High risk types of human papillomaviruses E6/E7 oncogenes and their association with tumor suppressor genes products are the key factors of cervical carcinogenesis. This study proposed them as specific markers for cervical dysplasia screening. The aim of the study is to compare the clinical and prognostic significance of HPV E6/E7 mRNA as an early biomarker versus HPV DNA detection and cytology in triage of woman for cervical cancer. The study group consists of 413 women: 258 NILM, 26 ASC-US, 81 LSIL, 41 HSIL, and 7 unsatisfactory cytology. HPV4AACE screening, real-time multiplex PCR and MY09/11 consensus PCR primers methods were used for the HPV DNA detection. The real-time multiplex nucleic acid sequence-based assay (NucliSENS EasyQ HPV assay) was used for HPV E6/E7 mRNA detection of the five most common high risk HPV types in cervical cancer (16, 18, 31, 33, and 45). The results show that HPV E6/E7 mRNA testing had a higher specificity 50% (95% CI 32-67) and positive predictive value (PPV) 62% (95% CI 46-76) for CIN2+ compared to HPV DNA testing that had specificity of 18% (95% CI 7-37) and PPV 52% (95% CI 39-76) respectively. The higher specificity and PPV of HPV E6/E7 mRNA testing are valuable in predicting insignificant HPV DNA infection among cases with borderline cytological finding. It can help in avoiding aggressive procedures (biopsies and over-referral of transient HPV infections) as well as lowering patient's anxiety and follow up period.

Abstract:The Tribulus terrestris L. (Zygophyllaceae) is a known medical plant used in traditional and folk medicine worldwide. The steroid saponine protodioscin, an active component found in this plant, serves as a marker for quality control of plant raw materials. In this study, we developed a simple and selective method for determination of protodioscin using convenient High-Performance Liquid Chromatographic (HPLC) laboratory equipment. The detection was performed by Diode-Array Detector (DAD). The proposed method was fully validated and according to the validation results, it was accurate and precise. It was proven to be linear over a protodioscin concentration range of 10,9 to 544.9 µg/mL. The low values of limit of detection (LOD) and limit of quantitation (LOQ) demonstrated adequate sensitivity (16.0 µg and 48.6 µg protodioscin per g plant material, respectively). The proposed method was successfully applied for quality control of a raw plant material intended for use in pharmaceutical industry, as well as for determination of protodioscin in a commercially available pharmaceutical formulation. The positive identification of protodioscin in analyzed samples was done by comparison of retention times of chromatographic peaks and their UV spectra. The content of protodioscin in analyzed samples was: 0.65 -0.73 % in a raw plant material, and 0.38 % in tablets, respectively.

BACKGROUND:The fractures of the distal radius are one of the most frequent cases in the pediatric population. The primary way of treating these fractures is conservative, with manual reduction and cast immobilisation. In patients where reduction and retention of the fracture cannot be achieved, a surgical approach is the treatment of choice.AIM:To evaluate the benefits of using the minimally invasive surgical treatment of closed reduction using Sommer - pins in the treatment of the fractures of the distal radius in the pediatric population with the method of the Kapandji technique.MATERIAL AND METHODS:In this study, we used cases treated from 2012 to 2017, of 48 completely dislocated fractures of the distal radius in patients ages 6 -14 yrs., where the use of non-surgical treatment proved ineffective. In the surgical treatment, we used one or two Sommer - pins to achieve a correct reduction and fixation.RESULTS:The post-op immobilisation lasted 4 - 7 weeks with an underarm cast. The patients were closely followed in the period of 6 months following the intervention. The anatomic reduction was easily achieved with this type of technique in every case. In the post-op period, there was no significant loss of reduction and another surgical procedure was not needed in any of the cases.CONCLUSION:With the use of the closed reduction Kapandji technique, an easy and good anatomical reduction is achieved with good post-op results in the treatment of completely dislocated fractures in the distal radius in children.

Aim:To examine the existing situation, barriers and consequences of the intercultural communication in health institutions and to offer training models for strengthening and improving communication skills of health professionals in the Republic of Macedonia.Methods:A cross-sectional survey was conducted to assess the relationship between patients and health professionals. A total of 813 health professionals (302 physicians and 511 other medical staff) from different healthcare institutions, and 1016 patients participated in cross-sectional survey performed in autumn 2010.Results:The research has showed that each third examined patient thought that his/her physician or the other medical personnel had no understanding for his/her emotions and gave no answer to all of his/her questions. From the other side, 60% of the physicians declare that they have a good communication with patients speaking other language than their mother tongue. Only 60% of physicians said that they know good the culture of their patient and 52% of the other medical staff said that they adjusted the treatment to the patient culture (religion, attitudes, language, life style).Conclusion:There are some gaps in current provision of health care practice in an aspect of effective interactions and communication skills of health professionals to meet patient needs in a multicultural and multilingual setting. A training model is proposed for strengthening communication skills of health professionals.

Interleukin 10 (IL-10) is an immunosuppressive cytokine and its genetic variants could have an indirect impact on viral biology and human papillomavirus (HPV) E6/E7 messenger RNA (mRNA) expression as well. This study evaluates the association between IL-10-592 C/A (rs1800872) single-nucleotide polymor-