Correlation of Human Papillomavirus multiple infections with cytological findings in a cohort of Greek women

Infection with the human papillomavirus (HPV) causes precursor intraepithelial lesions in women which may lead to the development of cervical cancer. There are several HPV types which show a variable distribution pattern worldwide. Therefore, identifying the prevalence of cancer-associated HPV types is important for the prevention of cervical cancer. In the current study, 627 cervical samples from individual women were collected by primary care clinics in Greece. The majority of women (70.17%) presented abnormal cytology as indicated by their Pap Test smear. Samples were sent to our laboratories for the detection of HPV by DNA analysis, PCR and reverse hybridization using HPV genotype-specific probes. Then, the prevalence of 28 different genotypes was estimated. Approximately 70% of all samples were infected with at least one HPV type. The most prevalent high risk (HR) HPV types associated with the development of cervical cancer were HPV types 16, 31 and 51. Prevalence of HPV types, as well as appearance of them as a single or multiple infection were also studied in samples with normal and abnormal cytology. Our analysis showed that infected women with normal cytology in our study population tend to have single HPV infections. In contrast, those with abnormal cytological phenotype tend to have multiple infections of HR HPV types

Stem cell therapy for idiopathic pulmonary fibrosis: a protocol proposal

<p>Abstract</p> <p>Background</p> <p>Idiopathic pulmonary fibrosis represents a lethal form of progressive fibrotic lung disorder with gradually increasing incidence worldwide. Despite intense research efforts its pathogenesis is still elusive and controversial reflecting in the current disappointing status regarding its treatment. Patients and Methods: We report the first protocol proposal of a prospective, unicentric, non-randomized, phase Ib clinical trial to study the safety and tolerability of the adipose-derived stem cells (ADSCs) stromal vascular fraction (SVF) as a therapeutic agent in IPF. After careful patient selection based on functional criteria (forced vital capacity-FVC > 50%, diffuse lung capacity for carbon monoxide-DL_CO> 35% of the predicted values) all eligible subjects will be subjected to lipoaspiration resulting in the isolation of approximately 100- 500 gr of adipose tissue. After preparation, isolation and labelling ADSCs-SVF will be endobronchially infused to both lower lobes of the fibrotic lungs. Procedure will be repeated thrice at monthly intervals. Primary end-point represent safety and tolerability data, while exploratory secondary end-points include assessment of clinical functional and radiological status. Results: Preliminary results recently presented in the form of an abstract seem promising and tantalizing since there were no cases of clinically significant allergic reactions, infections, disease acute exacerbations or ectopic tissue formation. In addition 6 months follow-up data revealed a marginal improvement at 6-minute walking distance and forced vital capacity.</p> <p>Conclusions</p> <p>Adipose tissue represents an abundant, safe, ethically uncontested and potentially beneficial source of stem cells for patients with IPF. Larger multicenter phase II and III placebo-controlled clinical trials are sorely needed in order to prove efficacy. However, pilot safety studies are of major importance and represent the first hamper that should be overcome to establish a rigid basis for larger clinical trials.</p

Potential preservation of dental pulp stem cells

Dental pulp stem cells (DPSCs) as postnatal stem cells have recently been described. They are clonogenic cells, capable for self-renewal with high proliferative potential. Their multilineage potential and plasticity enables their differentiation into different kind of cells, such as osteoblasts, chondrocytes, adipocytes, muscle cells, neural cells, odontoblasts, cementoblasts and ameloblasts. DPSCs are an important human stem cells source, especially in patients who lost their chance for umbilical cord blood isolation and preservation. As these cells became useful for tissue engineering and cell therapy, proper mode of their preservation also became important. The most important points in the cryopreservation and recovery procedure are: growth phase of harvested cells, number of cells, the proper cryopreservative concentration and serum concentration. The cryopreservation process includes the following general components: harvesting of the cells, addition of cryopreservative, the freezing procedure, the thawing procedure and assessment of the viability prior to transplantation. There is no single and perfect cryopreservation method. Further investigations should be regarding capability of DPSCs and their differentiated cells to recover and restart proliferation, differentiation and new tissue production for therapeutic use after cryopreservation

Acute Appendicitis: After Correct Diagnosis Conservative Treatment or Surgery?

Acute appendicitis is the most common surgical disease presented in ED. Ongoing evidence in the literature, in the last 20 years, shows a lot of benefits in favor of conservative treatment. Despite that conservative treatment does not gain the correct position at the daily practice up to day. A large number of parameters related to acute appendicitis, present diversity in their appearance, so the final estimation of the disease may by unclear and the decision for treatment may be incorrect. We analyze these parameters, aiming to clarify their role in correct diagnosis and decision making on appropriate treatment. In the present study a review of the literature is performed, regarding the etiology, pathology, clinical presentation, laboratory, and imaging data of acute appendicitis. The collection and correct estimation of these parameters, is the key for the correct diagnosis of acute appendicitis. Complicated or uncomplicated cases should be diagnosed preoperatively. The next step is the appropriate treatment, conservative or by surgery. At the present time, excluding generalized peritonitis and sepsis, the majority of patients with uncomplicated acute appendicitis and selected complicated cases can by treated successfully by conservative treatment. The majority of patients do not benefit from appendectomy

Pengaruh proporsi tepung labu kuning dan tepung terigu terhadap sifat fisikokimia dan organoleptik cake kukus

Labu kuning kaya akan β-karoten, gula, dan serat. Upaya diversifikasi pengolahan labu kuning adalah tepung labu kuning. Tepung labu kuning dapat dimanfaatkan dalam pembuatan cake kukus sebagai bahan pensubstitusi tepung terigu. Penggunaan tepung labu kuning diharapkan dapat meningkatkan kadar β-karoten dalam cake kukus. Penelitian ini bertujuan untuk menentukan proporsi tepung labu kuning dan tepung terigu yang tepat untuk menghasilkan cake kukus dengan sifat fisikokimia dan organoleptik yang dapat diterima oleh konsumen. Rancangan penelitian yang digunakan adalah Rancangan Acak Kelompok dengan satu faktor, yaitu faktor proporsi tepung labu kuning dan tepung terigu dengan lima level, yaitu: 0%:100%; 10%:90%; 20%:80%; 30%:70%; 40%:60%, yang diulang sebanyak lima kali. Parameter pengujian meliputi volume spesifik, firmness, dan organoleptik kesukaan warna, kemudahan digigit, moistness, dan rasa. Data dianalisis dengan ANOVA (Analysis of Variance) pada α = 5% untuk mengetahui ada tidaknya pengaruh proporsi tepung labu kuning dan tepung terigu terhadap sifat fisikokimia dan organoleptik cake kukus. Apabila terdapat pengaruh nyata maka dilanjutkan dengan uji DMRT (Duncan's Multiple Range Test) pada α = 5%. Penentuan perlakuan terbaik dilakukan dengan uji pembobotan. Cake kukus dengan perlakuan terbaik diuji kadar β-karoten. Hasil penelitian menunjukkan bahwa perlakuan proporsi tepung labu kuning : tepung terigu memberikan pengaruh nyata (α = 5%) terhadap volume spesifik, firmness, dan tingkat kesukaan terhadap warna, kemudahan digigit, moistness, dan rasa. Semakin besar proporsi tepung labu kuning, semakin kecil nilai volume spesifik, firmness, dan kesukaan warna cake, namun semakin besar nilai kesukaan kemudahan digigit, moistness, dan rasa cake. Proporsi tepung labu kuning : tepung terigu 20%:80% merupakan perlakuan terbaik dengan kadar β-karoten sebesar 8,569 µg β- karoten/g cake kukus

Correction to: Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members

Background: The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods: A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results: 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions: The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years

Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P &lt; 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P &lt; 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk

Pluripotent stem cells isolated from umbilical cord form embryonic like bodies in a mesenchymal layer culture

Recently the matrix of umbilical cord began to use as an alternative source of stem cells additionally to the blood of umbilical cord. Umbilical cord has been used mainly for mesenchymal stem cell banking. The immunological characteristics of mesenchymal stem cells in combination with their ability to avoid rejection make them an attractive biological material for transplantations. In this study the isolation of small in size pluripotent stem cells from umbilical cord expressing early transcription factors with characteristics that resemble to embryonic stem cells is investigated. Pluripotent stem cells were isolated from human umbilical cords, by a new strategy method based on unique characteristics such as the small size and the positivity on early transcription factors OCT and Nanog. An enriched population of CXCR4+ OCT+ Nanog+ CD45- small stem cells from the cord was isolated. This fraction was able to create alkaline phosphatase positive like spheres forms in a mesenchymal layer with multilineage differentiation capacity. Our results were assessed by RT PCR and electophoresis for the pluripotent genes. These data suggest that umbilical cord provides an attractive source not only of mesenchymal stem cells but moreover of pluripotent stem cells. The method described herein should be applied in the field of stem cell banking in addition to the classical umbilical cord harvesting method. Isolation of a population of cells with pluripotent characteristics from umbilical cord. Adoption of a second centrifugation step for the pluripotent stem isolation. Increasing the value of the cord and explaining the pluripotency. This work will enhance the value of umbilical cord harvesting