Expression of Ki-67, P53 and Progesterone Receptors in Uterine Smooth Muscle Tumors. Diagnostic Value

Aim was to investigate expression of Ki-67, P53 and progesterone receptors (PR) in leiomyomas (LM), smooth muscle tumors of uncertain malignant potential (STUMP) and leiomyosarcomas (LMS) and to establish possible usefulness of these three parameters in distinguishing between LM and STUMP, and STUMP and LMS. Retrospective study of 51 uterine smooth muscle neoplasm (16 LM, 18 STUMP, 17 LMS) technically acceptable for analyses from years 2002–2007 from Department of Gynecological and Prenatal Pathology, University Hospital Center Zagreb, Croatia. Immunohistochemical analysis of Ki-67, P53 and PR expression was performed. Every nuclei stained brown, regardless of shade intensivity, was considered positive. The interpretation of immunohistochemical staining was expressed as number of positive cells in 100 cell count in most active area of the slide. Non-parametric analysis of variance Kruskal-Walis test was performed. Ki-67 expression was negative in all LM and higher than 5% in 12/18 STUMP and 10/17 LMS. Significant differences were observed between LM and STUMP expression for Ki-67 (p=0.000), and LM and LMS expression for Ki-67 (p=0.000).There was no expression of P53 in LM, expression of P53 was found in 7/17 LMS and 5/18 STUMP. Expression of P53 was significant between LM and LMS (p=0.002), and between LM and STUMP (p=0.006). Expression of PR was found in 16/16 LM and 18/18 STUMP, 10/17 LMS did not show PR expression. Expression of PR was significant between LM and LMS (p=0.018) and STUMP and LMS (p=0.004). The findings of our study in concordance with other study results are helpful information establishing more diagnostic criteria and parameters for diagnosis in doubtful cases between three entities. Immunoassaying for Ki-67, P53 and PR are such parameters. The panel of their expression in specific case eases diagnosis

AUTOIMMUNE DISEASES OF ORAL MUCOSA

Autoimune bolesti nastaju kao posljedica djelovanja imunološkog sustava protiv stanica vlastitog organizma. Ovisno o ciljnim stanicama autoimune bolesti možemo podijeliti na organ specifične, tj. one koje zahvaćaju samo jedan organ odnosno organski sustav te sistemske autoimune bolesti. U velikom broju bolesti koje pripadaju ovoj skupini može biti zahvaćena sluznica usne šupljine, a kliničke slike kojima se manifestiraju mogu biti vrlo raznolike. Oralne se lezije mogu pojaviti u najranijim stadijima autoimunih bolesti, a nekima od njih mogu biti prva, pa čak i jedina manifestacija. S obzirom da mnoge od tih bolesti mogu imati ozbiljnu životnu prognozu važno je promjene na sluznici usne šupljine pravodobno prepoznati, dijagnosticirati te započeti odgovarajuće liječenje. U ovome su radu obrađene autoimune bolesti koje se najčešće manifestiraju na sluznici usne šupljine kao što su autoimune bulozne dermatoze te eritemski lupus.Autoimmune diseases occur as a consequence of activity of one’s own immune system against the body’s own cells. Depending on target cells, autoimmune diseases are divided into organ-specific, i.e. those that affect only one organ or organ system, and systemic autoimmune diseases. In a large number of diseases belonging to this group, oral mucosa may be affected and the clinical picture can be very diverse. Oral lesions may occur in the earliest stages of autoimmune diseases, and some of them may be the first, or even the only manifestation. Given that many of these diseases can have serious life prediction, it is important to recognize changes in oral mucosa, diagnose them and start appropriate treatment on time. This paper deals with autoimmune diseases that often manifest on oral mucosa, such as autoimmune blistering diseases and lupus erythematosus

The Most Common Cutaneous Side Effects of Epidermal Growth Factor Receptor Inhibitors and Their Management

The use of epidermal growth factor receptor inhibitors (EGFRI) for the treatment of solid tumors is increasing due to elevated expression of epidermal growth factor receptors (EGFR) in the stimulation of tumor development. EGFR inhibitors have shown to be effective in the treatment of neoplasms of the head, neck, colon, and lung. Inhibition of EGFR may cause cutaneous reactions in more than 50% of patients. The most common skin manifestations are papulopustular lesions in the seborrhoeic areas (upper torso, face, neck, and scalp). Other cutaneous side effects include xerosis and hair and nail changes. The onset of eruption is usually within one to three weeks after starting therapy, although in some cases it may occur much later. All dermatologic side effects are reversible and generally resolve after adequate therapy. However, for a minority of patients side effects are severe and intolerable, demanding dose reduction or even interruption of therapy. A positive correlation has been demonstrated between the degree of cutaneous toxicity and the antitumor response. For dermatologists the goal is to provide treatment of symptoms, so that the patient may continue to benefit from the EGFRI therapy. However, frequent cutaneous manifestations, even though related to a better antitumor response, may limit use of the therapy considering the interference with patient quality of life. Early management of cutaneous side effects of EGFRI may prevent severe, extensive symptoms, the need for dose reduction, or antitumor therapy interruption. This indicates a dermatologist should play a role in early stages of treatment. </p

Adverse Reaction to Cetuximab, an Epidermal Growth Factor Receptor Inhibitor

No abstract availabl

MENTAL HEALTH AND SELF-ESTEEM OF ACTIVE ATHLETES

Introduction: Systematic and continuous physical exercise of certain intensity and volume is irreplaceable in the stages of growth and development and in preventing impairments of the biological, functional and health state of the human organism.Many studies show that physical exercise contributes to development and reinforcement of mental health and increases self-esteem. Examine mental health and self-esteem of active athletes. Subjects and methods: The subjects of the study are active athletes from Herzegovina and students of the Faculty of Health Studies in Mostar. Mental health and self-esteem were measured by a sociodemographic questionnaire, The Symptom Checklist-90 and the Satisfaction With Life Scale. Results: There is a statistically significant difference in the frequency of exercise, active athletes have the highest percentage (100%) and state that they exercise often (almost every day) while university students have a significantly lower percentage (20%).Students scored significantly higher on the subscales for somatization, obsessive - compulsive symptoms, interpersonal vulnerability, depression, anxiety, aggression, phobia, and paranoia than active athletes. Active athletes have statistically higher scores for almost all the claims of the subjective assessment of life satisfaction. Conclusion: Active athletes showed significantly less psychological symptoms and better mental health, greater life satisfaction and higher self-esteem than students of the Faculty of Health Studies in Mostar

The correlation between patient safety culture and regional anesthesia development

Background and purpose: Through the development of security systems, improvement of knowledge and skills, and cooperation with other professions anesthesiologists have become leaders in improving patient safety and creators of a positive culture of patient safety among health professionals in the developing countries. Taking the significant progress made in regional anesthesia in Croatia as an indicator of the aforementioned role that anesthesiologists play within the health care system of transitional societies such as Croatian, research was carried out with the purpose of detecting differences in patient safety culture among anesthesiology, surgical and non-surgical staff in a sample of Croatian hospitals. Material and methods: The research covered 560 health professionals in three general hospitals in Croatia who anonymously and voluntarily filled in the Croatian version of the Hospital Survey on Patient Safety Culture (HSOPSC). One-way analysis of variance and multiple post hoc test according to Bonferroni were carried out in order to test statistical differences in 12 dimensions of patient safety culture between surgical, non-surgical and anesthesiology staff. Results: Statistically significant differences between the three groups of staff were found in 9 out of 12 HSOPSC dimensions, which was distributed to differences between anesthesiology and non-surgical staff in 7 dimensions, anesthesiology and surgical staff in 2 dimensions, and surgical versus non-surgical staff in 3 dimensions. Conclusions: Our research proved the hypothesis that anesthesiologists are the profession that is the most aware of and devoted to patient safety problems, spreading their positive influence through patient safety culture to all anesthesiology staff as well as to those with whom they predominantly collaborate

PROSPECTIVE FATHERS: PSYCHOSOCIAL ADAPTATION AND INVOLVEMENT IN THE LAST TRIMESTER OF PREGNANCY

Background: Paternal involvement in pregnancy has been recognized to have an impact on new-born’s outcomes and only recently got under the spot light of mental health perspective. The aim of this study was to test differences in paternal involvement in pregnancy, perceived stress and relationship quality regarding complications in pregnancy and pregnancy duration (gestational weeks) in the last trimester of pregnancy. The role of personality traits (neuroticism and extroversion), relationship quality satisfaction and perceived stress in prospective father’s perception of pregnancy involvement were examined. Subjects and method: One-hundred forty-three primiparus couples in the last trimester of their pregnancy participated in the study. Prospective fathers completed a booklet with questionnaires including The Quality of Marriage Index, The Perceived Stress Scale, Eysenck Personality Questionnaire and Partner’s Involvement in Pregnancy Scale. Prospective mothers completed only Eysenck Personality Questionnaire and questions on pregnancy complications and demographics. Results: The prospective fathers showed high involvement in their partner’s pregnancies, elevated levels of perceived stress and high relationship quality. There were found no differences in the above named variables regarding complications in pregnancy and pregnancy duration. Higher involvement of prospective fathers was related with older age, lower male neuroticism and higher female extroversion, better relationship quality and lower perceived stress. Conclusion: The findings demonstrate that prospective father’s involvement in pregnancy is supported with psychological factors, namely personality traits, quality of relationship and perceived stress. These results should lead to target interventions that can modify and improve fathers’ involvement perspective and promoting a couples mental health during pregnancy: thus clinically important for promotion of healthy prenatal behaviour and decrease in mothers’ emotional distress

Mastocytosis in children

Mastocitoze predstavljaju heterogenu skupinu bolesti, a obilježene su proliferacijom i nakupljanjem mastocita u različitim tkivima. Razlikujemo kožne mastocitoze, u kojih se nakupljanje mastocita nalazi isključivo u koži, od sistemske mastocitoze kod koje je proliferacija mastocita prisutna u koštanoj srži te u drugim organima kao što su gastrointestinalni trakt, limfni čvorovi, jetra i/ili slezena. U djece se javljaju gotovo isključivo kožne mastocitoze, za razliku od odraslih, u kojih se dijagnosticira sistemska mastocitoza. Izgled i rasprostranjenost kožnih promjena, kao i simptomi, mogu značajno varirati. Simptomi su posljedica oslobađanja upalnih medijatora iz mastocita, najčešće svrbež te crvenilo i urtike. Nužne su redovite kontrole ovih bolesnika, a organomegalija, značajno povišene vrijednosti serumske triptaze, kao i prisutnost KIT mutacije u perifernoj krvi, pomaže u odluci u kojeg je bolesnika nužno učiniti biopsiju koštane srži. Liječenje je najčešće simptomatsko, usmjereno na izbjegavanje okidača i smanjivanje simptoma bolesti koji su posljedica oslobađanja upalnih medijatora iz mastocita, najčešće primjenom H1i H2 blokatora, primjenom lokalnih kortikosteroida i pimekrolimusa.Mastocytosis are a heterogeneous group of diseases characterized by proliferation and accumulation of mastocytes in various tissues. Cutaneous mastocytosis is diagnosed if the accumulation of mastocytes is detected only in the skin. In cases of systemic mastocytosis the mastocytes accumulate in the bone marrow, gastrointestinal tract, lymph nodes, liver and/or spleen. Contrary to adults, in who systemic mastocytosis is the most common type of mastocytosis, in childhood the vast majority of patients are diagnosed with cutaneous forms of the disease. The type, distribution and extent of skin lesions, as well as symptoms, can vary from patient to patient. Symptoms are due to release of inflammatory mediators from mastocytes, most often itch, redness of the skin and wheals. Regular follow-ups are necessary, while organomegaly, significantly elevated serum tryptase levels and/or detection of KIT mutation in peripheral blood help in decision if and when to perform bone marrow biopsy. Treatment is aimed toward avoidance of triggers, and alleviation of symptoms caused by mast cell mediators, usually H1 and H2 blockers, as well as topical corticosteroids and pimecrolimus application

THE IMPACT OF EDUCATION ON CHRONIC WOUND CARE IMPROVEMENT

Inherited epidermolysis bullosa is a group of diseases characterized by skin/mucous membrane fragility and development of blisters and erosions after insignificant mechanical trauma. It is a multisystemic disease with complications occurring on numerous organs other than the skin. As there is no cure for these diseases, treatment consists of early recognition and therapy of complications, quality wound care and skin protection. Optimal wound treatment depends primarily on the type of the disease, localization and type of wounds. Apart from good skin care, treatment of these patients requires intensive supportive therapy in which various specialists must be involved.Although not fully understood, close relationship between health and education ensures unambiguous health and quality of life advantages to educated individuals. Education ensures different thinking and decision making processes and man is enabled to receive information from the external world. Even though the process of education and learning still relies on banking principles and coping of common knowledge, modern and technological society drives the system as well as education opportunities towards the new learning sources. In the developed world, the impact of chronic wounds on health systems is fairly perceived, as well as chronic wound treatment and education. Our health system still neglects the significant impact of chronic wounds on social and economic, individual and community well-being. Recognizing the importance of chronic wounds and implementation of a developed educational system gives us the potential for improving care for chronic wounds, and thus to substantially improve the quality of life of patients. Furthermore, consequent reduction of unnecessary health costs could reallocate substantial resources to other points of interest