Negative Smear Test Research Articles

Assessment of the impact of COVID-19 experienced at different stages of gestation on perinatal outcomes and structural changes in the placenta

BACKGROUND: At the beginning of the pandemic COVID-19, the attention of obstetricians and gynecologists was focused on studying the impact of SARS-CoV-2 on obstetric and perinatal outcomes. Currently, the dynamics of mutations in genes encoding SARS-CoV-2 proteins determines the emergence of a large number of new strains of the virus that are highly virulent. Given this fact, the problem of assessing the impact of COVID-19 on pregnancy outcomes also remains relevant.
 AIM: The aim of this study was to assess the impact of the novel coronavirus infection (COVID-19) transmitted at different stages of gestation on perinatal outcomes and structural changes in the placenta.
 MATERIALS AND METHODS: In 2022–2023, a prospective analysis of 113 cases of childbirth in women who had the novel coronavirus infection during pregnancy was carried out in obstetric institutions in Novosibirsk. The total sample of subjects was divided into three study groups using cluster analysis. Group 1 included 25 women who had SARS-CoV-2 at a gestation period of up to 16 weeks; Group 2 consisted of 61 patients who underwent COVID-19 at gestation period of 17 to 34 weeks; and Group 3 comprised 27 pregnant women in whom COVID-19 was detected after 34 weeks of pregnancy. The control group included 65 pregnant women who had a negative smear test result for SARS-CoV-2. Pathological examination of the placenta included macro- and microscopic studies. Statistical processing of the results was carried out using the IBM SPSS Statistics Version 25.0 program.
 RESULTS: The most common fetal distress was observed in patients of Groups 1 and 2 (p = 0.002). We found an inverse correlation between the gestational age at which a woman suffered coronavirus infection and the volumetric density of capillaries and intervillous fibrinoid, as well as the percentage of formation of the syncytial-capillary membrane and villi with symplastic buds. On the contrary, a direct correlation between the gestational age and the volumetric density of connective tissue was found. Intervillusitis was more often observed in the placentas of women of Groups 1 and 2. Histitocytic infiltration was characteristic of the placentas of patients of Group 2.
 CONCLUSIONS: The frequency of adverse perinatal outcomes and the intensity of structural changes in the placenta depend on the gestation period in which the patient suffered the novel coronavirus infection. The most significant structural changes in the placenta were detected in patients of Group 2.

QUALITY OF LIFE INDICATORS FOR THE PATIENTS WHO SUFFERED FROM COMMUNITY-ACQUIRED PNEUMONIA CAUSED BY SARS-CoV-2

Introduction. Respiratory pathology, both acute and chronic, remains one of the key problems of modern medicine in Ukraine and in the world in general, which is explained by its significant prevalence, negative impact on patients' work capacity, their quality of life, as well as the economic burden on society. The aim of the study – to analyze the subjective state of health using the SF-36 questionnaire for patients who undergone community-acquired pneumonia caused by SARS-CoV-2 in 1 year after inpatient treatment. Research Methods. A retrospective study of the medical records of 208 patients who had been hospitalized for non-hospital pneumonia with a negative smear test for the SARS-CoV-2 virus was conducted. The severity of pneumonia was calculated according to the PORT scale. The comparison group consisted of patients with SARS-CoV-2 nucleic acid identification and the absence. A telephone survey to assess the quality of life of the participants of the first stage of our study 1 year after discharge from the hospital were performed. The general investigator SF-36 was used to assess quality of life. Statistical analysis of data was carried out using the "STATISTICA 7.0" software. Results and Discussion. Physical functioning according to SF-36 was the lowest in the observation group IV and probably differed in relation to the data of the observation group II and the comparison group. Analyzing the general state of health, the values were found to be probably lower for patients who suffered from community-acquired pneumonia of 3rd and 4th categories of severity compared to the data of the observation group II and the comparison group. Conclusion. Thus, it was established low quality of life in patients after pneumonia caused by COVID-19. Practical value of the work consists in improving diagnostics and therapy, as well as improving the rehabilitation of patients who suffered from community-acquired pneumonia caused by SARS-CoV-2.

Markers of quality of life in patients with nosocomial pneumonia caused by SARS-CoV-2

Objective — to investigate and analyze total white blood cell count and leukogram in an order with community-acquired pneumonia caused by SARS-CoV-2 and to establish their relationship with subjective health assessment using the SF-36 tool 1 year after hospital discharge.
 Materials and methods. A retrospective study of the medical records of 208 patients who were hospitalized for community-acquired pneumonia with a negative smear test for the SARS-CoV-2 virus was conducted. The main group consisted of patients with SARS-CoV-2 nucleic acid identification and signs of pneumonia. According to the severity of pneumonia, patients were divided into three groups: II group —patients with pneumonia of category 2 of complexity (n = 124), group III — patients with pneumonia of category 3 of complexity (n = 68), group IV — patients with pneumonia of category 4 of complexity (n = 16). The comparison group consisted of patients with SARS-CoV-2 nucleic acid identification and the absence of pneumonia. Charlson’s comorbidity index (Charlson Comorbidity Index) for the general prognosis of mortality was calculated using a special computer program. The general questionnaire SF-36 was used to assess the quality of life. Statistical analysis of data was carried out using the Statistica 7.0 software.
 Results and discussion. Probably higher values ​​of the total number of leukocytes were established in the patients of the studied groups compared to the comparison group. At the same time, this indicator in patients of the IV group statistically significantly exceeded the similar data of the II and III groups. The increase in leukocytes as the complexity of pneumonia progressed was mainly due to segmented neutro­phils. In patients with acquired pneumonia of the 3rd and 4th severity category caused by SARS-CoV-2 1 year after discharge from the hospital, the indicators of physical and psychological components of health are likely to be lower, while increasing age is likely to be associated with a decrease in quality of life.
 Conclusions. In patients with community-acquired pneumonia caused by COVID-19, an increase in the content of leukocytes upon admission to the hospital is associated with a decrease in indicators of physical and psychological components of health 1 year after discharge from the hospital.

The outcome of colposcopy in women attending with persistent postcoital bleeding and negative HPV-DNA test

Objective: Women with postcoital bleeding (PCB) are recommended to be evaluated by colposcopy even if cytology is negative. Human papillomavirus (HPV) testing increases the detection of cervical intraepithelial neoplasia or worse compared to the Pap smear test. We aimed to determine the incidence of cervical pathology among women with persistent PCB with a negative Pap smear or HPV-DNA test. Our study, therefore, questions the place of HPV DNA test in women with PCB.
 Material and Methods: The clinical data of 212 women with persistent PCB and negative cytology or negative HPV DNA test referred to colposcopy, between January 2010 and June 2019, were retrospectively evaluated.
 Results: Among the 212 PCB patients, 161 (75.9%) were cytology negative and 51 (24.1%) were HPV DNA test (n=40) or co-test (n=11) (negative for HPV DNA test and cytology) negative. There were no cases of invasive cancer. The women referred with negative cytology were more likely than those with negative HPV DNA to have CIN (21/161 (13%), 1/51 (1.9%) p=0.042. Seven women (4.3%) were diagnosed with high-grade cervical dysplasia in the negative cytology group. None of the patients in the HPV DNA negative group was diagnosed with high-grade cervical dysplasia.
 Conclusion: Our data show that a normal Pap smear cytology in women with PCB does not rule out the possibility of HSIL. HPV DNA testing is a useful triage test to determine if colposcopy referral is required in the context of post-coital bleeding with negative smear test.

Combination of Percutaneous Lung Biopsy and Xpert MTB/RIF Ultra Enhances the Differential Diagnosis of Tuberculosis: A Prospective Cohort Study.

IntroductionTo evaluate the value of the combination of computed tomography (CT)-guided percutaneous lung biopsy and Xpert MTB/RIF Ultra (Xpert-Ultra) in enhancing the differential diagnosis of tuberculosis.MethodsPatients with lesions in the lungs for whom the differential diagnosis was difficult were prospectively and consecutively enrolled. Specimens collected by percutaneous lung biopsy were subject to Xpert-Ultra and histopathologic examination, respectively.ResultsBiopsy was successfully performed for 147 patients who were eligible for analysis, including 65 TB, 55 lung cancer and 27 other chronic infection cases. The sensitivity, specificity, positive predictive value and negative predictive value of Xpert-Ultra for TB diagnosis were 75.38% (49/65) and 95.12% (78/82), 92.45% (49/53) and 82.98% (78/94), respectively. Among patients with strong evidence for TB diagnosis (categorized as confirmed or probable TB cases), the overall positive rate of the Xpert-Ultra assay was 83.63% (46/55), which was much higher than for any reported sample type with negative smear test outcomes to date. Five rifampicin (RIF)-resistant cases were identified using the biopsy tissues. However, “trace” positive did not seem reliable for TB diagnosis with lung biopsy specimens; a 25.61% (21/82) “trace”-positive rate was acquired in the non-TB group.ConclusionPercutaneous lung biopsy combined with Xpert-Ultra produced high sensitivity for culture-negative pulmonary TB patient diagnosis. “Trace” outcome might not be a reliable positive category for lung biopsy specimens.Trial registrationClinicalTrials.gov identifier, ChiCTR1900026412. Retrospectively registered on Oct 8th, 2019).

Locally-secreted interleukin-6 is related with radiological severity in smear-negative pulmonary tuberculosis

Pulmonary tuberculosis (PTB) has been identified as a substantial public health threat and diagnostic challenge. A large proportion of patients exhibit negative smear tests despite active infection. The role of cytokines in the pathophysiology and clinical severity of PTB remains a controversial question. We evaluated the pattern of cytokines presents locally in patients with smear-negative PTB. Levels of tumor necrosis factor (TNF)-α, interferon (IFN)-γ, interleukin (IL)-2, IL-4, IL-6, IL-10, and IL-17 in bronchoalveolar lavage fluid (BALf) from patients with smear-negative PTB, as well as in those with other pulmonary diseases and controls, were performed by flow cytometry. ROC curve and a radiological severity scale were used to establish the potential diagnosis use and the relationship of the cytokine levels with disease severity, respectively. The levels of IL-6 were higher in the PTB (P = 0.0249) and pneumonia (P = 0.0047) groups compared to controls. Low to undetectable levels of TNF-α, IFN-γ, IL-2, IL-4, IL-10, and IL-17 were found in BALf, even after sample concentration using filtration columns and centrifugation. IL-6 levels measured in BALf could distinguish PTB patients or pneumonia patients from controls (AUC: 0.91, P = 0.002 and AUC: 0.86, P = 0.001, respectively), but not patients with PTB from those with pneumonia (AUC: 0.51, P = 0.86). IL-6 levels were related with the severity of PTB, as levels were higher in patients with higher radiological severity. These results confirm the importance of IL-6 in the immunopathology of smear-negative PTB.

Single incision sacrospinous hysteropexy combined with cystopexy (SISHC): a suitable mini-invasive approach for pelvic organ prolapse in post menopausal women

The aim of our study was to demonstrate, even in elderly postmenopausal patients, the minimal surgical impact of sacrospinous hysteropexy and cystopexy for uterovaginal prolapse using a single anterior vaginal incision (SISHC). Materials: Patients with genital apical prolapse stages ≥3 (POPQ System; BadenWalkerHWS) were eligible for the study. Other inclusion criteria: associated symptomatic stage ≥2 anterior prolapse, wish of uterus preservation, negative smear test, TVUSS and urodynamic test in previous 6 months. Exclusion criteria: abnormal uterus/ovaries, endometrial thickness >4 mm, abnormal smear test, clinical and/or urodynamic stress incontinence and/or symptomatic posterior prolapse. Subjective data on bladder, bowel, POPQ were collected before surgery, 6 months after surgery and at follow up. Sacrospinous hysteropexy was performed unilaterally to right ligament, under spinal anaesthesia. After a midline incision on anterior vaginal wall, endopelvic fascia was opened and dissection was extended through paravesical fossa. Two non-absorbable Prolene®00 filaments were placed through the right sacrospinous ligament, 2–3 cm medial to ischial spine. Filaments were fixed in the anterior part of cervix. Fascial cystopexy was performed. Patients were discharged 24 h after surgery, if post voiding residual was <100 cc. Patients were stratified in two groups: GROUP 1 (<15 years after menopause) and GROUP 2 (≥15 years after menopause). Shapiro–Wilk, Wilcoxon and Student's t-test. Significance level p-value <0.05. Results: 42 women had SISHC (16 GROUP 1, 26 GROUP 2). Main results are shown in Table. The preoperative POP scores were similar between the two groups. For both groups, anatomical findings for anterior and apical segments and symptoms of vaginal bulge were improved after surgery (p < 0.05). No women presented de novo incontinence symptoms. Neither significant effects on constipation, nor accidental bladder or rectal injuries were noted. A patient in GROUP 1 required removal of suture due to persistent pain for more than 6 months. Average hospital stay was 1.9 (±1.1) days. There was one recurrence after 1 month due to thread detachment. Discussion: Our data demonstrate, in both groups, that SISHC is a safe procedure (low incidence of complications and recurrence); it is effective for correction of anterior and apical segment. Anterior approach provides benefits compared to traditional posterior approach: a wider anatomical space for vaginal vault placement, a better exposure of the upper portion of sacrospinous ligament [[1]Dubuisson J. Gynecol Obstet Fertil. 2012; Google Scholar], longer average total vaginal length [[2]Goldberg R. Obstet Gynecol. 2001; Google Scholar], lower anterior and apical recurrence [[3]Tseng L.H. Taiwan J Obstet Gynecol. 2013; PubMed Google Scholar]. The risk of anterior approach is related to neurological damage (S3) [[4]Cayrac M. Int Urogynecol J. 2012; PubMed Google Scholar]. The conservative treatment could reduce surgical morbidity, ensure the anatomical integrity and reduce the risk of bladder injuries.

Cost-effectiveness of point-of-care digital chest-x-ray in HIV patients with pulmonary mycobacterial infections in Nigeria.

BackgroundChest-x-ray is routinely used in the diagnosis of smear negative tuberculosis (TB). This study assesses the incremental cost per true positive test of a point-of-care digital chest-x-ray, in the diagnosis of pulmonary mycobacterial infections among HIV patients with presumed tuberculosis undetected by smear microscopy.MethodsConsecutive patients with clinical suspicion of pulmonary tuberculosis were serially tested for Human immunodeficiency virus (HIV), their sputum examined for Acid Fast Bacilli then cultured in broth and solid media. Cultures characterized as tuberculous (M.tb) and non-tuberculous (NTM) mycobacteria by Hain assays were used as gold standards. A chest-x-ray was classified as: (1) consistent for TB, (2) not consistent for TB and (3) no pathology.ResultsOf the 1391 suspected cases enrolled, complete data were available for 952 (68%): 753/952 (79%) had negative smear tests while 150/753 (20%) had cultures positive for TB. Of those, 82/150 (55%) had chest-x-ray signs consistent with TB and 29/82 (35%) were positive for HIV. Within the co-infected, 9/29 (31%) had NTM infections. Among all suspects, the cost per positive case detected using smear microscopy test was $52.84; the overall incremental cost per positive case using chest-x-ray in smear negatives was $23.42, and in smear negative, HIV positive patients the cost was $15.77.ConclusionPoint-of-care chest-x-ray is a cost-effective diagnostic tool for smear negative HIV positive patients with pulmonary mycobacterial infection.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-014-0675-0) contains supplementary material, which is available to authorized users.

Factors Associated with Length of Hospital Stay among HIV Positive and HIV Negative Patients with Tuberculosis in Brazil

ObjectiveIdentify and analyze the factors associated to length of hospital stay among HIV positive and HIV negative patients with tuberculosis in Manaus city, state of Amazonas, Brazil, in 2010.MethodsEpidemiological study with primary data obtained from monitoring of hospitalized patients with tuberculosis in Manaus. Data were collected by interviewing patients and analyzing medical records, according to the following study variables age, sex, co-morbidities, education, race, income, lifestyle, history of previous treatment or hospitalization due to tuberculosis, treatment regimen, adverse reactions, smear test, clinical form, type of discharge, and length of hospital stay. The associated factors were identified through chi-square or t-Student test at a 5% significance level.ResultsIncome from 1 to 3 minimum wages (P = 0.028), pulmonary tuberculosis form (P = 0.011), negative smear test or no information in this regard (P = 0.014), initial 6-month treatment scheme (P = 0.029), and adverse drug reactions (P = 0.021) were associated to prolonged hospital stay in HIV positive patients.ConclusionWe found out that although there were no significant differences in the length of hospital stay in HIV positive patients, all factors significantly associated to prolonged hospital stay occurred in this group of patients. This finding corroborates other studies indicating the severity of tuberculosis in HIV patients, which may also contribute to lengthen their hospital stay.

Valor de QuantiFERON-TB Gold Test in Tube en el diagnóstico de tuberculosis pulmonar y extrapulmonar

The Interferon-γ in vitro detection tests could be a useful tool in the diagnosis of active tuberculosis compared to Mycobacterium tuberculosis (MTB). The QuantiFERON-TB-Gold in Tube (QFG-IT) test was performed on the blood of 118 patients with active tuberculosis and the results compared with the tuberculin test. The QFG-IT test was positive in 94 cases (79.7%), negative in 17 (14.4%) and indeterminate in 7 (5.9%). A negative or indeterminate QFG-IT test was more common in older patients (P=0.017) and in cases with negative smear tests (P=0.041). The kappa agreement between the tuberculin and QFG-IT tests was 74.5% with a kappa value of 0.45 (SE:0.136). Thirteen of the patients studied were infected with HIV and the tuberculin was positive in 5 of the 12 cases (38.5%) in whom it was performed, with the QFG-IT being positive in 9/13 (69.2%). The QFG-IT test may be a useful complimentary tool to the tuberculin test in the diagnosis of tuberculosis.

Differenzialdiagnose „steriler“ phlegmonöser Entzündungen der Hand

Bacterial infections represent a large proportion of emergencies in hand surgery. In some cases, pyoderma gangrenosum and mycobacterial infection may present with the same symptoms of swelling, pain, and purulent secretion. In these cases, operative treatment would be harmful. Therefore two cases-pyoderma gangrenosum and tuberculosis-are presented here in relation to common bacterial hand infection. Using two case reports of diseases that only rarely affect the hands, their relevance to differential diagnosis is shown with reference to the literature. In both cases, we found clinical symptoms of bacterial hand infection with negative bacterial smear tests. After several debridements, pyoderma gangrenosum of the dorsum of the hand was diagnosed in one patient after pyodermiform lesions at the thigh and the nasal septum were detected and pre-existing colitis ulcerosa was taken into consideration. Corticoid therapy induced complete remission. The second patient with similar clinical symptoms had been operated on at another hospital several times before being transferred to our institution. The presumptive diagnosis of pyoderma gangrenosum was made, and under treatment with prednisone the symptoms quickly improved. After 2 weeks, the wound conditions and the patient's condition rapidly worsened. Following amputation at the upper arm level, the patient died of septic multiple organ failure. Autopsy studies revealed tuberculous sepsis originating from the hand. Patient history should be evaluated carefully because of its value to correct diagnosis. In case of negative smear tests, especially from immunocompromised, elderly patients and in patients with a history of pulmonary tuberculosis, Ziehl-Neelsen staining should be obtained. In case of multilocular affection or pre-existing chronic inflammatory bowel disease, the presumptive diagnosis of pyoderma gangrenosum can be confirmed by biopsies from the lesions margin. In both cases, unnecessary traumatizing operations could thus be avoided and treatment optimized.

Women's understanding of a “normal smear test result”: experimental questionnaire based study

Objectives: To describe women's understanding of a negative smear test result when presented using the term “normal smear result,” as required by the NHS cervical screening programme, and to evaluate...

Analysis of the immunological humoral response toMycobacterium tuberculosis glycolipid antigens (DAT, PGLTb1) for diagnosis of tuberculosis in HIV-seropositive and -seronegative patients

Using an enzyme immunoassay (EIA) test, the concentrations of IgG antibodies against 2,3 diacyl trehalose (DAT) and phenolic glycolipid Tb1 (PGLTb1) were measured in the sera of 153 patients with active tuberculosis, 50 of whom were coinfected with HIV, and in the sera of 152 healthy blood donors, 149 asymptomatic HIV-seropositive patients, 12 HIV-seronegative patients with conditions simulating tuberculosis, 23 HIV-seropositive patients with disseminated infection caused by mycobacteria other than tuberculosis and 24 HIV-seropositive patients with pulmonary disease from whom mycobacteria was not isolated in culture. A slightly lower percentage (74%) of the HIV-seropositive than the HIV-seronegative (77%) tuberculosis patients were positive for anti-DAT and anti-PGLTb1 IgG antibodies, with a specificity ranging from 91 to 95%. There was no significant difference between EIA sensitivity in smear-positive and smear-negative patients with pulmonary tuberculosis for all HIV immune statuses and sites of disease (pulmonary vs. extrapulmonary). In HIV-seropositive patients, however, sensitivity was always lower for disseminated tuberculosis than for localized tuberculosis. Combining data for both the smear test and the EIA maximized sensitivity. The main value of the EIA test could be to provide early complementary information by antibody detection in patients with tuberculosis, particularly those with a negative smear test.

Screening for cervical intraepithelial neoplasia in north east Scotland shows fall in incidence and mortality from invasive cancer with concomitant rise in preinvasive disease

To assess the effect of screening for cervical intraepithelial neoplasia on the incidence of and mortality from invasive squamous cell carcinoma of cervix in north east Scotland and to discover why cases of invasive cancer still occur. (a) Analysis of data on cases of cervical intraepithelial neoplasia obtained from the cytology data bank; (b) analysis of data on 612 women presenting with invasive squamous cancer during 1968-91, obtained from cancer registry and hospital records; (c) analysis of death rates obtained from the registrar general's (Scotland) annual reports, the Information Services Division of the Home and Health Department (Scotland), and local records for 1974-91; (d) case-control studies on 282 cases of invasive cancer and 108 deaths which occurred in 1982-91. Cases were matched with two controls both for age and for having a negative smear test result at the time of presentation of the case. North east Scotland (Grampian region, Orkney, and Shetland). Women (n = 306,608) who had had cervical smear tests between 1960 and 1991. There had been a substantial increase in cases of cervical intraepithelial neoplasia grade III since 1982. The incidence of invasive cancer has fallen since the start of screening in 1960, the fall occurring mainly in the well screened age group 40-69 years. There was a rise in women aged under 40 and over 70. Women with invasive disease seen between 1982 and 1991 mostly presented at stage I. Of these, half were unscreened, one third were poorly screened, 11% were found in retrospect to have had abnormal cells, 3% had recurrence of disease after treatment for cervical intraepithelial neoplasia grade III, and 3% were lost to follow up. Death rates had fallen, most noticeably in women aged 45-64, who had had the opportunity to be screened and rescreened. There was a disturbing rise in deaths among women under 45. Most deaths (65%) occurred in unscreened women. Case-control studies showed that the longer the time and absence of a smear test before presentation the higher was the risk of invasive cancer and of death. Screening has been effective in reducing the incidence of and mortality from cervical cancer in north east Scotland. Most cases and deaths occurred in unscreened women or in those who had had few smears at long intervals. An increase in cases of cervical intraepithelial neoplasia grade III in women screened for the first time occurred during 1982-91.

Lower age limit for cervical screening.

The age limit for cervical screening could be lowered to 50 for women who have a history of negative smear test results, a new study has shown.

Predicting mortality from cervical cancer after negative smear test results

International Journal of Gynecology & ObstetricsVolume 41, Issue 1 p. 120-120 Citations from the literature oncology Predicting mortality from cervical cancer after negative smear test results GJ Van Oortmarssen, GJ Van OortmarssenSearch for more papers by this authorJDF Habbema, JDF HabbemaSearch for more papers by this authorM Van Ballegooijen, M Van BallegooijenSearch for more papers by this author GJ Van Oortmarssen, GJ Van OortmarssenSearch for more papers by this authorJDF Habbema, JDF HabbemaSearch for more papers by this authorM Van Ballegooijen, M Van BallegooijenSearch for more papers by this author First published: April 1993 https://doi.org/10.1016/0020-7292(93)90208-EAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume41, Issue1April 1993Pages 120-120 RelatedInformation

Negative smear tests and older women

Negative smear tests and older women