Objectives: Ductal carcinoma in situ (DCIS) is a non-invasive lesion of an increasing clinical importance. Individual risk assessment is essential for an optimal treatment. Our objective was to identify clinical and molecular characteristics of a subgroup of DCIS with an unfavorable prognosis. Methods: In a population study, we analyzed women with DCIS diagnosed within one mammography screening unit. In the experimental part of this work, we conducted a comparative analysis of five biological markers in normal tissue, DCIS and invasive breast cancer by means of gene expression analysis and analysis of loss of heterozygosity (LOH). Results: We demonstrated a high proportion of pure (no invasive component) DCIS (14.41%) of all breast lesions described as malignant. In our sample, we saw a homogeneous distribution of risk factors without noting a clear pattern identifying high-risk subtypes. We noted significant differences in clinical management of tumors with similar characteristics, which demonstrates the present state of limited use of clinical predictors. In the laboratory experiment, we showed differences in loss of heterozygosity (LOH) between DCIS and invasive breast cancer for BRCA1 (8.69% vs. 44.74%) and BRCA2 (9.52% vs. 45.0%). In contrast, we did not find any differences for p53 (31.82%...

The term "teachable moment" (TM) has been used to describe a life transition or event which motivates an individual to change a behavior or presents an opportunity to intervene to prompt behavior change. We examined whether receipt of a false positive ovarian cancer (OC) screening result may represent a TM. 403 women participating in an OC screening program completed questionnaires assessing demographic, clinical, behavioral, and psychosocial information. The TM was operationalized as expressed interest in receiving health-related information. We hypothesized that among women receiving a false positive screening test result, those women who had experienced greater personal perceived risk for OC as well as distress would be more interested in receiving health-related information than women receiving a normal result. Analyses revealed that women receiving a false positive screening result were less interested in receiving health-related information than women receiving a normal screening result. For women receiving a false positive result, expressed interest in receipt of health-related information was only modestly related to distress and related even less to perceptions of OC risk. Our data do not support viewing a false positive OC screening result as a TM. Potential explanations for the current findings as well as recommendations for future research investigating the TM are discussed.

No description available.

Bakgrund Mäns våld mot kvinnor är ett globalt hälsoproblem, som spänner över såväl religiösa, geografiska som socioekonomiska gränser. En metod för att hitta dessa kvinnor är att administrera ett så kallat screeningverktyg eller frågeformulär. De tillgängliga verktygen är många och inget anses än vara vedertaget inom svensk hälso- och sjukvård. Syfte Att sammanställa en översikt av olika screeningverktyg som kan hjälpa sjuksköterskan att upptäcka mäns våld mot kvinnor. Metod Litteraturöversikt i form av en beskrivande sammanställning, baserad på tolv vetenskapliga artiklar av kvalitativ ansats. Resultat En sammanställning av sex screeninginstrument (ASI, HITS, PVS, STaT, WAST och WEB) presenteras. Frågeformulärens sensitivitet och specificitet redovisas, exempel på frågor samt styrkor och svagheter i formuläret beskrivs. Slutsats De sex beskrivna screeninginstrumenten har ett gemensamt syfte, att upptäcka våld. De skiljer sig åt i psykometriska egenskaper och är svåra att jämföra med varandra. En beskrivande översikt har utformats där läsaren själv kan bilda sig en uppfattning. Klinisk betydelse Översikten i denna uppsats skulle kunna hjälpa verksamheter i vården att lättare välja ut ett frågeformulär för våldsscreening som passar för just den verksamheten. / Background Intimate partner violence is a global health issue concerning women, spanning across religious, geographic and socioeconomic boundaries. One way of finding these women is by administrating a screening tool, or questionnaire. There are many tools available but none of them are established in the Swedish healthcare system. Aim To compile an overview of different screening tools that can help the nurse to detect intimate partner violence. Method A literature overview in form of a descriptive compilation, based on twelve scientific articles of quantitative research. Result A presentation of six screening tools (ASI, HITS, PVS, STaT, WAST and WEB). The sensitivity, specificity and pros and cons of each questionnaire are described. Conclusion The six described screening instruments were all made to detect violence. They differ in psychometric properties and are difficult to compare. A descriptive overview has been designed where the reader himself can make an opinion. Clinical significance Intimate partner violence is a big health issue and it is of the out most concern that it is made public and that the women affected gets help. The screening tools presented may be the first step towards that.

Introduction: Globally approximately 570,000 women were diagnosed with cervical cancer during the year 2018 making the condition the fourth most common cancer in women. Studies indicate that migrant women are screened for cervical cancer to a lower extent than nonmigrant women, which is a problem that requires attention. Aim: The aim of the present study was to describe migrants' experiences of cervical cancer screening. The aim was specified with two questions: What do migrant women experience as hindering regarding screening for cervical cancer? What do migrant women experience as facilitating regarding screening for cervical cancer? Method: A descriptive design with a literature review was used, twelve scientific qualitative articles were reviewed and analysed. Results: The four main themes were: barriers related to the healthcare system, sociocultural barriers, barrier at the individual level, and factors that promote participation in cervical cancer screening. The results showed that the main barriers were insufficient knowledge, language barriers and cultural barriers. Facilitating factors included cultural adaption and increased dissemination of information. Conclusion: In order to also suit immigrant women development of the screening programmes in the countries included in the bachelor thesis (Sweden, Norway, Finland, USA and Canada) is needed.

Background: Lynch syndrome is a hereditary disorder, with a very high risk of the developing colorectal cancer (CRC) and a predilection to develop other cancers, including upper tract urothelial carcinoma (UTUC) that has an estimated lifetime risk of 0.2-25%, above that of the general population. Our aim was to assess the prevalence of UTUC in a Lynch syndrome cohort undergoing screening for CRC, to determine the need for a UTUC screening program. Methodology: Lynch syndrome patients were screened with urine dipstix for microscopic haematuria. Patients with confirmed microhaematuria were offered urine cytology, microscopy and culture, ultrasound (US) of their upper tracts and flexible cystoscopy. Results: Of the 89 patients screened, 86 had an MLH1 mutation and 2 had an MSH2 mutation. Eleven of the 12 patients who had microscopic haematuria were female. 10 patients had urinary tract infections. One patient had follicular cystitis and another had a simple renal cyst. No patients had hydronephrosis on ultrasound. All urine cytology specimens were negative for malignancy. Conclusion: No cases of UTUC were detected in our cohort during this study. A more rational screening protocol in this group may be to screen patients for UTUC with known MSH2 mutations at an earlier age (over 35).

Screening, Brief Intervention, and Referral to Treatment (SBIRT) for alcohol use has been shown to reduce rates of alcohol use across multiple clinical settings, and is routinely recommended by the United States Preventative Services Task Force (USPSTF). In 2005 the National Institute on Alcohol Abuse and Alcoholism (NIAAA) recommended implementing a single item screening question (SISQ) for this purpose. Since then the SISQ has been well validated compared to other tools, such as the Alcohol Use Disorders Identification Test (AUDIT). It has not, however, been well studied in particular populations, such as those with comorbid anxiety and/or depressive disorders. Medicare Annual Wellness Visits present a unique opportunity to study the SISQ because while they do inquire about alcohol use, they do not routinely include a SISQ. Our study seeks to investigate the efficacy of implementation of a SISQ during Medicare Annual Wellness Visits in a residency clinic population with anxiety and/or depressive disorders. Data collection is ongoing and will measure rates of referral to treatment before and after the SISQ is implemented, as well as rates of brief interventions given.

Bakgrund: Våld i nära relationer är ett globalt folkhälsoproblem och en diskriminering mot kvinnors mänskliga rättigheter. Av kvinnor mellan 15–49 år som varit i en relation har 27 procent blivit utsatta för våld i nära relation. Vanligtvis är det sjuksköterskor som träffar dessa kvinnor först när de söker sig till vården. I möte med dessa kvinnor behöver sjuksköterskor ha ett personcentrerat arbetssätt. Syfte: Syftet med studien var att undersöka sjuksköterskors erfarenhet av att möta kvinnor som blivit utsatta för våld i nära relation. Metod: En litteraturöversikt med kvalitativ metod och induktiv ansats. Artikelsökning gjordes i Cinahl, PubMed och Scopus. Resultatet framställdes av 12 vetenskapliga artiklar som analyserades med Fribergs 5-stegs modell. Resultat: I resultatet framkom 4 huvudteman med tillhörande 9 underteman. De fyra huvudteman var: avsaknad av träning, förutsättningar för ett bra möte, vikten av medvetenhet och samverkan och rollfördelning. Slutsats: Sjuksköterskor upplevde bristande kunskap och osäkerhet i hur de skulle agera kring hantering av våld i nära relation. De uppgav att en trygg miljö behövdes för att kvinnor skulle våga öppna upp sig. God samverkan mellan olika professioner var en viktig del av arbetet. / Background: Intimate partner violence is a global public health issue and a discrimination against women's human rights. Of women between the ages of 15 and 49 who have been in a relationship, 27 percent have been exposed to intimate partner violence. The nurse is usually the one who first sees these women when they seek care. When meeting these women nurses need to have a person-centered approach. Aim: The aim of the study was to explore nurses experience of meeting women who have been exposed to intimate partner violence. Method: A literature review with a qualitative method with an inductive approach. Articles included in this study were collected from Cinahl, PubMed and Scopus. The results are presented by 12 scientific articles that have been analyzed with Friberg's 5-step model. Results: The results showed 4 main themes with 9 sub-themes. The four main themes were: lack of training, prerequisites for a good encounter, the importance of awareness and collaboration and division of roles. Conclusion: Nurses experienced lack of knowledge and insecurity about dealing with intimate partner violence. They stated that a safe environment was needed for women to feel comfortable opening up. Good collaboration between different professions was an important part.

Lipid homeostasis is an essential factor for proper function both at the level of a cell and of an organism. Dysregulation of this process is responsible for some of the major health concerns of our societies such as obesity and atherosclerosis. Considering the wide variety of lipids and the high dynamic of the system, it is clear that regulation is required to keep the appropriate balance between the different lipids. Although a few regulation pathways are already characterized, some others still wait to be discovered. In order to unravel new players involved in lipid regulation, a screening procedure was developed combining RNA interference in Hela cells and thin layer chromatography. Thereby, it is possible to monitor modifications of lipid composition resulting from siRNA knock-down. Furthermore, the potential of mass spectrometry as a lipid analysis tool in large-scale studies was evaluated. This method was then applied to an essential family of regulatory proteins, the kinases. Lipid composition of 600 kinases knock-downs was analyzed. Mostly, variations in triglyceride and cholesterol levels were observed, suggesting that these lipids are more subject to variation in the cells. Unfortunately, it appears that the screen suffered from a high-rate of off-targets effects, implying that most of the phenotypes observed can’t reliably be linked to the corresponding kinase knock-downs. However, several interesting conclusions can still be derived from this screen. First, it was observed that several siRNA induce a decrease in cholesterol, which is coupled to accumulation of a new lipid. Several lines of evidence suggest that this new lipid is in fact a methylated sterol precursor such as lanosterol or demethyllanosterol. Previously, HMG-CoA reductase was considered as the rate-limiting enzyme of cholesterol biosynthesis and the major regulated step of this process. These data show that another major regulation step occurs more downstream in the pathway at the level of methylated cholesterol precursors. Furthermore, MAPK9 was identified as a new regulator of triglyceride homeostasis at the cellular level. Upon MAPK9 knock-down, an increase in triglyceride content was observed both by thin layer chromatography and mass spectrometry. Accordingly, these cells present an increase in lipid droplets, the cellular organelles responsible for triglyceride storage. Sty1 was also identified as the functional homolog of MAPK9 in S. pombe for this process, as similar increase in triglyceride and lipid droplets is observed in a deletion strain for this gene. Although more detailed studies will be necessary to unravel the molecular mechanism of this process, these data suggest the evolutionary conserved implication of the MAP kinase pathway in the regulation of lipid storage both in humans and in yeasts.

Introduction: About 5 - 10% of breast carcinomas are caused by genetic mutations. The most common genetic mutation that is involved in the development of this malignancy is a mutation in the tumor suppressor genes BRCA1/2 whose carriers have approximately a 70% lifetime risk of developing breast cancer. The prognosis of patients with BRCA1/2-asociated breast carcinoma, compared to patients with sporadic breast carcinoma is the subject of many studies with ambiguous results. Aim: The aim of the theoretical part of this work was to approach the issue of breast cancer and the most common genetic syndromes associated with it. In the practical part of this work a retrospective study was carried out in order to compare BRCA1/2 mutated breast cancer patients with non-mutated breast cancer patients in the tumor profile, methods of treatment and prognosis. Methods: We retrospectively analyzed the data of 134 patients who were tested for the presence of BRCA1/2 mutation at the Institute of Medical Genetics, University Hospital in Pilsen during the years 2013-2018 and at the same time were treated for early breast cancer at the University Hospital in Pilsen during the years 2000-2020. 32 patients were BRCA1 positive (24%), 10 BRCA2 positive (7%) and 92 without BRCA1/2 mutation (69%). The follow- up time was...