A randomized pilot study of acupuncture treatment for primary dysmenorrhea.

OBJECTIVE: To compare the therapeutic effect of acupuncture and non-steroidal anti-inflammatory drug (NSAID) therapy in primary dysmenorrhea patients. STUDY DESIGN: Thirty-five young women with a diagnosis of primary dysmenorrhea were recruited for the study. Their dysmenorrhea severity was rated by visual analog scale (VAS) immediately prior to entry into the study. They were randomly divided into two groups; and the following month they were given NSAID (group 1, n=24) or acupuncture treatment (group 2, n=11). Pain was rated again using VAS during menstruation in both groups. RESULTS: After one month's treatment, pain scores were significantly lower in both groups (p<0.05). Mean pain scores decreased by 52.2% and 69.5% in the NSAID and acupuncture groups, respectively. CONCLUSION: Acupuncture was as effective as NSAID therapy for patients with primary dysmenorrhea. Since this was a pilot study with a small sample size and short follow-up period, larger studies are needed to clarify the effect of acupuncture in the treatment of primary dysmenorrhea.

Survey of environmental exposure to asbestos in the town of Buyuktatlar, Turkey.

Asbestos-related cases admitted to Chest Diseases Clinic of Kahramanmaras Sutcu Imam University Medical Faculty generally came from Buyuktatlar, a town adjacent to the Afsin district of Kahramanmaras city. This led us to screen for lung pathologies due to exposure to environmental asbestos in the town of Buyuktatlar. Six hundred and eighty-five inhabitants older than 30 years living in the town were identified as the study group and 488 persons (71·2%) were accepted for evaluation. Then, chest X-rays of these cases were taken and bilateral pleural plaque, bilateral pleural thickening, reticular lung infiltrations, and costophrenic angle obliteration were evaluated as asbestos-related disorders (ARD). ARD were diagnosed in 56 (11·5%) of the 488 chest X-rays that were assessed and no differences were observed between genders. Twenty-five of the cases were investigated by high-resolution computed tomography. Twenty-four were confirmed as ARD. In addition, chrysotile fiber was found in two of four soil samples taken from the town.

Comparison of transforming growth factor ß1 concentrations in the ovaries of rats stimulated by human menopausal gonadotropin or recombinant follicle-stimulating hormone.

OBJECTIVE: To compare the effects of human menopausal gonadotropins (hMG) and recombinant follicle stimulating hormone (rFSH) on transforming growth factor (TGF) ß1 concentration in the rat ovary. STUDY DESIGN: Twenty-one fertile Wistar-Albino rats were divided into 3 groups of 7. Groups 1, 2 and 3 were injected with saline, hMG or rFSH, respectively, over 5 days, after which they underwent ovariectomy. Hematoxylin and eosin (H&E) staining was used for histological examination. TGF ß1 staining levels in ovarian stroma, vessel walls, granulosa cells of Graafian follicles and corpus luteum cells were investigated immunohistochemically. RESULTS: On histological examination, the number of smaller antral follicles was higher in the control group, while there were more and larger antral follicles in the hyperstimulated groups. There were statistically significant differences in staining in vessel walls and granulosa cells between the control and stimulated groups. Both stimulation protocols caused an increased TGF ß1 concentration in vessel walls, while there was weak staining in granulosa cells in the treatment groups compared to the control group (p<0.05). There were no significant differences in staining scores between the two treatment groups (p>0.05). CONCLUSIONS: The effects of two different gonadotropin preparations on TGF ß1 concentrations in different localizations in the rat ovaries are comparable. It may be postulated that the luteinizing hormone (LH) content of hMG contributes little or nothing to the TGF ß1 mediated angiogenesis.

Oxidative stress and antioxidant status in neonatal hyperbilirubinemia.

OBJECTIVE: To investigate the possible relationships between plasma bilirubin levels and concentrations of nitric oxide (NO), malondialdehyde (MDA), and erythrocyte antioxidant enzyme activities in newborn infants with hyperbilirubinemia. METHODS: Thirty term (gestational age > or = 37 weeks) newborn infants with indirect hyperbilirubinemia aged less than 10 days were prospectively recruited in the Kahramanmaras Sutcu Imam University Neonatal Unit, Kahramanmaras, Turkey, between January and July 2007. Thirty randomly selected healthy newborns who had similar age and without clinical jaundice comprised the control group. Erythrocyte catalase, superoxide dismutase, glutathione peroxidase (GPx), glucose-6-phosphate dehydrogenase, and plasma MDA and NO concentrations were measured. RESULTS: Both MDA and NO concentrations were higher in the study group than the controls (p=0.000). The mean activities of erythrocyte antioxidant enzymes were found to be lower in the study group compared with the controls (p=0.000). Furthermore, plasma bilirubin showed significant negative correlations with antioxidant enzyme activities but positive correlations with MDA and NO. CONCLUSION: In this sample, infants with significant hyperbilirubinemia had elevated oxidative stress and disturbed antioxidant enzyme activity. Since these states have been shown to cause cellular injury in neonatal patients with indirect hyperbilirubinemia, such patients should be followed-up and undergo therapy to prevent the harmful effects of hyperbilirubinemia. Further studies are needed to investigate possible benefits of antioxidants in hyperbilirubinemia.

The knowledge and attitudes of the primary care physicians on developmental dysplasia of the hip.

OBJECTIVE: For the prevention and early diagnosis of developmental dysplasia of the hip (DDH), a detailed clinical screening of the newborn performed by a primary care (PC) physician is recommended as a standard practice throughout the most western countries. We aimed to determine the knowledge and attitudes of the PC physicians towards DDH, and to develop further educational and training programs, according to the results obtained from the study. METHODS: The study was a pre- and post- test with a cross-sectional design. In winter of 2005, the participants included 102 PC physicians from 20 primary health care centers in Kahramanmaras, Turkey. A structured questionnaire was prepared consisting of 28 statements on medical, practical, and traditional knowledge and attitudes concerning DDH. RESULTS: There was a significant difference between the pre-test (71.47 +/- 9.92) and post-test scores (78.85 +/- 12.86) of participants (p=0.000). Of the participants, 83 (81.4%) before, and 93 (91.2%) after the lecture, thought that DDH is a preventable disease. Prior to the lecture, only 27.5% of the physicians were aware of the wrong traditional attitudes that are considered as risk factors for DDH. CONCLUSION: The knowledge and attitudes of PC physicians on DDH needs to be improved by providing continuous education programmes.

Evaluating environmental tobacco smoke exposure in a group of Turkish primary school students and developing intervention methods for prevention.

BACKGROUND: In countries like Turkey where smoking is highly prevalent, children's exposure to tobacco smoke is an important public health problem. The goals of this study were to determine the self-reported environmental tobacco smoke exposure status of primary school students in grades 3 to 5, to verify self-reported exposure levels with data provided from a biomarker of exposure, and to develop methods for preventing school children from passive smoking. METHODS: The study was conducted on 347 primary school students by using a standard questionnaire and urinary cotinine tests. Children with verified ETS exposure were randomly assigned to 2 intervention groups. Two phone interviews were conducted with the parents of the first group regarding their children's passive smoking status and its possible consequences. On the other hand, a brief note concerning urinary cotinine test result was sent to parents of the second group. Nine months after the initial urinary cotinine tests, measurements were repeated in both groups. RESULTS: According to questionnaire data, 59.9% of the study group (208 of 347) were exposed to ETS. Urinary cotinine measurements of children were highly consistent with the self-reported exposure levels (P < 0.001). Two different intervention methods were applied to parents of the exposed children. Control tests suggested a remarkable reduction in the proportion of those children demonstrating a recent exposure to ETS in both groups. Proportions of children with urinary cotinine concentrations 10 ng/ml or lower were 79.5% in Group I and 74.2% in Group II (P > 0.05). CONCLUSION: Self-reported ETS exposure was found to be pretty accurate in the 9-11 age group when checked with urinary cotinine tests. Only informing parents that their children' ETS exposure were confirmed by a laboratory test seems to be very promising in preventing children from ETS.

Effects of oestrogen replacement therapy on serum C-reactive protein levels in hysterectomised women.

BACKGROUND: It has been hypothesised that oral oestrogen replacement therapy may increase levels of C-reactive protein (CRP), a marker of inflammation associated with increased risk of future cardiovascular events. However, it is possible that intranasal oestrogen replacement therapy have different effects on serum CRP levels. AIM: To investigate the effect of postmenopausal intranasal oestrogen replacement therapy on serum levels of CRP. A prospective comparative study was carried out. METHODS: Twenty-nine healthy hysterectomised, postmenopausal women received 300 micro g/day of intranasal 17beta-oestradiol (E2). The serum levels of CRP after 3 and 6 months after starting treatment were compared with baseline values. RESULTS: There were no significant changes in the values of CRP after 3 and 6 months of treatment (P = 0.305, P = 0.149, respectively). CONCLUSIONS: The data from the present study suggest that intranasal administration of E2 does not affect CRP levels, possibly by avoiding a hepatic first-pass effect. The possible cardiovascular protective role of intranasal oestrogen might be related to its effect of not increasing CRP levels.

Effects of intranasal estradiol treatment on serum lipoprotein(a) and lipids in hysterectomized women.

The aim of the present study was to evaluate the effects of intranasal estradiol on lipid metabolism and lipoprotein(a) [Lp(a)] levels. A prospective comparative study was designed: 49 hysterectomized, healthy postmenopausal women received intranasal 17beta-estradiol (E2; 300 microg/day). Blood samples were collected at baseline and at the end of the 3 and 6 months of therapy. After 6 months, the serum levels of total cholesterol, LDL-cholesterol and triglycerides did not show any significant change with intranasal 17beta-E2 therapy. HDL-cholesterol levels at 3 and 6 months of treatment were significantly increased compared with baseline levels (p = 0.031, p = 0.000, respectively). There was a significant change in serum Lp(a) levels at the 6th month (p = 0.003) but not at the 3rd month (p = 0.183) compared with the baseline levels. Further studies are needed to detect whether these changes are significant and permanent or not.

Serum lipid and lipoprotein changes induced by preparations containing low-dose ethinylestradiol plus levonorgestrel.

The purpose of the present study was to evaluate the effects on lipid metabolism of a new low-dose monophasic combination oral contraceptive with 100 microg levonorgestrel and 20 microg ethinylestradiol. Sixty healthy women aged 18-45 years were administered the medication during three cycles. The study participants were screened for lipid changes. The differences in cholesterol and triglyceride levels were not statistically significant, but high-density lipoprotein levels were significantly lower and low-density lipoprotein levels were significantly higher than the baseline. Women at risk of cardiovascular disease should be carefully monitored even when using low-dose preparations.