Serum human epididymis protein 4 can be a useful tumor marker in the differential diagnosis of adnexal masses during pregnancy: a pilot study.

PURPOSE: The purpose of this study was to evaluate serum concentrations of human epididymis protein 4 (HE4) and cancer antigen 125 (CA 125) in healthy women and their pregnant counterparts to determine the influence of pregnancy on these biomarkers. MATERIALS AND METHODS: Serum concentrations of CA 125 and HE4 were measured in 27 healthy non-pregnant women and 26 healthy pregnant women in the first and second trimesters. RESULTS: Higher concentration of CA 125 was found in pregnants than in non-pregnant women (p = 0.002). There was no difference in CA 125 concentrations between first and second trimesters (p = 0.13). Serum HE4 concentration was not different in pregnant group compared to non-pregnant women (p = 0.510). Likewise, no difference was found in HE4 levels between the trimesters (p = 0.485). There was a positive correlation between increasing parity and CA 125 (p = 0.023), but not HE4 (p = 1.0). CONCLUSION: HE4 serum biomarker is unaffected by pregnancy status and may be useful for evaluation of doubtful pelvic masses in pregnancy. Contrarily, increased serum levels of CA 125 could yield increased number of false-positive results.

Pneumoconiosis in dental technicians: HRCT and pulmonary function findings.

BACKGROUND: Pneumoconiosis is a form of diffuse interstitial lung disease, often resulting from occupational exposures. As dental prosthetic technicians (DPTs) build prostheses, they are exposed to many chemical materials that increase their risk of developing pneumoconiosis. AIMS: To document pulmonary function and prevalence of pneumoconiosis in DPTs. METHODS: A cross-sectional study of DPTs working in prosthetic laboratories who underwent pulmonary function test and high-resolution chest computed tomography (HRCT) scanning. RESULTS: There were 76 participants and pneumoconiosis was diagnosed in 46%. The most commonly seen radiological finding was round opacities, present in 38%. Agreement among HRCT readers was moderate to good. As defined by HRCT, emphysema was diagnosed more often in those with a longer occupational history or a history of smoking, and low carbon monoxide diffusion capacity (DLCO), but not in those with pneumoconiosis. Forced expiratory rate and DLCO were significantly lower in those who had worked 16 years or more (all P < 0.05). DLCO values were significantly lower in technicians with emphysema and in current smokers (all P < 0.01). Round opacities were also present in a substantial proportion of DPTs who had 15 years or less exposure. Because HRCT is able to detect radiological changes of occupational lung disease very early, the prevalence of pneumoconiosis in our participants was quite high. CONCLUSIONS: Pneumoconiosis identified by HRCT was present in almost half of DPTs surveyed. Appropriate education and workplace protection should be given to DPTs in order to prevent exposure to hazardous materials in dental prosthetics laboratories.

Biofeedback assisted relaxation in essential hypertension: short-term follow-up of contributing effects of pharmacotherapy on blood pressure and heart rate. "Brief communication".

The present study was designed to evaluate the possible beneficial effects of biofeedback-assisted relaxation to pharmacotherapy on blood pressure and heart rate in patients with essential hypertension. Twenty patients with essential hypertension and without any complications or end-organ damage participated in the study. All the patients were using anti-hypertensive drugs. The study protocol consisted of an interview, 10 days baseline, 10 biofeedback-assisted relaxation sessions and a 10-day post-treatment period. Interview blood pressure (BP) and heart rate (HR) measurements, baseline mean values of systolic blood pressure (SBP), diastolic blood pressure (DBP) and HR recorded during the 1st, 10th and 20th minutes of each session and the post-treatment mean values were evaluated. Significant differences were found between the mean values of SBP, DBP and HR after the whole treatment protocol (Wilcoxon signed-ranks test). The mean values of SBP, DBP and HR measurements recorded during the 1st, 10th and 20th minutes of the biofeedback-assisted relaxation sessions, which were evaluated by repeated measures of ANOVA on ranks test, showed a significant decrease only for the 10th minute values at the end of the whole treatment program. Despite a short follow-up, it was suggested that these results were encouraging considering the fact that once the patients are thoroughly instructed in home practice of relaxation and encouraged to develop their own strategies for relaxation, the long term outcome may also be promising.

Screening of Hemoglobinopathies in Kahramanmaras, TURKEY.

Thalassemia and sickle cell anemia are prevalent in southern Turkey. Being in close proximity to Çukurova we screened Kahramanmaras to assess the prevalence and foci of the diseases. The sample sizes were calculated by EpiInfo 6.0 computer program at 95% confidence level. 1491 subjects aged 2-69 were studied. Hematological parameters were analyzed by an electronic cell counter. Electrophoresis were performed and Hemoglobin A2 and hemoglobin F levels were determined on samples with MCV< 80 fL. The results of Canatan et al. on Elbistan were included in the final results. Thus, the prevalence of ß-thalassemia, hemoglobin D, Hemoglobin O Arab carriers were 0.68%, 0.28% and 0.013%, respectively. No hemoglobin S was detected. In conclusion, Kahramanmaras seems not to be a high risk area but the public must be informed about these diseases. Every community in close proximity to high prevalence areas must be enlightened.

Knowledge, attitudes, and behaviors of officials of religion about organ donation in Kahramanmaras, an eastern Mediterranean city of Turkey.

OBJECTIVE: To establish the knowledge, attitudes, and behaviors of the officials of religion, a group with potentially powerful influence on the society, in particular regarding organ donation. METHODS: This study, performed in Kahramanmaras Province, Turkey, included 416 of 641 officials of religion (64.9%): 295 of 492 imams (59.9%) and 121 of 149 Koran course educators (81.2%). RESULTS: The mean (SD) age of the study group was 37.2 (8.2) years. Only 1.4% had stated that carried organ donation cards. Of participants who had not donated organs asked whether they thought of donation, 14.1% answered yes, 17.1% answered no, and 68.8% were undecided. Of the study group, 88.2% considered organ donation appropriate according to their religion. The imams compared with Koran course educators, and men compared with women demonstrated higher rates of considering organ donation appropriate according to their religion (P < .05). Among participants who stated they had knowledge about organ donation, the 3 leading information sources were television, newspapers or journals, and in-service training by the Directorate of Religious Affairs. The 3 primary organs the study group stated they were aware of being transplanted were kidneys, liver, and heart. CONCLUSION: Although 88.2% of religious officials in the present study stated that organ donation was appropriate according to their religion, only 1.4% agreed to donate organs. Officials of religion hold an important place in society, and should be well informed and educated about organ donation via in-service training courses, and encourage organ donation by members of society.

Age at menarche in Turkish adolescents in Kahramanmaras, Eastern Mediterranean region of Turkey.

OBJECTIVES: To determine the age at menarche in adolescents in the Eastern Mediterranean city of Kahramanmaras, Turkey. METHODS: The study was conducted in primary and high schools of Kahramanmaras, during the academic year 2003-2004. Data of 8212 female students were collected by using a standard questionnaire. Mean and median ages at menarche (with 95% confidence intervals) were calculated by Kaplan-Meier survival analysis. Also, probit analysis was performed to determine the age at menarche for all girls by estimating the age at which 10, 25, 50, 75 and 90% of the girls reached menarche. RESULTS: According to the answers obtained through the questionnaire, 5506 (67.5%) of 8161 respondents had had their menarche. Mean age at menarche was 13.04 years (95% CI: 13.01-13.06), and median age 13.00 years (95% CI: 12.97-13.03). According to probit analyses, the probability of menstruating before the age of 11.48 years was 10% and before 15.08 years 90%. CONCLUSION: We provide data about age at menarche in Kahramanmaras, an Eastern Mediterranean city of Turkey.

Hepatitis A seroprevalence and its relationship with environmental factors in children of different age groups in Kahramanmaras, Eastern Mediterranean region of Turkey.

Hepatitis A infections are influenced by environmental and socioeconomic factors. Epidemiologic studies regarding hepatitis A virus (HAV) infection in Turkey have not previously examined these factors. We investigated HAV seroprevalence and its association with sociodemographic factors among children of various ages in the Eastern Mediterranean region of Turkey. The study included 1142 children (603 male and 539 female) between ages of 6 months and 18 years. Seropositivity in the whole group was 57.2%. HAV prevalence rates according to age groups were as follows: 35.5% in 6-23 months group, 19.2% in 2-5 years group, 74.3% in 6-10 years group, 83.0% in 11-14 years group, 92.8% in 15-18 years group. Risk factors that influenced seropositivity were; dense population, over-crowded families, excessive number of siblings, low socioeconomic status and low education of the mother. As HAV seroprevalence in children older than 6 years of age is high, we recommend hepatitis A vaccination in this region after the first year of life.

Evaluation of a new chromogenic medium for isolation and identification of common urinary tract pathogens.

In the study presented here, a new chromogenic medium (CPS ID 3; bioMérieux, Marcy l'Etoile, France) was compared to routine media for the isolation, identification and antimicrobial susceptibility testing of bacteria recovered from urine specimens, and a cost analysis was performed. Escherichia coli, Proteeae tribe, Pseudomonas aeruginosa, Enterococcus spp. and Streptococcus agalactiae grew on the chromogenic medium as typical differentiated colonies and were accurately identified even in mixed cultures. Although the similarity of colors produced by isolates belonging to the Klebsiella, Enterobacter, Serratia and Citrobacter (KESC) group prevents differentiation among them, members of KESC were easily identified as coliforms. No substantial difference was observed when comparing the results of antimicrobial susceptibility testing performed on colonies selected from reference media versus CPS ID 3. Use of the new medium was associated with a savings of 75% over the conventional methods and the API system. Furthermore, this medium facilitated a remarkable reduction in the laboratory workload and consequently resulted in additional time and cost savings.

The influence of athletic activity on the plantar fascia in healthy young adults.

PURPOSE: Complaints deriving from the plantar fascia are relatively common in athletes. This study aimed to investigate the changes of thickness of plantar fascia via sonography in healthy young adults with different levels of activity. PATIENTS AND METHODS: One hundred ten adults with normal body mass index were separated into three groups according to activity level: sedentary (group 1, n = 50), athletic activity less than 7 hours per week (group 2, n = 30), and athletic activity 7 or more hours per week (group 3, n = 30). The thicknesses of the plantar fascia at origin and at a point 5 mm distal to origin were measured via sonography. RESULTS: The mean values of the thickness of the proximal plantar fascia (PFp) and the distal plantar fascia (PFd) in group 1 were similar to those of groups 2 and 3 (p > 0.05). The mean values of PFp and PFd were significantly higher in men than in women (p < 0.05). The mean values of PFp and PFd were similar in left and right feet (p > 0.05). There were moderate positive correlations between PFp and weight, height, and body mass index but no correlation between PFp and amount of athletic activity. CONCLUSIONS: The thickness of the plantar fascia at origin did not change with athletic activity at the amateur level.

Heel pad thickness and athletic activity in healthy young adults: a sonographic study.

PURPOSE: The aim of this study was to investigate the sonographic changes of heel fat pad thickness and compressibility index in healthy young adults in relation to level of athletic activity. MATERIALS AND METHODS: One hundred ten young adults (55 women and 55 men) with a body mass index between 18.5 and 24.9 were divided into 3 groups according to their athletic activity level: group 1, sedentary (n = 50); group 2, athletic activity <7 hours/week (n = 30); and group 3, athletic activity >or=7 hours/week (n = 30). The loaded heel pad thickness (LHPT) and unloaded heel pad thickness (ULHPT) were measured via sonography, and the heel pad compressibility index (HPCI) was calculated. RESULTS: The mean values of ULHPT, LHPT, and HPCI in group 1 were similar to those of group 2 (p > 0.05) and group 3 (p > 0.05). The mean values of ULHPT, LHPT, and HPCI were similar in the left and right feet in the 3 groups (p > 0.05). There was no correlation between level of athletic activity and ULHPT, LHPT, or HPCI. CONCLUSIONS: The heel pad thickness and HPCI of individuals engaging in athletic activity up to an average of 11 hours/week were similar to those of sedentary individuals.

Elevated second trimester serum homocysteine levels in women with gestational diabetes mellitus.

OBJECTIVE: Our aim was to investigate the association between total serum homocysteine, vitamin B12 and folate levels in pregnant women with gestational diabetes mellitus (GDM), glucose intolerance and compare them with those of glucose tolerant pregnant women. MATERIALS AND METHODS: Serum homocysteine, vitamin B12 and serum folate levels were prospectively measured in a total of 223 pregnant women who were grouped according to their status of glucose tolerance as gestational diabetes (abnormal 1-h and 3-h glucose tolerance test; n = 30), glucose intolerant (abnormal 1-h, but normal 3-h glucose tolerance test; n = 46) or normal controls (normal 1-h glucose test; n = 147). RESULTS: Mean serum homocysteine concentration of women in gestational diabetes, glucose intolerants and normal controls at 24-28 weeks of gestation was 9.0 +/- 3.1, 8.1 +/- 2.5 and 7.4 +/- 1.6 micromol/l, respectively. The only statistically difference in homocysteine levels was observed between women with gestational diabetes and normal controls (P < 0.01). However, no difference was observed for vitamin B12 and folate levels. CONCLUSION: Second trimester serum homocysteine concentrations are higher among women with GDM, as compared to normal controls.

Home environment and asthma in school children from the Edirne region in Turkey.

Studies have shown that environmental factors contribute to the development of asthma. Hence, we investigated the relation between current asthma and indoor environmental factors such as exposure to pets, tobacco smoke, home dampness, number of people living in home, and stuffed toys in child's bedroom in a questionnaire based study in primary school children aged 6 to 12 years living in Edirne (Turkey). In a random sample of 4 primary schools, questionnaires were completed by parents of 1000 children. Following the evaluation of 682 of these, 85 were selected as cases of asthma of which 24 were diagnosed by a physician. When required certain laboratory tests were also performed in order to confirm the diagnosis. Logistic regression was used to investigate the associations between asthma and potential risk factors. In logistic regression analyses, the following factors were associated with asthma. Dampness in the house [(odd's ratio (O.R) = 2.61; 95% CI 1.13 to 6.81), stuffed toys in the child's bedroom (O.R = 2.18; 95% CI 1.27 to 3.74), and the crowding index (O.R = 2.73; 95% CI 1.08 to 6.82)]. In conclusion, it was found that presence of asthma was significantly associated with the presence of dampness in the house, and stuffed toys in the child's bedroom. Asthma can be prevented by improvement of the indoor environment. Therefore providing education to high-risk populations for avoidance of these risk factors is particularly important.