Cytopathology Research Articles

Di (2-ethylhexyl) phthalate effects on the growth, development, and reproduction of Moina macrocopa (Crustacea: Cladocera)

Di (2-ethylhexyl) phthalate (DEHP) is used as a plasticizer in plastics. The effects of DEHP on terrestrial vertebrates have been extensively reported but the effects of DEHP contamination on aquatic ecosystems have not been thoroughly studied. Since water bodies are one of the main mediums through which DEHP is released worldwide, the impacts of DEHP contamination should be manifested in water fleas. Therefore, maternal Moina macrocopa were exposed to 1, 10, 100, and 1000 μg/L concentrations of DEHP. Changes in growth and reproduction were evaluated. The findings demonstrated that DEHP exposure did not have a negative impact on growth or the ability to reproduce. An analysis of the ovary yolk body (YB) demonstrated that the average size and number of yolk bodies (YBs) produced by M. macrocopa exposed to 1000 μg/L DEHP were not significantly different to the average size and number of YBs produced in blank control and solvent control conditions. These outcomes support the cellular pathology data gathered by other researchers. Nevertheless, when M. macrocopa was exposed to 1000 μg/L DEHP for five days, a significant increase in YB numbers was observed with changes in YB morphology. The critical cellular pathology of YB showed morphological abnormalities, including rod-shaped YBs, and YB density was higher than in the blank and solvent controls. Even though these results suggest that antioxidative stress can be induced by DEHP exposure, growth, and reproduction were not significantly different among exposed water fleas compared to fleas in the blank and solvent controls. The result was attributed to the antioxidant response of the water flea. In conclusion, the present study enhances our understanding of previous findings from risk assessments of DEHP contamination in aquatic ecosystems.

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.

Effect of different types of smoking on oral health and on cellular changes in oral mucosa

ObjectivesSmoking is known to be a major risk factor for several diseases. Recently, electronic cigarettes have been introduced to the market; however, their effect on oral health has not been well studied yet. We aim to compare the effect of different types of smoking on oral health and to evaluate cytomorphological changes in oral mucosa among different types of smokers. Study designA total of 112 participants were recruited, conventional cigarette smokers (n = 28), electronic cigarettes smokers (n = 26), hookah smokers (n = 29) and non-smokers (n = 29). Oral examination, brush cytology and salivary flow test were performed. Cytological smears were stained and examined for cytomorphological changes. Oral symptoms, type, and frequency of smoking were obtained through questionnaires. SPSS program was used for statistical analysis. ResultsMost of the oral symptoms reported in this study were among conventional and electronic cigarettes smokers. While hookah smokers reported the least oral symptoms. Increase in DMFT and gingival index were observed among all smokers, mainly among conventional cigarettes smokers. Conventional cigarette and hookah smokers were found to have the most significant cellular changes. Electronic cigarette smokers had certain cellular changes as well. ConclusionAll types of smoking adversely affect oral health and can induce cellular changes in the oral mucosa.

Improving cervical cancer classification in PAP smear images with enhanced segmentation and deep progressive learning-based techniques.

Cervical cancer, a prevalent and deadly disease among women, comes second only to breast cancer, with over 700 daily deaths. The Pap smear test is a widely utilized screening method for detecting cervical cancer in its early stages. However, this manual screening process is prone to a high rate of false-positive outcomes because of human errors. Researchers are using machine learning and deep learning in computer-aided diagnostic tools to address this issue. These tools automatically analyze and sort cervical cytology and colposcopy images, improving the precision of identifying various stages of cervical cancer. This article uses state-of-the-art deep learning methods, such as ResNet-50 for categorizing cervical cancer cells to assist medical professionals. The method includes three key steps: preprocessing, segmentation using k-means clustering, and classifying cancer cells. The model is assessed based on performance metrics viz; precision, accuracy, kappa score, precision, sensitivity, and specificity. In the end, the high success rate shows that the ResNet50 model is a valuable tool for timely detection of cervical cancer. In conclusion, the infected cervical region is pinpointed using spatial K-means clustering and preprocessing operations. This sequence of actions is followed by a progressive learning technique. The Progressive Learning technique then proceeded through several stages: Stage 1 with 64 × 64 images, Stage 2 with 224 × 224 images, Stage 3 with 512 × 512 images, and the final Stage 4 with 1024 × 1024 images. The outcomes show that the suggested model is effective for analyzing Pap smear tests, achieving 97.4% accuracy and approx. 98% kappa score.

Sensitive electrochemical flow injection analysis of H2O2 released from cells with a pass-through mode

Conventional plate electrodes were commonly used in electrochemical flow injection analysis and only part of molecules diffused to the plane of electrodes could be detected, which would limit the performance of electrochemical detection. In this study, a low-cost native stainless steel wire mesh (SSWM) electrode was integrated into a 3D-printed device for electrochemical flow injection analysis with a pass-through mode, which is different compared with previous flow-through mode. This strategy was applied for sensitive analysis of hydrogen peroxide (H2O2) released from cells. Under the optimal conditions (the applied potentials, the flow rate and the sample volume), the device exhibits high sensitivity toward H2O2. Linear relationships could be achieved between electrochemical responses and the concentration of H2O2 ranging from 1 nM to 1 mM. The excellent analytical performance of the SSWM-based device could be attributed to the pass-through mode based on the mesh microstructure and intrinsic catalytic properties for H2O2 by stainless steel. This approach could be further successfully extended for screening of H2O2 released from HeLa cells with electrochemical responses linear to the number of cells in a range of 3 - 1.35 × 104 cells with an injection volume of 30 μL. This study revealed the potential of mesh electrodes in electrochemical flow injection analysis for cellular function and pathology and its possible extension in cell counting and on-line analysis.

Endocrine and cellular physiology and pathology of the insulin-like growth factor acid-labile subunit.

The acid-labile subunit (ALS) of the insulin-like growth factor (IGF) binding protein (IGFBP) complex, encoded in humans by IGFALS, has a vital role in regulating the endocrine transport and bioavailability of IGF-1 and IGF-2. Accordingly, ALS has a considerable influence on postnatal growth and metabolism. ALS is a leucine-rich glycoprotein that forms high-affinity ternary complexes with IGFBP-3 or IGFBP-5 when they are occupied by either IGF-1 or IGF-2. These complexes constitute a stable reservoir of circulating IGFs, blocking the potentially hypoglycaemic activity of unbound IGFs. ALS is primarily synthesized by hepatocytes and its expression is lower in non-hepatic tissues. ALS synthesis is strongly induced by growth hormone and suppressed by IL-1β, thus potentially serving as a marker of growth hormone secretion and/or activity and of inflammation. IGFALS mutations in humans and Igfals deletion in mice cause modest growth retardation and pubertal delay, accompanied by decreased osteogenesis and enhanced adipogenesis. In hepatocellular carcinoma, IGFALS is described as a tumour suppressor; however, its contribution to other cancers is not well delineated. This Review addresses the endocrine physiology and pathology of ALS, discusses the latest cell and proteomic studies that suggest emerging cellular roles for ALS and outlines its involvement in other disease states.

Fatal coinfection of blastocystosis and intestinal trichomoniasis in a rhesus macaque (Macaca mulatta).

A 3-year-old male rhesus macaque was presented at Referral Veterinary Polyclinic-Teaching Veterinary Clinical Complex, with a chief complaint of chronic diarrhoea and swelling of dependent body parts. The patient's history indicates that the monkey had been experiencing diarrhoea for the past month, with 2-3 episodes of vomiting in the last 2days. Additionally, oedema has developed within the last 2weeks. The clinical examination findings revealed dullness and depression, the mucus membrane appeared pale, with a temperature-102.1°F, a respiration rate-28/min, and a heart rate-92/min. The capillary refill time was 4s. During the physical examination, the animal exhibited oedema on the dependent part of the body and faecal staining around the perineum along with loose yellow stool. Direct saline and iodine mount faecal smear examination revealed the presence of many motile pear-shaped flagellated protozoa and round vacuolated Blastocystis organisms. Giemsa-stained faecal smear cytology confirmed the presence of Pentatrichomonas sp. and Blastocystis sp. along with many microbes. The faecal culture was negative for all pathogenic microbes. The case was diagnosed as co-infection Blastocystosis and intestinal trichomoniasis. The treatment was initiated with a combination of sulfamethoxazole + trimethoprim @ 35mg/kg body weight and metronidazole @25mg/kg administered orally once daily for 7days. Supportive therapy includes hematinic injection (iron sorbitol, folic acid and vitamin B12) @ 1ml total dose, administered intramuscularly on alternate days for four occasions as well as intravenous infusion of crystalline amino acid @ 5ml total dose on alternate days for four occasions. To manage vomition, injection ondansetron was administered@0.5mg/kg intramuscularly, twice daily for 3days and H2 blockers, including injection ranitidine@2mg/kg intramuscularly twice daily for 3days. Electrolyte and probiotic supplementation were administered orally. After 7days of therapy, the oedema had significantly improved and episodes of vomition were stopped but there was no significant improvement in the episode of diarrhoea and consistency of faeces. Unfortunately, on the 10th day of therapy, the animal suddenly collapsed. Understanding the virulence pattern of opportunistic protozoa in primates is crucial, and identifying suitable therapeutic candidates to prevent fatal outcomes is the need of the hour, especially considering protozoal infections as an important differential diagnosis in gastrointestinal tract-related ailments. Our study successfully demonstrated the co-occurrence of blastocystosis and intestinal trichomoniasis, both uncommon infections with potential zoonotic implications.

Abstract MP56: Screening for Familial Hypercholesterolemia: School Based Programs May Be Best Alternative

Introduction: Familial Hypercholesterolemia (FH) is an autosomal dominant condition characterized by elevated cholesterol and premature development of cardiovascular (CV) disease affecting 1/200 - 1/500 individuals. Only 10% of the affected population in the United States have been identified and treated compared to 50-70% in Scandinavian countries identified through school-based or universal screening programs. Hypothesis Statement: School based programs are the best mechanism for FH screening. Methods: The Healthy Hearts and Minds Program (HHM) through UCHealth performs biometric screenings on 5th, 7th, and 10th grade students in Northern Colorado. HHM tested 10,991 5th grade students (9/2017 - 5/2022) and identified 424 students with total cholesterol levels ≥200 mg/dL (range 200-302). A buccal smear test (APOB, LDLR, PCSK9) was performed on 99 individuals with the highest total cholesterol levels to identify genetic status. A binomial logistic regression model was used for analysis. Results: Of the 99 students, six tested positive (50% male, 10.3 years, 22.8 BMI) for FH with five (40% male, 11.3 years, 17.3 BMI.) reporting a variant of indeterminate significance. A sigmoidal association between total cholesterol and predicted chance of FH was identified with the inflection point at ~270 mg/dL. Conclusions: Comprehensive school based programs are the most effective and equitable means of identifying this genetic based disease and should be supported in a collaborative manner with health care systems, industry and the community. With availability to all students, diversity, equity, and inclusion concerns are addressed and provide at risk populations with personalized health information. The results from this study suggest a school-based screening program can be effective at identifying students most at risk for FH. These results further define the relation between total cholesterol and predicted chance of FH for a school-aged population where 245 mg/dL indicates a 10.3% of testing positive for FH whereas 275 mg/dL has a 54.8% chance. Additionally, the multiplier effect documented through cascade FH testing enhances the benefit of the information to other family members, as the autosomal dominant pattern insures that 50% of members will be at risk. The individual benefit of identifying FH early is the treatability of this condition. Early use of lipid lowering agents can make the CV disease risk equal to the general population. If left untreated, CV disease occurs approximately 10 years earlier which results in increased mortality and disability, along with increased health care costs. Therefore, if elevated cholesterol is present in school children, genetic testing is warranted and treatment considered by age 8-10 years, especially if signs of abnormal vascular plaquing is identified.

Atypical squamous cells of undetermined significance cervical cytology in Bahrain: Reporting rates, high-risk HPV testing, and cytologic and histopathologic follow-up findings.

Atypical squamous cells of undetermined significance cytology (ASC-US) is a challenging and equivocal diagnosis for pathologists in cervical Pap smears. The data on ASC-US cervical cytology in Bahrain are deficient. This study reviewed and identified the reporting rates, high-risk human papillomavirus (HPV) testing results, histopathologic follow-up findings, and the cytologic progression of patients diagnosed with ASC-US in Bahrain. A retrospective chart review was conducted on the medical records of 23,888 women who had Pap smear test results between January 2019 and March 2022 at the main referral tertiary hospital in Bahrain to identify the ASC-US cases. High-risk HPV (hrHPV) genotype was identified, and the histopathological results of the cervical biopsy was recorded. In addition, cytologic follow-up Pap smear tests conducted within 1 year of ASC-US diagnosis were tracked to monitor the progression or regression of ASC-US. In this study, 259 out of 23,888 women reported to have ASC-UC cytology results with a reporting rate of 1.1%. The mean age of the ASC-US cases was 43 ± 11.6. Thirty percent of the ASC-US cases tested positive for hrHPV, and they were predominantly infected with the other hrHPV genotype (75%). When the histopathological changes of the cervix were analyzed, 82.1% had normal histopathologic findings. However, low-grade cervical intraepithelial neoplasia-1 was reported in 2 cases (7.1%), and high-grade cervical lesions (cervical intraepithelial neoplasia-2 and higher) were reported in 3 cases (10.7%). Regarding the cytologic follow-up, most of the ASC-US cases were negative for intraepithelial lesion or malignancy (NILM) (73.8%) or had persistent ASC-US (17.9%). The remaining minority of cases progressed into either low-grade squamous intraepithelial lesions (6%) or high-grade squamous intraepithelial lesions (2.4%). There was a statistically significant and relatively strong association between the cytology follow-up findings and the hrHPV test results (χ2 [2] = 8.869, P < 0.012, Cramer's V = 0.417). This is the first and largest study to characterize the ASC-US cytology cases in Bahrain. The reporting rates of ASC-US fell within the worldwide reported range. Although most of the ASC-US cases regressed into NILM, ASC-US showed progression into more advanced cervical cytologic diagnoses or contributed to the malignant transformation of cervical tissue, especially in the presence of hrHPV infection which was positive in 30% of the ASC-US cases. This emphasizes the role of cotesting (combination of hrHPV genotyping and Pap smear test) and the importance of colposcopic evaluation of those women with cytologic follow-up tests at 1 year of diagnosis. Implementing these recommendations in the cervical cancer screening practice in Bahrain will help in having a better management plan for women diagnosed with ASC-US cervical cytology.

The Affordable Care Act and Racial Disparities in Healthcare Utilization: New Evidence From Employer Mandate

The 2010 United States Affordable Care Act (ACA) mandates small and mid-size firms to provide health insurance for full-time workers. This study investigates whether a key provision of the ACA employer mandate has reduced racial disparities in health services use among uterine cancer (UC) survivors. Employing a nationally representative Medical Expenditure Panel Survey (MEPS) data from 2008 to 2017 and the Difference-in-Differences empirical model, we find that the ACA employer mandate increases the utilization of pap smear tests among all groups of UC survivors. Additionally, our results suggest a rise in physician's office visits among non-Hispanic Black and Hispanic UC survivors driven by the announcement of the employer mandate in the post-ACA period. Our results further suggest a reduction in out-of-pocket prescription drug expenditure among UC survivors of racial and ethnic minorities. Study findings have implications for improving ethnic minority female population health outcomes.

The level of medical students' knowledge regarding the prevention of cervical cancer.

In Palestine, cervical cancer is the third most common gynaecological cancer, exhibiting higher mortality rates compared to regional counterparts. Late-stage diagnosis and limited awareness contribute to this disparity. This study aims to assess the awareness of Palestinian medical students regarding cervical cancer prevention. A questionnaire-based survey involving 532 medical students from various Palestinian universities was conducted between October 2023 and December 2023. The survey encompassed closed-ended quantitative and demographic questions distributed through social media. The study was carried out on a group of 532 medical students (66.3% women and 33.6% men), (average age 21.7years). Most students (77.7%) knew that the main risk factor for cervical cancer was human papillomavirus (HPV) infection. Participants doing the internship had the greatest knowledge, whereas students from the first year had the poorest knowledge about the main risk factors for cancer of the cervix. Only about half, 50.2% of all students, knew that in Palestine, there is no screening program. 84.4% of students correctly indicated that the cervical cancer screening test is a pap smear test. 41.4% of respondents knew that microscopic evaluation of the exfoliated cells from the vaginal part of the cervix is the screening test for cervical cancer which is used. Only about half of the students (45.1%) knew that there were no specific early symptoms of cervical cancer. This study highlights the need for enhanced education, particularly regarding screening program awareness, among Palestinian medical students. Addressing these knowledge gaps is crucial for effective preventive strategies.

Nodal Low-Grade B-Cell Lymphoma Co-Expressing CD5 and CD10 but Not CD23, IRTA1, or Cyclin D1: The Diagnostic Challenge of a Splenic Marginal Zone Lymphoma.

The diagnosis of lymphoma is based on histopathological and immunophenotypical features. CD5 and CD10 are traditionally considered a T-cell antigen and a germinal center B-cell antigen, respectively. It is very unusual for a low-grade B-cell lymphoma (BCL) to co-express CD5 and CD10. Although the biologic basis or clinical significance of such co-expression is unclear, this rare event may pose a significant diagnostic challenge. Here, we report a case of a 63-year-old male presenting with bilateral cervical lymphadenopathy and lymphocytosis. Histologically, the nodal tumor was largely diffuse with neoplastic small atypical lymphocytes co-expressing CD5, CD10, and CD20, but not CD23 or cyclin D1. The leukemic cells in the peripheral blood exhibited hairy projections. Taking together the marked splenomegaly, involvement of lymph nodes, bone marrow, and peripheral blood, a final diagnosis of splenic marginal zone lymphoma (SMZL) was reached. The patient was alive with partial response for 10 months after immunochemotherapy. The dual expression of CD5 and CD10 is extremely unusual for low-grade BCL and may lead to an erroneous diagnosis. Integrating the findings into peripheral blood smear tests, flow cytometry, histopathology, imaging, and clinical features is mandatory to exclude other lymphoma types and to reach a correct diagnosis, particularly for a case with nodal presentation.

Cytological, Histopathological and Immunohistochemical Studies on Naturally Occurring Cutaneous Melanomas in Cattle in and Around Namakkal, Tamil Nadu, India

Background: Melanomas are tumours that originate from melanoblasts. The studies on bovine tumours are of clinical concern since some melanocytic tumours are congenital and occur in young animals. The present work was carried out to study the pathomorphological characteristics of melanomas in cattle for early diagnosis and intervention. Methods: Tumour samples were collected from suspected cases of neoplasia from four animals during the study period. Data pertaining to the animals were collected. Fine needle aspiration cytology and impression smear were stained with Giemsa stain. Tissue samples were collected in 10 per cent neutral buffered formalin for histopathological examination. Special staining with Fontana silver stain and immunohistochemistry with Melan- A and S- 100 markers for confirmatory diagnosis of melanin pigment was done. Result: Cytology revealed neoplastic cells with vacuolation and pleomorphism. Cytoplasm contained abundant melanin pigments. Microscopically, the cytoplasm contained abundant brown, black coloured melanin pigment granules. Tissue sections stained with Fontana silver impregnation method revealed the presence of black coloured granules. Immunohistochemistry with Melan-A and S-100 revealed strong expression of brown coloured reaction in the cytoplasm of the neoplastic cells.

Correlation of VIA Positive Cases with Colposcopic and Histopathological Findings in Diagnosis of Precancerous Lesion of Cervix in A Tertiary Care Hospital

Background: Cervical cancer prevention strategies are evolving by integrating new screening modalities such as human papillomavirus (HPV) DNA testing and visual inspection with acetic acid (VIA). Colposcopy, as a diagnostic tool, plays a crucial role in the management of abnormal cytology smears, especially in developed countries. However, its utilization and efficacy in resource-limited settings like Bangladesh remain underexplored. Objective: This study aimed to assess the correlation between VIA positivity and colposcopic/histopathological findings in diagnosing precancerous cervical lesions among women in Bangladesh. Method: A cross-sectional study was conducted among 200 women aged 30-60 attending the Gynecology OPD of Dhaka Medical College and Hospital. VIA positivity was determined, and all positive cases underwent colposcopic evaluation. Histopathological examination was performed for tissue samples obtained during colposcopy. Result: Among the participants, 21% were VIA-positive. Colposcopic evaluation revealed inflammation (26.2%), CIN I (38.1%), CIN II (11.1%), CIN III (9.5%), and invasive carcinoma (9.5%). Histopathology findings included inflammation (28.6%), CIN I (40.5%), CIN II (7.1%), and invasive carcinoma (16.7%). True positive and false positive cases were identified, with percentages calculated accordingly. Conclusion: Detailed colposcopic evaluation with guided biopsy is crucial for detecting pre-invasive and early cervical cancer. Integrating colposcopy into screening programs in Bangladesh could significantly reduce morbidity and mortality among young women.

Study of p40 is superior to p63 for the diagnosis of pulmonary squamous cell carcinoma on cytological smears

Background: Histology and genetically driven management are the current standard in carcinoma lung. Adequate tissue is a challenge in a few cases. While liquid biopsy is an, it’s an always preferred to get an initial cyto/histo morphological confirmation. While the immune-histo chemistry (IHC) is a proven method to differentiate the squamous vs adeno carcinoma, the role of various “immuno-cyto-chemical” makers were not studied widely. Methods: This is a retrospective (July 2018 to December 2018) for random sample collection and prospective (Jan 2019-August 2019) study conducted from in the Department of pathology, govt. chest hospital Osmania medical college, Hyderabad as a part of PG dissertation, 120 subjects with cytological diagnosis of non-small cell lung carcinoma were analyzed during this period and others were excluded. Results: Out of 120 cases 80-adenocarcinoma (ADC) and 40-squamous cell carcinoma (SCC). Most of the patients are in 61-70 years, 20 are 71-80 years, 20 between 51-60 and 10 are between 40-50 years. In this study sensitivity of p63 and p40 is equal, but specificity and positive predictive value are higher for p40 for diagnosis of SCC. Conclusions: Immuno-cyto-chemistry is still a valid option in selected cases where getting a biopsy is difficult. Our findings recommend the use of p40 immuno staining rather than p63 as a squamous cell marker.

Exploring the barriers to Pap smear test compliance: A qualitative study for improving cervical cancer screening in the primary health care.

Cervical cancer in Iran ranks as the fourth most frequent cancer among women. Pap smear (PS) is the best standard for detecting cervical cancer, but many people, even healthcare providers (HCPs), do not maintain it. HCPs play a critical role in promoting PS uptake. The purpose of the study was to explore barriers to cervical cancer PS screening compliance from the HCPs' perspective. The present qualitative content analysis was conducted through semi-structured in-depth interviews. A total of 28 HCPs were interviewed between July and August 2020. A diverse sample of HCPs was selected using purposive sampling. Data analysis was based on the five steps proposed by Graneheim and Lundman. MAXQDA (2020) was used for data analyzing. Ten key sub-categories were identified and organized into three categories: individual, environmental, and socio-cultural factors. The sub-categories included inadequate risk perception, inappropriate attitude, low commitment, emotional factors, low priority over health, requirements and consequences of the test, deficiencies of health centers, organizational factors, traditions and religious believes. HCPs face multiple barriers for PS. Exploring and decreasing barriers of PS in HCPs may increase compliance in them and their clients because they play an influential role in instructing and persuading women to take the PS. There is need to explore these barriers and identify possible interventions to change them. Insights from this study are useful for developing policies around national PS programs, too.

Stem Cell-Derived Extracellular Vesicles in the Treatment of Cardiovascular Diseases.

Cardiovascular disease constitutes a noteworthy public health challenge characterized by a pronounced incidence, frequency, and mortality rate, particularly impacting specific demographic groups, and imposing a substantial burden on the healthcare infrastructure. Certain risk factors, such as age, gender, and smoking, contribute to the prevalence of fatal cardiovascular disease, highlighting the need for targeted interventions. Current challenges in clinical practice involve medication complexities, the lack of a systematic decision-making approach, and prevalent drug therapy problems. Stem cell-derived extracellular vesicles stand as versatile entities with a unique molecular fingerprint, holding significant therapeutic potential across a spectrum of applications, particularly in the realm of cardio-protection. Their lipid, protein, and nucleic acid compositions, coupled with their multifaceted functions, underscore their role as promising mediators in regenerative medicine and pave the way for further exploration of their intricate contributions to cellular physiology and pathology. Here, we overview our current understanding of the possible role of stem cell-derived extracellular vesicles in the clinical management of human cardiovascular pathologies.

Personality and the use of cancer screenings - Results of the German National Cohort

ObjectiveTo determine the association between personality characteristics and use of different cancer screenings. MethodsWe used data from the German National Cohort (NAKO; mean age was 53.0 years (SD: 9.2 years)) – a population-based cohort study. A total of 132,298 individuals were included in the analyses. As outcome measures, we used (self-reported): stool examination for blood (haemoccult test, early detection of bowel cancer), colonoscopy (screening for colorectal cancer), skin examination for moles (early detection of skin cancer), breast palpation by a doctor (early detection of breast cancer), x-ray examination of the breast (“mammography”, early detection of breast cancer), cervical smear test, finger examination of the rectum (early detection of prostate cancer), and blood test for prostate cancer (determination of Prostate-Specific Antigen level). The established Big Five Inventory-SOEP was used to quantify personality factors. It was adjusted for several covariates based on the Andersen model. Unadjusted and adjusted multiple logistic regressions were computed. ResultsA higher probability of having a skin examination for moles, for example, was associated with a higher conscientiousness (OR: 1.07, p < 0.001), higher extraversion (OR: 1.03, p < 0.001), higher agreeableness (OR: 1.02, p < 0.001), lower openness to experience (OR: 0.98, p < 0.001) and higher neuroticism (OR: 1.07, p < 0.001) among the total sample. Depending on the outcome used, the associations slightly varied. ConclusionsParticularly higher levels of extraversion, neuroticism and conscientiousness are associated with the use of different cancer screenings. Such knowledge may help to better understand non-participation in cancer screening examinations from a psychological perspective.

A Cytohistologic Correlation Study of Thyroid Lesions: Evaluation of Diagnostic Accuracy and Pitfalls of Fine Needle Aspiration Cytology.

Background Only about 5% of palpable thyroid nodules are malignant; the rest are entirely benign. In order to reduce the number of unnecessary treatments and properly identify situations that need surgical intervention, it is essential to distinguish between benign and malignant lesions prior to surgery. There exists a "grey zone" in thyroid cytology characterized by a significant decrease in diagnostic accuracy, making it difficult to precisely classify the lesion and leading to discrepancies. Aims and objectives The study aims to accomplish the following objectives: (1) assess the prevalence of thyroid lesions according to age and sex; (2) evaluate the accuracy of the fine needle aspiration cytology (FNAC) in diagnosing thyroid conditions; and (3) investigate the causes of cytohistological discordance within the context of this study. Materials and methods In our five-year study of thyroid lesions, 125 cases were studied for cytohistological correlation. Discrepant and likened FNAs were classified according to the diagnostic findings. A review of the cytological smears and histological sections was conducted. Results The cytological diagnoses were correlated with histopathology in 109 cases (90.83%). A total of 11 cases (09.16%) were discrepant. There were no false positives (FPs). The causes of false negative (FN) diagnoses in our study can be attributed to geographic misses and failure to recognize dual pathologies. Conclusion FNA is a very precise and time-saving technique for the diagnosis and subsequent management of palpable thyroid nodules. Patients having thyroidectomies have a much higher malignant yield, and the frequency of procedures performed on the thyroid is decreased. When FNA interpretation based on strict specimen sufficiency standards is considered along with clinical and imaging findings, the occurrence of FN and FP diagnoses is expected to decrease.

Human Leucocyte Antigen Class II Risk and Protective Alleles in Women with Cervical Intraepithelial Neoplasia.

Persistent human papillomavirus (HPV) infection is a necessary cause for development of cervical precancerous lesions and cervical cancer, however, only a small percentage of women progress to cervical cancer. The local immune response, determined, among other factors, by Human Leucocyte Antigen (HLA) genes, is thought to be significant. Still the results of genome studies are inconsistent and differ between ethnical populations. The aim of the study was to assess an association between HLA-DQA1*; DQB1*; DRB1* allele's genetic variants between women with cervical precancerous lesions and healthy controls in Latvia. From January until April 2017 we enrolled 84 consecutive patients referred for colposcopy to Riga East University Hospital (Latvia) due to abnormal cervical cytology results. 57 women who came for a regular check-up and had normal cytology smears were included in the control group. Material from the cervix was taken for subsequent HLA genotyping of 13 DRB1*, 8 DQA1*, and 12 DQB1* alleles. Colposcopy was performed on all participants. In case of visual suspicion for CIN cervical biopsy was done. There were 57 "no CIN" patients, 23 histologically proven CIN 1 and 61 CIN2+ cases in the study population. CIN2+ was more often associated with DQA1*0401 (OR 6.68, 95% CI 1.47-30.29, p=0.014), DRB*15 (OR 2.99, 95% CI 1.22-7.39, p=0.017), DQB1*0401 (OR 2.91, 95%CI 1.11-7.68, p=0.03), DQA1*0103 (OR 2.72, 95% CI 1.02-7.21, p=0.045), DRB1*11 (OR 2.42, 95% CI 1.10-5.33, p=0.029) and DQB1*0301 (OR 1.94, 95% CI 1.12-3.38, p=0.018). Women with "no CIN" more often had DQB1*0501 (OR 0.17, 95% CI 0.04-0.81, p=0.026), DRB1*16 (OR 0.21, 95% CI 0.06-0.78, p=0.019), DQA1*0301 (OR 0.35, 95% CI 0.14-0.87, p=0.024) and DRB1*14 (OR 0.59, 95% CI 0.01-0.46, p=0.007). In the current study we have demonstrated a strong association with risk and protective HLA class II alleles that are determined by the HLA-DRB1*; DQA1*; DQB1*.