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Objectives: The aim of the study was to evaluate the frequency of emergency department admissions (EDA) and related factors in the last year among patients admitted to family health centers (FHC) with and without flexible working hours (FWH). Methods: This study was conducted in 6 regions in Turkey, 50 FHCs were selected for each study region by random sampling and the first nine patients who applied to the FHC were included in the study. Patients who applied to emergency department health services at least once for any health problem in the last year were considered to have EDA. Results: A total of 2605 patients were included in the study, and EDA was found in 1024 (39.3%) of the patients. EDA was detected in 246 (41.5%) patients with FHCs with FWH and 778 (36.7%) patients with FHCs without FWH (p=0.232). In addition, there was no significant difference between patients with and without FWH in the distance of the FHC from home, the frequency of making an appointment to see the FP, the ease of making an appointment, the waiting time after making the appointment, and the limitation of the working hours of the FHC (p>0.05). Conclusion: It has been determined that the presence of FWH did not cause a difference in terms of EDA, and further studies are needed on the reasons for this. [ABSTRACT FROM AUTHOR]

Objectives: In this study, it was aimed to evaluate the effect of structured short motivational interviewing in exercise and diet-related behavioral changes in type 2 diabetes patients in primary care. Methods: Participants were divided into control and intervention groups. The study was single-blinded, and only the researchers know the participants in each group. The intervention group received a motivating interview- based intervention a total of 4 times in the 1st month of the study and followed up in the 3rd month. The control group was followed by family physicians and evaluated at 3 months without any motivational intervention. One-week pedometer, international physical activity questionnaire (IPAQ2) scores, daily calorie intake, EuroQol (EQ5D), multidimensional diabetes questionnaire (MDQ), and motivational assessment scale were used at the beginning of the study and the 3rd-month follow-up. Results: The study included 84 (51.5%) participants in the intervention group and 79 (48.5%) patients in the control group. There was a significant difference between the control and intervention groups in terms of a 1-week pedometer (2785.0 [1002.0-7240.0] step/day vs. 5231.0 [1364.0-11827.0] step/day, p<0.001), IPAQ2 scores (0.0 [0.0-1056.0] vs. 495.0 [0.0-1396.0], p<0.001), EQ5D scale total scores (5.0 [5.0-10.0] vs. 5.0 [5.0-8.0], p=0.006), and MDQ scale total scores (607.0 [244.0-847.0] vs. 730.0 [235.0-847.0], p<0.001) at the 3rd-month follow-up. Conclusion: A structured motivational interviewing model that can be used in primary care may be effective in developing lifestyle changes in type 2 diabetes mellitus patients. [ABSTRACT FROM AUTHOR]

The ship-based greenhouse gas emissions along with the volumetric growth in maritime transportation have increased significantly over the years. International Maritime Organization (IMO) has tightened the emission limits by putting new regulations into effect to overcome the environmental impacts and therefore, the maritime industry has focused on energy-efficient ship design and operation, recently. Regarding the latest developments, dual-fuel engines operated with different fuels have been installed and new technological developments in emission control have been implemented onboard ships. In this context, the selection of engine systems where there are many options available has been a substantial problem in the design process of a ship, recently. The latest marine engines are capable of operating with various types of fuels at different emission control modes, therefore, energy efficiency and emission performance of the prime movers should be analyzed in detail. In this study, VLSFO, methanol, LPG, LNG and MDO-fueled engines with the same power output are investigated and the NOX reduction device integrated engines' technical specifications are compared. Then, the selected dual-fuel engines are thermodynamically analyzed and the environmental impacts are evaluated under different engine loads, Tier II, Tier III modes and ambient conditions. Moreover, EEDI calculations are conducted under the case study of powering a medium-range tanker and engine options are evaluated in terms of energy efficiency. Finally, a sensitivity analysis of engine performance is carried and the results are validated. According to the results, the energy efficiency of the ship can be increased by up to 20% by selecting the LNG-fueled engine as the prime mover while it requires more space and equipment compared to other engines. [ABSTRACT FROM AUTHOR]

Aim: Family health centers (FHCs) are reimbursed for their current expenditures based on a classification of four clusters in Turkey. This study compared the coordination, comprehensiveness, continuity, accessibility, and the first contact of care among different reimbursement FHC groups. Methods: The data were obtained from the Turkish data of the Quality and Costs of Primary Care in Europe study. Data was collected in provinces from six geographical regions. Physicians and patients from Classes A and B FHCs were called the first group, and others were called the second group. Results: A total of 296 physicians and 2623 patients were enrolled. According to the reimbursement groups, 593 (22.6%) patients received services from the first group and 2012 (77.4%) patients from the second group. The first contact with care and the admission frequency of 3 or more in the last six months were higher in the first group (respectively, 99.2% vs. 97.7%, p=0.027; 55.4% vs. 49.6%, p=0.015). Conclusion: The reimbursement classification did not make a difference in coordination, comprehensive care, continuity, accessibility, and being the first contact of care. Therefore, the current classification does not contribute to improving the quality of primary care in terms of service provision. [ABSTRACT FROM AUTHOR]

Objective: In this retrospective study, we analyzed the in vitro fertilization (IVF) clinical and laboratory outcome of cryptozoospermia cases compared to the extremely severe oligospermia cases in a single IVF center. Materials and Methods: All the IVF laboratory and clinical outcomes of cryptozoospermia and extremely severe oligospermia cases were analyzed and compared between January 2014 and December 2019 in Istanbul Florence Nightingale IVF Center. The same reproductive group treated all couples. Virtual azoospermia or cryptozoospermia were diagnosed once the mature sperm cells could be recognized after centrifugation (group 1). Patients without motile sperm were excluded. Extremely severe oligospermia was defined as a sperm count was less than <1 mil/mL (group 2). The study consisted of 33 virtual azoospermic patients with 40 cycles, whereas there were 40 severely oligospermic patients with 45 cycles. All patients underwent the intracytoplasmic sperm injection (ICSI) procedure and all the embryos were let to grow until the blastocyst stage on day 5. Groups were compared for clinical and laboratory reproductive outcome. Results: Both the median maternal and paternal ages were similar. All outcomes including fertilization rates, blastulation rates, clinical pregnancy and delivery rates were comparable. The miscarriage rates did not also show any statistical difference. Conclusion: Reproductive outcomes in cryptozoospermic IVF patients are comparable to those of extremely severe oligospermic patients provided that the ICSI is performed using motile spermatozoa. Our results favor using sperm from fresh ejaculate rather than surgical sperm retrieval when motile sperm is available in cryptozoospermic IVF patients. [ABSTRACT FROM AUTHOR]

In this study, we investigate chemical and isotopic characteristics of low-temperature geothermal waters issuing from carbonate reservoirs in the Çürüksu Graben within the eastern termination of the Büyük Menderes Graben in western Turkey. Temperatures and pH values of geothermal waters vary from 20.1 to 24.6 ºC and 6.62 to 7.11 and those of cold waters are 17.1 to 19.9 ºC and 6.85 to 7.72, respectively. Geothermal waters are of Ca-HCO3 and Ca-SO4 types whereas cold waters are characterized by these two types and Mg-HCO3 as well. δ18O and δD values of samples vary from –9.27‰ to –7.69‰ (VSMOW) and –58.06‰ to –52.2‰ and indicate a meteoric origin with local recharge. Tritium contents are from 0.12 to 2.17 TU for thermal waters and 0.28 to 4.85 TU for the cold waters implying relatively longer residence time for the hot waters. Thermal water samples mostly have positive δ13C values (varying from –0.32‰ to +1.99‰) and carbon in these waters is likely derived from marine limestone or metamorphic CO2 . δ34S and δ18O values of dissolved sulfate in the waters indicate that sulfur originates from dissolution of marine evaporite deposits (e.g., gypsum). Çürüksu waters are generally oversaturated with respect to calcite, dolomite and quartz but undersaturated with respect to gypsum. Common ion effect exerted a strong control for the formation of travertine deposits in the area. Chemical and isotopic evaluations indicated that the diversity in the water chemistry of samples is attributed to a combination of processes including water-rock interaction, ion exchange and mixing of various types of waters. Çürüksu thermal waters are immature and not in chemical equilibrium with the reservoir rock. Among the various geothermometers applied to Çürüksu thermal waters, temperatures computed by chalcedony, quartz and CaMg geothermometers are 21–52 ºC, 49–83 ºC and 73–96 ºC, respectively. HCO3 -SO4 -F and anhydrite-chalcedony (quartz) diagrams estimated a temperature range of 63–86 ºC and δ18O(SO4 -H2O) isotope geothermometer yielded 67–78 ºC. [ABSTRACT FROM AUTHOR]

We report the learnings gleaned from a four-country panel (Australia, South Africa, Egypt and Nigeria) sharing their countries' COVID-19 primary healthcare approaches and implementation of policy at the World Organization of Family Doctor's World virtual conference in November. The countries differ considerably with respect to size, national economies, average age, unemployment rates and proportion of people living rurally. South Africa has fared the worst with respect to waves of COVID-19 cases and deaths. All countries introduced strategies such as border closure, COVID-19 testing, physical distancing and face masks. Australia and Nigeria mobilised primary care, but the response was mostly public health and hospital-based in South Africa and Egypt. All countries rapidly adopted telehealth. All countries emphasised the critical importance of an integrated response between primary care and public health to conduct surveillance, diagnose cases through testing, provide community-based care unless hospitalisation is required and vaccinate the population to reduce infection spread. [ABSTRACT FROM AUTHOR]

Strong primary care does not develop spontaneously but requires a well-developed organizational planning between levels of care. Primary care-oriented health systems are required to effectively tackle unmet health needs of the population, and efficient primary care organization (PCO) is crucial for this aim. Via strong primary care, health delivery, health outcomes, equity, and health security could be improved. There are several theoretical models on how primary care can be organized. In this position paper, the key aspects and benchmarks of PCO will be explored based on previously mentioned frameworks and domains. The aim of this position paper is to assist primary care providers, policymakers, and researchers by discussing the current context of PCO and providing guidance for implementation, development, and evaluation of it in a particular setting. The conceptual map of this paper consists of structural and process (PC service organization) domains and is adapted from frameworks described in literature and World Health Organization resources. Evidence we have gathered for this paper shows that for establishing a strong PCO, it is crucial to ensure accessible, continuous, person-centered, community-oriented, coordinated, and integrated primary care services provided by competent and socially accountable multiprofessional teams working in a setting where clear policy documents exist, adequate funding is available, and primary care is managed by dedicated units. [ABSTRACT FROM AUTHOR]

Abstract Background Adolescence is a crucial period for development of dietary behaviors that continue into adulthood and influence the risk of chronic diseases later in life. The aim of this study was to determine the eating patterns of adolescents' and their compliance with the Food Guide Pyramid. Methods 625 students, aged between 11-15 years, from an elementary school in Istanbul, Turkey were enrolled in this cross-sectional survey. A questionnaire of eating patterns (QEP) was administered to all participants. QEP is consisted of questions assessing the knowledge and behaviors on healthy eating, factors affecting food choice, physical activity status and demographical variables. Height and weight of all participants were measured. Physical activity status was determined by questioning about participation in regular sport activities, how much time spent watching TV, playing computer games or doing homework. Results The mean age of the participants was 12.15 ± 1.15 and 50.5% were female. According to body mass index (BMI) percentiles, 8.3% (52) were obese and 10.2% were overweight. 51% had breakfast every day and only 1.9% met all the recommendations of the Food Guide Pyramid. Among the participants, 31% have fast food at least once every day and 60.8% skip meals. When participants were asked to rate the factors effecting their food choice according to a 10 point Likert scale, the highest mean scores (high impact on food choice) were for the factors; family, health, body perception, teachers and friends; 7.5 ± 3.1, 7.4 ± 3.1, 6.1 ± 3.2, 4.8 ± 3.3 and 4.2 ± 3.0 respectively. Total mean time spent on all passive activities (TV, computer, reading homework etc) per day was 9.8 ± 4.7 hours. Conclusions In this study we have demonstrated that, adolescents do not have healthy eating patterns. Educational interventions should be planned to decrease the health risks attributable to their eating behaviors.

Abstract Background Lectures supported by theatrical performance may enhance learning and be an attractive alternative to traditional lectures. This study describes our experience with using theatre in education for medical students since 2001. Methods The volunteer students, coached by experienced students, were given a two-week preparation period to write and prepare different dramatized headache scenarios during three supervised meetings. A theatrical performance was followed by a student presentation about history taking and clinical findings in diagnosing headache. Finally, a group discussion led by students dealt with issues raised in the performance. The evaluation of the theatre in education lecture "A Primary Care Approach to Headache" was based on feedback from students. Results More than 90% of 43 responding students fully agreed with the statement "Theatrical performance made it easier to understand the topic". More than 90% disagreed with the statements "Lecture halls were not appropriate for this kind of interaction" and "Students as teachers were not appropriate". Open-ended questions showed that the lesson was thought of as fun, good and useful by most students. The headache questions in the final exam showed results that were similar to average exam results for other questions. Conclusion Using theatrical performance in medical education was appreciated by most students and may facilitate learning and enhance empathy and team work communication skills.

Abstract Background While bio-medically, menopause could be treated as an illness, from a psychosocial and cultural perspective it could be seen as a "natural" process without requiring medication unless severe symptoms are present. Our objective is to explore the perceptions of Turkish women regarding menopause and Hormone Therapy (HT) to provide health care workers with an insight into the needs and expectations of postmenopausal women. Methods A qualitative inquiry through semi-structured, in-depth interviews was used to explore the study questions. We used a purposive sampling and included an equal number of participants who complained about the climacteric symptoms and those who visited the outpatient department for a problem other than climacteric symptoms but when asked declared that they had been experiencing climacteric symptoms. The interview questions focused on two areas; 1) knowledge, experiences, attitudes and beliefs about menopause and; 2) menopause-related experiences and ways to cope with menopause and perception of HT. Results Most of the participants defined menopause as a natural transition process that one should go through. Cleanliness, maturity, comfort of not having a period and positive changes in health behaviour were the concepts positively attributed to menopause, whereas hot flushes, getting old and difficulties in relationships were the negatives. Osteoporosis was an important concern for most of the participants. To deal with the symptoms, the non-pharmacological options were mostly favoured. Conclusion To our knowledge, this is the first qualitative study which focuses on Turkish women's menopausal experiences. Menopause was thought to be a natural process which was characterised by positive and negative features. Understanding these features and their implications in these women's lives may assist healthcare workers in helping their clients with menopause.

Background/aim: The predictability of clinical outcomes in hypertension in specific patient groups, especially underrepresented populations is the key to rational treatment. This study aimed to investigate the impact of baseline characteristics of <65-year-old hypertensive women with an increased risk of cardiovascular events, managed with standard- or intensive-approach, on their clinical outcomes and serious adverse events (SAEs). Materials and methods: Baseline characteristics of <65-year-old hypertensive women (n = 1247) in SPRINT, a multicenter randomized trial to compare standard and intensive antihypertensive treatment, were analyzed with Cox-regression method to determine potential predictors of the clinical outcomes and SAEs. The primary outcome was the composite of myocardial infarction (MI), non-MI acute coronary syndrome, stroke, heart failure, or cardiovascular death. Results: The primary outcome occurred in 3.1% and SAEs in 27.6% of the population. The treatment groups were similar in terms of the primary outcome, SAEs, or their individual components. The primary outcome occurred significantly more in current smokers vs. nonsmokers (HR: 2.85, 95% CI: 1.34–6.09). The subjects who were on aspirin in the intensive-group were significantly more likely to develop the primary outcome (HR: 3.17, 95% CI: 1.23-8.19) and MI (HR: 10.15, 95% CI: 1.19-86.88) compared with those not using aspirin. The risk of overall SAEs was significantly higher in blacks vs. nonblacks (HR: 1.27, 95% CI: 1.01-1.58), in current-smokers vs. nonsmokers (HR: 1.59, 95% CI: 1.23-2.05), and those with vs. without chronic kidney disease (CKD), (HR: 1.38, 95% CI: 1.08-1.77). The likelihood of SAEs significantly increased with age (HR: 1.04, 95% CI: 1.01-1.07). Conclusion: Smoking, aspirin, CKD, black race, and age seemed as important baseline characteristics in follow-up of <65-year-old hypertensive women, also depending on therapeutic strategy. Clinicians are expected to consider these critical parameters for effective antihypertensive management that promotes better outcomes in this middle-aged female population. [ABSTRACT FROM AUTHOR]

Objective To determine the magnitude of relationships of early life factors with child development in low/middle-income countries (LMICs). Design Meta-analyses of standardised mean differences (SMDs) estimated from published and unpublished data. Data sources We searched Medline, bibliographies of key articles and reviews, and grey literature to identify studies from LMICs that collected data on early life exposures and child development. The most recent search was done on 4 November 2014. We then invited the first authors of the publications and investigators of unpublished studies to participate in the study. Eligibility criteria for selecting studies Studies that assessed at least one domain of child development in at least 100 children under 7 years of age and collected at least one early life factor of interest were included in the study. Analyses Linear regression models were used to assess SMDs in child development by parental and child factors within each study. We then produced pooled estimates across studies using random effects meta-analyses. Results We retrieved data from 21 studies including 20 882 children across 13 LMICs, to assess the associations of exposure to 14 major risk factors with child development. Children of mothers with secondary schooling had 0.14 SD (95% CI 0.05 to 0.25) higher cognitive scores compared with children whose mothers had primary education. Preterm birth was associated with 0.14 SD (–0.24 to –0.05) and 0.23 SD (–0.42 to –0.03) reductions in cognitive and motor scores, respectively. Maternal short stature, anaemia in infancy and lack of access to clean water and sanitation had significant negative associations with cognitive and motor development with effects ranging from −0.18 to −0.10 SDs. Conclusions Differential parental, environmental and nutritional factors contribute to disparities in child development across LMICs. Targeting these factors from prepregnancy through childhood may improve health and development of children. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to demonstrate the relationship between obesity and musculoskeletal system examination findings and functionality among 5-16 years old population-based sample. Patients and methods: This is a cross-sectional field study. Sample of this study was selected from 4,246 participants of a study, which assessed the prevalence of obesity among school children aged between 6-15 in Pendik, Istanbul, in 2013-2014 school year. Physical examination included inspection, gait, balance, muscle strength and range of motion (ROM) assessment. Turkish version of Pediatric Outcomes Data Collection Instrument (PODCI) was used. Physical examination findings and PODCI scores of "normal weight" and "overweight/obese" groups were compared. Correlation between body mass index (BMI), ROM and PODCI subscale scores were also evaluated. Results: A total of 318 children were included in the study. 39.3% (n=125) were normal weight, 61.7% (n=193) were overweight/obese. Pes planus was the most common musculoskeletal problem with a rate of 23.9%. We found that pes planus was more common (p=0.000), standing time on one leg was shorter (p=0.002), time to complete timed up and go test (TUG) was longer (p=0.004) and "happiness" subscale scores of PODCI were lower (p=0.000) in overweight/obese children compared to their normal weight peers. Range of motion values were decreased, especially on the lower limbs, in overweight/obese children (p<0.05) compared to normal weight children. Body mass index values showed a negative correlation with ROM and PODCI "happiness" subscale scores (p<0.05). Conclusion: Musculoskeletal problems are more common in overweight/obese children than in their normal weight peers. Increase in BMI correlates with decrease in balance, emotional functionality and ROM values. It may be possible to protect overweight/obese children from serious musculoskeletal disorders by interventions that reduce BMI. [ABSTRACT FROM AUTHOR]

In this paper, we investigate the effects of various background gases on the formation and sustenance of a plasma jet. A helium plasma is ignited inside a dielectric tube and introduced into a vacuum chamber where the gas composition and pressure can be controlled. The gas composition inside the chamber is altered by separately injecting various background gases, such as air, nitrogen, and argon. Here, we report that, in order to sustain a plasma jet, there needs to be a physical boundary layer around the helium flow. This boundary can be in the form of a solid surface that encapsulates the flow, or a background gas other than helium. If only helium is present inside the chamber, no propagating jet is created; rather a diffuse plasma fills the chamber. If another gas is introduced, then the diffuse plasma reverts into a jet. Additionally, we discovered what can be considered as the signature emission line from a plasma jet operating with helium. This emission line is at 587.4 nm (He). This line appears in the emission profile only in the presence of a plasma jet, and disappears as the plasma transitions to a diffuse state at the same applied power parameters and pressure. [ABSTRACT FROM PUBLISHER]

Background: Adolescence is a crucial period for development of dietary behaviors that continue into adulthood and influence the risk of chronic diseases later in life. The aim of this study was to determine the eating patterns of adolescents' and their compliance with the Food Guide Pyramid. Methods: 625 students, aged between 11-15 years, from an elementary school in Istanbul, Turkey were enrolled in this cross-sectional survey. A questionnaire of eating patterns (QEP) was administered to all participants. QEP is consisted of questions assessing the knowledge and behaviors on healthy eating, factors affecting food choice, physical activity status and demographical variables. Height and weight of all participants were measured. Physical activity status was determined by questioning about participation in regular sport activities, how much time spent watching TV, playing computer games or doing homework. Results: The mean age of the participants was 12.15 ± 1.15 and 50.5% were female. According to body mass index (BMI) percentiles, 8.3% (52) were obese and 10.2% were overweight. 51% had breakfast every day and only 1.9% met all the recommendations of the Food Guide Pyramid. Among the participants, 31% have fast food at least once every day and 60.8% skip meals. When participants were asked to rate the factors effecting their food choice according to a 10 point Likert scale, the highest mean scores (high impact on food choice) were for the factors; family, health, body perception, teachers and friends; 7.5 ± 3.1, 7.4 ± 3.1, 6.1 ± 3.2, 4.8 ± 3.3 and 4.2 ± 3.0 respectively. Total mean time spent on all passive activities (TV, computer, reading homework etc) per day was 9.8 ± 4.7 hours. Conclusions: In this study we have demonstrated that, adolescents do not have healthy eating patterns. Educational interventions should be planned to decrease the health risks attributable to their eating behaviors. [ABSTRACT FROM AUTHOR]

Background: While bio-medically, menopause could be treated as an illness, from a psychosocial and cultural perspective it could be seen as a "natural" process without requiring medication unless severe symptoms are present. Our objective is to explore the perceptions of Turkish women regarding menopause and Hormone Therapy (HT) to provide health care workers with an insight into the needs and expectations of postmenopausal women. Methods: A qualitative inquiry through semi-structured, in-depth interviews was used to explore the study questions. We used a purposive sampling and included an equal number of participants who complained about the climacteric symptoms and those who visited the outpatient department for a problem other than climacteric symptoms but when asked declared that they had been experiencing climacteric symptoms. The interview questions focused on two areas; 1) knowledge, experiences, attitudes and beliefs about menopause and; 2) menopause-related experiences and ways to cope with menopause and perception of HT. Results: Most of the participants defined menopause as a natural transition process that one should go through. Cleanliness, maturity, comfort of not having a period and positive changes in health behaviour were the concepts positively attributed to menopause, whereas hot flushes, getting old and difficulties in relationships were the negatives. Osteoporosis was an important concern for most of the participants. To deal with the symptoms, the non-pharmacological options were mostly favoured. Conclusion: To our knowledge, this is the first qualitative study which focuses on Turkish women's menopausal experiences. Menopause was thought to be a natural process which was characterised by positive and negative features. Understanding these features and their implications in these women's lives may assist healthcare workers in helping their clients with menopause. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate nasopharyngeal carriage of S. pneumoniae in healthy children and resistance to penicillin and other antimicrobials and to assess related risk factors. Nasopharyngeal specimens collected from healthy children less than six years of age, visiting a Mother and Child Health Center for health control, were investigated microbiologically between February-March 2004. Carriage rate was 37.2% (n=112/301); 33.9% intermediate and 5.4% high penicillin resistance were detected. According to multivariate analysis, carriage rate was inversely related to number of rooms (OR:0.574) and child age (OR:0.978), while penicillin resistance was correlated well with antibiotic use in the last two months (OR:2.193). Decreased sensitivity plus resistance to other antimicrobials were: trimethoprim-sulfamethoxazole (TMP-SMX) 45.6%; erythromycin 16.1%, tetracycline 16.1%; clindamycin 9.8%, and ofloxacin 3.6% in pneumococcal isolates, which increased significantly (p<0.05) to 72.7%, 31.8%, 27.3%, 20.5%, and 6.8%, respectively, in penicillin non-sensitive S. pneumoniae (PNSSP) except for ofloxacin. Overall multidrug resistance was 17.9%, while PNSSP exhibited a resistance rate of 38.6%. In conclusion, S. pneumoniae carriage rates determined in healthy children were high and PNSSP strains also showed increased resistance to other antimicrobials. [ABSTRACT FROM AUTHOR]

The management of poor responders in IVF has always been a big problem. The ideal approach has yet to be formulated. In this study we aim to compare two alternative stimulation protocols. A total of 48 poor responder patients described from previous cycles were included and grouped into two: group I consisted of 24 patients in 24 cycles in which leuprolide acetate (40 microg s.c. per day) was initiated on cycle day 2 followed by exogenous gonadotrophins on cycle day 3; group II consisted of 24 patients in 24 cycles in which ovarian stimulation included gonadotrophin-releasing hormone (GnRH) antagonist (cetrorelix, 0.25 mg daily during late follicular phase) administration. While only the oestradiol concentrations on the day of HCG were lower in group II compared with group I, the clinical pregnancy and implantation rates among groups did not show any significance. The impact of these two regimens in ovarian stimulation of poor responders seem to be same and to establish these results further randomized studies with larger sample sizes are required. [ABSTRACT FROM AUTHOR]

Concern about the use of gonadotrophin-releasing hormone (GnRH) agonists in ovarian stimulation of poor responder IVF patients has arisen from the claim that GnRH agonists might have a direct deleterious effect through their receptors on the ovary. In this study, we compared two ovarian stimulation protocols in which no GnRH agonists were used. In all, 40 patients with a poor response in previous treatment cycles were included. They were divided into two groups: group I (n = 20) received ovarian stimulation for 20 cycles, without the addition of either GnRH agonist or antagonist; while group II (n = 20) patients received ovarian stimulation for 20 cycles, including the administration of a GnRH antagonist (Cetrorelix, 0.25 mg daily) during the late follicular phase. There was no statistically significant difference between the groups for mean age, duration of infertility, baseline FSH concentration, cancellation rate, number of ampoules of gonadotrophin used, number of mature oocytes retrieved, oestradiol concentrations on the day of injection of human chorionic gonadotrophin (HCG), fertilization rate and number of embryos transferred. The clinical pregnancy and implantation rates in group II appeared higher than in group I, but were not significantly different (20 and 13.33% compared with 6.25 and 3.44% respectively). The addition of GnRH antagonists to ovarian stimulation protocols might be a new hope for poor responder IVF patients, but this report is preliminary and further controlled randomized prospective studies with larger sample sizes are required. [ABSTRACT FROM AUTHOR]

One of the most spectacular shows that nature offers at northern latitudes is what is known as northern lights or Aurora Borealis. The Aurora Borealis is caused by energetic particles of the solar wind, which get trapped in Earth's magnetosphere. To simulate this phenomenon on a table top scale, we ignited a plasma jet and introduced the fast traveling plasma into a chamber, where the pressure can be lowered. A magnetized ball representing Earth was placed in the middle of the chamber. Fig. 1 shows what happens when the plasma jet reaches the ball: the plasma wraps around the ball. [ABSTRACT FROM PUBLISHER]

Plasma bullets have recently been used in novel applications in biology and medicine, which spurred interesting developments in the new interdisciplinary field of “Plasma Medicine.” In this paper, using high speed ICCD camera images we show that during their lifetime, plasma bullets undergo three distinctive phases: a launching phase during which the bullet velocity increases rapidly, a propagation phase during which the bullet velocity is temporarily maintained but later steadily decreases, and an ending phase during which the bullet collapses. [ABSTRACT FROM AUTHOR]

The presence of hydrosalpinx has been reported to negatively affect the pregnancy and implantation rate after in-vitro fertilization (IVF) with embryo transfer. Hydro-salpinges are able to enlarge during ovarian stimulation with a possible increased passage of tubal fluid into the endometrial cavity. We report the effect of hydrosalpinges during the transfer of previously cryopreserved/thawed embryos during a natural cycle. In all, 14 transfers in 10 patients with a sonographically-documented hydrosalpinx during the studied cycle (group I) were compared to 98 cycles in 74 patients with tubal disease but no such sonographic finding (group II). Both pregnancy and implantation rates were significantly lower in group I (7.14 versus 24.49% and 5.0 versus 10.8% respectively). The presence of hydrosalpinx negatively affects pregnancy and implantation rates during natural cycles. [ABSTRACT FROM PUBLISHER]

It is challenging nowadays for many authors to write and submit a scientific paper to peer reviewed journals due to strict editorial and reviewer evaluation processes and the competitive environment. For the dissemination of scientific papers (original research, literature review, case presentation, position paper etc.) relevant to Primary Health Care and General Practice it is important that authors understand the perspective of journal editors and their publication policies. This workshop aims to give an insight into the editorial evaluation process of a submitted manuscript and also to discuss the main aspects of preparing a manuscript for successful publication. The workshop will have the format of a highly interactive discussion. It will focus on the preparation and submission of scientific papers with special emphasis on choosing the appropriate journal, understanding the editor's perspective, peer review process, sharing experiences, common errors and how to prevent them. At the end of the workshop, participants will be able to get information about editorial evaluation and gain practical advice on how to successfully prepare a scientific paper for publication in a peer-reviewed journal. [ABSTRACT FROM AUTHOR]

: Objective:To report the birth of a healthy female infant from a father with nonmosaic Klinefelter syndrome (KS) and document the experience of men with KS undergoing assisted conception.: Design:Retrospective.: Setting:Private IVF center.: Patient(s):Twelve couples with male factor infertility due to Klinefelter syndrome undergoing assisted reproduction treatment.: Intervention(s):Controlled ovarian hyperstimulation, testicular sperm extraction, intracytoplasmic sperm injection (ICSI), round spermatid injection (ROSI), and preimplantation genetic diagnosis.: Main outcome measure(s):Testicular sperm retrieval rate, fertilization rate, and pregnancy outcome.: Result(s):There was a sufficient amount of motile sperm for injection into mature oocytes in 6 of the 11 testicular biopsies (54.5%). Fertilization rates for ICSI and ROSI cases were 54.2% and 41.6%, respectively. The pregnancy rate per ET was 27.2%. None of the ROSI cases resulted in pregnancy. Two patients had spontaneous abortions at 8 and 18 weeks of gestation, respectively. Only one patient delivered a healthy female baby after 36 weeks of an uneventful pregnancy.: Conclusion(s):Men with KS can benefit from assisted reproductive technologies, and the testicular sperm retrieval rate among them is promising. Although sex chromosome aberrations among the embryos from men with KS are not common, couples can be offered preimplantation genetic diagnosis before ET. [Copyright &y& Elsevier]

: ObjectiveTo report a case of cervical heterotopic pregnancy after IVF-ET treatment.: DesignCase report.: SettingPrivate IVF center.: Patient(s)A woman who had undergone controlled ovarian hyperstimulation and intracytoplasmic sperm injection–ET for primary male factor infertility.: Intervention(s)Resection of cervical heterotopic pregnancy by hysteroscopy.: Main outcome measure(s)Successful treatment of heterotopic cervical pregnancy.: Result(s)A successful pregnancy resulting in a term baby.: Conclusion(s)Hysteroscopic resection can be used to treat a cervical heterotopic pregnancy. [Copyright &y& Elsevier]

Objective: To compare the outcome of day 2 and day 3 embryo transfers in women demonstrating poor ovarian response. Design: Prospective randomized clinical trial. Setting: Private assisted reproductive technology center. Patient(s): Two hundred eighty-one women demonstrating poor ovarian response to controlled ovarian hyperstimulation. Intervention(s): Women who were poor responders were randomly allocated to day 2 or day 3 embryo transfer following oocyte retrieval. Main Outcome Measure(s): Implantation rates and pregnancy rates per oocyte retrieval and embryo transfer. Result(s): The clinical pregnancy rates per oocyte retrieval (37.2% vs. 21.4%, respectively; P<.05) and per embryo transfer (38.9% vs. 24.1%, respectively; P<.05) were significantly higher in the day 2 embryo transfer group compared with day 3. On the other hand, implantation rates were not different between groups (23.9% vs. 17.2%, respectively; P=.08). Conclusion(s): Our results demonstrated that transfering embryos on day 2 could provide an alternative to the management of poor responder patients. [Copyright &y& Elsevier]