RESUMO
Objective: Standard-dose methyl-prednisolone (methyl-Pd) is generally preferred as the first-line treatment in immune thrombocytopenia (ITP) unless there is an urgent indication to increase the platelet value. A significant proportion of patients (around 40%) does not benefit from this treatment. This study investigated whether pretreatment platelet level and other hemogram indices in patients with ITP patients can be used to predict early response to standard-dose methyl-Pd treatment. Methods: Patients who received first-line standard-dose methyl- Pd therapy with the diagnosis of primary ITP were included. Patients were categorized as complete responder (CR), responder (R), and non-responder (NR) according to the response status obtained within the first 14 days of treatment. The hemogram indices of the CR, R, and NR groups measured at the start of the treatment were compared retrospectively. Results: One hundred forty four patients with ITP were included in the study. The number of patients with NR, R, and CR were 47 (33%), 40 (28%), and 57 (39%), respectively. The mean platelet level of the NR group was lower than responders (R and CR groups) (p=0.002 and p=0.049, respectively). The mean platelet volume (MPV) levels of the NR group were statistically lower than that of the CR group (p=0.018). If MPV ≥10 fL and platelet >12,000/mm³, the probability of an early response with methyl-Pd is higher [sensitivity =98.1% (95% confidence interval (CI) =89.7-99.9%), specificity =45% (95% CI =23.1-68.5%), positive predictive value =82.3% (95% CI =75.7-87.4%), negative predictive value =90% (95% CI =54.9-98.5%)]. Conclusions: Patients with ITP with low platelet and MPV levels were less responsive to standard-dose methyl-Pd treatment. It may be more appropriate to apply more effective treatments to these patients other than standard-dose methyl-Pd alone.
RESUMO
Research has shown that most reported foodborne outbreaks are caused by food prepared and consumed at home, thus emphasizing the importance of consumer food safety knowledge. In this study, 2,000 randomly selected residents from Çanakkale, Turkey, participated in face-to-face interviews to assess their food safety perceptions and practices. Questions covered the attention given to expiration dates, safety certificates, and food additives during shopping; consumption of high-risk foods; safe food handling; storage knowledge; and their source of food safety knowledge. Statistical analyses were done to clarify the differences according to three main aspects: gender, age, and educational level. Results showed that women and middle-aged respondents were significantly more careful during shopping and more interested in food safety issues than men and younger individuals. A significant relationship was found between gender and consumption of high-risk foods, with men consuming more of these foods than women. Furthermore, high-risk foods were more frequently consumed by young participants than by older participants, with more highly educated consumers shopping more consciously. Although most respondents appeared to know proper food handling and storage practices, almost all participants lacked some information on some issues. In order to remove these deficiencies, a brochure was prepared and distributed to people in various parts of the city. In addition, public seminars were organized. However, to ensure that this information results in positive attitude and behavioral changes, seminars should be repeated at specific intervals, and education procedures and processes should be controlled regularly.
