High Anxiety Levels before Elective Cesarean Section Can Negatively Affect the Mother and Fetus.

BACKGROUND: Both pregnancy and surgery cause anxiety. This situation may negatively affect the health of the mother and baby. AIM: The effect of anxiety level before cesarean section (CS) on feto-maternal outcomes was investigated. METHODS: The preoperative anxiety score was determined with the State-Trait Anxiety Inventory (STAI) in 224 pregnant women who were planned for elective CS. RESULTS: Among patients, 33.5% were in the low anxiety group, 27.2% in the moderate, and 39.3% in the high anxiety group. The average birth weight in the low anxiety group was noticeably higher than that of the high anxiety group (P = 0.018). The mean heart rate at postop 1st and 24th hour in the high anxiety group was higher than the moderate anxiety group (P < 0.028). In addition, diastolic blood pressure (DBP) at the sixth hour in the low anxiety group was found to be lower than in the moderate anxiety group (P < 0.05). CONCLUSION: According to these results, it was found that an increased anxiety score before CS is associated with low birth weight in the baby, higher heart rate, and DBP in the mother.

Association of frontal and maxillary bone fractures and concomitant craniocerebral injuries in patients presenting with head trauma.

Background: Maxillofacial fractures and craniocerebral injuries are common in patients with head trauma. These are injuries with high mortality and morbidity. Therefore, patients with head trauma should be evaluated early with a multidisciplinary approach. Aim: The association between frontal and maxillary bone fractures and concurrent craniocerebral injuries were investigated in patients presenting with head trauma in this study. The data of the patients were analyzed retrospectively. Methods and Material: Age and gender distributions were evaluated in frontal and maxillary fractures. Concomitant craniocerebral injuries were investigated. Craniocerebral injuries were grouped as pneumocephalus, extra-axial, intra-axial injuries and brain edema. Craniocerebral injuries in frontal and maxillary fractures were compared statistically. Results: Frontal bone and maxillary bone fractures were detected in 24% and 95% of the patients. Coexistence of pneumocephalus and intra-axial injuries in frontal bone fracture was statistically significant. The association of frontal posterior wall fractures with pneumocephalus and parenchymal contusion was found to be statistically significant. In addition, the association of craniocerebral injuries were evaluated and statistically significant ones were determined. Conclusion: The presence of maxillofacial fractures in patients presenting with head trauma increases mortality and morbidity. Craniocerebral injuries can be life-threatening and delay the treatment of facial fractures. Upper facial bone fractures are significantly more common in craniocerebral injuries.

Analysis of cerebellum with magnetic resonance 3D T1 sequence in individuals with chronic subjective tinnitus.

Tinnitus is a symptom in which the patient can hear ringing, buzzing and similar sounds in the ear for 3 months longer. In our study, we aimed to analyse the cerebellum volume and cerebellum connections in patients with chronic tinnitus using VolBrain program. A total number of 10 patients and 10 otherwise healthy peoples records were then enrolled. Volumetric analysis was performed with automated segmentation of the cerebellum and its lobules, using magnetic resonance imaging (MRI). The mean volumes of 10 cerebellar volume were compared between the tinnitus and control groups. Quadrangular lobular portion of the cerebellum, the flocculonodular part and the volume of the central cerebellar lobule were decreased in the tinnitus group. White and grey matter decreased and the amygdala size was increased. We found statistically important volumetric changes in our study. VolBrain can be used in the future for analysing, diagnosis and treatment tinnitus patients. We recommend to use this practical, free of charge and easy programme to analyse for tinnitus patients. This may provide us with practical and useful information about the disease. In patients with tinnitus, the volume loss was 17.48% in the quadrangular lobe, 21% in the central lobule, and 9.33% in the total cerebellum volume.

Urinary Neutrophil Gelatinase-Associated Lipocalin (NGAL) as a Marker of Diabetic Nephropathy in Type 1 Diabetic Patients.

BACKGROUND: Glomerular and tubulointerstitial damage plays a role in renal function failure in diabetic patients. While both serum and urine levels of neutrophil gelatinase-associated lipocalin (NGAL) show significantly increased levels in acute renal pathologies, the NGAL increase in active phase indicates a reversible condition in chronic cases. MATERIALS AND METHODS: 52 type 1 diabetic patients and 30 healthy volunteers participated in the study. The diabetic participants were separated into two groups as follows: a normoalbuminuria group consisting of those with an albumin/creatinine ratio less than 30 mg/g and an albuminuria group consisting of those with an albumin/ creatinine ratio equal or greater than 30 mg/g. Albumin, creatinine and NGAL were measured in all participants. RESULTS: Urinary NGAL median level was 21.1 ng/mL for diabetic patients and 11.9 ng/mL for healthy controls, and the difference between the two groups was statistically significant. When diabetic patients were compared as those with and without albuminuria, the median urinary NGAL levels of normoalbuminuria and albuminuria were 24.7 and 16.1 ng/mL, respectively, but the difference was not statistically significant. Statistically similar results were obtained through evaluation of the ratio of urinary NGAL excretion to creatinine excretion. The NGAL/Cr ratio was significantly higher in diabetic patients than in healthy controls, but no statistically significant difference was found between the diabetic patients with and without albuminuria. CONCLUSIONS: Urinary NGAL excretion in type 1 diabetic patients is found to be increased over a wide range, but it does not correlate with urinary albumin excretion. In this regard, urinary NGAL excretion should not be used as an alternative to microalbuminuria in detecting diabetic nephropathy. The greater amount of NGAL excretion among diabetic patients may be due to diabetic nephropathy with possible tubulointerstitial damage pathologies.

Protective effects of quercetin against arsenic-induced testicular damage in rats.

This study investigated the effect of quercetin on changes in testes due to arsenic exposure. Twenty-seven male rats were divided into three groups: control (10 ml kg-1  day-1 saline), arsenic (10 mg kg-1  day-1 sodium arsenite) and arsenic + quercetin (arsenic + 50 mg kg-1  day-1 quercetin). The rats were sacrificed at the end of 15-day experiment. There was no difference between control group and arsenic group in body weight gain, testicular weight and serum total testosterone level. Quercetin treatment did not cause a significant difference in these parameters. In the arsenic group rats, we determined deterioration in the structure of seminiferous tubules, a decrease in the number of spermatogenic cells, an increase in the number of apoptotic cells, a decrease in the number of PCNA-positive cells, a decrease in SOD, CAT and GSH-Px activities, and an increase in the MDA level in testicular tissue. In all these changes, arsenic+quercetin group showed an improved compared to arsenic group. The amount of arsenic increased in the arsenic group was compared to the control group, and there was no difference between arsenic group and arsenic + quercetin group in the amount of arsenic. In conclusion, quercetin prevented arsenic-induced testicular damage with its anti-apoptotic and antioxidant effects.

Protective effects of thymoquinone on experimental testicular ischaemia-reperfusion injury: an apoptotic, proliferative and biochemical study.

The objective of this study was to examine the effects of thymoquinone (TQ), which has antioxidant properties in the experimental testicular I/R model in rats in terms of its anti-apoptotic, proliferative and biochemical attributes. In our study, 24 male rats were divided into three groups: control group, I/R group and I/R+TQ group. Testicular torsion was created by rotating the left testis 720° in a clockwise direction. The ischaemia period was 4 h, and an orchiectomy was performed after 4 h of detorsion. Spermatogenesis and the mean seminiferous tubule diameter were significantly decreased in the I/R groups compared to the control group. Furthermore, TQ-treated animals displayed an improved histological appearance in the I/R group. It was also observed that treatment with TQ increased the activity of PCNA, which decreased as a result of I/R, and this treatment also reduced the number of TUNEL-positive cells. The I/R+TQ group showed a decrease in malondialdehyde levels and an increase in the activities of superoxide dismutase, catalase and glutathione peroxidase in comparison with the I/R group. It could be concluded that cytoprotective effects of TQ on the I/R testicles are via reduction of apoptosis, oxidative stress and lipid peroxidation.

Determination of normal splenic volume in relation to age, gender and body habitus: a stereological study on computed tomography.

BACKGROUND: The aim of this study is to assess and document the dimensions of the normal spleen measured on computed tomography (CT) images with the normal splenic volume measured by Cavalieri principle on CT images and thereby serve as a baseline for comparison in cases of splenomegaly using abdominal CT. To investigate the relationship between these changes and body mass index, gender, abdominal diameters. MATERIALS AND METHODS: We retrospectively reviewed abdominal CT examinations of 212 adults between the ages of 20 and 88 years. There were seven groups of patients. The spleen volume (SV) measurements using abdominal CT images of each patient on the Image Information Systems were performed with Cavalieri principle. RESULTS: The mean SV and splenic length (SL), width (SW), and thickness (ST) for the total study population of 212 patients was 198 ± 88 cm³, 9.96 ± 2.1 cm, 8.87 ±± 1.6 cm and 4.58 ± 0.8 cm, respectively. There was a strong correlation between SV and ST (r = 0.752, p < 0.001), SL (r = 0.735, p < 0.001), SW (r = 0.681,p < 0.001) mean values of total study population. Comparison between mean splenic dimension parameters for males and females showed a statistically significant difference (p = 0.032 for SV, p = 0.04 for ST) but no statistically significant difference with SL and SW. Also there was a positive correlation between SV and body height, sagittal abdominal diameter and transvers abdominal diameter in mean of total groups and female groups, there was no correlation in males. CONCLUSIONS: The normal reference ranges for SV and size given in this study canserve as a standard to judge whether splenomegaly is present in patients.

Protective effects of fish omega-3 fatty acids on doxorubicin-induced testicular apoptosis and oxidative damage in rats.

The aim of this study was to examine the protective effects of fish omega-3 (n-3) fatty acids on acute doxorubicin (DOX)-induced testicular apoptosis and oxidative damage. 24 male rats were divided into three groups: control, DOX-treated and DOX+fish n-3 fatty acids. Fish n-3 fatty acids (400 mg kg(-1) ) were given for 30 days by intragastric gavage. The rats received a single intraperitoneal injection of DOX (30 mg kg(-1) ) and were sacrificed after 48 h. The DOX+fish n-3 fatty acids group showed a decrease in malondialdehyde levels and increased activities of superoxide dismutase and glutathione peroxidase in comparison with the DOX-treated group. Acute DOX treatment caused severe damage such as disorganisation and separation of germ cells. The fish n-3 fatty acids-pretreated rats showed an improved histological appearance in the DOX-treated group. Our data indicate a reduction in the activity of terminal deoxynucleotidyl transferase mediated dUTP nick end labelling; there was a rise in the expression of proliferating cell nuclear antigen in testis tissues of the DOX+fish n-3 fatty acids group compared with DOX-treated group. These data suggested that fish n-3 fatty acids pre-treatment may be beneficial for spermatogenesis following acute DOX-induced testicular damage by decreasing germ cell apoptosis and oxidative stress.

Cardioprotective effects of fish omega-3 fatty acids on doxorubicin-induced cardiotoxicity in rats.

The aim of this study was to investigate the protective effects of fish omega-3 (n-3) fatty acids on doxorubicin (DOX)-induced acute cardiotoxicity. A total of 24 rats were divided into three groups: control, DOX-treated, and DOX treated with fish n-3 fatty acids. Control group received 0.4 ml/kg/day of saline intragastrically. The rats in the fish n-3 fatty acid-pretreated group were given 400 mg/kg/day fish n-3 fatty acids for 30 days by intragastric intubation. To induce acute cardiotoxicity, DOX (30 mg/kg) was injected intraperitoneally by a single dose and the rats were killed after 48 h. DOX treatment caused severe damage in heart tissues. Disorganization of myocardial muscle fibers, myofibrillar loss, and cardiotoxic myocardial fibers with cytoplasmic vacuoles were seen. Fish n-3 fatty acid-treated rats showed an improved histological appearance in the DOX-treated group. Our data indicate a significant reduction in the activity of terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling in cardiomyocytes of the DOX-treated group with fish n-3 fatty acids therapy. The DOX-treated with fish n-3 fatty acids group showed a significant decrease in malondialdehyde levels, and an increase in superoxide dismutase and glutathione peroxidase activities in comparison with the DOX-treated group. This study showed that fish n-3 fatty acids may be a suitable cardioprotector against acute toxic effects of DOX.

Effects of quercetin and fish n-3 fatty acids on testicular injury induced by ethanol in rats.

The aim of this study was to investigate the effects of quercetin and fish n-3 fatty acids on the changes in testis induced by ethanol. Forty-five rats divided into five groups, control, ethanol, ethanol+quercetin, ethanol+fish n-3 fatty acids and ethanol+quercetin+fish n-3 fatty acids. At the end of 8 weeks, all the rats were sacrificed. Degenerative changes in histopathological analyses, the decreased body weight gain and seminiferous tubule diameters in ethanol group have been observed. TUNEL assay also showed an increase in apoptotic cell number. The activities of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px), xanthine oxidase (XO) and testosterone levels were decreased as well as the levels of malondialdehyde (MDA) and nitric oxide (NO) were increased in ethanol group. Histopathological changes caused by ethanol have been improved by quercetin and fish n-3 fatty acids. It was also found that protection was provided by increasing SOD, CAT and GSH-Px activities in groups administered quercetin, fish n-3 fatty acids and quercetin+fish n-3 fatty acids, and by decreasing the levels of MDA and NO in groups administered both quercetin and fish n-3 fatty acids together. These results suggest that quercetin and fish n-3 fatty acids are beneficial agents to reduce testicular injury induced by ethanol except for testosterone levels.

Endovenous laser ablation treatment with 980 nm diode laser for saphenous vein insufficiency: 6 months follow up results.

OBJECTIVE: Superficial venous insufficiency is a common problem associated with varicose veins which, if untreated, may progress to venous ulceration. Endovenous laser ablation (EVLA) is a new, minimally invasive method for management of superficial venous insufficiency and varicose veins. The aim of this study was to demonstrate the effectiveness of 980 nm EVLA for treatment of symptomatic saphenous venous insufficiency and to present its early outcomes. METHODS: Thirty-eight great saphenous veins and 5 small saphenous veins in 40 patients with saphenofemoral reflux were treated with 980 nm diode endovenous laser equipment. The diameter and length of the vein treated, total laser energy and energy density (Joules/cm) delivered were recorded. To determine the severity of the venous disease Venous Clinical Severity Score (VCSS) and Visual Analogue Scale (VAS) were used. Patients were followed up for 6 months after the procedure. Complications were recorded prospectively. RESULTS: Forty-three saphenous veins in 40 patients were treated. The mean age of the patients was 39.9 (range 21-72) years. The mean diameter and length of the veins were 4.9 mm (range, 3.5 to 8.5 mm) and 30.2 cm (range, 16 to 50 cm), respectively. At 6 months follow-up, total occlusion rate was 95.4% (41/43), and recanalization rate was 4.6%. Significant decrease was observed for VCSS and VAS scores after the procedure. No major complication was detected. CONCLUSION: EVLA treatment for superficial venous insufficiency is safe and can be carried out under local anaesthesia in an outpatient setting with good patient satisfaction and low complication rates.

CDC25B, Ki-67, and p53 expressions in reactive gliosis and astrocytomas.

PURPOSE: To investigate the expression of CDC25B, which is a member of the cyclin-dependent kinase activating phosphatase family, in diffuse astrocytoma (DA), anaplastic astrocytoma (AA), glioblastoma multiforme (GBM), pilocytic astrocytoma (PA) and reactive gliosis (RG). Also, to study the relationship of the expression level of CDC25B with clinical parameters and with p53 and Ki-67 proliferation index (PI). METHODS: Tissues were collected from 36 cases diagnosed with astrocytoma (10 DA, 6 AA, 20 GBM), 10 PA, 10 RG and 10 normal brain tissues for controlling purposes. The sections were immunohistochemically stained with CDC25B, Ki-67 and p53. For each marker, 1000 tumor cells were counted and the ratio of positive tumor cells was calculated. RESULTS: The average CDC2B staining index (CSI) was 0.6% in PA, 0.4% in DA , 7.7% in AA and 25.5% in GBM. The increase of CSI in parallel with the increase of WHO grade was significant (p=0.001). No expressions were identified in RG and normal brain. There was also significant relationship between the tumor size and CSI (p=0.027) and also between Ki-67 PI and CSI (p=0.001). Among the groups with low and high CSI in astrocytoma cases, the disease free survival (DFS) was significantly higher in the low CSI group (p=0.0001). CONCLUSIONS: Positive expression of CDC25B in astrocytoma affects the prognosis in an adverse manner. CSI can be used as a diagnostic method and CDC25B may be a possible target molecule for treatment.

Vertical vs. transverse sections of scalp biopsy specimens: a pilot study on the comparison of the diagnostic value of two techniques in alopecia.

BACKGROUND: Using both vertical and transverse sections is preferred for histopathological diagnosis of alopecia. However, in cases in which only a single biopsy is taken, it is not clear which type of sectioning is better. AIM: To compare the diagnostic value of transverse and vertical sections. METHODS: In total, 53 patients with alopecia were enrolled in the study. Two biopsies were taken from each patient, and cut into either transverse or vertical sections. The clinical and histopathological findings were evaluated together for the definitive diagnosis. After the study period, a pathologist randomly re-evaluated the sections. We compared the histopathological diagnoses with the definitive diagnoses, and determined the sensitivity and specificity of each method. RESULTS: A definitive diagnosis was made for 47 patients (88.7%). Of these, 30 (63.8%) had noncicatricial and 17 (36.2%) had cicatricial alopecia, and the diagnosis was made by transverse and vertical sections for 43 (91.5%) and 39 (88%), respectively (P > 0.05; sensitivity; 91.5% vs. 82%). All 30 patients with noncicatricial alopecia were diagnosed by transverse sections, and 25 (83.3%) of the 30 were diagnosed with vertical sections (P = 0.05; sensitivity 100% vs. 83.3%). Of the 17 patients with cicatricial alopecia, 13 (76.5%) and 14 (82.4%) patients were diagnosed by transverse and vertical sections, respectively (P > 0.05; sensitivity 76.5% vs. 82.4%). Five patients with lichen planopilaris were diagnosed by vertical sections, and one by transverse sections. There were several limitations to the study: (i) statistical subtype analysis could be performed only for alopecia areata; (ii) no conclusion could be drawn about the interobserver reliability of two sections; and (iii) having the pathologist-blinded study performed retrospectively might have caused a recall bias. CONCLUSION: If only a single biopsy specimen is available, it may be preferable to have transverse sections in cases of suspected noncicatricial alopecia, and vertical sections in cases of suspected lichen planopilaris. Either type of sectioning is suitable for cicatricial alopecia when lichen planopilaris is clinically unlikely.

The diet of Clinitrachus argentatus (Blennioidei: Clinidae) in the northern Aegean and Marmara Seas.

Differences in the diet composition of small (28-42 mm total length, L(T)) and large (43-75 mm L(T)) individuals of the cline Clinitrachus argentatus (Clinidae) were evident. Smaller individuals preyed mainly on copepods, whereas larger individuals ate mainly amphipods, isopods, brachyurans and polychaetes.

An analysis of nursing and medical students' attitudes towards and knowledge of complementary and alternative medicine (CAM).

AIMS AND OBJECTIVES: This study aims to evaluate and compare nursing and medical students' attitudes and knowledge about complementary and alternative medicine (CAM). BACKGROUND: Despite increased popularity of the use of complementary and alternative medicine, it is not included in nursing and medicine schools' curricula in many countries. DESIGN: A cross-sectional design was used. METHOD: This study's research population included 972 students who were educated at a school of nursing and a faculty of medicine during the academic year 2006-2007. The study used a questionnaire the researchers prepared as data collection form. Pearson chi-square test was used to observe the differences between nursing and medical students. A p-value <0.05 was accepted statistically significant. RESULTS: The population was 49.1% nursing students and 50.9% medical students. Of the nursing students, 57.8% agreed with the statements that complementary and alternative medicine modalities should be integrated into clinical practice, 61.3% agreed for curriculum. Of the medical school students, 32.6% agreed for clinical practice and 37.9% for curriculum. The nursing students had sufficient knowledge of mostly massage and imagery; and medical students had sufficient knowledge of mostly diet therapy, vitamins and prayer. CONCLUSIONS: The results of current study reveal that nursing students adopt more positive attitudes than medical students towards complementary and alternative medicine therapies and that both student groups have limited knowledge of complementary and alternative medicine modalities. RELEVANCE TO CLINICAL PRACTICE: Physicians and nurses play important roles in helping patients use complementary and alternative medicine safely and accurately. Therefore, as future nurses and physicians, nursing and medical students should have sufficient knowledge of and education on complementary and alternative medicine modalities. In this context, handling complementary and alternative medicine on a scientific scale and including it in nursing and medical students' educational programmes should be among the goals and plans in Turkey.

The association of tethered cord, syringomyelia, diastometamyelia, spinal epidermoid, spinal lipoma and dermal sinus tract in a child.

We report on a 5-year-old boy presenting with tethered cord, diastometamyelia, spinal dysraphism, terminal lipoma, spinal epidermoid, and dermal sinus tract with CT, conventional MRI, and diffusion-weighted MRI findings. To the best of our knowledge, our case has the property to be the first case in the literature showing the association of these pathologies all together.

Body image and self-esteem in somatizing patients.

AIM: The aim of the present study was to determine dissatisfaction with body appearance and bodily functions and to assess self-esteem in somatizing patients. METHODS: Body image and self-esteem were investigated in 128 women; 34 of those had diagnosed somatoform disorders, 50 were breast cancer patients with total mastectomy surgery alone, and 44 were healthy subjects. Body image and self-esteem were assessed using the Body Cathexis Scale and Rosenberg Self-Esteem Scale. RESULTS: The two clinical groups did not differ from one another (z = -1.832, P = 0.067), but differed from healthy controls in terms of body image (somatizing patients vs healthy controls, z = -3.628, P < 0.001; total mastectomy patients vs healthy controls, z = -3.172, P = 0.002). They also did not differ significantly in terms of self-esteem (z = -0.936, P = 0.349) when depressive symptoms were controlled. No statistically significant difference was observed between total mastectomy patients and healthy controls in terms of self-esteem (z = -1.727, P = 0.084). The lower levels of self-esteem in somatizing patients were largely mediated by depressive symptoms. Depressed and non-depressed somatizing patients differed significantly from healthy controls with respect to their self-esteem and body image. CONCLUSIONS: Somatizing patients who were dissatisfied with their bodily functions and appearance had lower levels of self-esteem and high comorbidity of depression. In clinical practice it is suggested that clinicians should take into account psychiatric comorbidity, self-esteem, and body image in somatizing patients when planning treatment approaches.

Diagnostic pitfalls in the evaluation of fine needle aspiration cytology of the thyroid: correlation with histopathology in 260 cases.

OBJECTIVES: Fine needle aspiration cytology (FNAC) of the thyroid is a non-invasive, cost-effective screening procedure that is valuable for distinguishing neoplastic lesions from non-neoplastic nodules. The aim of this study was to determine the diagnostic accuracy of FNACs performed at our institution by correlating FNAC results with histopathological diagnoses. METHODS: Two hundred and seventy-one aspiration cytology specimens followed by thyroidectomy were included in the study, and the results of 260 adequate FNACs were compared with their histological diagnoses. RESULTS: The sensitivity and specificity of thyroid FNAC for detecting neoplasia were 92.6% and 91.6%, respectively. There were 15 (5.7%) false positives and six (2.3%) false negatives. CONCLUSIONS: The results showed that follicular cells that exhibit some of the features of papillary carcinoma could be observed in a cytology slide of Hashimoto's thyroiditis, leading to a diagnostic pitfall. In addition, cellularity and overlapping cytological criteria in hyperplasia might lead to a false diagnosis.