Diagnostic

Cytopathic effects related to the human papillomavirus (HPV) infection are more frequently found in cervical intraepithelial neoplasia (CIN) 1; however, there are indications that at least half the histological diagnoses of CIN2 and CIN3 include koilocytosis areas. The objective of this study was to evaluate the frequency of the cytological criteria suggestive of HPV infection in the cervical smears of women with a histological diagnosis of CIN. One hundred and sixty-two women with abnormal cervical smears and a diagnosis of CIN confirmed by histopathology were selected, including 46 cases of CIN 1, 42 of CIN 2 and 74 cases of CIN 3. Koilocytosis was found in 63% of the smears from women with a histopathological diagnosis of CIN 1. This sign was observed in 26.2% and 25.7% of smears of women with a diagnosis of CIN 2 and CIN 3, respectively. Cytomegaly also was frequent in cervical smears of women with histopathological diagnosis of CIN 1 (71.8%). On the other hand, spindle cells and atypical metaplasia were more frequent in women with CIN 2 and CIN 3. Atypical parakeratosis showed similar frequency in all grades of CIN diagnosis. Koilocytois and cytomegaly were inversely correlated with the diagnosis of CIN2 or CIN 3, with OR values respectively of 0.30 (95%CI 0.13-0.68) and 0.26 (95%CI 0.11-0.58). The others signs analyzed did not show any significant association. Koilocitosis and cytomegaly can provides good reassurance that a patient with atypical cervical smear have CIN 1.

En 1970, la Côte d’Ivoire a opté pour le tourisme balnéaire au détriment de celui de découverte dans
les perspectives décennales de développement du pays. Plusieurs régions (Assouindé, Adiaké, Grand-
Bassam, San Pedro, Grand-Béréby, etc.) ont amorcé leur véritable essor de l'activité touristique. Mais,
le département de Tiassalé ne figure pas parmi ces destinations privilégiées, en dépit de ses
nombreuses potentialités. Le problème qui fonde cette étude est les obstacles freinant la promotion et
la valorisation des potentialités touristiques dans ce département. L’objectif de cet article vise à
identifier les contraintes et à proposer les stratégies pour le développement touristique dans le
département de Tiassalé. À partir des recherches documentaires, des enquêtes qualitatives et
quantitatives, la stratégie de développement local touristique efficiente du département de Tiassalé a
été étudiée. Il ressort de cela que dans le département de Tiassalé, la mise en tourisme local est sujette
de trois types de contraintes majeures, notamment naturelle, sociologique et organisationnelle. Ainsi,
ces contraintes peuvent-elles être surmontées par des stratégies efficientes comme le développement
de l’écotourisme, l’aménagement des sites à intérêt touristique dans ledit département.
Mots-clés : Contraintes et stratégies, développement touristique, département de Tiassalé

Resumen El virus dengue es el arbovirus de mayor importancia a nivel mundial; alrededor de 2 500 millones de personas viven en más de 100 países endémicos. Hasta 50 millones de infecciones ocurren anualmente con 500 000 casos de fiebre hemorrágica por dengue y 22 000 muertes principalmente entre niños. En el Ecuador el dengue es una enfermedad endémica y los cuatro serotipos se encuentran circulando. Este trabajo hace una breve revisión bibliográfica de las bases moleculares de la patogenicidad; así como también de las interacciones inmunológicas moleculares virus-huésped, haciendo énfasis en los hallazgos más importantes tanto a nivel experimental cuanto a nivel clínico, finalmente se discuten las perspectivas del conocimiento actual. PALABRAS CLAVE: dengue, patogenicidad, patología molecular. Abstract The dengue virus is the most important arbovirus worldwide; about 2500 million people live in more than 100 endemic countries. Up to 50 million infections occur annually with 500,000 cases of hemorrhagic fever caused by dengue and 22000 deaths mainly among children. In Ecuador dengue is endemic and the four serotypes are circulating. This paper is a brief bibliographic review of the molecular basis of pathogenicity; as well as of the immunological molecular virus-host interactions, with emphasis on the most important findings both experimentally and clinically. Finally the prospects of current knowledge are discussed. Resumo O vírus da dengue é a arbovirose de maior importância ao nível global; aproximadamente 2.500 milhões de pessoas vivem em mais de cem países endêmicos. Até 50 milhões de infecções ocorrem cada ano com 500 mil casos de dengue hemorrágica e 22 000 mortos principalmente entre crianças. No Equador, a dengue é uma doença endêmica e os quatro sorotipos circulam. Este documento faz uma breve revisão da literatura das bases mole-culares da patogenicidade; bem como a interações imunológicas moleculares vírus-hospedeiro, com ênfase nos achados mais importantes tanto no nível experimental como no nível clínico, finalmente, se discutem as perspectivas do conhecimento atual.

Telecytology (TC) can assist cytopathologists in efficiently providing immediate evaluation for fine needle aspirations (FNAs) performed at remote locations. Our aim was to evaluate the accuracy and feasibility of TC for immediate assessments of FNAs. Phase I: Diff-Quik and Pap stained smears from two retrospective sets of 20 pilot cases each (n = 40) were included for TC assessments. For the first set, diagnoses were rendered by four pathologists and for the second set, in addition, four cytotechnologists also participated. Diagnostic concordance with the final diagnosis was assessed. Phase IIA: These were followed by real time assessments (RTA) of 56 TC FNAs and diagnostic concordance was compared to that of 100 conventional in-person immediate assessments (Phase IIB). Phase I: 79/80 (98.8%) diagnoses (20 cases × 4 pathologists) from the first set were accurate. On the second set, 160 diagnoses were rendered on Pap stained slides and 160 on Diff-Quik stained slides. The accuracy rate was 95% (76/80) for malignant diagnoses and 96.2% (77/80) for benign diagnoses on Pap stain. Diff-Quik stains were more difficult to interpret than Pap stains and accuracy rates for them were lower. Endoscopic bronchial ultrasound guided (EBUS) FNAs of paratracheal nodes were more difficult to interpret. Phase IIA and B: 95% (53/56) RTAs by TC were concordant with the final diagnoses compared with 97% (97/100) for in-person assessments. TC is a useful aid and yields concordance rates comparable to in-person assessments. Individual practices should perform pilot studies to understand the pitfalls and limitations before employing telecytology.

Four cases of non-Hodgkin lymphoma of thyroid, diagnosed by fine-needle aspiration (FNA) cytology during a period of 3 1/2 yr constituted 0.2% of 1,716 thyroid FNAs and 3.4% of 118 thyroid neoplasms. The age of the patients ranged from 42 to 78 yr with an average of 63 yr and all were females. Three cases had thyroid swellings, and one case had cervical lymphadenopathy and fullness in the thyroid region. The lymphomas were categorized as mixed small and large cell lymphomas, large cell lymphoma, small noncleaved lymphoma (non-Burkitt-type), and plasmacytoid lymphoma. Histopathology as well as immunohistochemistry confirmed the cytodiagnosis of lymphoma in the first and fourth cases. In the second case where possibility of anaplastic carcinoma could not be ruled out altogether at initial cytologic examination, the histopathology report was undifferentiated carcinoma but immunohistochemically it was proved to be a B-cell neoplasm.