Forkhead box protein 3 (FoxP3) mRNA as a diagnostic marker in ovarian tumors: a pilot study.

PURPOSE: To assess the diagnostic performance of forkhead box protein 3 (FoxP3) mRNA in ovarian tumors. MATERIALS AND METHODS: Using quantitative real time reverse transcription PCR (q-RT-PCR), FoxP3 mRNA level was measured in fresh frozen ovarian tumors and its diagnostic performance was compared to those of preoperative serum CA 125 and risk of malignancy index (RMI). RESULTS: FoxP3 mRNA was differentially expressed in the malignant (n = 25) and benign (n = 25) groups, yet without statistically significant differences; positivity rate: 15/25 vs. 10/25; p = 0.157, median: 0.429 vs. 0.046; p = 0.684, and mean ± SD: 73.75 ± 234.68 vs. 247.09 ± 792.17; p = 0.30 1. Although it showed much less diagnostic performance (AUC: 0.534), FoxP3 mRNA enhanced the diagnostic sensitivity and specificity of both CA125 and RMI (96% and 100%, for both). CONCLUSION: FoxP3 mRNA may not be good diagnostic marker in ovarian tumors; however it may prove valuable in defining underlying tumor molecular signature.

Review of lignocellulolytic enzyme activity analyses and scale-down to microplate-based assays.

With the increasing use of enzymes in environmental applications, there is a need for analytical methods adapted to large factorial experiments. Existing reference methods are chemical and labor intensive and unsuitable to analyze in parallel a large number of samples. Based on an extensive literature review and on experimental results, this work compares reference and microplate adapted methods to define the most adequate filter paper, carboxymethylcellulase, ß-glucosidase and xylanase activity tests. In the adapted methods, the total reaction volume was reduced from 2.2-24.5 mL to 0.21-0.24 mL. Statistical analysis of the activities measured on enzyme mixtures by applying the 96-well plate reduced methods showed that they were not significantly different to the activities obtained with reference tests.

Frequency of glutathione-S-transferase null-M1 and null-T1 genotypes among the Turabah population in Saudi Arabia.

Glutathione-S-transferases (GST) are key phase II detoxifying enzymes that play critical roles in protection against products of oxidative stress and against electrophiles. Glutathione S-transferase mu (GST-M1) and theta (GST-T1) are isoforms of glutathione transferase enzymes that participate in the metabolism of a wide range of chemicals. Deletion variants that are associated with a lack of enzyme function exist at both these loci. The frequencies of homozygous GSTM1 and GSTT1 deletion carriers are very high in most of the populations studied to date. The aim of this study was to investigate the frequencies of GSTM1 and GSTT1 genotypes among the Turabah population in Saudi Arabia in comparison with the data published for some other Arabic populations. The subjects consisted of 164 unrelated healthy individuals from the Turabah population. GST genotyping was performed by multiplex polymerase chain reaction-based methods. The GSTM1 deletion homozygosity was 56.1% and GSTT1 deletion homozygosity was 20.7%, while the GSTM1 and GSTT1 double-deletion homozygosity was 11.0%. Comparison with published data from Bahraini, Lebanese, and Tunisian populations demonstrated no significant difference for GSTM1 between these populations. The GSTT1 null-allele frequency was significantly lower than those for the Lebanese and Tunisian populations (P = 0.001) but similar to that for the Bahraini population (P = 0.099). Characterization of GST genetic polymorphisms in the Saudi population may aid in genetic studies on the association of GSTM1 and GSTT1 polymorphisms with disease risks and the pharmacogenetics of chemotherapy.

Optimization of municipal solid waste leaching test procedure: assessment of the part of hydrosoluble organic compounds.

Despite national recycling campaigns, the amount of municipal solid waste (MSW) to be treated remains very important in France with almost 39% of the waste produced going to landfills. Therefore with the increasing concern over sustainable development and energy valorization, it seems essential to optimize current treatment methods and develop new preparation techniques of the waste. Nevertheless an important first step to take into account is to evaluate the waste using a different method than biogas production. In this perspective, the leaching test (LT) could be used as a tool to evaluate the ability of a waste to mobilize organic and mineral compounds. This research aims at optimizing a leaching test protocol mainly adapted to organic waste in order to be used on MSW to assess the fractions of both fast and slow mobilized organic matter. Several leaching tests have thus been implemented, optimized and compared in terms of accessible organic matter in the waste. Results have shown that the test conditions have a great influence on the mobilization of pollutants. The duration of the test affects mainly the quantity and quality of organic molecules extracted. The renewal of the eluent does not properly simulate the conditions of a landfill. The results would be used to assess the performance and the efficiency of new ways of waste pretreatment.

Parity is associated with increased waist circumference and other anthropometric indices of obesity.

BACKGROUND: There is growing interest in the effect of childbearing on the development of chronic medical conditions. In the present study we aim at seeing whether parity is associated with increased waist circumference (WC) and other anthropometric indices of obesity, or not, in a sample of Iraqi women. METHODS: This was a cross sectional study conducted during the period from January 2006 to the end of December 2007. Subjects were women attending two primary health care centers in a rural district population in Basrah (Abu-Al-khasib district), Iraq. RESULTS: A total of 9135 women with a mean age of 46.4+/-15.5 years were included in the study. The mean weight was 69.9+/-16.9 kg and the mean WC was 92.7+/-15.0 cm with 78.9% of women having WC >or=80 cm. The mean and the standard deviation of other anthropometric variables were 27.0+/-6.25 for body mass index (BMI), 0.57+/-0.09 for waist-to-height ratio (WHtR) and 0.89+/-0.08 for waist-to-hip ratio (WHpR). Body weight, WC, BMI, WHpR, and WHtR progressively and significantly increased with increasing parity (p<0.001). Increasing age and higher number of births were associated with a consistent significant increase in the risk of increasing WC. While the reverse was true with respect to education, the risk of increased WC significantly decreased with the increase in education. The risk of increased WC was higher among housewives compared to employed women. On multiple logistic regression analyses of parity and risk of increasing WC, the number of births remained significantly and independently associated with increased WC after adjustment for a range of potential confounders (age, BMI, employment, education, and marital status). However, when parity was analyzed as a dichotomous variable (parous versus nulliparous), no significant association was found (p>0.05). CONCLUSION: Parity was associated with increased WC and other anthropometric indices of obesity in a sample of rural Iraqi women attending two primary health care centers.

Cut-off values for waist circumference in rural Iraqi adults for the diagnosis of metabolic syndrome.

BACKGROUND: The determination of cutoff points for healthy waist circumference (WC) is of paramount importance for prevention, optimum management, and prognostication of obesity, the metabolic syndrome (MetS), type 2 diabetes mellitus, and coronary heart disease. The aim of this project was to establish the cutoff level for WC in rural Basrah in Iraq, one of the eastern Mediterranean and Middle East (Arab) populations. METHODS: This was a community-based, cross-sectional survey for establishing the normal value for WC among a rural district population in Basrah (Abu-Al-khasib), Iraq. A stratified sampling procedure was used for sample selection. RESULTS: The cutoff level yielding maximum sensitivity and specificity for predicting the presence of multiple risk factors was 97 cm in men and 99 cm in women. Sensitivity and specificity using these cutoff values were 70% and 50%, respectively, in men and 70% and 45%, respectively, in women. CONCLUSION: We propose the optimal cutoff point for WC for the diagnosis of MetS in the Iraqi adult rural population as 99 cm in women and 97 cm in men.

Adjunct therapy with corticosteroids or paracentesis for treatment of tuberculous pleural effusion.

To determine the effect of adjunct therapy, we carried out a prospective cohort study on 190 patients with tuberculous pleural effusion during May 2003-April 2004. Patients were divided into 3 groups. All groups were treated with anti-tuberculosis (TB) drugs for 6 months; in group 2 (n = 46) prednisolone, 30 mg/day for 10 days, was added; group 3 (n = 78) were given paracentesis to remove fluid. Fever and constitutional symptoms disappeared faster in group 2 (P > 0.05). After 10 days, there was a significantly greater reduction in the size of pleural effusion in group 2, but after 6 months the difference was not statistically significant. We found corticosteroids and therapeutic paracentesis are not necessary in the management of TB pleural effusion.

Adjunct therapy with corticosteroids or paracentesis for treatment of tuberculous pleural effusion

To determine the effect of adjunct therapy, we carried out a prospective cohort study on190 patients with tuberculous pleural effusion during May 2003- April 2004. Patients were divided into3 groups. All groups were treated with anti- tuberculosis [TB] drugs for 6 months; in group 2 [n = 46]prednisolone, 30 mg/ day for 10 days, was added; group 3 [n = 78] were given paracentesis to remove fluid. Fever and constitutional symptoms disappeared faster in group 2 [P > 0.05]. After 10 days, there was a significantly greater reduction in the size of pleural effusion in group 2, but after 6 months thedifference was not statistically significant. We found corticosteroids and therapeutic paracentesis are not necessary in the management of TB pleural effusion

Control of GT repeat stability in Schizosaccharomyces pombe by mismatch repair factors.

The mismatch repair (MMR) system ensures genome integrity by removing mispaired and unpaired bases that originate during replication. A major source of mutational changes is strand slippage in repetitive DNA sequences without concomitant repair. We established a genetic assay that allows measuring the stability of GT repeats in the ade6 gene of Schizosaccharomyces pombe. In repair-proficient strains most of the repeat variations were insertions, with addition of two nucleotides being the most frequent event. GT repeats were highly destabilized in strains defective in msh2 or pms1. In these backgrounds, mainly 2-bp insertions and 2-bp deletions occurred. Surprisingly, essentially the same high mutation rate was found with mutants defective in msh6. In contrast, a defect in swi4 (a homologue of Msh3) caused only slight effects, and instability was not further increased in msh6 swi4 double mutants. Also inactivation of exo1, which encodes an exonuclease that has an MMR-dependent function in repair of base-base mismatches, caused only slightly increased repeat instability. We conclude that Msh2, Msh6, and Pms1 have an important role in preventing tract length variations in dinucleotide repeats. Exo1 and Swi4 have a minor function, which is at least partially independent of MMR.

A study to test the effectiveness of placebo Reiki standardization procedures developed for a planned Reiki efficacy study.

Reiki is one type of alternative therapy that is increasing in popularity. It is advocated by its practitioners as a precise method for connecting universal life energy with the body's innate process of healing through hands-on techniques. The claim of Reiki practitioners is that Reiki reduces a variety of physical problems and improves psychospiritual well-being. There are abundant anecdotal records that support the previous claim, and a few pioneer scientific studies are starting to emerge. Although the Reiki research in totality supports the anecdotal records, the absence of randomized and placebo-controlled trials precludes the interpretation of the outcomes as resulting from specific effects as opposed to placebo effects plus natural history. Authorities in the field indicate that researchers interested in placebo-controlled studies should have the placebo treatment look exactly like the real intervention in every respect. Because no studies could be found in the literature that tested standardization procedures for real and placebo Reiki, the decision was made to conduct one. The purpose of this study was to test the standardization procedures developed by our research team for placebo Reiki, before going ahead and conducting our planned full-scale randomized and placebo-controlled Reiki efficacy study. This study used a 4-round, crossover experimental design in which 20 blinded subjects (12 students, 4 breast cancer survivors, and 4 observers) were exposed to a combination of 2 interventions (Reiki plus Reiki, or placebo plus placebo, or Reiki plus placebo, or placebo plus Reiki); and were then asked to evaluate the interventions using a self-administered questionnaire. The blinded observers were used in round number 4. Two real Reiki practitioners in the Usui system were chosen first, then 2 placebo practitioners who closely resembled them were recruited. The placebo practitioners were trained in Reiki by the study Reiki Master and the principal investigator, but were not initiated. The belief in Reiki is that only practitioners that are initiated could give Reiki, thus making it possible to have a placebo arm in efficacy studies. The findings of the study indicate that the developed standardization procedures were successful because none of the final participants in round 4 (4 breast cancer patients and 4 observers) could differentiate between the identity of placebo and Reiki practitioners. The qualitative comments expressed by the participants further con-firmed the quantitative data. It was concluded based on these findings that it is safe to go ahead and conduct the planned randomized 3-arm Reiki efficacy clinical trial. It is recommended that scholars interested in Reiki research could incorporate our techniques to strengthen their designs by adding a placebo arm.

A study of health centers in Saudi Arabia.

Saudi Arabia is a developing country with a tremendous potential for growth and development. In an attempt to endorse Primary Health Care (PHC) concepts, it abolished all its former dispensaries and maternal and child health centers, and amalgamated their services into health centers that deliver PHC services. This expansion in centers development created a need for evaluation to assess the extent at which the new objectives are being achieved. The purpose of this study was to evaluate the resources available in three large health centers in Saudi Arabia, and determine consumers' satisfaction with the services provided. The study was conducted in the City of Riyadh. Three centers were chosen purposefully and the consumers of the respective centers were interviewed as to their satisfaction with the services provided. The results show that there was a discrepancy between the findings obtained from the centers' resources evaluation and those derived from the satisfaction portion. It is recommended that the Saudi Ministry of Health would upgrade its centers' resources, and that more studies would be conducted in the other centers of the country.

PIP: This article presents the findings from an evaluation of three of the largest maternal-child health centers dispensing primary health care (PHC) in Riyadh, Saudi Arabia. The evaluation included an assessment of the availability and quality of equipment and facilities at each center and the number and qualifications of staff. Consumer satisfaction with services was determined from interviews. Responses were scored on a 4-point Likert scale. Findings indicate that resources were inadequate at each center. Staff was complete for physicians, nurses, and clerks only. Centers did not meet requirements from the Ministry of Health for technicians, pharmacists, health workers, social workers, and health inspectors. The condition of the equipment was adequate in all centers, but some specific treatment areas were deficient. For example, the emergency rooms in centers 1 and 3 were underequipped. Facilities were inadequate in centers 2 and 3. None of the centers had public phones. Two centers did not have an area for praying. There were statistically significant differences between center facilities. Consumers were generally satisfied, despite the deficiencies in manpower, equipment, and facilities. Consumer satisfaction was highest for the humaneness of treatment. Effectiveness of care was also given a high satisfaction score. The lowest satisfaction scores were given to thoroughness, continuity, and informativeness. Findings may reflect Saudi reluctance to complain about services or the acceptance of lower standards of care. It is concluded that care was dispensed by many who were not fluent in Arabic and trained in PHC. Other centers should be evaluated and improvements should be made in manpower, facilities, and equipment. Process evaluations should be initiated in order to explain the contradictions between client satisfaction and center resource inadequacy.

The conceptualization of health among residents of Saskatoon.

Health for all by the year 2000 is a goal for many professionals. Health promotion is a key strategy for attaining that goal. An essential step in the process is defining the term health. A review of literature reveals that the public was not consulted regarding their definition of the term, although it is their health that everyone is trying to promote. The aim of this study was to find out how lay people in Saskatoon define health, and investigate the effects of several independent variables on their conceptualizations. One hundred residents participated in the study. The mail and telephone survey method was used to collect the data. Chi-square tests, Mann-Whitney and Kruskal-Wallis were used to analyze the data. The results of the study show that the respondents preferred functional and wellness definitions of health. They disagreed though that health is wellness despite the presence of disease, which is contrary to the expectations of many health professionals. They, moreover, disagreed with economical and religious definitions of health. Several independent variables were tested for their influence on the respondents' conceptualization. Sex seems to have a major impact on one's definition of health, and the value one places on the different aspects of life determines how one defines health. It is recommended that health professionals always assess their clients' definition of health prior to prescribing interventions. Health is not a commodity, but a basic right of human beings; and if community involvement is to become a reality, it should start with a public definition of the term "Health."

Factors that influence women's nutrition knowledge in Saudi Arabia.

We studied knowledge of nutritional needs during pregnancy and lactation in 150 pregnant Saudi women at three primary health care centers in Riyadh, Saudi Arabia. We used an interview schedule to collect data regarding the women's knowledge and to determine the effects of certain independent variables on the knowledge scores. Green et al.'s (1980) PRECEDE model provided the theoretical framework for the study. Descriptive statistics, t test, and chi-square methods were used to analyze the data. The majority of the women had poor nutrition knowledge scores, with no significant differences among the three centers. A positive relationship was found between knowledge score and educational level. Negative relationships were found between knowledge score and number of pregnancies, number of deliveries, and number of living children. The findings have several implications for efforts to improve the health status of women in Saudi Arabia.

A study of satisfaction among primary health care patients in Saudi Arabia.

Primary Health Care is essential health care based on delivering integrated health services (curative and preventive). The Kingdom of Saudi Arabia adopted this approach in 1980, and by the year 1987 the Ministry of Health had established 1477 Primary Health Care centers. The expansion in Primary Health Care created a need for various types of evaluation. Theorists recommended the study of patients' satisfaction as a way of evaluating care. The aim of this study was to assess the satisfaction of patients with different aspects of Primary Health Care services in Riyadh. The sample consisted of 300 patients chosen systematically from three Primary Health Care centers in Riyadh. The data were collected by personal interviews. The tool consisted of demographic data, a 4-point rating scale of 40 statements measuring satisfaction with different aspects of Primary Health Care services, and an open question eliciting the patients' suggestions for improvements. The analysis of variance (ANOVA) was used to determine the difference in level of patient satisfaction between the three centers. The results show that the patients were moderately satisfied with the services. They were most satisfied with the effectiveness and humane aspects of care, and least satisfied with the thoroughness and continuity aspects of care. It is recommended that the Ministry of Health develop programs for its personnel to sensitize them to the different aspects of Primary Health Care.