Pattern and predictors of cervical epithelial cell abnormalities among unscreened and under-screened women in Lagos, Nigeria: a cross-sectional study.

Women who had never undergone cervical screening (CS) or who have infrequent CS are at increased risk of having cervical epithelial cell abnormalities (CECA) that may lead to cervical cancer (CCa). Our study determined the pattern and factors that predict the occurrence of CECA among unscreened and under-screened women in Lagos, Nigeria. This was an analytical cross-sectional study among 256 consenting sexually active women between 21 and 65 years who attended a community CS programme in Surulere, Lagos, Nigeria, in June 2019. Information on socio-demographic, reproductive, sexual, behavioural and clinical characteristics were collected and a Pap smear test was done. Women with abnormal cervical cytology were followed up and given appropriate treatment. Data analysis was done using Statistical Package for Social Sciences version 23. Descriptive statistics were computed using frequencies and association was tested using odd ratio. The participants' mean age was 42.7 ± 10.3 years, majority were married (79.9%) and were human immune deficiency syndrome (HIV) negative (63.1%). The prevalence of CECA was 9.8%. Atypical squamous cell of undetermined significance and atypical squamous cell cannot exclude high-grade squamous intraepithelial lesion were the most common CECA with prevalence rates of 7.4% and 2.0%, respectively. Having a partner with multiple sexual partners (adjusted odd ratio (AOR) = 19.23), being HIV positive (AOR = 25.61), giving birth for the first time before the age of 26 years (AOR = 5.55) and presence of a combination of either abnormal vaginal discharge, contact bleeding or an unhealthy cervix on clinical examination (AOR = 13.65) independently predicted the occurrence of CECA. There is a need to prioritise CS for women with these risk factors to prevent CCa and reduce the burden of the disease in our environment.

The Correlation of Papanicolaou Smears and Clinical Features to Identify the Common Risk Factors for Cervical Cancer: A Retrospective and Descriptive Study from a Tertiary Care Hospital in Trinidad.

Background: Cervical cancer, the fourth most frequent cancer in women, is associated with the human papillomavirus (HPV). This study identifies risk factors and clinical findings for abnormal cervical cytology and histopathology in the Trinidad and Tobago populations. Some risk factors include early age of first coitus, a high number of sexual partners, high parity, smoking, and using certain medications, such as oral contraception. This study aims to identify the significance of Papanicolaou (pap) smears and the common risk factors that contribute to the development of premalignant and malignant cervical lesions. Method: A three-year retrospective, descriptive study of cervical cancer was conducted at the Eric Williams Medical Sciences Complex. The subject population included 215 female patients aged 18 years and older with the following documented abnormal cervical cytology: (ASCUS), ASC-H, LSIL, HSIL, Atypical Glandular cells, HPV, Adenocarcinoma, and Invasive Squamous Cell Carcinoma. Histopathology records were analysed for thirty-three of these patients. Patients' information was recorded on data collection sheets adapted from the North Central Regional Health Authority's cytology laboratory standardised reporting format request form. Results and Findings: The data were analysed via Statistical Package for Social Sciences (SPSS) software edition 23 using frequency tables and descriptive analysis. The mean sample age of the population was 36.7 years, the first age of coitus was 18.1 years, the number of sexual partners was 3.8, and the number of live births was 2. LSIL was the most popular abnormal finding, 32.6%, followed by HSIL, 28.8%, and ASCUS, 27.4%. Most histopathological reports resulted in CIN I and II. Conclusions: The significant risk factors observed for cytology abnormalities and premalignant lesions were early age of coitus, a high number of sexual partners, and no use of contraception. Patients mostly presented as asymptomatic despite obtaining abnormal cytology results. Hence, regular pap smear screening should continue to be highly encouraged.

Reduced activated regulatory T cells and imbalance of Th17/activated Treg cells marks renal involvement in ANCA-associated vasculitis.

The role of naturally occurring regulatory T cells (Treg) in the control of the immune tolerance of ANCA-associated vasculitis (AAV) has not been well defined. Therefore, we separate the phenotypically heterogeneous Treg cells into different subsets based on the expression of FOXP3 and CD45RA during AAV pathogenesis. Fifty-four AAV patients (38 patients with renal involvement) and 19 healthy controls (HCs) were enrolled in this study. Levels of CD4+T cell subsets and cytokines were detected by flow cytometry. Treg immunesuppression capacity was measured in co-culture experiments. The diagnostic value for Treg subsets was evaluated by the areas under the receiver operating characteristic curves (AUC). Patients with AAV had lower percentages and numbers of activated Treg cells (aTreg, P = 0.044, P = 0.002), while higher levels of total Treg cells (P = 0.001, P = 0.026) with diminished immunosuppression capacity. The proportions of effector memory T-cell subpopulation (P < 0.001) were increased in AAV patients. Interestingly, the AUC of the aTreg improved significantly the diagnostic potential of AAV. Furthermore, the ratio of Th17/aTreg was significantly increased in active and renal vasculitis patient and positive correlation between Th17/Treg subset ratio and creatinine or BUN. In addition, we found that cytokine IL-2 and IL-4 exhibited a downward while IL-6, IL-10, TNF-α, IFN-γ and IL-17A trend upward in AAV patients. Increase in total Treg levels, along with functional deficiency, and decrease in aTreg cells constitute potential novel biomarkers for AAV. And the ratio of Th17/aTreg might serve as an important tool to recognize and monitor AAV patients with renal involvement and disease remission.

Intravascular lymphoma forming massive aortic tumors complicated with sarcoidosis and focal segmental glomerulosclerosis: a case report and literature review.

BACKGROUND: Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of extranodal diffuse large B-cell lymphoma characterized by proliferation of B cells within small vessels. Herein, we report a case of a 77-year-old man who presented with IVLBCL and massive tumor formation on the aortic wall who was previously diagnosed with sarcoidosis and focal segmental glomerulosclerosis (FSGS). To our knowledge, this is the first reported case of an IVLBCL with aortic tumor formation. CASE PRESENTATION: A 77-year-old ambulatory man with sarcoidosis and FSGS had neurological symptoms for nine months. The patient presented to the emergency department with sudden left leg pain, and was diagnosed with acute femoral artery occlusion. Emergency thrombectomy was performed subsequently. Pathological evaluation of the thrombi revealed that its surface was filled with large atypical B cells. Bone marrow biopsy showed infiltration of large atypical B cells within the small vessels. IVLBCL was suspected and further examination was planned, but the patient died due to sudden respiratory and cardiac arrest on hospital day twelve. Autopsy revealed intravascular tumors adherent to the aortic arch, left ventricle, and the abdominal aorta. All enlarged lymph nodes and the ventricular septum of the heart showed hyalinized lesions with granular formation consistent with sarcoidosis. The patient was diagnosed with IVLBCL with aortic tumor formation complicated with sarcoidosis and FSGS. CONCLUSIONS: IVLBCL may present with tumor formation on the aortic wall. Although the cause of its affinity to the aortic wall is yet unknown, autopsy findings imply that arteriosclerosis may have contributed to the tumor formation. The literature suggests that T-cell abnormalities could possibly be the common etiology of intravascular lymphoma, sarcoidosis, and FSGS.

Biochemical and cellularchanges in Oreochromis niloticus related to the water pollution of a degraded river / Alterações bioquímicas e celulares em Oreochromis niloticus relacionadas com a poluição da água de um rio degradado

The effects of polluted water at three sites in the Marinho River, Brazil, on Oreochromis niloticus (Nile tilápia) were investigated using histological, hematological and biochemical approaches. Fish exposed to the impacted water demonstrated that histological changes in gills were accompanied by nuclear and micronuclei abnormalities in cells. The activity of liver and plasma biomarkers (alkaline phosphatase (ALP), acid phosphatase (ACP), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and liver glutathione S-transferase (GST)) showed an expressive change due to the. The results were also correlated with the highest levels of Cu+2, Zn+2 and Mn+2 in the water. The data of this study evidenced the importance of using a set of biomarkers to quantify pollution in lentic ecosystems. Additionally, histological analyses of gills and erythrocytes have proven to be an important instrument for signaling the impact of pollutants in rivers.

Os efeitos da poluição da água de três locais do Rio Marinho, Brasil, em Oreochromis niloticus foram investigados usando técnicas histológicas, hematológicas e bioquímicas. Peixes expostos à água impactada demonstraram que alterações histológicas nas brânquias foram acompanhadas de anomalias nucleares e micronúcleo nas células. A determinação da atividade de biomarcadores em fígado e plasma de tilápia (fosfatase alcalina (ALP), fosfatase ácida (ACP), alanina aminotransferase (ALT), aspartato aminotransferase (AST) e glutationa S-transferase (GST)) mostrou uma substancial alteração em função da poluição. Os resultados são correlacionados com os níveis mais elevados de Cu+2, Zn+2 e Mn+2 na água. Os dados deste estudo demonstram a importância de utilizar um conjunto de biomarcadores para quantificar a poluição em ecossistemas lênticos. Adicionalmente, as análises histológicas das brânquias e de eritrocitos têm provado ser importante instrumento para sinalizar a impactação de poluentes ao longo de rios.

The clinicopathologic significance of glandular cell abnormality on preoperative abnormal PAP smears in endometrial carcinoma / 부인종양

OBJECTIVE: The aim of this study was to evaluate the correlation between the results of preoperative PAP smears and known poor prognostic factors in patients with endometrial carcinoma. METHODS: Between Jan. 2000 and Dec. 2003, preoperative evaluation of PAP smears were done in 111 patients with endometrial carcinoma who underwent surgical staging. Pathologic parameters of permanent specimens were evaluated and correlated with the results of PAP smears. chi-square-test was used for statistical analysis and p-values <0.05 was considered as statistically significant result. RESULTS: The mean age of patients was 49 years with range between 24 and 75 years old. The results of preoperative PAP smears were normal in 70 patients (57.7%), atypical glandular cells of undetermined significance (AGUS) in 22 patients (22.5%), adenocarcnoma in 19 patients (19.8%) on preoperative PAP smears. Statistically significant associations were found between preoperative PAP smears and poor histologic grade (p=0.000), depth of myometrial invasion (p=0.000), lymph-vascular space invasion (p=0.003), cervical involvement (p=0.004), adnexal involvement (p=0.024), positive peritoneal cytology (p=0.042). However, old age, poor histologic type, higher surgical staging, pelvic nodes metastasis and para-aortic lymph node metastases were not statistically significant. CONCLUSION: This study revealed glandular cell abnormalities on preoperative PAP smears in patients with endometrial carcinoma were significantly associated with poor histologic grade, deep myometrial invasion, lympho-vascular invasion, cervical involvement, adnexal involvement, positive peritoneal cytology. Therefore, the results of preoperative PAP smears could be considered as an important part of the preoperative evaluation in patients with endometrial carcinoma.