Immediate prepectoral breast reconstruction in nipple-sparing mastectomy with Wise-pattern incision in large and ptotic breasts: Our experience and short-term results.

INTRODUCTION: Current breast cancer treatment trends advocate nipple-sparing mastectomy (NSM) as the preferred technique for selected patients. A considerable and ptotic breast is often considered a relative contraindication for NSM due to the increased risk of skin and nipple necrosis. METHODS: A retrospective review was performed for patients who underwent immediate prepectoral breast reconstruction (PPBR) after NSM with Wise-pattern incision between February 2020 and February 2023 at our institution. This procedure was offered to patients with grade II or III ptosis or large breasts eligible for NSM for therapeutic or prophylactic purpose. Exclusion criteria comprised a preoperative nipple-sternal notch distance greater than 30 cm, previous radiotherapy, pinch test <1 cm, body mass index (BMI) greater than 34 and active smoke. We present our short-term results with this technique. RESULTS: During the study period, 62 patients (76 breasts) had NSM with Wise-pattern incision. Patients had immediate PPBR with implant or tissue expander, both entirely wrapped with ADM. The median age of the patients was 57.0 years [The Interquartile Range (IQR 50.0-68.6)] with a median BMI of 25.5 (IQR 23.3-28.4). The median mastectomy specimen weight was 472 g (341-578). Median implant volume was 465 g (IQR 370-515). Major complications occurred in 8 patients (10.5%). Three patients experienced total nipple-areolar complex (NAC) necrosis (3.9%), and partial NAC necrosis occurred in 2 patients (2.6%). Two patients developed implant infection (2.6%). Univariate analysis showed a statistically significant correlation between major complications and the mastectomy specimen weight (p = 0.003). CONCLUSION: If oncologically indicated, NSM with Wise-pattern incision and immediate PPBR can safely be performed in selected patients with large and ptotic breasts.

Carotenoids from persimmon juice processing.

The aim of this study was the use and revalorization of two persimmon by-products A and B generated in the juice production process. The by-product B resulting from a pectinase enzymatic treatment of peels and pulp to optimize juice extraction was especially suitable for recovery of valuable bioactive carotenoids. The extraction solvents and solvent combinations used were: ethanol, acetone, ethanol/acetone (50:50 v/v) and ethanol/acetone/hexane (25:25:50 v/v/v). HPLC-DAD analysis detected and identified a total of nine individual carotenoids namely violaxanthin, neoxanthin, antheraxanthin, lutein, zeaxanthin, ß-cryptoxanthin 5,6-epoxide, ß-cryptoxanthin, α-carotene, and ß-carotene. ß-cryptoxanthin and ß-carotene represented 49.2% and 13.2% of the total carotenoid content (TCC) in the acetone extract from by-product B. TCC contributed greatly to antioxidant activity of acetone extract derived from this by-product. Pectinase enzymatic treatment of persimmon peels and pulp followed by absolute acetone extraction of carotenoids could be an efficient method to obtain a rich extract in these compounds that could be used as nutraceutical ingredient.

Functional characteristics of the growth factor receptor family and some ligands in the oropharyngeal cavity of the Chukar partridge (Alectoris chukar).

1. The aim of the present study is to describe, immunohistochemically, the expression and cell type localisation of growth factor receptors and some of their ligands in the oropharyngeal organs of the Chukar partridge. 2. The tissue samples from 10 healthy adult partridges were dissected under ether anaesthesia and then embedded in paraffin following routine histological procedures. The immunoreaction for receptors and ligands of the epidermal growth factor receptor (EGFR)/ligand system was localised in the cell membrane, nucleus and cytoplasm of the luminal and glandular epithelial cells, stromal and striated muscle cells, and vascular endothelial and smooth muscle cells. 3. Variations were observed in the avian oropharyngeal organs. The immunostaining for the erbB1/HER1 (human epidermal growth factor receptor 1) and the EGF (epidermal growth factor) and AREG (Amphiregulin) ligands in the luminal epithelial cells was higher than in the glandular epithelial, stromal and striated muscle cells. However, the immunostaining for erbB3/HER3 (human epidermal growth factor receptor 3) and erbB4/HER4 (human epidermal growth factor receptor 4) were similar in the luminal epithelium, stromal and striated muscle cells. 4. Growth factor receptors and some of their ligands were localised in different cell types in the oropharyngeal organs. We suggest that erbB/HERs (human epidermal growth factor receptors) and their ligands play an important role in proliferation, differentiation, growth, survival and migration of the cells.

Effect of fermentation and subsequent pasteurization processes on amino acids composition of orange juice.

The fermentation of fruit produces significant changes in their nutritional composition. An orange beverage has been obtained from the controlled alcoholic fermentation and thermal pasteurization of orange juice. A study was performed to determine the influence of both processes on its amino acid profile. UHPLC-QqQ-MS/MS was used for the first time for analysis of orange juice samples. Out of 29 amino acids and derivatives identified, eight (ethanolamine, ornithine, phosphoethanolamine, α-amino-n-butyric acid, hydroxyproline, methylhistidine, citrulline, and cystathionine) have not previously been detected in orange juice. The amino acid profile of the orange juice was not modified by its processing, but total amino acid content of the juice (8194 mg/L) was significantly increased at 9 days of fermentation (13,324 mg/L). Although the pasteurization process produced partial amino acid degradation, the total amino acid content was higher in the final product (9265 mg/L) than in the original juice, enhancing its nutritional value.

Alcoholic fermentation induces melatonin synthesis in orange juice.

Melatonin (N-acetyl-5-methoxytryptamine) is a molecule implicated in multiple biological functions. Its level decreases with age, and the intake of foods rich in melatonin has been considered an exogenous source of this important agent. Orange is a natural source of melatonin. Melatonin synthesis occurs during alcoholic fermentation of grapes, malt and pomegranate. The amino acid tryptophan is the precursor of all 5-methoxytryptamines. Indeed, melatonin appears in a shorter time in wines when tryptophan is added before fermentation. The aim of the study was to measure melatonin content during alcoholic fermentation of orange juice and to evaluate the role of the precursor tryptophan. Identification and quantification of melatonin during the alcoholic fermentation of orange juice was carried out by UHPLC-QqQ-MS/MS. Melatonin significantly increased throughout fermentation from day 0 (3.15 ng/mL) until day 15 (21.80 ng/mL) reaching larger amounts with respect to other foods. Melatonin isomer was also analysed, but its content remained stable ranging from 11.59 to 14.18 ng/mL. The enhancement of melatonin occurred mainly in the soluble fraction. Tryptophan levels significantly dropped from 13.80 mg/L (day 0) up to 3.19 mg/L (day 15) during fermentation. Melatonin was inversely and significantly correlated with tryptophan (r = 0.907). Therefore, the enhancement in melatonin could be due to both the occurrence of tryptophan and the new synthesis by yeast. In summary, the enhancement of melatonin in novel fermented orange beverage would improve the health benefits of orange juice by increasing this bioactive compound.

Validation of a dutch self-efficacy scale for adherence to fluid allowance among patients on haemodialysis.

Many haemodialysis patients have problems limiting their fluid intake, and this might be influenced by their self-efficacy. Thus interventions to improve patients' self-efficacy might lead to an improvement in their adherence to fluid restriction. The fluid intake appraisal inventory (FIAI) evaluates patients' self-efficacy with regard to fluid intake. The aim of this study was to translate and validate the FIAI for use in the Netherlands. Four translators, seven experts, and four haemodialysis patients participated in the translation part of the study. Thirty-three patients from one dialysis centre in the Netherlands completed the Dutch FIAI. The instrument had good content validity (interdialytic weight gain was found to be negatively correlated with self-efficacy), internal consistency (Cronbach's alpha = 0.982), and stability (Spearman's rho = 0.823). These findings indicate that the Dutch FIAI can be used in clinical practice as a self-efficacy screening instrument for adult haemodialysis patients on fluid restriction.

Two methods to determine the prevalence of overweight and obesity in 8-9 year-old-children in Seville, Spain.

OBJECTIVE: The prevalence of overweight and obesity in Spanish children has increased considerably in the last decades. Obesity has been recognized as a public health problem in developed countries because its association with increased risk for several pathologies. Obesity in children and, specifically, in adolescents, is a major concern. Actually, in Spain, the prevalence rates of childhood overweight and obesity are among the highest in European countries. The objective of this study was to measure the prevalence of overweight and obesity in children from Seville. METHOD: A cross-sectional study was performed on 990 children, aged 8-9 years old (51.5% 8-year old and 48.5% 9-year old). Overweight and obesity were defined according to two methods: Spanish standards, applying the criterion of BMI-specific percentiles for age and sex, and the international standards established by Cole et al. (IOTF). RESULTS: A high prevalence of overweight (11%) and obesity (22%) was observed. The prevalence of obesity as well as the prevalence of overall excess weight was significantly higher in 9-year old children (28% and 41%, respectively) than in 8-year old children (17% and 27%, respectively). CONCLUSION: The prevalence of overweight and obesity among Sevillian school children is high, and increases in the studied range of age.

Two methods to determine the prevalence of overweight and obesity in 8-9 year-old-children in Seville, Spain / Dos métodos para determinar la prevalencia de sobrepeso y obesidad en niños de 8 a 9 años de Sevilla, España

Objective: The prevalence of overweight and obesity in Spanish children has increased considerably in the last decades. Obesity has been recognized as a public health problem in developed countries because its association with increased risk for several pathologies. Obesity in children and, specifically, in adolescents, is a major concern. Actually, in Spain, the prevalence rates of childhood overweight and obesity are among the highest in European countries. The objective of this study was to measure the prevalence of overweight and obesity in children from Seville. Method: A cross-sectional study was performed on 990 children, aged 8-9 years old (51.5% 8-year old and 48.5% 9-year old). Overweight and obesity were defined according to two methods: Spanish standards, applying the criterion of BMI-specific percentiles for age and sex, and the international standards established by Cole et al. (IOTF). Results: A high prevalence of overweight (11%) and obesity (22%) was observed. The prevalence of obesity as well as the prevalence of overall excess weight was significantly higher in 9-year old children (28% and 41%, respectively) than in 8-year old children (17% and 27%, respectively). Conclusion: The prevalence of overweight and obesity among Sevillian school children is high, and increases in the studied range of age (AU)

Objetivo: La prevalencia de sobrepeso y obesidad infantil ha aumentado durante las últimas décadas en España. La obesidad se ha convertido en un problema de salud pública en los países desarrollados por su influencia en el aumento del riesgo de padecer ciertos tipos de enfermedades. Este problema se manifiesta especialmente en escolares y adolescentes. En España, este aumento de la prevalencia de sobrepeso y obesidad infantil le ha hecho llegar a ocupar una de las primeras posiciones en las tasas de sobrepeso y obesidad europeas. El objetivo de este estudio es determinar la prevalencia de sobrepeso y obesidad en niños sevillanos. Método: Se realizó un estudio epidemiológico transversal en 990 niños de edades comprendidas entre 8 y 9 años (51,5% de 8 años y 48,5% de 9 años). Se definió el sobrepeso y la obesidad según dos métodos: los estándares españoles, usando como criterio los puntos de corte del IMC correspondientes a percentiles específicos por edad y sexo, y los estándares internacionales establecidos por Cole y cols. (IOTF). Resultados: Se ha observado una prevalencia alta de sobrepeso (11%) y obesidad (22%). Tanto la prevalencia de obesidad como de la carga ponderal total han sido significativamente superiores en niños de 9 años (28% y 41%, respectivamente) que en niños de 8 años de edad (17% y 27%, respectivamente). Conclusiones: La prevalencia de sobrepeso y obesidad en niños escolares de una población de Sevilla es alta, y aumenta especialmente en el rango de edad estudiado (AU)

Categorical and dimensional study of the predictive factors of the development of a psychotrauma in victims of car accidents.

OBJECTIVE: This study aimed to evaluate the predictive factors of the emergence of complete PTSD and subsyndromal PTSD (defined as individuals exposed to a traumatic event with at least one psychopathological impact, such as hyperarousal, avoidance or persistent re-experiencing) following a motor vehicle accident (MVA). METHODS: We recruited 155 adult MVA patients, physically injured and admitted to trauma service, over two years. In the week following the accident, patients were asked to complete questionnaires assessing their social situation (sex, age, marital and employment status, prior MVA or trauma), comorbidity (MINI), distress (PDI) and dissociation (PDEQ) experienced during and immediately after the trauma. An evaluation using the CAPS was conducted six months after the trauma to assess a possible PTSD. RESULTS: At six months, 25.8% of the participants developed subsyndromal symptoms and 7.74% developed complete PTSD. The three symptoms that best discriminated the groups were dysphoric emotion, perceived life threat and dissociation. Logistic regression results showed that the strongest predictor of PTSD was the perceived life threat. In addition, a dimensional approach to the results revealed significant correlations between (1) peritraumatic distress and persistent re-experiencing or hyperarousal and (2) dissociation score and avoidance strategy. The presence of a prior traumatic event reinforces avoidance strategies. CONCLUSIONS: Our results stress that peritraumatic factors (especially the perception of a life threat) are good predictors of PTSD development. A dimensional perspective allows better identification of psychological complications following an MVA.

The effect of self-efficacy on cardiovascular lifestyle.

BACKGROUND: It is important that patients with vascular diseases adopt a healthy lifestyle so as to reduce vascular risk. Since self-efficacy is an important precondition for health behavior change in patients with chronic disease, we investigated whether self-efficacy was associated with cardiovascular lifestyle in patients with clinical manifestations of vascular diseases. METHODS AND DESIGN: In this observational cohort study, 125 patients who had recently been referred for cerebrovascular disease, coronary heart disease, or peripheral arterial disease participated in a 1-year self-management intervention. They completed a self-efficacy questionnaire and questions about their cardiovascular lifestyle at baseline and after 1 year. Logistic regression analyses were performed to quantify the impact of change in self-efficacy on physical activity, smoking behavior, alcohol consumption, and food choices. RESULTS: Improved self-efficacy was associated with improved adherence to guidelines for physical activity (OR 3.5, 95%CI 1.0-11.0) and food choices (B 0.15, 95%CI 0.00-0.31). No such improvement was seen regarding adherence to guidelines for smoking or alcohol intake. CONCLUSION: In patients with vascular diseases, improvements in self-efficacy are associated with an improvement in cardiovascular lifestyle, namely, more exercise and better food choices.

Surfactant protein B and RAGE increases in the plasma during cardiopulmonary bypass: a pilot study.

Surfactant derived protein B (SPB) and plasma receptor for advanced glycation end products (RAGE) have been proposed as markers of lung injury. The former is produced specifically by pneumocytes while RAGE production is present in several body tissues. Cardiopulmonary bypass (CPB) generates a transient lung injury. We measured SPB and RAGE in plasma before surgery and after CPB, as well as 24 h and 48 h later. We analysed plasma samples from 20 subjects scheduled for elective coronary artery bypass grafting. We performed a quantitative analysis of plasma levels of RAGE and SPB mature form (8 kDa) by ELISA and a semi-quantitative analysis of SPB immature form (~ 40 kDa) by Western blotting. Surgery procedures were uneventful. After CPB RAGE median (75th-25th interquartile difference) increased from 633 (539) pg·mL⁻¹ to 1,362 (557) pg·mL⁻¹ (p < 0.01), while mature SPB increased from 5,587 (3,089) ng·mL⁻¹ to 20,307 (19,873) ng·mL⁻¹ (p < 0.01). RAGE and mature SPB returned to normal values within 48 h. This behaviour was confirmed when RAGE and SPB were normalised for protein content. Parallel changes were observed for immature SPB. Plasma RAGE and SPBs are sensitive and rapid markers of lung distress.

The effect of a self-management intervention to reduce vascular risk factors in patients with manifestations of vascular diseases.

BACKGROUND: Self-management can improve health behaviors and influence reduction of vascular risk. We developed a 1-year self-management intervention and investigated its effect on vascular risk factors and quality of life in patients with different vascular diseases. DESIGN AND METHODS: This observational cohort study involved 223 patients (self-management group, n=125; usual care group n=98) with at least two modifiable vascular risk factors. RESULTS: Patients in the self-management group achieved treatment goals for LDL-cholesterol (difference 13%; 95%CI 1-26) and HDL-cholesterol (difference 9% 95%CI 0-19) significantly more often than did patients in the usual care group. Mean systolic blood pressure decreased significantly by 5mm Hg (95%CI -9 to 0) in the self-management group and mean BMI increased significantly by 0.4 kg/m(2) (95%CI -0.8 to -0.1) in the usual care group. No significant differences were seen in waist circumference, smoking, or triglycerides. General health (RAND36) improved more in the self-management group (by 8 points 95%CI 3-12) than in the usual care group. CONCLUSION: After 1 year, the self-management intervention was more effective than usual care on several important vascular risk factors in patients with vascular diseases. PRACTICE IMPLICATIONS: This self-management intervention used in a hospital population may be applicable in different care settings.

Social support and change in vascular risk factors in patients with clinical manifestations of vascular diseases.

BACKGROUND AND AIMS: Vascular risk can be reduced by adequate medical treatment of vascular risk factors and by adopting a healthy lifestyle, a behavioral change that is influenced by social support. We investigated whether social support is associated with change in vascular risk factors in patients with vascular diseases during 1 year. METHODS: 140 patients who had 2 modifiable vascular risk factors participated. Social support was measured with a questionnaire about the patient's perception of active involvement, protective buffering, and overprotection. RESULTS: Most types of social support were not associated with a change in vascular risk factors over 1 year. Having a partner was associated with a reduction in BMI of 1.4 kg/m2 (95%CI -2.2 to -0.5), less protective buffering was associated with a decrease in blood glucose of 0.47 mmol/l (95%CI 0.09-0.84), and less active involvement was associated with an increase in BMI of 0.42 kg/m2) (95%CI 0.05-0.78). CONCLUSION: Having a partner and active involvement are only associated with a decrease in BMI but not with changes in other vascular risk factors. Protective buffering is only associated with blood glucose whereas overprotection is not associated with changes in vascular risk factors.

The role of self-efficacy in vascular risk factor management: a randomized controlled trial.

OBJECTIVE: Given the large number of patients at high risk of vascular events, new strategies are needed to reduce vascular risk. We investigated whether self-efficacy promotion could change self-efficacy levels in patients with vascular diseases and whether baseline self-efficacy and changes in self-efficacy were related to changes in vascular risk factors. METHODS: One hundred fifty-three recently referred patients with symptomatic vascular diseases (cerebrovascular, abdominal, or peripheral arterial) participated in a randomized trial investigating the effect of nursing care, as compared with usual care, on vascular risk factors. Nursing care consisted of self-efficacy promotion and medical treatment of vascular risk factors. Self-efficacy and vascular risk factors (smoking, BMI, waist, blood pressure, lipid, and glucose levels) were measured at baseline and after 1 year. RESULTS: While total self-efficacy did not change over the 1-year intervention period in either treatment group, self-efficacy in choosing healthy food (mean +0.4+/-1.4, p-value 0.01) and in doing extra exercise (mean +0.3+/-1.3, p-value 0.03) increased in the intervention group. No relation was seen between baseline total self-efficacy or change in composite self-efficacy and change in vascular risk factors. CONCLUSION: The nursing intervention did not influence total self-efficacy but did improve self-efficacy in choosing healthy food and doing extra exercise. Change in composite self-efficacy was not related to change in vascular risk factors in patients at high risk of developing (new) cardiovascular diseases. PRACTICE IMPLICATIONS: Influencing self-efficacy in choosing healthy food and doing extra exercise could be incorporated in vascular risk reduction programs in addition to medical treatment of vascular risk factors.

Effect of ovariectomy and female sex hormones administration upon gastric ulceration induced by cold and immobility restraint stress.

OBJECTIVE: To investigate the protective effects of estrogen and progesterone administrations on gastric mucosal barrier of rats applied ovariectomy, cold and immobility stress. METHODS: Seventy female Wistar rats, obtained from Medical Science Application and Research Center, Dicle University, Turkey on the year 2004, were divided into 10 separate groups (n=7). Nothing was applied to the animals of Group 1 (control); bilateral ovariectomy was performed on the animals of the Groups 2, 4, 5, 6, 7, 8, 9, and 10. Groups 5 and 6 was applied 5 mg/kg 17beta-estradiol and groups 7 and 8 was applied 10 mg/kg progesterone for 7 days. The animals in the Groups 9 and 10 were applied 2.5 mg/kg 17beta-estradiol and 5 mg/kg progesterone during 7 days. The animals in the groups 3, 4, 6, 8 and 10 were exposed to cold and immobility stress for 4 hours at 4degrees celsius. RESULTS: The levels of mucus and phospholipids were decreased in the rats applied ovariectomy and stress as compared to the control groups (p<0.001). The increase determined the mucus and phospholipids levels in estrogen and progesterone administered rats as compared to stress applied group (p<0.001). While the cold and immobility stress causes important damages in gastric mucosa, estrogen and progesterone administrations has protective effects in ovariectomized rats. CONCLUSION: The estrogen and progesterone administration prevents the stress that caused decrease in the levels of mucus and phospholipids, thus females are more resistant to gastric ulcer rather than males due to their sex hormones.

[Acute febrile disease with splenomegaly and pancytopenia. A 66-year-old Greek patient with a prosthetic mitral valve]. / Akute fieberhafte Erkrankung mit Splenomegalie und Panzytopenie. 66-jähriger griechischer Patient mit Mitralklappenprothese.

We report on a 66-year-old patient originating from Greece and living in Germany with a prosthetic mitral valve because of a combined vitium following juvenile rheumatic fever. The patient fell ill with acute fever, splenomegaly, and pancytopenia. After unsuccessful antibiotic therapy because of presumed endocarditis or sepsis with unknown focus, visceral leishmaniasis was suspected because of recent travel to Greece. Subsequently, this diagnosis was confirmed by serology. Considering thrombocytopenia and concurrent anticoagulation after prosthetic mitral valve replacement, we avoided a bone marrow biopsy usually required for definite proof of leishmania infection. Instead, infection with Leishmania infantum was diagnosed by PCR of a peripheral blood sample. After treatment with liposomal amphotericin B the patient recovered fully.

A randomized, controlled trial for risk factor reduction in patients with symptomatic vascular disease: the multidisciplinary Vascular Prevention by Nurses Study (VENUS).

BACKGROUND: Patients with manifest vascular disease are at high risk of a new vascular event or death. Modification of classical risk factors is often not successful. We determined whether the extra care of a nurse practitioner could be beneficial to the cardiovascular risk profile of high-risk patients. DESIGN: We conducted a randomized, controlled trial based on the Zelen design. METHODS: Two hundred and thirty-six patients with manifestations of a vascular disease and who had two or more modifiable vascular risk factors were pre-randomized to receive treatment by a nurse practitioner plus usual care or usual care alone. After 1 year, risk factors were remeasured. The primary endpoint was achievement of treatment goals for blood pressure, lipid, glucose and homocysteine levels, body mass index, and smoking. RESULTS: Of the pre-randomized patients, 95 of 119 (80%) in the intervention group and 80 of 117 (68%) in the control group participated in the study. After a mean follow-up of 14 months, the patients in the intervention group achieved significantly more treatment goals than did the patients in the control group (systolic blood pressure 63 versus 37%, total cholesterol 79 versus 61%, low density lipoprotein-cholesterol 88 versus 67%, and body mass index 38 versus 24%). Medication use was increased in both groups and no differences were found in patients' quality of life (SF-36) at follow-up. CONCLUSION: Treatment delivered by nurse practitioners, in addition to a vascular risk factor screening and prevention program, resulted in a better management of vascular risk factors than usual care alone in vascular patients after 1-year follow-up.

The comparative investigation of left ventricle papillary muscle arteries in different species.

OBJECTIVE: To determine whether similar histologic findings exist in left ventricle papillary muscle arteries in different species and to elicit whether those animal hearts may be used as models for human heart in experimental studies related to papillary muscles. METHODS: We examined 360 samples taken from the tip, mid-portion and base of papillary muscles in 60 normal adult hearts (15 each from human, dog, sheep, goat). The samples were obtained from Dicle University and Kahramanmaras Sutcu Imam University, Turkey and the study was conducted in June-September 2004. Tissues were processed by routine histologic methods, stained with hematoxylin-eosin and van giesson, and later evaluated under a light microscope. RESULTS: While the values of human and dog heart resembled each other by means of left ventricle papillary muscle arteries, the hearts of sheep and goat were also found to be similar. The number of thin walled arteries increased from the tip (18%) to the base (48%), intermediate walled arteries decreased from the tip (56%) to the base (14%), thick walled arteries decreased from the tip (62%) to the mid-portion (38%). The differences among human and animals were not statistically significant in any group. We found that the thickness values of papillary muscle arterial walls at the tip, mid-portion and base varied from 4.86 microm to 107.7 microm in all species. The difference among values of human and animals was not significant statistically (p>0.05). CONCLUSION: The values for arterial walls of tip, mid-portion and base of papillary muscles were similar between human and dog, sheep and goat. These morphologic findings in human and animal hearts of different species prove that anatomists, cardiologists, experimental investigators, pathologists and physiologists may benefit from the hearts of those animals as a good model to imitate the human heart in experiments concerning papillary muscles.

Self-efficacy in patients with clinical manifestations of vascular diseases.

OBJECTIVE: Patients with established cardiovascular disease are at high risk of developing new vascular events or death. This risk can be reduced by lifelong treatment of risk factors and by permanent changes in lifestyle. Self-efficacy is important for achieving behavior change by self-management. The self-efficacy of different vascular risk factors subgroups in patients with clinical manifestations of atherosclerotic vascular diseases was investigated. METHODS: From January 2001 to September 2003, 192 patients with recently established clinically manifest atherosclerotic disease with > or = 2 modifiable vascular risk factors were selected for the study. The mean self-efficacy scores were calculated for vascular risk factors (age, sex, vascular disease, weight, diabetes mellitus, smoking behavior, hypercholesterolemia, hypertension, and hyperhomocysteinemia). RESULTS: Diabetes, overweight, and smoking, but none of the other risk factors, were significantly associated with the level of self-efficacy in these patients. CONCLUSIONS: Patients with vascular diseases appear to have high levels of self-efficacy regarding medication use, exercise, and controlling weight. In patients with diabetes, overweight, and in smokers, self-efficacy levels were lower. PRACTICE IMPLICATIONS: In nursing care and research on developing self-efficacy based interventions, lower self-efficacy levels can be taken into account for specific vascular patient groups.

Influence of ovariectomy and flutamide treatment on vaginal tissue and body weight.

OBJECTIVE: To determine the effect of flutamide on vaginal histology, and to ascertain whether flutamide regulates body weight gain in the ovariectomized rat model. METHODS: We chose 36 sexually mature female Wistar-Albino rats in this study. The study took placed in the Department of Medical Science Application and Research Center of Dicle University, Diyarbakir, Turkey, in 2002. We divided the model rats into 3 groups: group 1--control group, group 2--sham-operated group and group 3--bilaterally ovariectomized group. In addition, we gave flutamide to group 3. RESULTS: We found that the body weight was higher in the ovariectomized rats than the control rats. Furthermore, the body weight decreased a little after flutamide therapy. The thickness in the vaginal epithelium of the control group decreased, moreover, the appearance of stromal tissue was rather loose. After flutamide applications, infiltration of the stromal cells increased, the vaginal epithelial layer thickened and became keratinized. Microscopic papillae and anatomical processes appeared in the flutamide treated group. CONCLUSION: We observed that the antiandrogen drug flutamide is hormonally active and may exhibit estrogenic-antiestrogenic activity in rats. Our study may be a source for further research examining the relationship between the androgen receptor antagonist flutamide and reproductive function in female rats.