Hepatitis A seroprevalence and demographic risk factors in the susceptible population: a cross-sectional study.

OBJECTIVE: The epidemiology of hepatitis A virus (HAV) infection is influenced by variables such as age, sex, environmental conditions, and vaccination status. This study aimed to evaluate HAV seropositivity after the inclusion of hepatitis A vaccination in the national childhood immunization program and identify demographic risk factors of the susceptible population before routine vaccination. PATIENTS AND METHODS: This cross-sectional epidemiological study was conducted by retrospectively examining the laboratory records of patients who underwent HAV serology testing in a tertiary care center in eastern Turkey between 2008 and 2019. RESULTS: Overall immunity to HAV was 81.6%. According to birthplace and year, the rate of anti-HAV positivity was higher among people born before 2006 in the Southeast and Eastern Anatolia regions. For those born in 2012 or later, the lowest seropositivity was among those born in the Southeast region, while it was over 60% in the other regions. When analyzed by year of birth, the lowest seropositivity was in those born between 1994 and 2011, and the frequency of seropositivity increased with age. Of those born between 1982 and 1999, the seropositivity rate was higher among men than women. Rural dwellers born before 2012 had higher seropositivity than urban dwellers. Among those born before the introduction of routine childhood HAV vaccination, female sex, urban dwelling, and each additional year of age were identified as independent demographic risk factors for HAV susceptibility. CONCLUSIONS: Socioeconomic development and immunization programs have altered HAV seroprevalence patterns. Planning catch-up vaccinations, especially in adolescents and young adults (born in 1994-2011) with low seropositivity and ensuring the continuity of hygiene and sanitation practices are important to protect the susceptible population.

The effect of human amniotic fluid on mandibular distraction osteogenesis.

The aim of this study was to evaluate the effects of local administration of human amniotic fluid (HAF) on newly formed bone obtained by mandibular distraction osteogenesis (DO) with histomorphometry. A unilateral mandibular osteotomy at the left corpus was performed in 32 adult male rabbits. After a 5-day latency period, the left mandibles were lengthened by mandibular DO over 5 days, at a rate of 1mm/day, via a custom-made distractor. After the distraction, the rabbits were divided randomly into four groups: 0.3 ml HAF was injected into the distraction gap followed by 21 (group 1) or 45 (group 2) days of consolidation; or 0.3 ml normal saline (NS) was administered followed by 21 (group 3) or 45 (group 4) days of consolidation. Mandibles were removed at the end of the consolidation period and investigated histomorphometrically. The newly formed bone area (NFBA) and number of fibroblasts increased significantly in the HAF groups compared to the NS groups (NFBA: group 1 vs. group 3, P<0.05; group 2 vs. group 4, P<0.01; fibroblasts: group 1 vs. group 3, and group 2 vs. group 4, P<0.05), and also in both 45-day consolidation groups compared to the 21-day consolidation groups (NFBA: group 1 vs. group 2, and group 3 vs. group 4, P<0.001; fibroblasts: group 1 vs. group 2, and group 3 vs. group 4, P<0.01). Additionally, the numbers of osteoblasts and capillaries were increased significantly at 45 days of consolidation compared to 21 days in both the HAF and NS groups (osteoblasts: group 1 vs. group 2, P<0.01; group 3 vs. group 4, P<0.05; capillaries: group 1 vs. group 2, and group 3 vs. group 4, P<0.01). Histomorphometric analysis demonstrated that local HAF administration effectively accelerated bone formation. Thus, a HAF injection procedure could improve new bone formation around the bone in maxillofacial operations such as DO.

Comparison of risk of malignancy indices; RMI 1-4 in borderline ovarian tumor.

PURPOSE: The aim of this study was to evaluate prognostic values of the risk of malignancy index (RMI)/1-4 in patients with borderline ovarian tumors (BOTs). METHODS: The study consisted of 50 patients with BOT diagnosed and treated between 2005-2010 and 50 patients with benign adnexal massses between 2009-2010 as a control comparison group in the retropsective study. Preoperative serum CA125, U score, tumor size (S), and menopausal status were recorded. The RMI 1-3 was calculated according to the formula; UxMxCA125 and RMI4 formulation was; UxMxCA125xS. S equaled 1 for tumor size <7 cm and was 2 when size a 7 cm. The RMI 1-4 indices were calculated for all patients together with the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy (DA). The performances of RMI indices were evaluated by McNemar's test and determined the best score cutoff value by the receiver operating characteristic (ROC) curve. RESULTS: The mean age, median value of CA125, ultrasound score, menopausal status, median values of RMI 1-4 of BOTs were statistically higher than benign adnexal masses. The sensitivity of RMI 1-4 was 26, 36, 62, and 60% at cutoff 200 level, respectively. The areas under curve of RMI 1-4 were found to be 0.676, 0.665, 0.668 and 0.734, respectively. DA of RMI 1-4 was found to be 56, 59, 50, and 71, respectively. When RMI 1-4 indices were compared with each other RMI 4 was the best RMI for BOTs. CONCLUSION: RMI 4 was the best predictive RMI for preoperative discrimination of BOT at a cutoff level of 200.

Comparison of tumor markers and clinicopathological features in serous and mucinous borderline ovarian tumors.

OBJECTIVE: The aim of this study was to assess tumor markers and clinicopathological findings of patients with serous and mucinous borderline ovarian tumor (BOT) features. METHODS: The study consisted of 50 patients that were diagnosed with and treated for BOT between 2005-2010 in three centers. CA125, CA19-9, and CA125+CA19-9 levels and clinicopathological features were compared in serous and mucinous histotypes. In serous and mucinous BOTs, correlations between tumor markers and demographics such as age, menopausal status, parity, clinical findings (stage, relapse, adjuvant chemotherapy, cytology, lymph node involvement and tumoral morphology (cystic-solid content, papilla, septation) were evaluated. RESULTS: There were no significant differences between serous and mucinous tumors in the clinicopathological features such as stage, tumor markers, age, menopausal status, or cytology. In serous BOTs we found a significant relation between elevated CA125+ CA19-9, CA19-9 and recurrence (p < 0.05). Also there was a significant relation between elevated CA125+ CA19-9, CA19-9 and cytology positivity (p < 0.05). We found a significant relation in serous BOTs between elevated CA125+CA19-9, adjuvant chemotherapy and lymph node metastases (p < 0.05). Also In mucinous BOTs with papilla formation we found a significant relation between elevated CA125 and CA125+ CA19-9 (p < 0.05). There was significant relation between cytology positivity and elevated CA19-9 in mucinous BOTs (p < 0.05). CONCLUSION: Serum tumor markers of serous and mucinous BOTs were different in relation to their clinicopathological features. This may reflect differences of serous and mucinous BOTs.

Effects of human amniotic fluid on costal cartilage regeneration (an experimental study).

OBJECTIVE: After surgical correction of thoracic wall deformities, promoting neochondrogenesis in the perichondrial bed is very important for obtaining a flexible chest wall. In this experimental study, we aimed to investigate the effects of human amniotic fluid on cartilage regeneration in the costal perichondrial bed in a rabbit model. METHODS: Fifty-four adult New Zealand rabbits were divided into three groups, with 18 rabbits in each group. The third and fifth costal cartilages were excised totally on the right side and partially excised on the left side in all groups. Group 1 served as controls. All rabbits in group 1 underwent closure of the perichondrium of the third costal cartilage and closure of the perichondrium of the fifth costal cartilage with reimplantation of reshaped cartilage into the fifth costal perichondrial bed. Rabbits in group 2 underwent closure of the perichondrium of the third and fifth costal cartilages after the administration of human amniotic fluid into the perichondrial bed. Group 3 rabbits received both human amniotic fluid and underwent cartilage reimplantation. The third and fifth costal perichondriums in group 3 rabbits were closed after the administration of human amniotic fluid and the reimplantation of reshaped cartilages. Rabbits were sacrificed at two, eight and 12 weeks after operation. RESULTS: Numerical scores for the right perichondrial bed were significantly higher for group 2 compared to group 1 ( P < 0.05). But the difference was not significant for the left perichondrial bed ( P > 0.05). The diameter of chondrogenesis also did not differ significantly between left and right perichondrial bed for all groups. CONCLUSION: Our study shows that administration of human amniotic fluid into the perichondrial bed increases chondrogenesis in adult rabbits, an important finding which may contribute to improving chest wall flexibility after the surgical correction of pectus excavatum.

Comparison of bolus remifentanil-propofol versus bolus fentanyl-propofol for dilatation and sharp curettage.

BACKGROUND AND OBJECTIVE: The study was conducted to determine whether bolus administrations of remifentanil-propofol could provide adequate analgesia and similar patient comfort with a faster recovery profile compared with bolus administrations of fentanyl-propofol during dilatation and sharp curettage. METHODS: The patients were randomized to a remifentanil group (n=36) or fentanyl group (n=36). The remifentanil group received an IV bolus dose of 1 pg kg(-1) remifentanil. The fentanyl group received an IV bolus dose of fentanyl 0.5 microg kg(-1). The Verbal Pain Scale (VPS), modified Aldrete scores, blood pressure, heart rate, peripheric oxygen saturation, recovery time from anesthesia and adverse events during or after surgery were evaluated. RESULTS: The groups were found to be similar in duration of the surgical procedure, anesthesia time and hemodynamic variables and VPS scores. Patients in the remifentanil group recovered from anesthesia earlier. Modified Aldrete scores were higher in the remifentanil group at 5 and 10 min postoperatively. The frequency of perioperative adverse events did not differ significantly between the groups. CONCLUSIONS: Bolus injections of remifentanil appear to be a safe and effective alternative to fentanyl, producing faster recovery in providing analgesia during dilatation and sharp curettage procedures.

Mode of delivery and subsequent long-term sexual function of primiparous women.

Minimal information exists on unintended health consequences following childbirth, particularly in relation to mode of delivery. This study aimed to evaluate the impact of mode of delivery on long-term sexual satisfaction of women by using a validated questionnaire. Forty-five primiparous women who had cesarean deliveries and 90 primiparous women who had vaginal deliveries with mediolateral episiotomies enrolled in the study. Quality of sexual relations and sexual satisfaction were self-reported by using Golombock-Rust Inventory of Sexual Satisfaction. Prevalence of sexual dissatisfaction was compared between the two groups and logistic regression analysis was carried out to identify the predictors of sexual dissatisfaction. The prevalence of overall sexual dissatisfaction was 4.4% in cesarean group while it was 14.4% in vaginal delivery group (P=0.081). Vaginal delivery group demonstrated a trend toward higher prevalence of dissatisfaction in all subscales except sensuality area than cesarean group, however, differences between two groups did not reach to statistical significance. Degree of pleasure for relationship with the spouse was identified as a significant predictor for overall sexual dissatisfaction (P=0.008). Our findings suggest that sexual dissatisfaction should not be assumed simply a product of the delivery mode. Individual, socio-demographic, lifestyle and marital characteristics should also be taken into account.

Sonographic features of tuberculous peritonitis with female genital tract tuberculosis.

Our aim was to illustrate the sonographic features of tuberculous peritonitis with female genital tract tuberculosis in an attempt to facilitate the recognition of the disorder preoperatively. Transabdominal and transvaginal sonographic features and the findings from laparotomy/laparoscopy, endometrial biopsy and microbiology were reviewed and compared in 15 patients with tuberculous peritonitis with female genital tract tuberculosis. Of the 15 patients, 12 had wet tuberculosis and three had dry (adhesive) tuberculosis. Sonographic features of wet tuberculosis were categorized as follows: septated ascites (ten patients), particulate ascites (two patients), loculated fluid (two patients), thickened peritoneum (eight patients), thickened omentum (eight patients), adnexal mass (11 patients), adhesions (seven patients) and endometrial involvement (five patients). Adnexal masses, adhesions and loculated fluid were found to be present in the dry type. When sonographic findings were compared with those of laparotomy and/or laparoscopy and/or endometrial biopsy, ultrasound was able to identify aspects of tuberculosis infection as follows: ascites/loculated fluid, 13/13 (100%); adnexal mass, 12/13 (93%); peritoneal thickening, 9/13 (69%); omental thickening, 8/13 (61%); and endometrial involvement, 5/6 (83%). We conclude that awareness of the sonographic changes associated with tuberculosis infection may improve diagnostic accuracy, and avoid clinical mismanagement and surgical explorations in the wet type of tuberculosis.