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1.
J Obstet Gynaecol ; 35(3): 290-6, 2015 Apr.
Article in English | MEDLINE | ID: mdl-25259651

ABSTRACT

To determine the efficacy and safety of primary medical treatment with systemic methotrexate (MTX) in caesarean scar ectopic pregnancy, we conducted a Medline/PubMed search on the relevant English literature from January 1978 to January 2012. The search yielded 27 publications of 40 cases of caesarean scar ectopic pregnancy. The literature search showed a very liberal use of systemic MTX treatment with unfavourable outcomes, although the major determinant of the clinical efficacy was found in here to be ß-hCG level together with embryonic cardiac activity (ECA) status. A caesarean scar ectopic pregnancy presented with a serum ß-hCG concentration of ≤ 12,000 mIU/ml (odds ratio, OR 5.68, 95% confidence interval, CI, 1.37-23.48) and absence of ECA (OR 4.80, 95% CI, 1.14-20.08) was found to be associated with higher efficacy rate of primary systemic MTX treatment. Administration of primary systemic MTX treatment was found to be ideal for a caesarean scar ectopic pregnancy presented before 8 weeks' gestation, with a ß-hCG concentration of ≤ 12,000 mIU/ml together with an absent ECA (OR 14.52, 95% CI, 2.36-89.09).


Subject(s)
Abortifacient Agents/therapeutic use , Cesarean Section/adverse effects , Cicatrix/complications , Methotrexate/therapeutic use , Pregnancy, Ectopic/drug therapy , Abortifacient Agents/adverse effects , Chorionic Gonadotropin, beta Subunit, Human/blood , Female , Gestational Age , Humans , Methotrexate/adverse effects , Pregnancy , Pregnancy, Ectopic/blood , Pregnancy, Ectopic/etiology
7.
Int J Impot Res ; 23(1): 27-31, 2011.
Article in English | MEDLINE | ID: mdl-21209618

ABSTRACT

ED is prevalent in hemodialysis (HD) patients, and closely related to poor sleep and depression. Efficacy of treating ED either with sildenafil or vardenafil has been shown to be beneficial in ameliorating concomitant depression in non-HD patients. It is yet to be shown whether treatment of ED with a PDE-5 inhibitor would improve poor sleep in HD patients. We aimed to compare the effects of sildenafil and vardenafil on sleep quality and depression in HD patients with ED. A total of 32 maintenance HD patients with ED randomized into two groups to receive either sildenafil or vardenafil for 4 weeks. After a 2-week washout and a crossover, each group received the other drug for another 4-week period. Sleep quality and depression were evaluated via post-sleep inventory (PSI) and Beck's depression inventory (BDI), respectively, at baseline and at the end of the treatment. Sildenafil and vardenafil both improved PSI and BDI scores significantly compared with pretreatment values. However, there was no difference between sildenafil and vardenafil with respect to these parameters. PDE-5 inhibitors, sildenafil and vardenafil, caused a significant improvement in sleep quality and depression in this cohort of HD patients with ED.


Subject(s)
Depressive Disorder/physiopathology , Erectile Dysfunction/drug therapy , Imidazoles/therapeutic use , Kidney Failure, Chronic/physiopathology , Phosphodiesterase 5 Inhibitors/therapeutic use , Piperazines/therapeutic use , Sleep/drug effects , Sulfones/therapeutic use , Adult , Cross-Over Studies , Depressive Disorder/complications , Depressive Disorder/psychology , Erectile Dysfunction/complications , Erectile Dysfunction/physiopathology , Erectile Dysfunction/psychology , Humans , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/psychology , Male , Middle Aged , Prospective Studies , Purines/therapeutic use , Renal Dialysis , Self Report , Sildenafil Citrate , Surveys and Questionnaires , Treatment Outcome , Triazines/therapeutic use , Vardenafil Dihydrochloride
8.
J Eur Acad Dermatol Venereol ; 25(9): 1080-4, 2011 Sep.
Article in English | MEDLINE | ID: mdl-21118309

ABSTRACT

BACKGROUND: Treatment of psoriatic nail is difficult. OBJECTIVE: The aim of this study was to evaluate and compare the efficacy and safety of methotrexate and cyclosporine in psoriatic nail. METHODS: Thirty-seven psoriatic patients with nail involvement were randomized to treatment with methotrexate (initial dose, 15 mg per week) or cyclosporine (initial dose, 5 mg per kg of bodyweight per day) for 24 weeks. The primary outcome was the Nail Psoriasis Severity Index (NAPSI). The Psoriasis Area and Severity Index (PASI), doctor and patient global score were also measured. The scores were determined by a blinded observer. RESULTS: Seventeen patients completed the study in each group. The mean percentages of reduction of the NAPSI score after methotrexate and cyclosporine treatments were 43.3% and 37.2%, respectively. No significant differences between the treatment groups was found for in the NAPSI, PASI, physician's and patient's global score at the end of the study period. The methotrexate group showed a significant improvement in nail matrix scores and the cyclosporine group in nail bed score. CONCLUSION: Moderate effectiveness on psoriatic nail was found in the two treatment agents and there were no significant differences in efficacy between the groups. A significant improvement was detected in methotrexate group for the nail matrix findings, and in cyclosporine group for the nail bed findings.


Subject(s)
Cyclosporine/therapeutic use , Methotrexate/therapeutic use , Nail Diseases/drug therapy , Psoriasis/drug therapy , Cyclosporine/adverse effects , Humans , Methotrexate/adverse effects , Nail Diseases/etiology , Nail Diseases/physiopathology , Psoriasis/complications , Psoriasis/physiopathology , Single-Blind Method
9.
J Nutr Health Aging ; 13(7): 652-6, 2009 Aug.
Article in English | MEDLINE | ID: mdl-19621202

ABSTRACT

OBJECTIVE: This study used the Brief Version of The World Health Organization's Quality of Life Questionnaire (WHOQOL-BREF) to assess and compare the quality of life in older people who live at home and older people who live in public assisted-living facilities for the elderly. DESIGN: Cross-sectional. SETTING: Data were collected by a research nurse in each home and in the assisted living facility. PARTICIPANTS: PARTICIPANTS were 60 years old and older. The sample included 37 people who were living in a public assisted-living facility and 37 elderly people living in their own homes. MEASUREMENT: The WHOQOL-BREF was used to measure participants' quality of life. RESULTS: The groups were similar according to gender, literacy, existence of chronic diseases, and general perceived health. However, quality of life scores for social relationships and environment domains were lower in those living in an assisted living facility than those living in their own homes. The scores for elderly females staying in the assisted living facility were lower compared to the scores of males in the facility. CONCLUSION: The results suggest that social and environmental domains of life quality are low in elderly assisted living facilities. Social activities should be diversified for elderly people staying in assisted living facilities to improve social relationships. Physical and psychological health of females in assisted living facilities should be comprehensively supported by professionals. Alternatively, elderly people may be professionally supported to live in their own homes.


Subject(s)
Geriatric Assessment , Homes for the Aged/standards , Independent Living/standards , Nursing Homes/standards , Quality of Life , Surveys and Questionnaires , Aged , Aged, 80 and over , Cross-Sectional Studies , Environment , Female , Health Status , Health Surveys , Humans , Male , Middle Aged , Sex Factors , Social Environment , Turkey
10.
J Perinatol ; 27(5): 268-71, 2007 May.
Article in English | MEDLINE | ID: mdl-17363912

ABSTRACT

OBJECTIVE: To find out whether there is considerable influence on second trimester serum concentrations owing to the rhesus status. STUDY DESIGN: This retrospective cohort study was performed at the Perinatology Unit of the GATA Haydarpasa Teaching Hospital. During the study interval, 2265 pregnancies met inclusion criteria. The blood samples were collected in 117 pregnancies with a maternal rhesus-negative blood group status. The control group consisted of 2148 pregnancies with a maternal rhesus-positive blood group status. Statistical analysis was performed by SPSS 11.0 statistical software. RESULTS: Pregnancies with a maternal rhesus-negative blood group status were identified in 117 patients. The overall prevalence of pregnancies with a maternal rhesus-negative blood group status were 5.1% in our study. Only unconjugated estriol multiples of the median values were significantly decreased in rhesus-negative women (P<0.001). Alpha-fetoprotein and human chorionic gonadotrophin multiples of the median values did not differ significantly (P>0.05). CONCLUSION: We conclude that if second trimester screening test to be used in Rh negative pregnancies, either the corrected value should be referred or double test result should be considered ignoring the unconjugated estriol result. Another option is the first trimester Down syndrome screening test.


Subject(s)
Down Syndrome/diagnosis , Mass Screening , Prenatal Diagnosis , Rh Isoimmunization/diagnosis , Adult , Chorionic Gonadotropin/blood , Down Syndrome/epidemiology , Down Syndrome/prevention & control , Estriol/blood , Female , Humans , Infant, Newborn , Predictive Value of Tests , Pregnancy , Reference Values , Rh Isoimmunization/blood , Rh Isoimmunization/epidemiology , Turkey , alpha-Fetoproteins/metabolism
11.
Emerg Med J ; 23(11): 862-4, 2006 Nov.
Article in English | MEDLINE | ID: mdl-17057139

ABSTRACT

BACKGROUND: The importance of early and effective fluid resuscitation in hypovolaemic shock treatment is indisputable. AIM: To examine the effects of fluid replacement via the rectum in an animal model of hypovolaemic shock as a possible life-saving method in situations where veins cannot be accessed quickly. METHODS: Rabbits were randomly divided into two groups: a control group of 7 animals and a second group of 10, the fluid replacement via the rectum (FRVR) group. The femoral artery of each subject was catheterised and 15 ml blood was withdrawn over 1 min at 5-min intervals. After reaching a mean arterial pressure (MAP) of 30 mm Hg, additional blood was withdrawn until the MAP dropped to <25 mm Hg, at which time blood withdrawal ceased. At this point, control animals were given no treatment and were monitored for 30 min. The FRVR group, however, was given 0.9% sodium chloride solution (amount equal to three times the amount of blood withdrawn) via the rectum over a 15-min period. The MAPs of both groups were then measured, every 5 min after the start of resuscitation, for 30 min. RESULTS: In the FRVR group, the MAP began to rise significantly after 15 min of receiving fluid per rectum (p = 0.035) and continued to be significantly greater than the control group at 20, 25 and 30 min (p = 0.035, 0.002 and 0.001, respectively). CONCLUSION: FRVR is a viable alternative for fluid resuscitation in this animal model of hypovolaemic shock. This easy and non-invasive method of fluid replacement may be useful when standard intravenous access is unobtainable, and should be compared with other access routes using varying types and amounts of fluids in future animal studies.


Subject(s)
Fluid Therapy/methods , Models, Animal , Shock, Hemorrhagic/therapy , Animals , Emergencies , Female , Male , Rabbits , Random Allocation , Rectum , Treatment Outcome
12.
Occup Med (Lond) ; 52(6): 353-5, 2002 Sep.
Article in English | MEDLINE | ID: mdl-12361997

ABSTRACT

The objective of the study was to identify job satisfaction levels and their causes among health care workers employed at public health centres. A survey was therefore carried out of health care workers in 21 health centres in Konya, Turkey. The Minnesota Satisfaction Questionnaire was used to investigate job satisfaction. The satisfaction score and proportion of those satisfied were determined according to demographic features. The percentage of satisfied health care workers was 60% and the satisfaction score was 3.8 +/- 0.5. Midwives had the lowest satisfaction scores. Working environment and income were the most important factors for dissatisfaction. There was no correlation between global satisfaction and other demographic variables. These results showed that the health care workers at public health centres in the province have low satisfaction scores. Improving working conditions and income may improve the overall quality of health care provision.


Subject(s)
Attitude of Health Personnel , Community Health Centers , Health Personnel/psychology , Job Satisfaction , Humans , Primary Health Care , Surveys and Questionnaires , Turkey , Workforce , Workplace
13.
Genet Couns ; 8(4): 295-301, 1997.
Article in English | MEDLINE | ID: mdl-9457498

ABSTRACT

This study was conducted in the town of Konya, Turkey, on 1120 randomly selected women to find out the overall rate of consanguineous marriages among couples. The frequency of consanguineous marriages was found to be 23.2%. It was found that 14.6% of this figure was first cousin marriages and the rest was 8.6%. Consanguineous marriages were higher among women born in villages compared to those born in provinces and the town center. Based on the findings, it was not too difficult to say: the higher the level of education of women, the lower the rate of consanguineous marriages. The number of children with an abnormality was high in consanguineous marriages, while the frequency of spontaneous abortion, still-birth and infant death remained the same.


Subject(s)
Congenital Abnormalities/epidemiology , Consanguinity , Infant Mortality , Abortion, Spontaneous/epidemiology , Adolescent , Adult , Education , Female , Fetal Death/epidemiology , Humans , Infant, Newborn , Pregnancy , Socioeconomic Factors , Turkey/epidemiology
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