Knowledge on preconceptional folic acid supplementation and intention to seek for preconception care among men and women in an urban city: A population-based cross-sectional study

Background: To study the knowledge of a large city population on preconception folic acid supplementation and intention to seek for preconception care within an urban perinatal health program. Methods: Cross-sectional surveys run in Rotterdam, the Netherlands, in 2007 and annually from 2009 to 2014. A random sample of residents aged between 16 and 85 years was taken each year from the municipal population register. Bivariate analysis, interaction analysis, trend analysis and logistic regression were performed. Results: Knowledge on preconceptional folic acid supplementation significantly improved (+20 %) between 2007 and 2009, and the intention to consult a GP or midwife in the preconception period significantly increased (+53 %) from 2007 to 2012. Logistic regression analyses showed that low socio-economic status was significantly associated with low preconceptional folic acid knowledge, but with higher intention to seek out preconception care. An interaction effect was found between educational level and ethnicity, showing that the higher the educational level the lower the gap of level of knowledge between the different ethnic groups. Conclusion: Despite campaigns about folic acid supplementation knowledge on this supplement remains low. The intention amongst men and women to seek out preconception care is still insufficient. Structural interventions to increase and maintain awareness on folic acid supplementation, especially among high-risk groups, are needed

Akut İskemik İnmede Yeni Bir Biyobelirteç Olan Serum NR2 Düzeyinin İnmenin Şiddeti ve Prognozu ile İlişkisi

Giriş: Akut iskemik inme tanısı için klinik deneyim ve görüntüleme bulgularını destekleyecek kan testine ihtiyaç vardır. Bu çalışma- da serum NR2 antikor düzeyinin akut iskemik inme tanısındaki değerinin ortaya konması amaçlandı. Gereç ve yöntem: Çalışmaya prosfektif olarak, çalışmaya alınma kriterlerini dolduran 64 iskemik inmeli hasta ile 68 sağlıklı gönüllü dahil edildi. İskemik inmenin akut döneminde serum NR2 anikor düzeyi ELİSA yöntemi ile ölçüldü. İnmenin şiddeti ve prognozu, giriş NIH İnme Skalası, 3. Ay modifiye Rankin Skalası ve Barthel indexi skorları ile, enfarkt hacmi AXBXC/2 hesaplamasıyla belirlendi. Sonuçlar Kolmogorov Smirnov, Tukey HSD, Wilcoxon ve Mann-Whitney U Testi kullanılarak NR2 düzeyi ile kıyaslandı. Bulgular: Ortalama serum NR2 antikor düzeyi iskemik inme grubunda 2.64±1.43 iken, kontrol grubunda 2.28±1.13 idi. Gruplar arasındaki fark istatistiksel olarak anlamlı değildi. S100B değerlerinin yaş, cinsiyet, koroner arter hastalığı, diyabetes mellitus, hiperlipidemi, hipertansiyon, periferik damar hastalığı, sigara içiminden etkilenmediği görülmüştür. Sonuç: Bu çalışma sonuçları NR2 antikor düzeyinin akut iskemik inmeli hastalardaki serum düzeylerinin normal kontrollere göre farklı olmadığını gösterdi. Bu verilere göre iskemik inmede NR2 antikor düzeyinin etkili bir rol almadığını düşünüyoru

Knowledge on preconceptional folic acid supplementation and intention to seek for preconception care among men and women in an urban city: a population-based cross-sectional study

Background: To study the knowledge of a large city population on preconception folic acid supplementation and intention to seek for preconception care within an urban perinatal health program. Methods: Cross-sectional surveys run in Rotterdam, the Netherlands, in 2007 and annually from 2009 to 2014. A random sample of residents aged between 16 and 85 years was taken each year from the municipal population register. Bivariate analysis, interaction analysis, trend analysis and logistic regression were performed. Results: Knowledge on preconceptional folic acid supplementation significantly improved (+20 %) between 2007 and 2009, and the intention to consult a GP or midwife in the preconception period significantly increased (+53 %) from 2007 to 2012. Logistic regression analyses showed that low socio-economic status was significantly associated with low preconceptional folic acid knowledge, but with higher intention to seek out preconception care. An interaction effect was found between educational level and ethnicity, showing that the higher the educational level the lower the gap of level of knowledge between the different ethnic groups. Conclusion: Despite campaigns about folic acid supplementation knowledge on this supplement remains low. The intention amongst men and women to seek out preconception care is still insufficient. Structural interventions to increase and maintain awareness on folic acid supplementation, especially among high-risk groups, are needed

Genetic alterations in benign, preneoplastic and malignant breast lesions

Context: The c-erbB-2 proto-oncogene is a member of the epidermal growth factor receptor family and has been associated with a more aggressive breast tumor biology and resistance to some types of treatments. Aims: The aim is to investigate the correlation among bcl-2 and c-erbB-2 and the micronucleus (MN) formation in patients with early breast cancer (BC). Materials and Methods: This study was conducted between May 2010 and December 2011. We analyzed the MN frequencies in 15 patients with invasive breast carcinoma (IBC), 13 patients with intraductal proliferative lesion (IDPL) and 12 benign breast lesion (BBL). The sample consisted of 40 formalin-fixed, paraffin-embedded blocks of benign and malignant breast tissue. The specimens were evaluated for bcl-2 or c-erbB-2 immunoreactivity was semi-quantitatively evaluated in at least 1000 cells examined under the microscope at 40Χ magnification and recorded as the percentage of c-erbB-2 and bcl-2 positive tumor cells over the total number of cells examined in the same area. The percentage scores were subsequently categorized using the 5% cut-off point for positive staining. Results: The MN was significantly increased in IBC and in IDPL patients compared to BBL patients (3.82 ± 0.17 and 2.37 ± 0.52, respectively, vs. 1.61 ± 0.40, P < 0.001). On other hand, the MN frequencies in IBC patients were higher than those in IDPL patients (3.82 ± 0.17 vs. 2.37 ± 0.52, P < 0.01). c-erbB-2, had the highest record in IBC (60%), and the score was not observed in both IDPL and BBL: bcl-2 immunostaining was also assessed, the lowest recorded score was in IBC (46.66%) and the highest in both BBL and IDPL (100%). Furthermore, there was a significantly difference in the mean MN frequency between c-erbB-2 positive IBC patients (4.06 ± 0.48) and c-erbB-2 negative IBC patients (3.44 ± 0.39) (P < 0.05). Conclusions: Our results suggest that increased chromosome / DNA instabilities may be associated with the pathogenesis of early BC

Clinical predictors of pulmonary functions, respiratory/peripheral muscle strength and exercise capacity at discharge in adults with burn injury

WOS: 000511791300001PubMed: 31999499Purpose: To identify clinical predictors of pulmonary functions, respiratory and peripheral muscle strength and functional exercise capacity in burn injury patients, and to compare these parameters with healthy subjects. Methods: the study included 47 burn injury patients aged 20-49 years, and 47 age and gender-matched healthy subjects. the patients were evaluated on the day of discharge from hospital. Pulmonary functions and respiratory muscle strength were assessed with a spirometer (Cosmed Pony FX). Hand grip and pain were evaluated with a Jamar dynamometer and visual analog scale, respectively. the six-minute walk test (6-MWT) was performed to determine the functional exercise capacity of the participants. Results: With the exception of FEV1/FVC, all the parameters of pulmonary functions test, respiratory and peripheral muscle strength and 6-MWT distances were lower in the burn injury patients than in the healthy subjects (p < 0.05). Significant predictors for these parameters were age, gender, height, body mass index, total burn surface area, burn injury type, the presence of trunk burn, hand burn, lower limb burn, inhalation injury, and intubation in the burn group (p < 0.05). Conclusions: Burn injury and the demographic characteristics of the patients are important determinants of clinical parameters. These results are clinically important as they can be of guidance in creating a personalized rehabilitation program

APRI, the FIB-4 score, and Forn's index have noninvasive diagnostic value for liver fibrosis in patients with chronic hepatitis B

Objectives The aim of this study was to evaluate the potential use of serum transforming growth factor-1 (TGF-1), tissue inhibitor of metalloproteinase-1 (TIMP-1), fetuin-A, and fibroblast growth factor 21 (FGF21) in the detection of liver fibrosis in patients with chronic hepatitis B (CHB). The value of the noninvasive fibrosis models - that is, the aspartate aminotransferase to platelet ratio index (APRI), the fibrosis index based on the four factors (FIB-4) score, and Forn's index - was also examined.Materials and methods CHB patients who underwent liver biopsy for the evaluation of fibrosis were included in the study. A total of 73 patients were divided into two groups according to their METAVIR scores (F0-1, no/minimal fibrosis; F2-4, significant fibrosis). Serum levels of TGF-1, TIMP-1, fetuin-A, and FGF21 were measured besides APRI, FIB-4, and Forn's scores. The area under the receiver operating characteristic curve was measured for each parameter, followed by calculation of sensitivity, specificity, and positive and negative predictive values.Results APRI, FIB-4, and Forn's index scores were significantly higher in patients with significant fibrosis (P0.05). The areas under the receiver operating characteristic curve for TGF-1, TIMP-1, fetuin-A, FGF21, APRI, FIB-4, and Forn's index were 0.445, 0.483, 0.436, 0.585, 0.662, 0.687, and 0.680, respectively.Conclusion Our results suggest that serum TGF-1, TIMP-1, fetuin-A, and FGF21 are not useful for the assessment of the extent of liver fibrosis in CHB in this patient group. However, APRI, FIB-4, and Forn's index have a better diagnostic value in patients with significant fibrosis than in those with no/minimal fibrosis. (C) 2013 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins

Exploring of the Unpredicted Effects of Olfactory Network Injuries on Mammary Gland Degeneration: A Preliminary Experimental Study

Purpose of the study: Hypofunctioning breasts are typically considered a dysfunction of higher brain centers that regulate hormonal feedback, and olfactory information has been proposed as a triggering factor for lactation in the maternal body. However, there are no substantive studies regarding whether olfaction disorders and/or loss of olfactory sense may result in breast gland atrophy by causing diminished olfactory stimulation. To fill this gap in the literature, we studied the histologic features of breast glands as a sample model in animals that had undergone an olfactory bulb lesion (OBL). Materials and methods: This study was conducted on 22 rats. Six, eight, and six of them were used as control, SHAM, and OBL groups, respectively. After 10 weeks, the animals were decapitated. Olfactory bulbs and breast glands were stained with Hematoxylin-eosin and tunnel dye. Specimens were analyzed stereologically to evaluate the loss in volume of the olfactory bulbs, total breast follicle volume (TBFV) and Meissner's corpuscles per cubic centimeter, and these two senior metrics were compared with each other statistically. Results: Olfactory bulb volume loss and breast gland atrophy were both detected in study group. Mean TBFV and OB volumes were measured as: (296 ± 89) × 106 µm3/cm3 and 4.43 ± 0.98 mm3 in control (Group I); (264 ± 63) × 106 µm3/cm3 and 3.86 ± 0.81 mm3 in SHAM (Group II) and (194 ± 52) × 106 µm3/cm3 and 1.52 ± 0.36 mm3 in OBL group (Group III). It was noted that the TBFV was significantly diminished, with apoptotic degradation in the olfactory bulbs and breast glands of OBL-applied animals (p < 0.001). Conclusion: It seems that diminished milk secretion is attributable to the degradation of breast glands that results from olfaction loss in OBL animals

Diagnostic delay in rare diseases

OBJECTIVE Post-operative radiotherapy (PORT) in non-small cell lung cancer (NSCLC), especially after complete resection, has long been an unresolved dilemma and debated among therapeutic disciplines. We aimed to evaluate the effects of different radiotherapy volumes and techniques on local-regional recurrence patterns and PORT results in patients with NSCLC. METHODS The results of 389 patients who underwent surgery and received PORT at 11 centers were analyzed retrospectively. The surgical margin was positive or closes in 100 (26%) patients. The PORT dose was a median of 50 Gy (36-60 Gy). Intensity-modulated RT methods were used in 68 (17.5%) patients. RESULTS The first recurrence of the patients who developed relapse, local recurrence was found in 77 (19.8%) patients, distant recurrence was found in 95 (24%) patients, and both recurrences was found in 30 (8%) patients. The median time to locoregional relapse was 14 months (1.84-59.7 months). Local-regional recurrence was not significantly higher in patients with positive surgical margins than in negative pa-tients (39% vs. 29%, p=0.1), but the dose administered to these patients was also higher. Mediastinal recurrence occurred in 28 (19%) patients who did not receive radiotherapy to the mediastinum; 25 of these recurrences (89%) were just near or outside the field. Cardiac events became 7% in all groups and did not change according to chosen mediastinal radiotherapy volume. CONCLUSION A clear description of the PORT volumes according to the localization of the primary tumor and the involved lymph nodes would be beneficial in terms of establishing the recurrence/toxicity balance better