinely requested by our gynecologists for review in our own Department of Pathology before major surgical or other therapeutic procedures are undertaken. On the other hand, women whose cervicovaginal Papanicolaou smears were interpreted in outside laboratories-often because of contracts with health care insurersare usually referred for colposcopic biopsy and repeat cytology on the basis of the outside Papanicolaou smear diagnosis. Because anecdotally numerous cases were seen with negative follow-up colposcopic, biopsy, and repeat Papanicolaou smear findings after an outside Papanicolaou smear reading of atypical squamous cells of undetermined significance (AS-CUS) or squamous intraepithelial lesion (SIL), we decided to compare the cytohistologic correlation between our cervical biopsy material and corresponding in-house and outside laboratory Papanicolaou smear reports.
MATERIALS AND METHODSWe reviewed cervical cytologic specimens at
SynopsisThe Forth is of great importance for nature conservation. More than half of the coastline of the estuary and the Firth of Forth is assessed to be sufficiently important for designation as Sites of Special Scientific Interest (SSSIs). The basis of the selection of these sites is discussed. The SSSIs are then described, including those which are managed as nature reserves. Wider aspects of conservation in the Forth are referred to. The main threats to wildlife sites and species are indicated, together with possible solutions, and opportunities for conservation.
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