The impact of education on the diagnostic accuracy of tension-type headache and migraine: a prospective study.

General practitioners (GPs) diagnose and treat headache in primary care settings. The objective of this study was to investigate the effect of a 2-day headache education programme for GPs primarily on diagnostic accuracy. The education programme included theoretical lectures and face-to-face patient evaluation with headache specialists. Three GPs evaluated headache patients before and after the programme. Each GP was planned to interview a total of 60 patients (30 before, 30 after the programme). All patients were evaluated by headache specialists following evaluation by the GPs. A total of 189 patients were included in this study. Diagnostic accuracy increased from 56.3% to 81.0% after the headache education programme (P < 0.001), which also significantly improved the choice of proper treatment (P = 0.043). The headache education programme for GPs significantly improved diagnostic accuracy in patients with tension-type headache and the choice of proper treatment. Such education programmes can be standardized and given to GPs working in the primary care setting. These programmes can be arranged locally by the universities and might have a favourable impact on the diagnosis and treatment of headache.

Multipotent mesenchymal stem cells reduce interstitial fibrosis but do not delay progression of chronic kidney disease in collagen4A3-deficient mice.

Multipotent mesenchymal stem or stromal cells (MSC) have shown to improve outcome of acute renal injury models, but whether MSC can delay renal failure in chronic kidney disease is not known. We injected primary MSC or saline into mice that lack the alpha3-chain of type IV collagen (COL4A3), a model of chronic kidney disease with close similarities to human Alport disease. Weekly injections of MSC from week 6 to 10 of life prevented the loss of peritubular capillaries and reduced markers of renal fibrosis, that is, interstitial volume, numbers of smooth muscle actin-positive interstitial cells, and interstitial collagen deposits as compared to saline-injected COL4A3-deficient mice. However, renal function, that is, blood urea nitrogen, creatinine levels, proteinuria as well as survival of COL4A3-deficient mice were not affected by MSC injections. Although MSC were found to localize to kidneys of COL4A3-deficient mice after injection, differentiation into renal cells was not detected. However, MSC expressed growth factors, that is, vascular endothelial growth factor (VEGF) and bone morphogenetic protein-7 under basal culture conditions. In fact, VEGF mRNA levels were increased in kidneys of MSC-injected COL4A3-deficient mice and MSC supernatants enhance endothelial cell proliferation in vitro. Thus, weekly injections with MSC prevent loss of peritubular capillaries possibly owing to local production of growth factors rather than by differentiation into renal cells. The maintenance of interstitial vasculature is associated with less interstitial fibrosis but, is insufficient to delay renal failure and survival of COL4A3-deficient mice.

Enuresis and the effective factors--a case-control study.

OBJECTIVE: Enuresis is widespread and affects the child and the family both psychologically and socially. This research was performed between 1 February and 30 June 1998, in Gemlik district to investigate the effective factors on enuresis among 5-9 year-old children. MATERIAL AND METHODS: A questionnaire containing 31 questions was answered by the mothers during the house visits. Two hundred and seventy-seven cases were determined in a previous study and randomly selected 277 controls were matched according to their ages, gender and residential districts. RESULTS: Younger mothers, mothers with less education and working mothers have more enuretic children. Enuresis is more prevalent within the first children. Odds ratio is 11.1 if his/her mother and/or father has had enuresis. The age of toilet training was earlier among controls than cases. CONCLUSIONS: As enuresis is rather widespread, the parents may consider this as a transient problem and therefore no effort might be given for the solution. Trained health personnel and physicians should enlighten the parents about enuresis in order to eliminate the negative effect on the child.

The comparison of reproductive health data in a rural district in Turkey (1981-2001).

OBJECTIVES: The main objective was to compare new reproductive and family planning data with data from the 1981 survey. METHODS: All 15-49-year-old married women living in seven villages of Gemlik were interviewed and the data were compared with the 1981 data of the same villages. RESULTS: In 1981, 66.8% used a family planning method, 6.8% used an intrauterine device, 10.2% used oral contraceptives and 10.0% used condoms. In 2001, these values were 93.0%, 36.5%, 6.0% and 14.8%, respectively. In 1981, 51.5% and in 2001 35.5% used coitus interruptus. CONCLUSION: In 20 years, users of both current family planning methods and modem methods have increased; users of traditional methods have decreased.

[Epidemiology of rotavirus infantile diarrhea in Istanbul using virus genome RNA electrophoresis]. / Istanbul'da Rotavirus çocuk diyareleri epidemiyolojisinin virus genom RNA'si elektroforezi ile arastirilmasi.

Rotaviruses were detected using ELISA and latex agglutination, in 210 of 826 (25.4%) stool specimens collected from children with gastroenteritis between October 1984 and August 1990. In 82 of the 85 specimens (96%), Rotavirus specific RNA pattern was detected with polyacrylamide gel electrophoresis and silver staining. In 44 of the 56 strains with long migration pattern, 20 different electropherotypes and in 25 of the 26 strains with short migration pattern, 9 different electropherotypes were seen, respectively. Of the remaining strains, 3 were accepted as having mixed RNA pattern since 15 or 16 bands were detected in electrophoresis and 2 strains (one from long; one from short migration pattern) showed an extra RNA band.