Slavonski Brod, Croatia
Slavonski Brod, Croatia

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Jelakovic B.,University of Zagreb | Vukovic Lela I.,University of Zagreb | Karanovic S.,University of Zagreb | Dika Z.,University of Zagreb | And 17 more authors.
Clinical Journal of the American Society of Nephrology | Year: 2015

Background and objectives Improvements in agricultural practices in Croatia have reduced exposure to consumption of aristolochic acid-contaminated flour and development of endemic (Balkan) nephropathy. Therefore, it was hypothesized that Bosnian immigrants who settled in an endemic area in Croatia 15–30 years ago would be at lower risk of developing endemic nephropathy because of reduced exposure to aristolochic acid. To test this hypothesis, past and present exposure to aristolochic acid, proximal tubule damage as a hallmark of endemic nephropathy, and prevalence of CKD in Bosnian immigrants were analyzed. Design, setting, participants, & measurements In this cross-sectional observational study from 2005 to 2010, 2161 farmers were divided into groups: indigenous inhabitants from endemic nephropathy and nonendemic nephropathy villages and Bosnian immigrants; a-1 microglobulin-to-creatinine ratio.31.5 mg/g and eGFR,60 ml/min per 1.73 m2 were considered to be abnormal. Results CKD and proximal tubule damage prevalence was significantly lower in Bosnian immigrants than inhabitants of endemic nephropathy villages (6.9% versus 16.6%; P,0.001; 1.3% versus 7.3%; P=0.003, respectively); 20 years ago, Bosnian immigrants observed fewer Aristolochia clematitis in cultivated fields (41.9% versus 67.8%) and fewer seeds among wheat seeds (6.1% versus 35.6%) and ate more purchased than homemade bread compared with Croatian farmers from endemic nephropathy villages (38.5% versus 14.8%, P,0.001). Both Croatian farmers and Bosnian immigrants observe significantly fewer Aristolochia plants growing in their fields compared with 15–30 years ago. Prior aristolochic acid exposure was associated with proximal tubule damage (odds ratio, 1.64; 95% confidence interval, 1.04 to 2.58; P=0.02), whereas present exposure was not (odds ratio, 1.31; 95% confidence interval, 0.75 to 2.30; P=0.33). Furthermore, immigrant status was an independent negative predictor of proximal tubule damage (odds ratio, 0.40; 95% confidence interval, 0.19 to 0.86; P=0.02). Conclusions Bosnian immigrants and autochthonous Croats residing in endemic areas are exposed significantly less to ingestion of aristolochic acid than in the past. The prevalence of endemic nephropathy and its associated urothelial cancers is predicted to decrease over time. © 2015 by the American Society of Nephrology


Leon D.A.,Universitary Hospital Dr Peset | Gayete J.V.,Universitary Hospital Dr Peset | Munoz C.A.,Cytology Unit | Batalla C.C.,University of Valencia | And 2 more authors.
Journal of Reproduction and Contraception | Year: 2014

Objective: To study the identification of the cause of specific sperm abnormalities. Methods: Two adult men with specific alterations in sperm morphology causing 100% immobility were included in this study. The study of sperm used: transmission electron microscopy (both patients); apoptotic markers, DNA fragmentation test and fluorescence in-situ hybridization (patient 1) and immunocytochemistry study of sperm flagellum using anti-β tubulin antibodies and ciliary activity test (patient 2). Results: Increased DNA fragmentation (52.6%) and apoptosis biomarkers were detected in patient 1, and loss of the central pair of microtubules in patient 2 ('9+0' axoneme); the nasal ciliary activity was normal. Conclusion: Results suggest an apoptotic origin of the abnormalities in the sperm from patient 1 and dysplasia of the fibrous sheath in patient 2. © 2014 The Editorial Board of Journal of Reproduction and Contraception.


Abdullgaffar B.,Cytology Unit | Kamal M.O.,Dubai Hospital | Khalid M.,Dubai Hospital | Samuel R.,Dubai Hospital | Alghufli R.,Dubai Hospital
Journal of Lower Genital Tract Disease | Year: 2010

OBJECTIVE: To investigate the possibility of the occurrence of errors in the interpretation of cervical smears in the presence of lubricant, mucus and other contaminant particles in ThinPrep (TP) technique (Cytyc Corp., Boxborough, MA) liquid-based cervical cytology. MATERIALS AND METHODS: Four thousands sixty-eight TP cervical smears were reviewed over a 12-month period. Those cases that initially had caused interpretation errors in which lubricant, mucus, and other contaminant materials were confused with infectious agents or epithelial abnormalities among the primary screening cytotechnologists and pathologists were selected for our study. These cases were retrieved from the cytology unit's registered logbook. The possibility of these detected lubricant, mucus, and other contaminant materials in these cases to cause misinterpretation for randomly selected pathologists and cytotechnologists who were blinded for the study was further investigated. Three cytotechnologists and 2 pathologists were independently asked to give their opinions on each case without their prior knowledge of the selected cases. RESULTS: Only 15 cases out of 4068 were found to cause interpretation errors. Five different contaminant patterns were detected. The main potential misinterpretations included secondary diagnosis that is confused mainly with infectious agents. However, other contaminants were even misinterpreted as high-grade squamous epithelial abnormalities. CONCLUSIONS: This study illustrates the potential of lubricant, mucus, and foreign body contaminant materials to cause interpretation errors in TP cervical cytology. Although liquid-based preparation reduces the obscuring effect of these materials, the unusual appearance of some of these particles in TP cervical smears not only can mimic infectious microorganisms, but also squamous dyskaryosis. This can lead to serious interpretation errors for the inexperienced cytotechnologists and pathologists, which subsequently can have an effect on the women's management. © 2009 American Society for Colposcopy and Cervical Pathology.


Gupta R.K.,Cytology Unit
Acta Cytologica | Year: 2010

Objective: To study fine needle aspiration cytologic features of granulomatous mastitis (GM), which can clinically mimic a carcinoma of the breast. Study Design: The aspirate was obtained using a 10-mL syringe and 22-gauge needle in 18 women. No smears were made, and material was collected as needle and syringe washings in a cytology container in which 30% ethyl-alcohol in physiologic saline was present. From about half of this material, filter preparations were made on 3-mm Schleicher and Schuell filters and stained by the Papanicolaou method; the remainder of the aspirate was spun, and a cell block was made from the sediment and sections cut and stained with hematoxylin-eosin (H-E). Results: The ages of the women ranged from 28 to 38 years, with a mean of 33 years, and time of last childbirth ranged from 4 to 7 years. Sixteen of the women had breast-fed for 6-15 months, and none were pregnant or breast-feeding at this time. The presenting symptom was a breast mass, left side (n = 10) and right side (n = 8). The diagnosis of GM was made on cytology and cell blocks of the aspirate and confirmed subsequently on stained tissue sections of the excised, operable lump in 12 of the cases. No organisms were found on microbiologic testing of aspirate and/or tissue sample, and stains for acid-fast bacilli and fungus were negative in sections of cell blocks and tissue in all cases. The cytohistologic features were characterized by noncaseating epithelioid cell granulomas with multinucleate giant cells, lymphocytes, plasma cells and a variable number of neutrophils along with inflammatory cell infiltrate in the interlobular and intralobular stroma. Conclusion: GM, despite infrequent reporting but typical cytohistologic features, cannot only be diagnosed by the noninvasive method of fine needle aspiration cytology, but can also resolve the differential diagnosis between an inflammatory process and malignancy of the breast, which may not be possible alone on clinical and image-guided investigations. © The International Academy of Cytology.


PubMed | Cytology Unit
Type: Journal Article | Journal: Acta cytologica | Year: 2010

To study fine needle aspiration cytologic features of granulomatous mastitis (GM), which can clinically mimic a carcinoma of the breast.The aspirate was obtained using a 10-mL syringe and 22-gauge needle in 18 women. No smears were made, and material was collected as needle and syringe washings in a cytology container in which 30% ethyl-alcohol in physiologic saline was present. From about half of this material, filter preparations were made on 3-mm Schleicher and Schuell filters and stained by the Papanicolaou method; the remainder of the aspirate was spun, and a cell block was made from the sediment and sections cut and stained with hematoxylin-eosin (H-E).The ages of the women ranged from 28 to 38 years, with a mean of 33 years, and time of last childbirth ranged from 4 to 7 years. Sixteen of the women had breast-fed for 6-15 months, and none were pregnant or breast-feeding at this time. The presenting symptom was a breast mass, left side (n=10) and right side (n=8). The diagnosis of GM was made on cytology and cell blocks of the aspirate and confirmed subsequently on stained tissue sections of the excised, operable lump in 12 of the cases. No organisms were found on microbiologic testing of aspirate and/or tissue sample, and stains for acid-fast bacilli and fungus were negative in sections of cell blocks and tissue in all cases. The cytohistologic features were characterized by noncaseating epithelioid cell granulomas with multinucleate giant cells, lymphocytes, plasma cells and a variable number of neutrophils along with inflammatory cell infiltrate in the interlobular and intralobular stroma.GM, despite infrequent reporting but typical cytohistologic features, cannot only be diagnosed by the noninvasive method of fine needle aspiration cytology, but can also resolve the differential diagnosis between an inflammatory process and malignancy of the breast, which may not be possible alone on clinical and image-guided investigations.

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