The role of colposcopy and typization of human papillomavirus in further diagnostic proceedings in patients with ASC-US cytological finding of the uterine cervix

Background/Aim. Bethesda system of classification of cytological findings was introduced in 2001 two subcategories in the category of atypical squamous cells (ASC) findings: ASC of undetermined significance (ASC-US) and ASC which cannot exclude high-grade intraepithelial lesions (ASC-H). The aim of our study was to assess a possible association of these two subcategories with pathologic biopsy finding and to find out the best further diagnostic proceedings. Methods. At the Clinic of Gynecology and Obstetrics, Niš 130 patients with ASC findings were analyzed. Colposcopy was performed in all study participants. Patients with pathological colposcopic findings underwent cervical biopsy. In 10 patients with pathologic histologic and 15 with benign findings human papilloma virus (HPV) typization was done using the Hybrid Capture method. Results. Patients with ASC-H finding had significantly more pathologic biopsies compared with patients with ASC-US finding (57.84: 20.72). Conclusion. Colposcopy was exhibited somewhat higher sensitivity compared to HPV typization (94.7 : 90), but lower sensitivity (79.27 : 86.6). The usage of HPV typization in the triage of patients with ASC cytologic smear induces statistically significant reduction of unnecessary percentage of cervical biopsies

The LysR-type transcriptional regulator CysB controls the repression of hslJ transcription in Escherichia coli

The LysR-type transcriptional regulator (LTTR) CysB is a transcription factor in Escherichia coli cells, where as a homotetramer it binds the target promoter regions and activates the genes involved in sulphur utilization and sulphonate-sulphur metabolism, while negatively autoregulating its own transcription. The hslJ gene was found to be negatively regulated by CysB and directly correlated with novobiocin resistance of the bacterium. cysB mutants showed upregulation of the hslJ:: lacZ gene fusion and exhibited increased novobiocin resistance. In this study the hslJ transcription start point and the corresponding putative sigma(70) promoter were determined. The hslJ promoter region was defined by employing different hslJ-lacZ operon fusions, and transcription of the hslJ gene was shown to be subject to both repression imposed by the CysB regulator and direct or indirect autogenous negative control. These two regulations compete to some extent but they are not mutually exclusive. CysB acts as a direct repressor of hslJ transcription and binds the hslJ promoter region that carries the putative CysB repressor site. This CysB binding, apparently responsible for repression, is enhanced in the presence of the ligand N-acetylserine (NAS), hitherto considered to be a positive cofactor in CysB-mediated gene regulations. Interallelic complementation of characterized CysB mutants I33N and S277Ter partially restored the repression of hslJ transcription and the consequent novobiocin sensitivity, but did not complement the cysteine auxotrophy

Identification of the CysB-regulated gene, hslJ, related to the Escherichia coli novobiocin resistance phenotype

The cysB gene product is a LysR-type regulatory protein required for expression of the cys regulon. cysB mutants of Escherichia coli and Salmonella, along with being auxotrophs for the cysteine, exhibit increased resistance to the antibiotics novobiocin (Nov) and mecillinam. In this work, by using lambdaplacMu9 insertions creating random lacZ fusions, we identify a gene, hslJ, whose expression appeared to be increased in cysB mutants and needed for Nov resistance. Measurements of the hslJ::IacZ gene fusion expression demonstrated that the hslJ gene is negatively regulated by CysB. In addition we observe the negative autogenous control of HslJ. When the control imposed by CysB is lifted in the cysB mutant, the elevation of Nov resistance can be achieved only in the presence of wild-type hslJ allele. A double cysB hslJ mutant restores the sensitivity to Nov. Overexpression of the wild-type HslJ protein either in a cysB(+) or a cys(B-) background increases the level of Nov resistance indicating that hslJ product is indeed involved in accomplishing this phenotype. The hslJ::OmegaKan allele encodes the C-terminaly truncated mutant protein HslJ Q121Ter which is not functional in achieving the Nov resistance but when overexpressed induces the psp operon. Finally, we found that inactivation of hslJ does not affect the increased resistance to mecillinam in cysB mutants

The value of Pap test in women with endometrial cancer

Introduction: Endometrial cancer is the second most common gynecological tumor. There is still no recommended screening method for endometrial cancer. The application of transvaginal sonography, hysteroscopy and Pap test may prove useful in screening for this disease. Atypical glandular cells represent an important finding in Pap tests and they are related to histopathological verification of the endometrium. The aim of the study was to determine the usefulness of the Pap test in assessing the cervical infiltration, as well as to determine the significance of hormonal status and histopathological type of tumor in a pathological Pap test in patients with endometrial cancer.Methods: The study was retrospective. The analysis included the data obtained from 62 operated patients diagnosed with enometrial cancer, medical history (menopausal status), histopathological findings after surgery (type and stage of the disease) and a preoperative Pap smear. The chi squared and Fisher’s test were used.Results: The difference in the prevalence of pathological Pap test in premenopausal and postmenopausal group of patients was not statistically significant. The difference in the prevalence of pathological Pap test in the group of endometrioid and non-endometrioid tumours of the uterine corpus had statistical significance. The difference in the prevalence of pathological Pap test compared to the present stage (I and II) was not statistically significant.Conclusion: Pap smear does not correlate with menopausal status in women with endometrial carcinoma. Abnormal Pap test is more commonly found in cases of non-endometroid tumours. Pap smears cannot beused to assess cervical involvement

THE IMPACT OF THE COVID-19 PANDEMIC ON PEDIATRIC APPENDICITIS MANAGEMENT AND OUTCOMES

The pandemic caused by the SARS-CoV-2 virus had a significant impact on providing health services the world over and is reflected in pediatric surgery also. The aim of this study was to determine the differences in the prevalence of forms of appendicitis among children during and prior to the pandemic, and to compare the demographic characteristics. A retrospective study which covered a period from September 1, 2018 until September 1, 2021 and all the patients who underwent surgery for acute appendicitis was carried out. Demographic and clinical data were collected and analysed. The study included a total of 267 patients. Prior to the pandemic a total of 160 children underwent surgical treatment, 61.9% boys and 38.1% girls, while during the pandemic a total of 107 underwent surgical treatment, mostly boys 68,2%, and to a lesser extent, girls 31.8%. The average age of the patients was 11.0±3.9 years. Even though there is a difference in the number of children who underwent surgical treatment for perforated appendicitis prior to and during the Covid-19 pandemic, 54:44 or 33.8:41.1%, the difference is not statistically significant. During the pandemic, two patients who tested positive for the SARS-CoV-2 virus received surgical treatment for a perforated appendicitis. The Covid-19 pandemic had an impact on the healthcare system worldwide. In most centers for pediatric surgery, there was an increased incidence of perforated appendicitis without significant deviations in the demographic characteristics, which correlates with the results of this stud

The value of Pap test in women with endometrial cancer

Introduction: Endometrial cancer is the second most common gynecological tumor. There is still no recommended screening method for endometrial cancer. The application of transvaginal sonography, hysteroscopy and Pap test may prove useful in screening for this disease. Atypical glandular cells represent an important finding in Pap tests and they are related to histopathological verification of the endometrium. The aim of the study was to determine the usefulness of the Pap test in assessing the cervical infiltration, as well as to determine the significance of hormonal status and histopathological type of tumor in a pathological Pap test in patients with endometrial cancer. Methods: The study was retrospective. The analysis included the data obtained from 62 operated patients diagnosed with enometrial cancer, medical history (menopausal status), histopathological findings after surgery (type and stage of the disease) and a preoperative Pap smear. The chi squared and Fisher’s test were used. Results: The difference in the prevalence of pathological Pap test in premenopausal and postmenopausal group of patients was not statistically significant. The difference in the prevalence of pathological Pap test in the group of endometrioid and non-endometrioid tumours of the uterine corpus had statistical significance. The difference in the prevalence of pathological Pap test compared to the present stage (I and II) was not statistically significant. Conclusion: Pap smear does not correlate with menopausal status in women with endometrial carcinoma. Abnormal Pap test is more commonly found in cases of non-endometroid tumours. Pap smears cannot be used to assess cervical involvement

Opportunities for emotional intelligence in the context of nursing

Introduction: Emotional intelligence is the ability to recognize and control one´s own emotions as well as emotions of other people. There are two orientations in studying emotional intelligence. They differ in whether they relate abilities and personal characteristic features or not. Emotional intelligence usage is currently being understood as a fundamental requirement of nursing in care provision to patients.Methods: In a research conducted with a group of nursing students (n = 86), we were examining emotional intelligence as an ability and as a feature. We used SIT-EMO (Situational Test of Emotional Understanding) scales in order to fi nd out emotional intelligence as an ability, and SEIS (Schutte Emotional Intelligence Scale), measuring emotional intelligence as a feature. In the context of nursing, we were finding out emotional self-effi cacy in relation to geriatric patients (ESE-GP). TEIQue-SF (Trait Emotional Intelligence Questionnaire – short form) method was used to set up our own questionnaire.Results: We were fi nding out the extent of emotional intelligence and we were analyzing it from the viewpoint of its grasping as a feature, ability and emotional self-effi cacy in relation to geriatric patients. We found out lower levels in social awareness, emotional management and stress management dimensions of the nursing students.Conclusion: Emotional intelligence as an ability of the nursing students can be enhanced through psychological and social trainings. Emotional intelligence has an impact on social and communication skills, which are a precondition of effective nursing care

VAGINAL DELIVERY OF GIANT FETUS – SHOULDER DYSTOCIA

Shoulder dystocia (SD) is defined as unpredictable and urgent obstetric complication that happens when the pelvis of a mother is spread sufficiently to deliver fetal head, but insufficiently to deliver fetal shoulders. It is associated with high percentage of maternal and fetal morbidity. Fetal lethality from hypoxia ranges from 2-16%.We observed the case of vaginal delivery in a multiparous woman in the 39th gestational week. Head delivery was performed by using vacuum extraction. Because of the shoulder dystocia, we applied McRoberts’ maneuver with Resnik’s suprapubic pressure and performed one more episiotomy. Since these maneuvers did not give the expected result, we did the aspiration of the upper respiratory paths of the fetus, after which we performed Hibbard’s cord with simultaneous Kristeler’s maneuver. It led to releasing the shoulders and fetal delivery. On delivery, male fetus was 6000 g/60 cm, estimated with Apgar 1. The urgent reanimation was undertaken. After few hours, the baby was transferred to Pediatric Surgical Clinic for further treatment of present pneumotorax and humerus fracture. After many days, the baby being in normal state, was referred to physical rehabilitation treatment. Today, the baby is without sequelae.SD is one of the most difficult, hardly predictable perilous obstetric complications with high percentage of maternal morbidity and fetal morbidity and mortality. It requires caution, training and skills of obstetric-neonatal team. Liberalization of the use of Caesarian section in managing SD decreases the appearance of injuries in both mother and child. However, regardless of very rapid development of perinatology and the use of modern diagnostic-therapeutic protocols, some questions from classical, practical obstetrics remain unanswered