Wczesne versus opóźnione odżywianie po cięciu cesarskim z różnymi metodami znieczulenia – badanie randomizowane

Objective: The aim of the study was to evaluate the safety and efficacy of early feeding after cesarean delivery under different anesthetic methods. Study design: Two hundred women with elective cesarean delivery were randomly assigned to early oral feeding (EOF) or routine oral feeding (ROF) groups. EOF patients were informed that they could begin taking fluids orally (regime I) as soon as 2 hours after the delivery and then gradually progress to solid foods (regime III), if tolerated. ROF patients were informed that they could start regime I right after bowel sounds were heard on examination and then gradually move on to regime III. Hospitalization time and total time to ambulation (primary outcomes), gasstool discharge time and onset of bowel sounds (secondary outcomes) were compared in groups A [EOF patients after regional anesthesia (n=49)], B [EOF patients after general anesthesia (n=48)], C [ROF patients after regionalanesthesia (n=47)] and D [ROF patients after general anesthesia (n=48)]. Results: There were significant differences in primary and secondary outcomes between group A and the remaining groups, especially group D. The status of patients from group B was not better than group C. In fact, the latter were discharged home sooner and passage of gas, as well as initiation of regime I occurred earlier as compared to the former. Conclusions: Cesarean section under regional anesthesia and encouragement of oral feeding 2 hours after the operation should be recommended in order to achieve postoperative recovery and early hospital discharge. Routine oral feeding (right after bowel sounds are heard on examination) after cesarean section under general anesthesia should be the last choice.Cel: Celem badania była ocena bezpieczeństwa i skuteczności wczesnego włączenia odżywiania po cesarskim wykonanym przy różnych metodach znieczulenia. Do badania włączono 200 kobiet po elektywnym cięciu cesarskim. Po randomizacji pacjentki przydzielano do grupy wczesnego odżywiania dojelitowego (EOF) lub grupy zwykłego włączania jedzenia (ROF). Pacjentkom z grupy EOF pozwolono pić płyny już 2 godziny po porodzie (reżim I) a następnie stopniowo przechodzić do pokarmów stałych (reżim III). Pacjentki z grupy ROF mogły rozpocząć odżywianie wg reżimu I gdy w badaniu osłuchiwaniem obecna była perystaltyka a następnie stopniowo przechodzić do reżimu III. Czas hospitalizacji, całkowity czas do uruchomienia (pierwotny punkt końcowy), czas do oddania gazów i stolca i czas do rozpoczęcia perystaltyki (wtórny punkt końcowy) porównano pomiędzy grupami A [pacjentki EOF ze znieczuleniem przewodowym, n=49], B [EOF ze znieczuleniem ogólnym, n=48], C [ROF ze znieczuleniem przewodowym, n=47] i D [ROF ze znieczuleniem ogólnym, n=48]. Wyniki: Zaobserwowano istotne różnice pomiędzy grupą A a pozostałymi grupami, zwłaszcza grupą D, w odniesieniu do pierwotnego i wtórnego punktu końcowego. Status pacjentek z grupy B nie był lepszy niż z grupy C. W rzeczywistości pacjentki z grupy C były zwalniane do domu wcześniej, również pasaż gazów i włączenie diety wg reżimu I następowały wcześniej niż w grupie B. Wnioski: Cięcie cesarskie ze znieczuleniem przewodowym i włączeniem odżywiania 2 godziny po operacji powinno być zalecane ze względu na szybszą rekonwalescencję oraz wczesny wypis ze szpitala. Jako ostatnie powinno się wybierać cięcie cesarskie ze znieczuleniem ogólnym i rutynowym włączeniem odżywiania po usłyszeniu perystaltyki jelit

Early versus delayed oral feeding after cesarean delivery under different anesthetic methods - a randomized controlled trial Anesthesia, feeding in cesarean delivery

Objective: The aim of the study was to evaluate the safety and efficacy of early feeding after cesarean delivery under different anesthetic methods

Early versus delayed oral feeding after cesarean delivery under different anesthetic methods – a randomized controlled trial Anesthesia, feeding in cesarean delivery

Objective: The aim of the study was to evaluate the safety and efficacy of early feeding after cesarean delivery under different anesthetic methods

Meta Analysis of Studies about Breast Self Examination between 2000-2009 in Turkey

Aim: The aim of this study was to analyze studies in Turkey about self-breast examination and produce conclusive, reliable and detailed basis for future studies. Methods: Studies performed between 2000 and 2009 (until the end of September) were retrieved from databases using breast cancer, breast examination, breast cancer screening and risk factors as key words. Fifty-nine studies were identified and 18 of them (15 journal articles and three theses) were used for the meta-analysis. Results: Married women and women with a family history of breast cancer were found to perform self-breast examination more frequently than single women and women without a family history of breast cancer, respectively (OR=1.02 %CI 0.82-1.63; OR=1.16 %CI 0.82-1.63). According to the health belief model scales, women performing self-breast examination were determined to have 1.7 times higher susceptibility (OR=1.70), 1.34 times higher seriousness perception (OR=1.34), 3.32 times higher health motivation (OR=3.32), 5.21 times more self-efficacy/confidence (OR=5.21) and 2.56 times higher self-breast examination benefit perception (OR=2.56). Conclusion: Nursing care models caused an increase in self-breast examination by women, and thus, it may be useful to organize and evaluate such health-related programs and consider women health perceptions

Updating the role played by immunotherapy for allergic rhinitis: meta-analysis

WOS: 000348915400007PubMed: 25424754BackgroundAlthough the effectiveness of allergen monotherapy immunotherapy for allergic rhinitis (AR) has been well established by many prior studies, other aspects of immunotherapy are still incompletely documented by high-quality studies. The many published papers describe various results. The aim of the present study was to conduct a meta-analysis on the effectiveness of allergen immunotherapy. MethodsA total of 56 homogeneous studies were included in the analysis. The inclusion criteria used to select articles were as follows: (1) placebo-controlled clinical trials; (2) the use of immunotherapy; (3) participants and/or physicians were or were not blinded to immunotherapy or placebo assignment (single-blinding, double-blinding, or no-blinding studies); and (4) randomization or not of those in the immunotherapy and placebo groups. ResultsBetween 2003 and 2013, 114 placebo-controlled clinical trials were reported in Medline. Studies describing recovery rates in immunotherapy and placebo groups numbered 56. The distribution of such works was homogeneous (heterogeneity chi-square = 16.11; degrees of freedom [df] = 55; p = 1.000). The extent of recovery in immunotherapy groups was 53.671-fold greater than in placebo groups (Mantel-Haenszel [M-H] pooled risk ratio [RR] = 53.671; 95% confidence interval [CI], 36.981 to 77.893; z = 20.96; p < 0.001). ConclusionOur meta-analysis suggests that immunotherapy is associated with a recovery rate 53.671-fold that of placebo

Evaluation of labral pathology and hip articular cartilage in patients with femoroacetabular impingement (FAI) : comparison of multidetector CT arthrography and MR arthrography

Background: To compare the multidetector computed tomography (MDCT) arthrography (CTa) and magnetic resonance (MR) arthrography (MRa) findings with surgical findings in patients with femoroacetabular impingement (FAI) and to evaluate the diagnostic performance of these methods. Material/Methods: Labral pathology and articular cartilage were prospectively evaluated with MRa and CTa in 14 hips of 14 patients. The findings were evaluated by two musculoskeletal radiologists with 10 and 20 years of experience, respectively. Sensitivity, specificity, accuracy, and positive predictive value were determined using surgical findings as the standard of reference. Results: While the disagreement between observers was recorded in two cases of labral tearing with MRa, there was a complete consensus with CTa. Disagreement between observers was found in four cases of femoral cartilage loss with both MRa and CTa. Disagreement was also recorded in only one case of acetabular cartilage loss with both methods. The percent sensitivity, specificity, and accuracy for correctly assessing the labral tearing were as follows for MRa/CTa, respectively: 100/100, 50/100, 86/100 (p0.05) and for femoral cartilage assessment were 100/75, 90/70, 86/71 (p>0.05). Inter-observer reliability value showed excellent agreement for labral tearing with CTa (k=1.0). Inter-observer agreement was substantial to excellent with regard to acetabular cartilage assessment with MRa and CTa (k=0.76 for MRa and k=0.86 for CTa) Conclusions: Inter-observer reliability with CTa is excellent for labral tearing assessment. CTa seems to have an equal sensitivity and a higher specificity than MRa for the detection of labral pathology. MRa is better, but not statistically significantly, in demonstrating acetabular and femoral cartilage pathology

Induction of apoptosis in human breast adenocarcinoma MCF-7 cells by tannic acid and resveratrol

Tannic acid (TA), a plant polyphenol, has been described as having anticarcinogenic, antioxidant, antimutagenic, antimicrobial, antiallergic, antiinflammatory and astringent properties. Resveratrol (RES), a phytoalexin phenolic compound, has been known as an antioxidant, anticarcinogenic, antiinflammatory, antimutagenic, antiproliferative, antiviral, antibacterial, estrogenic and vasodilator agent. Although molecular mechanisms of TA and RES responsible for anticancer activity are yet to be known, there are in vitro studies indicating that these substances contribute to anticancer activity by inducing apoptosis. In this study, the effects of TA and RES in MCF-7 breast cancer cells on apoptotic index, FAS-associated death domain (FADD) and Bak proteins were investigated. Terminal transferase-mediated dUTP nick end-labeling (TUNEL) method was applied for apoptosis and immunohistochemical staining for FADD and Bak proteins. Our study results show that TA and RES increased apoptotic index, percentage ratios of apoptotic proteins Bak and FADD in MCF-7 cell line.Keywords: Bak, Fas-associated death domain (FADD), MCF-7, resveratrol, tannic acidAfrican Journal of Biotechnology Vol. 12(12), pp. 1431-143

Effects of various agents on DNA fragmentation and telomerase enzyme activities in adenocarcinoma cell lines

Natural compounds such as resveratrol, tannic acid, and quercetin may help to treat cancer. Tamoxifen is a non-steroidal anti-estrogen drug widely used in the treatment of patients with estrogen receptor-positive breast cancer. The aim of the study was to compare the effects of these natural compounds and tamoxifen in colon adenocarcinoma (CaCo-2) and breast adenocarcinoma (MCF-7) cell lines, on telomerase enzyme activity, cell viability, number of cells and DNA fragmentation. In this study to determine telomerase enzyme activity was used PCR-ELISA kit. To determine cell viability and number of cells were used tripan blue stain. DNA fragmentation was determined by DNA ladder isolation kit. Tannic acid was more effective than resveratrol, with respect to reduction in telomerase activity, cell viability and cell count in breast adenocarcinoma. Tannic acid and tamoxifen was more effective than resveratrol and quercetin telomerase activity, cell viability and cell count in colon adenocarcinoma. Flavonoids such as resveratrol, tannic acid and quercetin which was studied on, has benefical effects on cancer therapy. These effects such as decreasing telomerase enzyme activity, cell viability and number of cells and inducing DNA fragmentation (apoptosis) must be studied for assist to develop new therapeutic pathways. There should be much more sudies in order to discover resveratrol, tannic acid and quercetin and other potential medicines

Do Probiotics have a role in the Treatment of Allergic Rhinitis? A Comprehensive Systematic Review and Metaanalysis

WOS: 000390854700003Objective: To investigate clinical evidence for the efficacy of probiotics in the treatment of allergic rhinitis (AR). Methods: A systematic search was conducted to review the results of all randomized, double-blind, placebo-controlled trials by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. Primary outcome measurements were total nasal and ocular symptom scores (SS) and quality of life (QoL) questionnaires. Secondary outcome measurements were individual nasal SS and immunologic parameters. Results: Twenty-two randomized, double-blind, placebo-controlled studies were included. Seventeen trials showed significant benefit of probiotics clinically, whereas eight trials showed significant improvement in immunologic parameters compared with placebo. All five studies with Lactobacillus paracasei (LP) strains demonstrated clinically significant improvements compared with placebo. Probiotics showed significant reduction in nasal and ocular SS (standardized mean difference [SMD], -1.23, p < 0.001; and SMD, -1.84, p < 0.001; respectively), total, nasal, and ocular QoL scores compared with placebo (SMD, -1.84, p < 0.001; SMD, -2.30, p = 0.006; and SMD, -3.11, p = 0.005; respectively). Although heterogeneity was high, in subgroup analysis, SMD for total nasal and ocular symptoms with patients with seasonal AR and for nasal QoL scores for studies with LP-33 strain were significant and homogenous. Scores of nasal blockage, rhinorrhea, and nasal itching were significantly lower in the probiotic group compared with placebo. The meta-analysis studies SS the Japanese guidelines revealed a significant, homogenous SMD score of -0.34 for individual nasal SS, above the minimal important clinical difference value of 0.3. The T-helper 1 to T-helper 2 ratio was significantly lower in the probiotic group compared with placebo (SMD, -0.78; p = 0.045). Conclusion: Despite high variability among the studies, synthesis of available data provided significant evidence of beneficial clinical and immunologic effects of probiotics in the treatment of AR, especially with seasonal AR and LP-33 strains. With the rising pool of studies, the most promising strains in specific allergies can be revealed and adjuvant therapy with probiotics can be recommended for the treatment of AR.Continuous Education and Scientific Research AssociationWith the exception of data collection, the preparation of this manuscript, including its design and planning, was supported by the Continuous Education and Scientific Research Associatio