ABSTRACT
<B>Objectives:</B> In developing countries, measuring household income is difficult. The Wealth Index is an alternative to household income; however, it contains too many items making its use in a healt-related study difficult. Thus, we developed a shorter version of the index appropriate for rural areas in Cambodia and analyzed the relationship between economic status and maternal health knowledge and behavior using the index.<BR><B>Methods:</B> We conducted the study in four health center areas in Kampong Cham Province. We administered structured questionnaires to 640 women who had delivered babies within a year prior to the study. The development of the Cambodian Wealth Index-Rural version (CWI-R) followed the procedures of the Demographic and Health Survey (DHS) Wealth Index. Out of 69 items in the Cambodian DHS, we selected 18 items by assessing the distribution and correlation between the items and then performed principal component analysis. Those items that had principal component scores (PCS) below 0.4 were removed. As a result, we created an 11-item wealth index weighted by PCS; Cronbach’s <I>α</I> was 0.81. We tabulated economic status using quintiles and calculated health behavior and the women’s healt-related knowledge for each quintile.<BR><B>Results:</B> The mean age (SD) of the women was 27.0 (6.4) years. The rate of antenatal and postnatal care and skilled birth attendant increased as economic status improved. Knowledge of risk factors during pregnancy and delivery varied according to item. For prolonged labor and edema, knowledge increased as economic status improved; however, we observed no significant differences for vaginal bleeding. More women who had a higher economic status knew the benefits of Vitamin A and the causes of intestinal parasitic infections.<BR><B>Conclusion:</B> The pattern of maternal knowledge and behavior analyzed with the CWI-R was parallel to the original wealth index, indicating its usefulness as an alternative to the original wealth index.
ABSTRACT
Multiple endocrine neoplasia type 1 (MEN1) is an inherited autosomal dominant disease presenting with pancreatic neuroendocrine tumors (pNETs), parathyroid tumors, or pituitary tumors. Using the PubMed database, we reviewed the literature on information regarding the proper diagnosis and treatment of MEN1-associated pNET. Many cases of MEN1-associated pNET are functioning pNETs. Gastrinomas and insulinomas tend to occur frequently in the duodenum and pancreas, respectively. In addition to diagnostic imaging, the selective arterial secretagogue injection test (SASI test) is useful for localizing functioning pNET. The standard treatment is surgical resection. However, in the case of a functioning pNET, the tumor should first be accurately located using the SASI test before an appropriate surgical method is selected. In cases of a MEN1-associated non-functioning pNET that exceeds 2 cm in diameter, the incidence of distant metastasis is significantly increased, and surgery is recommended. In cases of unresectable pNET, a somatostatin analog has been shown to demonstrate antitumor effects and is considered to be a promising treatment. In addition, molecular-targeted drugs have recently been found to be effective in phase III clinical trials.