Prevalence, comorbidities and mediators of childhood anxiety disorders in urban Turkey: a national representative epidemiological study.

PURPOSE: The aim of this study is to evaluate the prevalence of anxiety disorders, its correlation with sociodemographic characteristics, its comorbidities with other psychiatric disorders and its predictors in school-aged children. METHODS: This study is part of a representative, multi-centered national study that is planned by the Turkish Association of Child and Adolescent Mental Health to evaluate the prevalence of psychopathology among elementary school students in Turkey between the years 2014-2015. Children are screened via Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version. Impairment is assessed by a 3-point Likert type scale independently by the parent and the teacher. The final sample included 5842 children with the mean age of 8.7 years. RESULTS: The prevalence of any anxiety disorder without considering impairment is 16.7% and considering impairment is 5.2% in children according to our study. We found significant differences for comorbid Attention Deficit Hyperactivity Disorder, Disruptive Behavior Disorder, Mood Disorders, Tic Disorders, Obsessive Compulsive Disorder, Enuresis Nocturna, Encopresis, and Intellectual Disability. Having a history of paternal physical disorder, living in the regions of Marmara, Mediterranean and Black Sea were found to be the main predictors of having childhood anxiety disorders according to the logistic regression analysis. CONCLUSION: Better understanding of childhood anxiety disorders, comorbid conditions and predictors will result in earlier diagnosis and more appropriate treatment.

Effects of total knee arthroplasty on balance and fall risk in elderly patients with severe gonarthrosis: An age- and sex-matched comparative study.

Background: Falls are a severe cause of morbidity and mortality in elderly patients, and gonarthrosis causes a tendency to fall. Total knee arthroplasty (TKA) is a widely used successful surgical procedure for end-stage gonarthrosis. Aims: To investigate whether there is a difference in the frequency of falls, balance and fall risk, and clinical and radiological results in patients with end-stage gonarthrosis with and without TKA. Patients and Methods: This was a single-center, retrospective, case-control study with age- and gender-matched groups. A total of 100 patients over 60 years of age, with end-stage gonarthrosis and who met the inclusion criteria were included in the study. Fall risk was analyzed using the Berg Balance Scale (BBS), TUG tests, and the ITAKI Fall Risk Test. Knee varus angles were measured using standing long-leg radiographs, and radiological gonarthrosis grading was performed. Pain levels and quality of life were assessed using the VAS and WOMAC. Each patient's knee extensor muscle strength and range of motion were measured. Results: WOMAC, ITAKI, TUG test, and VAS scores were significantly higher in the control group than in the TKA group. BBS scores were significantly lower in the control group. Although the number of falls was high in the control group, there was no statistically significant difference between the two groups. Conclusion: The results of this study showed that total knee arthroplasty provided statistically significant improvement in the clinical, radiological, and fall risk results of the patients. Although there was a decrease in the frequency of falls compared to the control group, it was statistically insignificant. In addition, in our study, it was evaluated that the most important risk factor for falling was advanced age.

Lycopene supplementation does not change productive performance but lowers egg yolk cholesterol and gene expression of some cholesterol-related proteins in laying hens.

1. This work examined the effects of purified lycopene (LYC) supplementation or a source of LYC as tomato powder (TP) on productive performance, egg yolk cholesterol levels as well as gene expression related to mechanism and regulation of cholesterol.2. One hundred and fifty laying hens (Lohman LSL, hybrid) were randomly divided into one of three treatments, with 10 replicates of five hens per cage, totalling 50 hens per treatment. The hens were fed either a standard diet (control) or a standard diet supplemented with 20 mg purified lycopene/kg diet (LYC) or an equal amount of lycopene-containing tomato powder (TP) for 12 weeks.3. Feed consumption, egg production, and feed efficiency remained similar among treatments (P ≥ 0.27). Supplementing lycopene, either as a purified form or in TP, increased the levels of serum and egg yolk lycopene and reduced serum and egg yolk cholesterol concentrations (P < 0.001). Supplementation in either form decreased gene expression for intestinal NPC1L1, MTP, ACAT2, hepatic SREBP1c, ACLY, and LXRα but increased hepatic ABCG5 and ABCG8 (P < 0.001).4. The results of the present work revealed that egg yolk cholesterol metabolism is regulated by the modulation of a group of genes, particularly with LYC supplementation.

Genotype-phenotype correlation, gonadal malignancy risk, gender preference, and testosterone/dihydrotestosterone ratio in steroid 5-alpha-reductase type 2 deficiency: a multicenter study from Turkey.

BACKGROUND: Studies regarding genetic and clinical characteristics, gender preference, and gonadal malignancy rates for steroid 5-alpha-reductase type 2 deficiency (5α-RD2) are limited and they were conducted on small number of patients. OBJECTIVE: To present genotype-phenotype correlation, gonadal malignancy risk, gender preference, and diagnostic sensitivity of serum testosterone/dihydrotestosterone (T/DHT) ratio in patients with 5α-RD2. MATERIALS AND METHODS: Patients with variations in the SRD5A2 gene were included in the study. Demographic characteristics, phenotype, gender assignment, hormonal tests, molecular genetic data, and presence of gonadal malignancy were evaluated. RESULTS: A total of 85 patients were included in the study. Abnormality of the external genitalia was the most dominant phenotype (92.9%). Gender assignment was male in 58.8% and female in 29.4% of the patients, while it was uncertain for 11.8%. Fourteen patients underwent bilateral gonadectomy, and no gonadal malignancy was detected. The most frequent pathogenic variants were p.Ala65Pro (30.6%), p.Leu55Gln (16.5%), and p.Gly196Ser (15.3%). The p.Ala65Pro and p.Leu55Gln showed more undervirilization than the p.Gly196Ser. The diagnostic sensitivity of stimulated T/DHT ratio was higher than baseline serum T/DHT ratio, even in pubertal patients. The cut-off values yielding the best sensitivity for stimulated T/DHT ratio were ≥ 8.5 for minipuberty, ≥ 10 for prepuberty, and ≥ 17 for puberty. CONCLUSION: There is no significant genotype-phenotype correlation in 5α-RD2. Gonadal malignancy risk seems to be low. If genetic analysis is not available at the time of diagnosis, stimulated T/DHT ratio can be useful, especially if different cut-off values are utilized in accordance with the pubertal status.

Turkish health field periodical editors' Views on publication process and ethical problems.

OBJECTIVE: We aimed in this study to investigate views and suggestions of health field editors about the publication process and ethical problems. MATERIALS AND METHODS: The study involved 42 journal editors who accepted to participate in the study. The data were collected through 70-item "Editor Views Questionnaire" which was developed by the researchers in line with the related literature. RESULTS: The editors who participated in the study were asked about their views about the most common problems they encountered related to publication ethics; the top three problems indicated by the editors included unjustified authorship (40.5%), duplicate publication (33.3%), and falsification (26.2%). An analysis of the problems encountered in the initial evaluation stage revealed the top three issues as articles that did not follow the writing rules of the journal (33.3%), unqualified articles (30.1%), and negligence of the author(s) (14.3%). Views in relation to the problems about the referee evaluation stage included evaluations that were not completed within the time given (28.6%), insufficient importance attached to the evaluation (23.9%), and inability to find sufficient number of referees (16.7%). CONCLUSION: some editors were found to encounter violation of publication ethics, to experience problems in the revision stage, and not to feel fully independent in their contribution to article publication and thus the improvement of the journal quality. Identification of journal editors' views and problems is an important step for the solution to these problems; it could thus contribute to improving the quality of publication process and journal quality.

Organic chromium modifies the expression of orexin and glucose transporters of ovarian in heat-stressed laying hens.

In this study, the effect of the supplemental organic chromium (Cr) forms on the expression of ovarian orexin(hypocretin), glucose transporters (GLUTs), heat shock proteins (HSPs) andnuclear factor-kappaB (NF-κB)were investigated in laying hens (HS). Laying hens (n=1800; 16-wk-old; Lohmann LSL-Lite) were allocated to 6 random groups according to a 2 × 3 factorial trial scheme with two different environmental temperatures [Thermoneutral (TN groups; at either 22±2 °C 24 h/d)  and heat stress (HS groups; at 34±2 °C for 8 h/d, 08:00 to 17:00 h, followed by 22°C for 16 h for a period of 12 wks)], andhens reared under both environmental conditions were fed either a basal diet or the basal diet supplemented with 1.600 mg of chromium-picolinate (CrPic, 12.43% Cr) and 0.788 mg of chromium-histidinate (CrHis, 25.22% Cr) per kg of diet, delivering 200 µg elemental Cr per kg diet. HS groups showed decreased levels of orexin and GLUTs(GLUT1, GLUT4), and increased NFκB, HSP60, HSP70 and HSP90 levels compared to the TN groups in ovarian tissue of hens (P < 0.0001 for all).However, dietary chromium supplementation (CrPic-CrHis) increasedorexin and GLUTs levels and significantly reduced the NF-κB and HSPs levels making them closer to those of thermoneutral group (P < 0.0001).In conclusion, CrPic and CrHis showed supported the relief and treatment of stress complications.

MPV, NLR, and platelet count: new hematologic markers in diagnosis of malignant ovarian tumor.

OBJECTIVE: Evaluation of mean platelet volume (MPV), neutrophil to lymphocyte ratio (NLR), and platelet count in the detection of malignant and benign ovarian tumors. MATERIAL AND METHODS: Sixty-six patients admitted to the present clinic over three years were in- cluded in the study. Patients diagnosed with ovarian cancer were grouped into the areas of epithelial and granulosa cell tumor diagno- sis. The values were compared to patients with benign cystic structure. Patients' preoperative hematologic parameters and their values four weeks postoperatively were analyzed. Statistical analyses were performed with SPSS software. RESULTS: MPV, NLR, and platelet count were observed at a higher rate as statistically significant in patients diagnosed with malignant ovarian cancer, compared to those with benign adnexal mass. CONCLUSION: The hemnatological parameters such as MPV, NLR, and platelet count in the detection of malignant ovarian tumors have been evaluated as useful new markers.

Capsaicinoids improve egg production by regulating ovary nuclear transcription factors against heat stress in quail.

1. To examine the molecular mechanism of capsaicinoid supplementation from capsicum extract, laying Japanese quail (n = 180, 5 weeks old) were reared either at 22°C for 24 h/d (thermoneutral, TN) or at 34°C for 8 h/d (heat stress, HS) and fed on one of three diets containing 0, 25 or 50 mg of capsaicinoids per kilogram for 12 weeks (2 × 3 factorial arrangement). 2. The results revealed that exposure to HS decreased feed consumption by 10.7% and egg production by 13.6%, increased serum and ovary malondialdehyde (MDA) levels by 66.9% and 88.1%, respectively, and reduced ovary superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) activities by 28.3%, 48.7% and 43.8%, respectively. 3. There were magnifications in the ovary nuclear factor kappa-light-chain-enhancer of activated B cell (NF-κB) levels by 42.4% and suppressions in nuclear factor (erythroid-derived 2)-like 2 (Nrf2), protein kinase B (Akt) and haem-oxygenase 1 (HO-1) levels by 29.2%, 38.2% and 30.7%, respectively, in heat-stressed quail. 4. With increasing supplemental capsaicinoids, there were linear increases in egg production, antioxidant enzyme activity, linear decreases in ovary MDA and NF-κB levels and linear increases in ovary Nrf2, Akt and HO-1 levels at a greater extent in quail reared under TN condition than those reared under HS condition. Two-way treatment interactions showed that the degree of restorations in all response variables was more notable under the HS environment than under the TN environment as supplemental capsaicinoid level was increased. 5. In conclusion, capsaicinoid supplementation alleviates oxidative stress through regulating the ovary nuclear transcription factors in heat-stressed quail.

Association between fear of childbirth and maternal acceptance of pregnancy.

AIM: This descriptive study aimed to explore the associations between fear of childbirth, acceptance of pregnancy and identification with the motherhood role among primipara women. BACKGROUND: Women who have difficulty accepting their pregnancy have a harder time adapting to pregnancy and motherhood and experience more fears related to childbirth. The number of studies conducted on this topic is limited. METHODS: This study involved 310 pregnant women admitted to a public hospital in Istanbul between January and June of 2013. A participant identification form, the Prenatal Self-Evaluation Questionnaire and the Wijma Delivery Expectancy/Experience Questionnaire Version A were used for data collection. RESULTS: Pregnant women participating in the study experienced moderate levels fear of childbirth. Pregnant women who requested caesarean section experienced more intense fear of childbirth. Fear of childbirth scores had significant but weak correlations with acceptance of pregnancy and identification with the motherhood role. CONCLUSION: The findings showed that acceptance of pregnancy and identification with the motherhood role are weakly associated with fear of childbirth. IMPLICATIONS FOR NURSING AND HEALTH POLICY: The results from this study can be used to help: increase awareness among health professionals (doctors, nurses, midwives) in antenatal care services about a mother's adaptation to pregnancy and the negative effects of fear of childbirth; direct future research examining factors affecting adaptation to pregnancy and fear of childbirth; establish routine assessments for adaptation to pregnancy and fear of childbirth; provide professional support for women with difficulties adapting to pregnancy and with fear of childbirth; result in reduced complications from invasive methods such as caesarean section due to less requests for these procedures; and promote the health of mothers and babies.

Sarcoidosis of the vagina treated with methotrexate.

We describe the first case of mediolateral episiotomic sarcoidosis of the deep vaginal tissue, without involvement of the pulmonary parenchyma or pulmonary symptoms. A 68-year-old female was admitted with a vaginal mass that had developed about 1 month prior. On bimanual examination, we found a painful solid mass approximately 4 cm in diameter on the episiotomy line of the deep vaginal tissue. The patient underwent pelvic magnetic resonance imaging on suspicion of a malignancy, and a vaginal true-cut biopsy was performed. The biopsy specimen exhibited non-caseating, granulomatous inflammation and many multinucleated giant cells, strongly suggesting sarcoidosis. We had excluded other granulomatous diseases; a final diagnosis was made of stage-1 sarcoidosis in the deep vaginal mass. A 3-month course of methotrexate (2.5 mg/week) was commenced to treat a flare-up of rheumatoid arthritis. The vaginal mass resolved. To the best of our knowledge, this is the first case of sarcoidosis in a deep vaginal mass without pulmonary parenchymal or other solid-organ involvement.

A CASE OF CONFINED PLACENTAL MOSAICISM WITH TRISOMY 15 ASSOCIATED WITH TURNER SYNDROME.

We here present a rare case of a Turner syndrome with mosaic trisomy 15 identified on chorionic villous sampling (CVS). Although there are several reports in the literature indicating confined placental mosaicism (CPM), counseling parents of a fetus with trisomy 15 mosaicism at CVS remains difficult because of the phenotypic variability. To illuminate that condition an amniocentesis or cord blood study should be offered in conjunction with genetic counseling.

Mayer-Rokitansky-Kuster-Hauser syndrome accompanied by invasive ductal carcinoma: a case report.

Milllerian agenesis and the absence of organs of Millerian canal origin are referred to as Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. Invasive ductal carcinoma constitutes 47-75% of all breast carcinomas and is the most common type. The authors report the first case of invasive ductal carcinoma associated with MRKH syndrome in the literature to their knowledge. A 25-year-old woman with a palpable mass in her right breast for three months presented to the presented clinic. On physical examination a mobile, firm mass measuring 2x2 cm was detected in right breast, at a region close to axilla. A fine needle aspiration biopsy from the lesion revealed malignant cells and thus a segmental mastectomy operation was performed. All genital tract and endocrinological system should be thoroughly examined before administering hormone replacement therapy to patients presenting with primary amenorrhea.The co-occurrence MRKH syndrome of with invasive ductal carcinoma is regarded as coincidental. Confirming the absence of a common etiology, however, requires further genetic studies.

Lycopene activates antioxidant enzymes and nuclear transcription factor systems in heat-stressed broilers.

This study was conducted to evaluate the effects of dietary lycopene supplementation on growth performance, antioxidant status, and muscle nuclear transcription factor [Kelch like-ECH-associated protein 1 (Keap1) and (erythroid-derived 2)-like 2 (Nrf2)] expressions in broiler chickens exposed to heat stress (HS). A total of 180 one-day-old male broiler chicks (Ross 308) were assigned randomly to one of 2×3 factorially arranged treatments: two housing temperatures (22°C for 24 h/d; thermoneutral, TN or 34°C for 8 h/d HS) and three dietary lycopene levels (0, 200, or 400 mg/kg). Each treatment consisted of three replicates of 10 birds. Birds were reared to 42 d of age. Heat stress caused reductions in feed intake and weight gain by 12.2 and 20.7% and increased feed efficiency by 10.8% (P<0.0001 for all). Increasing dietary lycopene level improved performance in both environments. Birds reared under the HS environment had lower serum and muscle lycopene concentration (0.34 vs. 0.50 µg/mL and 2.80 vs. 2.13 µg/g), activities of superoxide dismutase (151 vs. 126 U/mL and 131 vs. 155 U/mg protein), glutathione peroxidase (184 vs. 154 U/mL and 1.39 vs. 1.74 U/mg protein), and higher malondialdehyde (MDA) concentration (0.53 vs. 0.83 µg/mL and 0.78 vs. 0.45 µg/ mg protein) than birds reared under the TN environment. Changes in levels of lycopene and MDA and activities of enzymes in serum and muscle varied by the environmental temperature as dietary lycopene level increased. Moreover, increasing dietary lycopene level suppressed muscle Keap1 expression and enhanced muscle Nrf2 expression, which had increased by 150% and decreased by 40%, respectively in response to HS. In conclusion, lycopene supplementation alleviates adverse effects of HS on performance through modulating expressions of stress-related nuclear transcription factors.

The association of impaired gestational glucose tolerance with maternal and fetal outcomes.

The aim of the present study was to examine the associations of gestational diabetes mellitus (GDM) and impaired glucose tolerance (IGT) with maternal and fetal outcomes.A total of 200 pregnant women were included in this cross-sectional study. A 50-gram oral glucose challenge test (GCT) was performed between 24 and 28 weeks of gestation, followed by glucose tolerance test (OGTT) with 100 grams of oral glucose in those with an abnormal one-hour test result. The following were not significantly different between groups. Preterm labour (PL), pregnancy induced hypertension(PIH), pre-eclampsia, polyhydramnios, and macrosomia. However, a significant increase was noted in the fetal birth weight as well as in number of cesarean deliveries among GDM subjects. Neonatal outcomes were also similar between the two groups. In conclusion, the present results suggest that single high glucose readings in OGTT may be as important as a diagnosis of GDM in terms of fetomaternal complication risk.

Endometrial pathology in postmenopausal women with no bleeding.

OBJECTIVE: The aim of this study was to determine the rate of unexpected uterine pathology in postmenopausal women admitted to a gynecology clinic with symptoms other than vaginal bleeding and who were scheduled to undergo hysterectomy. MATERIALS AND METHODS: We reviewed retrospectively the medical records of 283 postmenopausal patients who had gynecological surgery between September 2007 and January 2014. We reviewed their presenting symptoms on admission, the indications for surgery, and their transvaginal ultrasonographic findings. Postoperative histopathological results based on uterine specimens were also recorded. The results were analyzed statistically. RESULTS: Of 283 patients who had surgery, 209 had no vaginal bleeding at the time of admission. From this group, 75.6% were found to have unsuspected pathology, including endometrial hyperplasia, endometrial polyps, uterine fibroids, adenomyosis, and one case of endometrial carcinoma (0.5%). The remaining 74 patients had experienced postmenopausal bleeding and in 87.8% there were pathological findings including 13 cases (17.6%) of endometrial cancer (p = 0.0001). CONCLUSION: Vaginal bleeding in postmenopausal women is indicative of a wide array of gynecological pathologies, including endometrial carcinoma. However, uterine fibroids, pelvic masses, or even endometrial cancer may develop without co-morbid vaginal bleeding. Therefore we advocate that postmenopausal women should undergo yearly screening and consultation, without waiting for an episode of vaginal bleeding.

The effect of photon-initiated photoacoustic streaming, ultrasonically and sonically irrigation techniques on the push-out bond strength of a resin sealer to the root dentin.

OBJECTIVES: The present study investigated the effects of various irrigation activation techniques, including laser-activated irrigation using a laser with a novel tip design (photon-induced photoacoustic streaming, PIPS) on the bond strength of an epoxy resin-based sealer to root dentin. MATERIALS AND METHODS: Seventy-two single-rooted human mandibular premolars were prepared using the rotary system to size 40 and randomly divided into four groups (n = 18) according to the final irrigation activation technique used as follows: conventional irrigation (CI), laser-activated irrigation with PIPS (LAI-PIPS), passive ultrasonic irrigation (PUI), and sonic irrigation (SI) with 5 mL of 17 % EDTA and 2.5 % NaOCl. The root canals were then obturated with gutta-percha and AH PlusJet sealer. A push-out test was used to measure the bond strength between the root canal dentin and the sealer. The data were analyzed using the two-way analysis of variance and least significant difference (LSD) post hoc tests (P = 0.05). RESULTS: The LAI-PIPS and PUI resulted in higher push-out values compared to CI and SI (P < 0.05). There were no statistically significant differences between CI and SI (P = 0.978) and between LAI-PIPS and PUI (P = 0.051). There was a statistically significant interaction between the final irrigant activation techniques used and root canal thirds (P < 0.05). A chi-square test revealed no significant differences in the failure mode within the groups (P > 0.05). CONCLUSIONS: The use of LAI-PIPS and PUI can provide higher bond strength of resin sealer to root dentin compared to CI and SI techniques. CLINICAL RELEVANCE: The activation of the irrigant and the creation of the streaming have a positive effect on the bond strength of the resin sealer to root dentin.

A diagnostic dilemma for solid ovarian masses: the clinical and radiological aspects with differential diagnosis of 23 cases.

OBJECTIVE: This study aimed to analyze the clinical characteristics and diagnostic features of ovarian fibromatous masses. MATERIALS AND METHODS: The authors reviewed the records of 23 women who underwent laparotomic surgeries and whose final histopathological diagnoses were ovarian fibroma, cellular fibroma, or fibrothecoma from January 2005 to January 2013. The clinical, ultrasonographic, magnetic resonance imaging, tumor marker, therapeutic, and histologic data were analyzed. RESULTS: The mean age of the patients was 50.9 years. Sixteen patients were menopausal. The preoperative ultrasonography examination incorrectly diagnosed seven lesions as uterine fibromas, and the magnetic resonance imaging examination incorrectly labeled three lesions as pedunculated subserous uterine fibromas. The cancer antigen-125 levels of 17 cases were measured, with four being abnormal. Twenty-three patients underwent a laparotomy. Twenty patients underwent a total hysterectomy with bilateral salpingo-oophorectomy, and three underwent a tumorectomy. The histological diagnosis was fibrothecoma in 21 cases, fibroma in one case, and cellular fibroma in one case. Histopathologic examination of the endometrium of seven of the 20 patients who underwent hysterectomy revealed simple endometrial hyperplasia without atypia. CONCLUSION: Ovarian fibromas and fibrothecomas are often misdiagnosed as uterine fibromas and occasionally mistaken for malignant tumors of the ovary preoperatively. As these tumors originate from ovarian stroma, they may be hormone-active tumors. Therefore, they may lead to premalignant changes in the endometrium. The preoperative evaluation of the endometrium is recommended.

Chromium-histidinate ameliorates productivity in heat-stressed Japanese quails through reducing oxidative stress and inhibiting heat-shock protein expression.

An experiment was conducted to evaluate the effects of a histidine complex of chromium (chromium histidinate, CrHis) on egg production, lipid peroxidation and the expression of hepatic nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) and heat-shock proteins (HSPs) in Japanese quails (Coturnix coturnix japonica) exposed to heat stress (HS). A total of 180 5-week-old female quails were reared either at 22°C for 24 h/d (thermoneutral, TN) or 34°C for 8 h/d (heat stress, HS) for 12 weeks. Birds in both environments were randomly given one of three diets: basal diet and basal diet supplemented with 400 or 800 µg of elemental Cr as CrHis per kg of diet. Blood, egg yolk and liver samples collected at the end of the trial were analysed to determine concentrations of cholesterol and malondialdehyde (MDA) and expressions of transcription and heat-shock proteins. Exposure to HS caused reductions in feed intake (-8.1%) and egg production (-15.8%), elevations in serum (14.8%) and egg-yolk (29.0%) cholesterol concentrations, decreases in serum (113%) and egg-yolk (73.0%) MDA concentrations and increases in the expressions of hepatic NF-κB (52.3%) and HSPs (averaging 53.6%). The effects of increasing supplemental CrHis on the response variables were more notable in the HS environment than in the TN environment. There were considerable improvements in feed intake and egg production, decreases in serum and egg-yolk cholesterol concentrations and suppressions in the expressions of hepatic nuclear protein and HSPs in response to increasing supplemental CrHis concentration in the diet of quails reared under the HS environment. In conclusion, supplemental CrHis improves productivity through alleviating oxidative stress and modulating the expressions of hepatic NF-κB and HSPs in heat-stressed quails.

Does bupivacaine and fentanyl combination for epidural analgesia shorten the duration of labour?

In this study we aimed to explore the effects of epidural analgesia achieved by a combination of low-dose bupivacaine and fentanyl infused through an epidural catheter on mother, foetus and labour process in nulliparous at-term pregnant women during vaginal delivery. This study was designed in a prospective, randomised controlled manner. Epidural analgesia was achieved in 50 nulliparous women. Fifty nulliparous women did not undergo epidural analgesia procedure. The duration of the first stage of labour was significantly shortened, while the second stage was significantly lengthened in pregnant women who underwent epidural analgesia (p < 0.05). In conclusion, starting epidural analgesia application during the active phase of the first stage of labour may shorten the duration of the first stage compared with the group of nulliparous women not undergoing epidural analgesia. The factor that has an impact on this may be the addition of fentanyl to bupivacaine used for epidural analgesia.

Diffusion-weighted imaging in the evaluation of hormonal cyclic changes in abdominal wall endometriomas.

AIM: To investigate the utility of diffusion-weighted (DW) magnetic resonance imaging (MRI) in the diagnosis of abdominal wall endometrioma (AWE) and to compare the ADC (apparent diffusion coefficient) values of AWE with those of the uterine endometrium during two different phases of the menstrual cycle. MATERIALS AND METHODS: A total of 22 women aged between 27 and 42 years (mean 32.8 years) and who had regular menstrual cycles were included in the study. These patients had a total of 25 AWE lesions. The mean and standard deviation of the ADC values of the normal endometrium/AWE were calculated for the menstrual and luteal phases. All examinations were performed using a 1.5 T magnet (b-values of 50, 400, and 800 mm/s(2)). The results were analysed using the Shapiro-Wilk test, the Pearson correlation test, the analysis of variance (ANOVA) test, and the paired sample t-test. RESULTS: The ADC values of the endometrium were different in the two phases of the menstrual cycle (menstrual phase: 0.924 ± 0.171; luteal phase: 1.171 ± 0.135). Similarly, the ADC values of the AWE were different in these phases (menstrual phase: 0.937 ± 0.256, luteal phase: 1.256 ± 0.215). In both AWE and the uterine endometrium, the ADC measurements were significantly lower in the menstrual phase than during the luteal phase. This difference was statistically significant (p < 0.05). There was no significant difference in the ADC values between the endometrial layer and AWE during the same phase (p = 0.216 for menstrual phase, p = 0.104 for luteal phase, paired sample t-test). CONCLUSION: The present study demonstrated that in all patients, the DWI features of AWEs were significantly similar to those of the uterine endometrial tissue. Additionally, the ADC measurements of the patients showed similar cyclical changes. These results suggest that the ADC values of a lesion close to the uterine endometrium may be used to differentiate AWE from the other disease entities of the abdominal wall.