The Effect of a High-Protein Diet and Exercise on Cardiac AQP7 and GLUT4 Gene Expression.

High-protein (HP) diets are commonly consumed by athletes despite their potential health hazard, which is postulated to enforce a negative effect on bone and renal health. However, its effects on heart have not been known yet. Aquaporin-7 (AQP7) is an aquaglyceroporin that facilitates glycerol and water transport. Glycerol is an important cardiac energy production substrate, especially during exercise, in conjunction with fatty acids and glucose. Glucose transporter 4 (GLUT4) is an insulin-sensitive glucose transporter in heart. We aimed to investigate the effect of HPD on AQP7 and GLUT4 levels in the rat heart subjected to exercise. Male Sprague-Dawley rats were divided into control (n = 12), exercise (E) training (n = 10), HPD (n = 12), and HPD-E training (n = 9) groups. The HPD groups were fed a 45 % protein-containing diet 5 weeks. The HPD-E and E groups were performed the treadmill exercise during the 5-week study period. Real-time polymerase chain reaction and immunohistochemistry techniques were used to determine the gene expression and localization of AQP7 and GLUT4 in heart tissue. Results of relative gene expression were calculated by the 'Pfaffl' mathematical method using the REST program. Differences in AQP7 and GLUT4 gene expression were expressed as fold change compared to the control group. Heart weight/tibia ratio and ventricular wall thickness were evaluated as markers of cardiac hypertrophy. Further, serum glucose, glycerol, and insulin levels were also measured. AQP7 gene expression was found to be increased in the E (3.47-fold, p < 0.001), HPD (5.59-fold, p < 0.001), and HPD-E (3.87-fold, p < 0.001) groups compared to the control group. AQP7 protein expression was also increased in the HPD and HPD-E groups (p < 0.001). Additionally, cardiac mRNA expression levels of GLUT4 showed a significant increase in the E (2.16-fold, p < 0.003), HPD (7.14-fold, p < 0.001), and HPD-E (3.43-fold, p < 0.001) groups compared to the control group. GLUT4 protein expression was significantly increased in the E, HPD, and HPD-E groups compared to the control group (p = 0.024, p < 0.001, and p < 0.001, respectively). Furthermore, Serum glucose levels were significantly different between groups (p < 0.005). This difference was observed between the HPD groups and normal-protein diet groups (C and E). Serum insulin levels were higher for HPD groups compared with the normal-protein diet groups (p < 0.001), whereas no differences were observed between the exercise and sedentary groups (p = 0.111). Serum glycerol levels were significantly increased in the HPD groups compared with control and E groups (p < 0.05 and p < 0.05, respectively). Consumption of HPD supplementation caused the increased effects on AQP7 and GLUT4 expression in rat heart.

Hypertension and Occupational Health: A General Overview and Expert Consensus Suggestions.

Hypertension is a common public health issue, and its incidene increases parallel to age. It is inevitable that certain occupational conditions may pose risks for high blood pressure or cause difficulties in managing blood pressure. Working under specific circumstances may compromise the safety of individuals with hypertension and potentially others. Therefore, it is crucial to implement activities that enhance awareness of hypertension, to ensure regular periodic examinations, and to establish necessary precautions in the workplace for the health of employees and the public. Given the limited resources offering guidance on hypertension in the context of occupational health, the authors of this paper, who hail from different disciplines, have prepared a set of consensus-based suggestions.

Medical Education in the Era of Advancing Technology

Technology is developing rapidly and affecting the field of medicine in two main areas- medical education and health care. As a rapidly evolving field with the need and ability to constantly incorporate newer technologies, medical education must be able to prepare future doctors as per changing trends in practice patterns, the role of medicine in disease diagnosis and treatment, and innovations, and advances in medical science. In this article, we discuss the various digital learning tools introduced into medical education, as well as their advantages and disadvantages. We also try to understand how the shift to artificial intelligence may affect medical education and practice and how we can make technology efficient without losing the human dimension in doctor-patient relationships.

Neuromuscular morphometry of the uterine ligaments and vaginal wall in women with pelvic organ prolapse.

AIMS: The aim of this study was to compare neuromuscular histomorphometry of the uterine ligaments and vaginal wall in women with and without pelvic organ prolapse. METHODS: Biopsies were obtained from the round, uterosacral, and cardinal ligaments of the uterus and apical vaginal wall of women having pelvic organ prolapse repaired (stage ≥ II; prolapse group, 37) and the same location in patients with no prolapse (stage < II; control group, 47). Routine hematoxylin-eosin (H & E) staining and immunohistochemical staining for Protein Gene Product 9.5 (PGP 9.5) and smooth muscle α-actin were performed for all specimens. RESULTS: Smooth muscle percentage of the uterosacral and cardinal ligaments were not significantly different in women with prolapse than in women without. In round ligament, mean smooth muscle percentage was lower than in women with normal support (81.63 ± 8.2 vs. 51.63 ± 16, P=0.000). Mean distance of the smooth muscle fibers from surface epithelium of the vaginal epithelium of the women with prolapse were significantly higher than the control group (1.679 ± 0.34 vs. 2.240 ± 0.33, P = 0.000). PGP 9.5 stained area percentage of uterine ligaments and vaginal wall tissue samples were significantly lower in women with prolapse. CONCLUSIONS: Both total innervation of the anterior vaginal epithelium and uterine ligaments, and muscular percentage of the round ligament and vaginal wall were decreased in women with pelvic organ prolapse.

Hand-washing behaviour and nurses' knowledge after a training programme.

The aim of this study was to evaluate the nurses' hand-washing behaviour and knowledge before and after a training programme. This prospective study involved 200 nurses who participated in hand-washing training at a university hospital in Turkey. The data were collected using a personal information form and pre- and post-test surveys that had been developed by the researchers. During the study, the nurses received 40 min of training on hand washing and a handbook prepared by the researchers. The hand-washing behaviour and knowledge of the nurses were assessed before training and 1 month after the training. To analyse the data, descriptive statistics, a t-test and a Mc Nemar chi-squared test were used. Following the training, there was a significant increase in the frequency of hand washing by the nurses (t = -2.202, P = 0.029), together with an increase in the time allowed for hand washing (P = 0.024, P < 0.05), knowledge of hand-washing practices (t = -16.081, P < 0.05) and quality (t = -10.874, P < 0.05). Planned training programmes for hand washing should be implemented to improve the behaviour and knowledge of nurses.

Neuromuscular morphometry of the vaginal wall in women with anterior vaginal wall prolapse.

INTRODUCTION AND HYPOTHESIS: The aim of this study was to compare the changes in hystomorphometry and innervation of the anterior vaginal wall in women with and without anterior vaginal wall prolapse. METHODS: Eighty-nine biopsy specimens were obtained from the anterior vaginal wall of women having a cystocele repaired (stage >or=II; prolapse group, 49) and the same location in patients with no prolapse (stage

Mucins, trefoil factors and pancreatic duodenal homeobox 1 expression in spasmolytic polypeptide expressing metaplasia and intestinal metaplasia adjacent to gastric carcinomas.

INTRODUCTION: Gastric cancers are the second cause of cancer related deaths all around the world but gastric carcinogenesis remains a mystery. Intestinal metaplasia (IM) and spasmolytic polypeptide expressing metaplasia (SPEM) are the two types of preneoplastic metaplasias. In this study, we aimed to investigate expression of Pancreatic duodenal homeobox 1 (PDX1), mucins (MUCs), trefoil factors (TFFs) in SPEM and IM surrounding gastric carcinomas. MATERIAL AND METHODS: Tissue samples of tumor adjacent gastric mucosa including IM (n = 61) and SPEM (n = 36) from 70 gastrectomy specimens were used for immunohistochemical analysis of PDX1, mucins (MUC5AC, MUC6) and trefoil factors (TFF2, TFF3). RESULTS: Nuclear expression of PDX1 was present in both SPEM (32/36) and IM (60/61) and there was no significant difference in expression of PDX1 between the two types of metaplasias. While TFF3 and MUC5AC were abundant in IM, SPEM showed 100% expression of TFF2 and MUC6 and also lower positivity with TFF3 and MUC5AC. PDX1 positivity was related to expression of MUC5AC (60/61, p < 0.001) and TFF3 (60/61, p < 0.001) in IM and also associated with expression of MUC5AC (14/32, p < 0.05), MUC6 (32/32, p < 0.001), TFF2 (32/32, p < 0.001) and TFF3 (9/32, p < 0.05) in SPEM. Coexpression of TFF3 and TFF2 was present in 10 of 36 (27.7%) samples of SPEM and also 29 of 61 (47.5%) samples of IM exhibited dual expression of trefoil peptides. CONCLUSIONS: PDX1 may affect the development of SPEM and IM. Expression patterns of TFFs and MUCs may indicate that IM evolves from SPEM.

The effects of neuromuscular electrical stimulation on clinical improvement in hemiplegic lower extremity rehabilitation in chronic stroke: a single-blind, randomised, controlled trial.

OBJECTIVE: In this study, the effectiveness of neuromuscular electrical stimulation (NMES) was evaluated in lower extremity rehabilitation in patients with chronic stroke. METHOD: The study enrolled 40 patients with chronic stroke. Twenty patients each were assigned to the treatment group and the control group. All patients received a conventional rehabilitation program for a 4-week period. In addition to this rehabilitation program, patients in the treatment group received NMES treatment for hemiplegic foot dorsiflexor muscles for 4 weeks, 5 days a week. The sessions were performed as one session per day and added to a total of 20 sessions. Clinical parameters were evaluated before and after the treatment. RESULTS: Pre-treatment and post-treatment evaluations showed a significant increase in ankle dorsiflexion and a significant decrease in the level of spasticity in the treatment group (p < 0.05); however, there were no significant differences in the control group between the pre-treatment and post-treatment measures. Although Brunnstrom Stage, Rivermead leg and trunk score and Functional Independence Measurement motor subscore showed a significant improvement in pre- and post-treatment comparisons for both groups, the treatment group's scores were significantly higher than the control group (p < 0.05). Functional Ambulation Categories showed a significant improvement in both groups following the treatment; however, there was no significant difference between the two groups (p > 0.05). CONCLUSIONS: Use of NMES in hemiplegic foot dorsiflexion can contribute to the clinical improvement of patients when used in combination with rehabilitation programs.

[Hepatitis E virus epidemiology in adult population in Edirne province, Turkey]. / Edirne'de eriskinlerde hepatit e virus enfeksiyonu epidemiyolojisi.

Hepatitis E virus (HEV) clinical presentations range from asymptomatic infection to fulminant hepatitis which is frequently seen in pregnant women. Epidemics due to HEV mostly originate from contaminated water and the virus is transmitted by fecal oral way. Its frequency is closely related to the socioeconomical status of the community. The aim of this first community-based study performed in Edirne province (located at Trace region of Turkey) was to determine the seroprevalence of HEV and the risk factors in the city center. Five hundred eighty two people (273 men, 309 women) over age 15 years, representing the population of Edirne city center were included in the study. Anti-HEV IgG antibodies were investigated in the serum samples by ELISA method. Anti-HEV antibodies were detected in a total of 14 cases (11 women, 3 men) and HEV infection prevalence was found to be 2.4%. The mean age of seropositive people was 50.86 +/- 16.76 years while it was 40.7 +/- 16.9 years in seronegative people (p = 0.027). This result was attributed to the better water supply and sanitation conditions in Edirne province in comparison to other parts of Turkey and shift of HEV seropositivity in older ages. No statistically significant difference was detected between seropositive and seronegative cases in terms of socioeconomical conditions, both groups being in high socioeconomical level. The analysis of the risk factors revealed that the rate of people living in houses built with materials other than reinforced concrete (p = 0.044), dealing with stockbreeding (p = 0.046) and consuming fruits and vegetables without proper washing (p = 0.015) were significantly higher in the seropositive group. No statistically significant difference was detected for the other risk factors such as the number of household, presence of city water supply and sewage system in the house, location of the water closet outside house, lack of hand-washing habits, sharing utensils, consumption of raw vegetables, history of blood transfusion, surgery, dental intervention, jaundice, contact with a case of hepatitis, abortion/stillbirth and suspicious sexual contact. While the HEV seropositivity rate (2.4%) detected in Edirne was lower than the average of Turkey (6%), it was similar to the results reported from western part of the country. High rates of seropositivity among people with individual incompatibility to the hygiene rules denotes that personal hygiene is an important factor for prevention from HEV infection. High rate of seropositivity among people dealing with stockbreeding also suggests that there may be different ways of HEV transmission other than contaminated water in sporadic cases.

Does noise exposure during pregnancy affect neonatal hearing screening results?

OBJECTIVE: The aim is to investigate whether noise is effective on hearing screening tests of neonates born to mothers exposed to noise during pregnancy. MATERIAL AND METHOD: Screening results of 2653 infants from the period of January 2013-May 2017 were evaluated. Transient Evoked Otoacoustic Emissions (TEOAE) and Auditory Brainstem Response (ABR) were used. Infants of 65 mothers exposed to noise (LAeq 80-85 dBA/8 hours/day) during pregnancy (Week ± SD; 32.58 ± 2.71) comprised the study group while the control group consisted of infants of 2588 mothers without noise exposure. RESULTS: Among the 65 infants, 23 (35.4%) passed screening at the first emission test (OAE1); 34 (52.3%) at the second emission test (OAE2); 7 (10.8%) at the ABR stage, 1 (1.5%) infant was referred to a tertiary center. In the control group, 458 (17.7%) infants passed at OAE1; 1822 (70.4%) at OAE2; 289 (11.2%) at ABR stages, 19 (0.7%) infants were referred to a tertiary center. The rate of infants that passed screening at OAE1 in the study group was high (P = 0.00001). Sixty-four (98.46%) infants in the study group and 2569 (99.26%) infants in the control group passed the tests. The difference between the two groups was not significant, indicating that exposure to noise during pregnancy had no unfavorable effects on auditory functions (P = 0.392). CONCLUSION: Unfavorable effect of noise exposure during pregnancy was not observed on auditory functions of the infants. The higher rate of infants that passed the screening test at OAE1 stage in the study group raised the question, "Does the exposure of the noise at exposure action levels (80-85 dB A) during pregnancy contribute to auditory maturation of fetus?"

Does abdominal obesity cause increase in the amount of epidural fat?

It is known that epidural fat does not alter in obese people. This study aims to find out a possible relationship with epidural fat and abdominal obesity. In this cross-sectional study, 63 patients who were referred to our clinic for lumbar magnetic resonance imaging (MRI) examination were evaluated. Patients with the history of steroid treatment, thyroid disease or Cushing disease were excluded. Waist circumferences (WC), body weight and height were measured and subsequently body-mass index (BMI) was calculated (kg/m(2)). On midsagittal T1-weighted images, anterior epidural fat (AEF), posterior epidural fat (PEF) and posterior subcutaneous fat (SCF) thicknesses were measured at the S1 level. The results were compared with age, gender, body weight, height, WC and BMI. There were 31 men and 32 women, age ranged 19-77 years (mean 49). The mean BMI was 29.25 kg/m(2) (20.7-52.7); the mean WC was 97.4 +/- 13.2 cm (72-122) in women and 97.6 +/- 9.8 cm (72-118) in men. Cutoff value of WC was considered as 88 cm for women and 95 cm for men. BMI > 27.5 was considered to be obese. No statistical difference with respect to epidural fat thickness between genders was determined in AEF and PEF (P = 0.237, P = 0.616). SCF was significantly thicker in women (P = 0.021). A very poor and negative correlation was found between age and PEF (r = 0.373, P = 0.003), and a very poor and positive correlation between weight and PEF was found (r = 396, P = 0.001). The thickness of the epidural fat was not differ between obese and nonobese people (p = 0.571 for AEF and p = 0.307 for PEF). The thickness of the epidural fat was not different in people whose WC was greater than normal values in both gender (p > 0.05). Epidural fat is not affected by age, gender, BMI and WC which means that epidural fatty layer. A clear correlation has not been found between epidural fat amount and obesity or abnormal fat distribution yet.

Personal characteristics of enuretic children: an epidemiological study from South-East Europe.

INTRODUCTION: This study examined the personal characteristics of enuretic children and investigated the risk factors of nocturnal enuresis among schoolchildren. METHODS: It was a cross-sectional and descriptive questionnaire study and 2,000 children were stratified according to school population, age and gender. The questionnaire was designed for parents to collect information about the prevalence and associated factors as well. RESULTS: Nocturnal enuresis was reported in 159 cases (9.8%). The parameters of bladder control after 2 years of age, urination more than 5 times a day, urinary infection history, history of psychological or physical trauma, siblings with health problems, large family size, lack of a private bedroom, and constipation were more frequent in enuretics (p < 0.05). The parameters of having fecal incontinence, parents and siblings with nocturnal enuresis, low educational level of the mother and poor school performance seem to be risk factors for nocturnal enuresis. However, the parental concern level was high, approximately half of the enuretic children did not visit a physician for management of the problem. CONCLUSION: Nocturnal enuresis could be a multifactorial problem originating from bladder dysfunction, deranged sleep patterns and psychological and hereditary predisposition. Hereditary disposition and having fecal incontinence may be important risk factors for enuresis.

Prevalence of cryptorchidism, retractile testis and orchiopexy in school children.

OBJECTIVE: The aim of this study was to determine the prevalence of cryptorchidism, retractile testis and orchiopexy and investigate the effects of these clinical conditions on testicular volume among schoolchildren aged 7-12 years. METHODS: It was a cross-sectional and descriptive study. The participants were stratified by school population and age and 1,800 questionnaires were distributed. The inguino-scrotal examinations and the testicular volumes of the children were recorded. RESULTS: The parents of 1,500 children agreed to allow their children to be examined. The prevalence of cryptorchidism and orchiopexy was found to be 0.73 and 1.3%, respectively. Retractile testis was found in 3.9% of the children. The mean testicular volume of children having retractile testis (1.82 +/- 1.41 ml) was less than the ones who do not (2.38 +/- 1.40 ml, p < 0.05). The prevalence was 1.7%, and 4% in the participants who had inguinal hernia also had hernioplasty. CONCLUSIONS: The prevalence of cryptorchidism and the mean age of orchidopexy are high among schoolchildren aged 7-12. Retractile testis might have some negative effects on the development of testicular volume in children. Parents and healthcare and education professionals should give special attention to inguino-scrotal diseases.

[Etiologic agents and risk factors in nosocomial urinary tract infections]. / Nozokomiyal üriner sistem enfeksiyonlarinda etiyolojik etkenler ve risk faktörleri.

Nosocomial urinary tract infection (NUSI) is one of the most common hospital acquired infections. In this study, we aimed to determine the risk factors, frequency and the bacterial etiology of NUSI in hospitalized patients at Trace University Hospital, Turkey. Between September 1st 2004 to March 1st 2005, 104 NUSI episodes from 91 adult patients (mean age; 60.8 +/- 16.1 years; 46 were female) were determined among 8704 patients admitted to the hospital. During the study period, cumulative incidence of NUSI was 1.04% and episode rate of NUSI was 1.19%. The most important risk factors for NUSI were detected as urinary catheterization (78.8%), antimicrobial therapy within the previous 15 days (60.6%), fecal incontinence (33.7%) and surgical operations [29.8% (42% of them were urological pertainings)]. In 37.8% of the episodes urinary catheterization was considered as performed unnecessarily. In 26% of the episodes another infection (pneumoniae, abdominal infection, wound infection) accompanied. The causative microorganisms were resistant to the antibiotics used for therapy in 93.6% of the episodes. A total of 118 microorganisms (14 were polymicrobial) have been isolated from the urine cultures. The most frequently isolated ones were Escherichia coil (n: 48; 40.8%), Candida spp. (n: 27; 23%), Enterococcus spp. (n: 13; 11%), Pseudomonas aeruginosa (n: 9; 7.6%), Klebsiella pneumoniae (n: 8; 6.8%) and Acinetobacter spp. (n: 5; 4.2%). The highest susceptibility rates of E. coli isolates were against imipenem and nitrofurantoin (100%) and amikacin (97.7%), the lowest susceptibility rates were against ampicillin (26.7%) and amoxycillin-clavulonate (44.4%). No glycopeptid resistance was detected for Enterococcus spp. while the susceptibility rates to penicilin and nitrofurantoin were 38.5% and 63.6%, respectively. Since the number of the other bacterial species was low (<10) their antimicrobial resistance rates were not evaluated. Extended-spectrum beta-lactamase (ESBL) production was determined in 27% of E. coli and in 25% of K. pneumoniae isolates, and cases with ESBL producing strains had significiantly higher antibiotic consumption rate in the previous 15 days (p = 0.004). Blood cultures which were collected during NUSI episodes yielded positive results in 31.8%. The mortality rate due to NUSI was significantly higher in cases with bloodstream infection (p = 0.000). In conclusion, the high rates of NUSI associated with bloodstream infections and mortality detected have pointed out serious problems in our hospital, and indicated that more attention should be paid on urinary catheterisation, rational antibiotic usage and control of nosocomial infections.

The Burden of Premature Mortality in Turkey in 2001 and 2008.

BACKGROUND: Standard expected years of life lost (SEYLL) is a measure that is used to evaluate losses due to premature deaths. AIMS: The present study provides an analysis of premature mortality in Turkey for the years 2001 and 2008 and supplies evidence for making policies and setting health agendas over the long term. STUDY DESIGN: Cross-sectional study. METHODS: This study calculated SEYLL by gender, age group and causes of death in Turkey in 2014. The SEYLL measure counts the years lost in a population as a result of premature mortality and is computed by multiplying the number of deaths and standard life expectancy at the age at which death occurs. RESULTS: The burden of premature mortality in Turkey was calculated as 4 104 253 SEYLL and 4 472 443 SEYLL in 2001 and 2008, respectively. Among these 42.7% and 43.9% of SEYLL were in females in 2001 and 2008, respectively. The leading five causes of premature mortality in the Turkish population in 2001 were cardiovascular system diseases (34.72%), perinatal conditions (12.69%), neoplasms (12.51%), external causes of injury (7.66%), and infections and parasitic diseases (6.57%). In 2008, the major causes were cardiovascular diseases (41.17%), neoplasms (14.63%), respiratory system diseases (9.81%), perinatal conditions (5.59%), and external causes of injury (5.29%). CONCLUSION: The majority of the burden of premature mortality in Turkey is attributable to non-communicable diseases. While premature deaths from infections and parasitic diseases, perinatal conditions and congenital anomalies decreased between 2001 and 2008, deaths from cardiovascular diseases, neoplasms and respiratory system diseases increased dramatically. Coordinated efforts for effective national prevention programs (such as regular monitoring of adults for early diagnosis of cardiovascular diseases and for malignancies by family physicians) should be developed by policy makers to decrease preventable and premature deaths from non-communicable diseases.

Prognostic Value of Angiogenesis and Survivin Expression in Patients with Glioblastoma.

AIM: Glioblastoma (GBM) is the most common and the most aggressive primary brain tumor with poor prognosis. We aimed to evaluate the association between immunohistochemical expression of survivin and angiogenic parameters (microvessel density and vascular pattern) in patients who underwent surgery for GBM. MATERIAL AND METHODS: The pathology reports and also clinical and follow-up data of patients with GBM were retrospectively evaluated. Control tissues were obtained from the archive for each antibody (Survivin, CD 34). Then, control staining of these antibodies was performed. Vessels were evaluated according to the standardized assessment of vascular pattern. RESULTS: Mean survival for classical vascular pattern was longer than bizarre vascular pattern (p < 0.001). The survival time of patients decreased with increasing score of survivin staining. There was a significant correlation between survivin and survival time (p < 0.001). There was no significant correlation between microvessel density and survival time (p > 0.05). CONCLUSION: With these findings, it is considered that high expression of survivin, bizarre vascular pattern and development of secondary GBM correlates with the low survival rates, however microvessel density has no correlation with the survival rates. Since only malignant cells express survivin, it might be a target protein for the development of novel therapies.

Histopathological Features of Gastrointestinal Stromal Tumors and the Contribution of DOG1 Expression to the Diagnosis.

BACKGROUND: Gastrointestinal stromal tumors (GIST) have KIT or platelet-derived growth factor receptor α (PDGFRα) mutations affecting receptor tyrosine kinase activity and do not benefit from classic treatment regimens. AIMS: The aim of this study was to review the algorithm that may be followed for the diagnosis and differential diagnosis in GISTs by investigating the histomorphological parameters and expression characteristics of classical immunohistochemical antibodies used in routine tests in addition to DOG1 expression. STUDY DESIGN: Diagnostic accuracy study. METHODS: We reevaluated the histological and immunohistochemical parameters of 37 GISTs. The standard immunohistochemical diagnosis and differential diagnosis panel antibodies (CD117, PDGFRα, CD34, vimentin, desmin, SMA, S-100, and Ki67) were studied on the tumor sections. We also used the popular marker DOG1 antibody with accepted sensitivity for GISTs in recent years and the PDGFRα immune marker for which the benefit in routine practice is discussed. RESULTS: Classification according to progressive disease risk groups of the 37 cases revealed that 54% were in the high risk, 19% in the moderate risk, 16% in the low risk, 8% in the very low risk and 8% in the no risk group. Cytological atypia, necrosis, mucosal invasion and the Ki67 index were found to be related to the progressive disease risk groups of the tumors (p<0.05). Positive immunoreaction was observed with CD117 and PDGFRα in all GISTs in the study (100%). Positivity with the DOG1 antibody was found in 33 (89%) cases. CD34 was positive in 62% (23) of the cases. CONCLUSION: The CD117 antibody still plays a key role in GIST diagnosis. However, the use of DOG1 and PDGFRα antibodies combined with CD117 as sensitive markers can be beneficial.

Prevalence of postpartum depression in Edirne, Turkey, and related factors.

OBJECTIVE: To estimate the community prevalence of postpartum depression (PPD) in Edirne, Turkey, and the potential risk factors for it. STUDY DESIGN: The study was performed on mothers during the 6-week postpartum visit at home. A questionnaire that was devised to collect data on basic demographic information on the mothers and the Edinburgh Postnatal Depression Scale (EPDS) were applied. A total of 210 mothers were interviewed between January and April 2002, and 178 of them whose data were complete were analyzed. We evaluated EPDS cutoff scores > or =12. RESULTS: With an EPDs cutoff score of > or =12, the prevalence of PPD was 40.4%. Such factors as the husband's unemployment and a low educational level, living in a rented house, and having psychological or other problems during a previous pregnancy were the most significant risk factors for PPD. In the logistic model, the family's preference for a male infant in the previous pregnancy, female infant in the previous delivery and unwanted pregnancy were associated with PPD. The OR for these 3 variables and their 95% CI are, respectively, OR = 3.10, 95% CI 1.57-6.12; OR = 2.18, 95% CI 1.09-4.37, and OR = 2.84, 95% CI 1.22-6.61). CONCLUSION: The prevalence of PPD was high. Although the risk factors were similar to those in other studies, other family members' mention of wanting a son can cause depression in the mothers.