Management of patients with atypical squamous cells of undetermined significance (ASCUS) on Papanicolaou smears.

Management of patients whose Papanicolaou smears show atypical squamous cells of undetermined significance (ASCUS) is a complex challenge for the family physician. It is critical that patients with the ASCUS smear be properly evaluated and triaged, as the ASCUS smear may be a manifestation of high-grade disease in 20% or more of cases. Several options for triage exist. Colposcopy is considered by many the option of choice. However, alternative options include cervicography, speculoscopy, and human papillomavirus subtyping. For proper management of the patient with the ASCUS smear, the clinician must consider the patient's Pap test history, risk factors for cervical cancer, and the cytopathologist's interpretation/recommendation.

Risk factors for maternal colonization with group B beta-hemolytic streptococci.

Colonization with group B beta-hemolytic streptococci (GBS) at any time during pregnancy is an important risk factor for neonatal sepsis. To determine which groups of pregnant women are at high risk for GBS, a retrospective chart review was conducted on 608 pregnant women who had recorded data on prenatal charts and were seen between October 1995 and December 1997 at a family practice-run prenatal clinic. A total of 543 subjects were studied after exclusion of women who had no results of GBS colonization recorded. Demographically, the study population comprised 91.1% white non-Hispanic, 4.8% African-American, 1.5% Asian, and 2.6% white Hispanic women; 28.9% were primiparas, 38.9% unmarried; 60.0% low income; 31.1% smokers, 7.7% with a history of drug or alcohol use; 8.4% with a history of sexually transmitted disease; and 27.2% with fewer than 11 prenatal visits. The mean age was 26.4 years (range, 14 to 42 years). Seventy-six (14.0%) of the study subjects were colonized with GBS. White non-Hispanic women had a GBS colonization prevalence of 13.6%; for all others, prevalence was 18.7%. No statistically significant differences were found in regard to age, weight, number of prenatal visits, income level, marital status, history of drug use, or parity. The GBS colonization rate for smokers was 33.1% versus 16.4% for nonsmokers (P = .012). Maternal colonization of GBS was not found to be associated with any of the risk factors studied, other than smoking. This study identified smoking as a possible risk factor for GBS infection. Routine screening for GBS infection during pregnancy may be beneficial because no strong risk factors for colonization exist.

Linked markers exclude KIT as the gene responsible for appaloosa coat colour spotting patterns in horses.

The appaloosa coat colour pattern of the horse is similar to that caused by the rump-white (Rw) gene in the mouse. In the mouse Rw colour pattern is the result of an inversion involving the proto-oncogene c-kit (KIT). Therefore, we investigated KIT as a candidate gene that encodes the appaloosa coat colour gene (Lp) in horses. KIT plays a critical role in haematopoiesis, gametogenesis, and melanogenesis and encodes a transmembrane tyrosine kinase receptor that belongs to the PDGF/CSF-1/c-KIT receptor subfamily. Half-sib families segregating for Lp were uninformative for a reported polymorphism in KIT. However, KIT is located on horse chromosome 3 close to albumin (ALB), serum carboxylesterase (ES), vitamin D-binding protein (GC) and microsatellite markers ASB23, LEX007, LEX57, and UCDEQ437. Indeed, KIT and ASB23 were localized to ECA3q21-22.1 and 3q22.1-22.3, respectively, by fluorescent in situ hybridization. Family studies were conducted to investigate linkage of Lp to these markers using eight half-sib families in which Appaloosa stallions were mated to solid coloured mares. Linkage of Lp to the chromosome region containing ES, ALB, GC, ASB23, UCDEQ437, LEX57, and LEX007 was investigated by a multipoint linkage analysis using the computer program GENEHUNTER. LOD scores over the interval under investigation ranged from -4.28 to -12.48, with a score of -12.48 at the location for ASB23. Therefore, it was concluded that appaloosa (Lp) is not linked to any of the tested markers on ECA3, and thus Lp is unlikely to be the product of KIT.