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Objectives@#Symptomatic local treatment of vaginal atrophy (VA) in menopausal women includes hormonal and nonhormonal preparations. Some women may be reluctant to use vaginal estradiol preparations because of the concern for developing breast cancer and endometrial hyperplasia. Therefore, it is necessary to compare the therapeutic effectiveness of alternative vaginal drugs, such as promestriene, an estrogen agonist, and sodium hyaluronate (NaH), a nonhormonal, water-based agent. @*Methods@#Ninety-one postmenopausal women diagnosed with symptomatic VA were divided into three groups and treated for 12 weeks; 30 women with vaginal estradiol (VE), 30 women with promestriene, and 31 women with NaH. Composite scoring, vaginal maturation index (VMI), pH, frequency of sexual activity, serum hormone levels, and endometrial thickness were evaluated VA before and after treatment. @*Results@#In the comparison of VA examination findings composite scoring, VMI, and vaginal pH values, three different drugs were found to be effective in the treatment (P < 0.05). The VMI following VE treatment was significantly higher than that after NaH treatment (P = 0.031), whereas the promestriene group had a more positive change than the others in terms of increase in after treatment composite scoring and sexual activity frequency (P = 0.031, P = 0.020). There were no differences between the groups in terms of pre and after treatment serum E2 levels and endometrial thickness. @*Conclusions@#Based on these findings, we can conclude that the use of promestriene or NaH can prove to be as effective and well tolerated as vaginal estradiol in the symptomatic treatment of vaginal atrophy.
ABSTRACT
Objectives@#Symptomatic local treatment of vaginal atrophy (VA) in menopausal women includes hormonal and nonhormonal preparations. Some women may be reluctant to use vaginal estradiol preparations because of the concern for developing breast cancer and endometrial hyperplasia. Therefore, it is necessary to compare the therapeutic effectiveness of alternative vaginal drugs, such as promestriene, an estrogen agonist, and sodium hyaluronate (NaH), a nonhormonal, water-based agent. @*Methods@#Ninety-one postmenopausal women diagnosed with symptomatic VA were divided into three groups and treated for 12 weeks; 30 women with vaginal estradiol (VE), 30 women with promestriene, and 31 women with NaH. Composite scoring, vaginal maturation index (VMI), pH, frequency of sexual activity, serum hormone levels, and endometrial thickness were evaluated VA before and after treatment. @*Results@#In the comparison of VA examination findings composite scoring, VMI, and vaginal pH values, three different drugs were found to be effective in the treatment (P < 0.05). The VMI following VE treatment was significantly higher than that after NaH treatment (P = 0.031), whereas the promestriene group had a more positive change than the others in terms of increase in after treatment composite scoring and sexual activity frequency (P = 0.031, P = 0.020). There were no differences between the groups in terms of pre and after treatment serum E2 levels and endometrial thickness. @*Conclusions@#Based on these findings, we can conclude that the use of promestriene or NaH can prove to be as effective and well tolerated as vaginal estradiol in the symptomatic treatment of vaginal atrophy.
ABSTRACT
Objective: To examine the relation of the health-related practices of expectant mothers during pregnancy and fatigue in mother and prenatal attachment. Study Design: Descriptive study. Place and Duration of Study: Sakarya Training and Research Hospital, Turkey, between February and April 2016
Methodology: The study sample consisted of pregnant women [at least 20-week gestation] aged 18 years or above [n=211] who applied to prenatal care services and agreed to participate in the study. The data were collected through a Personal Information Form, Brief Fatigue Inventory [BFI] and the Prenatal Attachment Inventory [PAI]
Results: The PAI medians of the participants were 55 [42-64], and the BFI medians were 30 [23-42], and a negative, statistically significant relationship was found between BFI and PAI [r= -0.184, p=0.007]
Conclusion: Expectant mothers who develop positive health behaviors during pregnancy feel less fatigue and positively affect the prenatal attachment. It is important to evaluate prenatal attachment and identify the mother with low attachment scores
ABSTRACT
<p><b>BACKGROUND</b>Postmastectomy pain syndrome (PMPS) is defined as a chronic (continuing for 3 or more months) neuropathic pain affecting the axilla, medial arm, breast, and chest wall after breast cancer surgery. The prevalence of PMPS has been reported to range from 20% to 68%. In this study, we aimed to determine the prevalence of PMPS among mastectomy patients, the severity of neuropathic pain in these patients, risk factors that contribute to pain becoming chronic, and the effect of PMPS on life quality.</p><p><b>METHODS</b>This cross-sectional study was approved by the Sakarya University, Medical Faculty Ethical Council and included 146 patients ranging in age from 18 to 85 years who visited the pain clinic, general surgery clinic, and oncology clinic and had breast surgery between 2012 and 2014. Patients were divided into two groups according to whether they met PMPS criteria: pain at axilla, arm, shoulder, chest wall, scar tissue, or breast at least 3 months after breast surgery. All patients gave informed consent prior to entry into the study. Patient medical records were collected, and pain and quality of life were evaluated by the visual analog scale (VAS) for pain, a short form of the McGill Pain Questionnaire (SF-MPQ), douleur neuropathique-4 (DN-4), and SF-36.</p><p><b>RESULTS</b>Patient mean age was 55.2 ± 11.8 years (33.0-83.0 years). PMPS prevalence was 36%. Mean scores on the VAS, SF-MPQ, and DN-4 in PMPS patients were 1.76 ± 2.38 (0-10), 1.73 ± 1.54 (0-5), and 1.64 ± 2.31 (0-8), respectively. Of these patients, 31 (23.7%) had neuropathic pain characteristics, and 12 (9.2%) had phantom pain according to the DN-4 survey. Patients who had modified radical mastectomy were significantly more likely to develop PMPS than patients who had breast-protective surgery (P = 0.028). Only 2 (2.4%) of PMPS patients had received proper treatment (anticonvulsants or opioids).</p><p><b>CONCLUSIONS</b>PMPS seriously impacts patients' emotional situation, daily activities, and social relationships and is a major economic burden for health systems. We conclude that the rate of PMPS among patients receiving breast cancer surgery in Turkey is 64.1% and that challenges to the proper treatment of these patients deserve further investigation.</p>
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Cross-Sectional Studies , Mastectomy , Pain, Postoperative , Epidemiology , Prevalence , Quality of LifeABSTRACT
Objective: Polysomnography [PSG] remains the gold standard for the diagnosis of obstructive sleep apnoea syndrome [OSAS]. While PSG is essential for OSAS, this technique is not suitable for epidemiological investigation due to its high cost. This study aimed to compare a portable monitoring device with PSG for the measurement of parameters related to the diagnosis of OSAS in rural areas
Methods: We conducted a descriptive study of 155 patients [30 women and 125 men; mean age, 52 +/- 12 years] who visited to the Hendek Government Hospital Sleep Laboratory between February 2011 and January 2013 Apnoea hypopnea index [AHI], mean levels of O[2] [meanO[2]], desaturation index [DI], and minimum oxygen saturation [minO[2]] variations as measured using both PSG and a portable Somnocheck Micro [SM] device were compared
Results: Differences were found between the meanO[2] and DI, but not between AHI and minO[2]. Differences between the methods were not desired, but the relationship between the methods was distinct and supported our hypothesis
Conclusions: The results of our study have shown that the SM portable device can be used as an alternative diagnostic tool in this population either at home or in sleep clinic
ABSTRACT
This experimental study was designed to produce ischemia-reperfusion injury in rat kidney by performing partial unilateral ureteral obstruction [PUUO] and investigated the effects of melatonin on the levels of oxidative injury parameters. Twenty-four adult male rats were randomly divided into three groups as follows; control group [Group 1]; only nephrectomy and blood [5 ml] drawn from vena cava inferior, PUUO group [Group 2]; PUUO [10 days]+ipsilateral nephrectomy after recovery of PUUO+blood from vena cava inferior VCI, melatonin treated group [Group 3]; PUUO [10 days]+melatonin [1/2 hr before release, 50 mg/kg, ip]+ipsilateral nephrectomy after recovery of PUUO+blood from VCI. The left ureter was embedded into the psoas muscle to create PUUO. After 10 days, PUUO was recovered and ipsilateral nephrectomies were performed for biochemical analysis of superoxide dismutase [SOD], catalase [CAT], malondialdehyde [MDA], glutathione peroxidase [GSH-Px], and protein carbonyl [PC] in the tissues and blood was drawn from inferior vena cava to study the same parameters in systemic circulation. The results were compared statistically. The blood levels of MDA, NO, and PC were increased in the PUUO group in comparison to the sham-operated group [P<0.05]. Melatonin treatment reduced MDA, NO, and PC levels in blood after PUUO recovery, but statistically significance consisted only for MDA and NO [P<0.05]. The antioxidant enzyme activities [SOD, GSH-Px] were increased in the PUUO group [P<0.05]. Melatonin treatment reduced SOD and GSH-Px activities in comparison with the sham-operated control group [P<0.05]. Similarly, renal tissue levels of MDA, NO, and PC were increased in the PUUO group in comparison with the sham-operated group [P<0.05]. Melatonin treatment ameliorated MDA, NO, and PC levels in renal tissue after PUUO recovery only MDA was statistically significant [P<0.05]. Antioxidant enzyme activities [SOD, CAT, and GSH-Px] were increased in the PUUO group. Melatonin treatment caused reduction in SOD, CAT, and GSH-Px activities in comparison to the sham-operated control group [P<0.05]. The results of this study showed that experimentally induced PUUO caused oxidative stress in rat kidney and melatonin treatment reduced oxidative stress and therefore may have a preventive effect on PUUO induced oxidative kidney damage in rats