The Effect of Labor Dance in the First Stage of Labor on Labor Pain, Anxiety, Duration of Labor, and Maternal Satisfaction with Labor: A Randomized Controlled Study

Objective: The study aimed to examine the effects of labor dance applied in the first stage of labor on perceived labor pain, anxiety, duration of labor, and maternal satisfaction with labor. Design: This study is a randomized controlled trial. Methods: A sample size of 128 pregnant women was randomly assigned to a control (n = 64) or experimental (n = 64) group while ensuring equal numbers of primiparous and multiparous participants in each group. After admission to the hospital for parturition, and during the first stage of labor, the women in the experimental group were exposed to a 15-min labor dance every hour when the cervical dilation was between 3 and 8 cm. The labor dance included movements of the sacrum and waist massaged by a partner using a massage glove, which was accompanied by self-selected music. Outcome measures included the Visual Analogue Scale (VAS), the State Anxiety Scale (SAS), and the Scale for Measuring Maternal Satisfaction (SMMS)-normal birth and labor duration. These were administered before the labor dance and at the end of the labor dance at three points of cervical dilation: 3, 5-6, and 7-8 cm for the experimental group, and at similar points in the control group: at the start of dilation and 15 min later. The data were analyzed using the generalized linear model and Mann-Whitney U tests. Results: In comparison to the control group, for the group performing the labor dance, the mean VAS scores were lower (p < 0.05) at each evaluation period, and the mean scores of total SMMS and some of its subdivisions were significantly higher in the experimental group (p < 0.05). There was no statistically significant difference between the SAS scores at any evaluation point, including postpartum (p > 0.05). Similarly, there were no significant differences in labor time (p > 0.05) between groups. Conclusions: The practice of labor dance was found to be effective in reducing the perceived labor pain in pregnant women and increasing maternal satisfaction at birth, but not on the duration of labor, and anxiety. Trial registration: ClinicalTrials.gov (NCT04746170).

Why mothers with midwifery-led vaginal births recommend that mode of birth: a qualitative study

OBJECTIVE

This study aimed to examine why mothers with midwifery-led vaginal births recommend giving birth vaginally.

METHOD

This qualitative study was conducted with 14 mothers who had a vaginal birth with midwives and recommended it to other women. The data were collected using an in-depth interview form and analysed with the thematic analysis technique.

RESULTS

The reasons why these mothers recommend vaginal birth (VB) are discussed under five main themes: 'positive birth experience, postpartum comfort, beliefs and values, body image, and sexual life'. VB is mainly recommended to other women for emotional, medical, religious, and socio-cultural reasons, including pleasure/excitement related to the birth, newborn, and maternity, birth satisfaction, absence of interventions, early physical activity, early discharge from the hospital, beliefs and values, body image (easy weight loss, no incision, etc.), and early and safe sex life in the postpartum period.

CONCLUSION

Vaginal birth is mainly recommended to other women for emotional, medical, religious, and socio-cultural reasons. To support similar favourable views of vaginal birth, it is necessary to prioritise midwifery care that upholds the physiology of childbirth, minimises unnecessary medical interventions, ensures ongoing physical and emotional support, and respects socio-cultural beliefs and values.

The impact of severe perinatal events on maternity care providers: a scoping review

BACKGROUND

Severe events during the perinatal period can be experienced as traumatic by pregnant women, their partners or others who are closely involved. This includes maternity care providers who can be affected by being involved in or observing these events. This may have an impact on their personal well-being and professional practice, influencing quality of care. The aim of this study is to map research investigating the impact of severe events during the perinatal period on maternity care providers, and how these experiences affect their well-being and professional practice.

METHOD

A scoping review following the manual of the Joanna Briggs Institute was undertaken. The electronic bibliographic databases included PubMed/MEDLINE, CINAHL, PsycINFO, PsycARTICLES, SocINDEX, Cochrane, Scopus, Web of Science and databases for grey literature. Records passing the two-stage screening process were assessed, and their reference lists hand searched. We included primary research papers that presented data from maternity care professionals on the impact of severe perinatal traumatic events. A descriptive content analysis and synthesis was undertaken.

RESULTS

Following a detailed systematic search and screening of 1,611 records, 57 papers were included in the scoping review. Results of the analysis identified four categories, which highlighted the impact of traumatic perinatal events on maternity care providers, mainly midwives, obstetricians and nurses: Traumatic events, Impact of traumatic events on care providers, Changes in care providers' practice and Support for care providers; each including several subcategories.

CONCLUSION

The impact of traumatic perinatal events on maternity care providers ranged from severe negative responses where care providers moved position or resigned from their employment in maternity care, to responses where they felt they became a better clinician. However, a substantial number appeared to be negatively affected by traumatic events without getting adequate support. Given the shortage of maternity staff and the importance of a sustainable workforce for effective maternity care, the impact of traumatic perinatal events requires serious consideration in maintaining their wellbeing and positive engagement when conducting their profession. Future research should explore which maternity care providers are mostly at risk for the impact of traumatic events and which interventions can contribute to prevention.

The prevalence and associated factors of fear of childbirth among Turkish pregnant women

OBJECTIVE

This study was conducted to determine the prevalence of fear of childbirth and affecting factors in pregnant women in Turkey.

MATERIALS AND METHODS

This was a cross-sectional study and included a total of 2025.    Pregnant Women Assessment, some variables related to previous and current perinatal processes and Wijma Delivery Expectancy/Experience Questionnaire (version A) were used for data collection.

FINDINGS

In this sample, 42.4% of the women reported fear of childbirth. What the women were afraid of most was the development of unwanted conditions at childbirth, obscurity/uncertainty, and negative attitudes of health professionals. The factors causing fear of childbirth were the low education level, unemployment status, low financial status, stillbirth, unplanned pregnancy, indecisiveness about the type of delivery, not attending prenatal education programs, negative effects of other people, insufficient social support, confiding in the healthcare centre and health professional, negative, and indecisive birth perceptions, prior negative birth experiences and not feeling ready for childbirth (p < 0.001).

CONCLUSIONS

The prevalence of fear of childbirth in this Turkish sample, especially in the multipara is higher than in Western countries. Causes of fear of childbirth can vary with countries and even with each region of a country.

The effect of pregnant women’s health-seeking behavior and preference for mode of birth on pregnancy distress during the COVID-19 pandemic

In this study, the researchers investigated to the impact of pregnant women's health-seeking behavior and mode of birth preferences on pregnancy distress during the COVID-19 pandemic. This study was conducted with 351 pregnant women. The risk rate of pregnancy distress using the Tilburg Pregnancy Distress Scale (TPDS) cut-off point was 16.5%. 13.3% of pregnant women changed their mode of birth preferences due to the pandemic. The risk of pregnancy distress in women who changed their mode of birth preferences due to the pandemic increased 5.4 times more than in those who preferred vaginal birth before and during the pandemic (OR: 5.4, p<0.001). We determined that the increase in the Health Seeking Behavior Scale total scores had a reducing effect on pregnancy distress due to a lack of partner involvement for TPDS.

Examination of the effect of the perceived stress in the coronavirus-19 pandemic on marital adjustment, sexual life and intimate partner violence

Aims

The aim of the study was to explore the effects of perceived stress during the pandemic on marital adjustment, sexual life and intimate partner violence.

Design

A cross‐sectional design was employed in this study.

Methods

The data were collected with an online survey between October and December 2020 from 901 participants in Turkey. Participants completed the Descriptive Information Form, the Marital Adjustment Scale and the Perceived Stress Scale. Multivariate analysis of variance and moderation analysis were used in the analysis of the data.

Results

The pre‐pandemic marital adjustment scores of the participants significantly decreased during the pandemic. The marital adjustment and sexual life of those with high perceived stress levels were found to be negatively affected, and they were exposed to violence during the pandemic. In the moderation analysis, a non‐standardized coefficient of the marital adjustment variable in the model turned out to be significant, and the perceived stress decreased as marital adjustment increased. The marital adjustment was low, and the stress level was high in individuals exposed to violence. Besides, perceived stress was found to be effective in being exposed to intimate partner violence.

Conclusion

The stress perceived by individuals during the COVID‐19 pandemic negatively affected their marital adjustment and sexual life. Besides, perceived stress was found to be effective in being exposed to intimate partner violence, and marital adjustment decreased during the pandemic compared to the pre‐pandemic period.

Impact

During the pandemic period, health care providers should routinely screen the psychosocial health of individuals. Continuous, accessible, free psychosocial support services should be available in order to increase the psychosocial health and marital adjustment of people with high‐stress levels and prevent exposure to violence.

Patient or Public Contribution

The conduct of this study is based on an online survey with participants living in the same house with their spouses during the pandemic.

An Investigation of the Relationship between Health Literacy Levels of Pregnant Women and Their Perceptions of Traumatic Childbirth

The researchers aimed to investigate the relationship between the health literacy levels of pregnant women and their perceptions of traumatic childbirth. The sample consisted of 384 pregnant women. The data were collected using the 'Pregnancy Information Form", the "Health Literacy-32 Scale," and the "Traumatic Birth Perception Scale." Health literacy levels of pregnant women were found to be inadequate (44%) and limited (43.5%). 56.8% of pregnant women had moderate, and 27.1% had a high perception of traumatic birth. A negative correlation was determined between the total score and sub-dimensions of the Health Literacy Scale of pregnant women (i.e. access to health information, understanding health information, protection from diseases, and health promotion) and their perceptions of traumatic birth (p < .001).

The effect of maternal functional and postpartum depression status on breastfeeding self-efficacy of the mothers: A cross-sectional study

In this study, the researchers investigated the effect of maternal functioning and postpartum depression status on breastfeeding self-efficacy of mothers. The study was conducted with 254 mothers with babies aged 2-6 months old. The total mean scores of the mothers were found to be 57.201 ± 7.612 on the breastfeeding self-efficacy scale, 8.516 ± 5.304 on the postpartum depression scale, and 74.055 ± 11.738 on the maternal functioning scale. 21.3% of mothers had a risk of postpartum depression. A negative relationship was found between breastfeeding self-efficacy and postpartum depression scores (p < 0.001), and a positive relationship was seen between breastfeeding self-efficacy and maternal functioning scores (p < 0.001). Maternal functioning and postpartum depression status were found to have a cumulative effect of 31.5% on maternal breastfeeding self-efficacy (F = 59.086 R2=0.315).

An investigation of women's pregnancy experiences during the COVID-19 pandemic: A qualitative study

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has adversely affected the physical and psychosocial health of pregnant women and their access to antenatal care and health services.

AIM

To examine women's pregnancy experiences during the COVID-19 pandemic.

MATERIALS AND METHODS

The study was conducted in a qualitative design with 14 pregnant women who were admitted to a state hospital pregnancy outpatient clinic for antenatal control. The data were collected using a semi-structured individual interview form and were analysed using the thematic analysis technique. COREQ checklist guide was followed in the study.

RESULTS

The pregnancy experiences of women in the COVID-19 pandemic were examined under 7 main themes: "physical health, psychosocial health, adaptation to pregnancy, pregnancy follow-ups, social life, spouse relationship and coping methods". Pregnant women have both positive and negative pregnancy experiences in the COVID-19 pandemic.

CONCLUSION

The study concluded that the pandemic has affected both the physical and psychosocial health of pregnant women, their social life, marital relationship and access to antenatal care services. Health professionals need to evaluate psychosocial health as well as the physical health of pregnant women, especially during the pandemic, and create a care plan accordingly. Midwives and other health professionals should improve the bio-psychosocial health of the pregnant/family via telehealth and counselling services.

Midwives' experiences of traumatic births: A systematic review and meta-synthesis

INTRODUCTION

Midwives experiencing traumatic births are emotionally affected by this process, lose their self-confidence, and may intend to leave the profession. This study aims to carry out a meta-synthesis of current qualitative research exploring the experiences of midwives witnessing traumatic births.

METHODS

The meta-synthesis consisted of 18 full-text studies in English, obtained from PubMed, Scopus, Web of Sciences, Cumulative Index of Nursing and Allied Health Literature (CINAHL), EMBASE, and PsycINFO databases. The results of the studies were analyzed using the thematic analysis technique. The study includes qualitative, mixedmethod, and full-text studies published between 2000 and 2020 that explored the experiences of midwives and obstetric nurses witnessing birth trauma.

RESULTS

The thematic analysis identified seven themes: post-traumatic feelings, posttraumatic stress symptoms, the impact of trauma on professional values, social support, learning from experience, legal process, and reflection of emotions of women experiencing traumatic birth on the midwife.

CONCLUSIONS

Midwives who witnessed traumatic birth were mostly emotionally affected. They lost their self-confidence and intended to leave their profession. They emphasized the importance of peer support through which they could share their experiences after trauma. Psychological education should be provided to midwives who witness the trauma by specialists, and midwives should be strengthened against the effects of trauma in terms of both the institutional policies where the birth takes place and midwifery-specific legal policies.

The childbirth experiences of Syrian refugee mothers living in Turkey: a qualitative study

Objective:The study aims to examine the childbirth experiences of Syrian refugee mothers living in Turkey.Methods: This qualitative study was conducted with 12 mothers who had a vaginal birth and were assisted by midwives. The data were collected using an in-depth interview form and analyzed with the thematic analysis technique.Results: The childbirth experiences of the mothers were grouped under two main headings as negative and positive experiences. "Negative childbirth experiences" were divided into 4 main themes as "negative emotions experienced during childbirth, lack of effective communication due to the language barrier, difficulties experienced related to hospital policies and dissatisfaction with midwives". "Positive birth experiences", were categorized under three main themes as "satisfaction with the midwife, finding the country safe to give birth, and mother' s positive attitude towards birth process". The mothers were satisfied with "the attitudes and behaviors of the midwives and their professional practices", and the positive attitude of mothers towards birth in religious and cultural terms contributed to the positive birth perception.Conclusion: Refugee mothers were found to have both positive and negative childbirth experiences. Individualized, empathic communication-based, culturally sensitive and evidence-based care may contribute to the positive childbirth experiences of refugee women.

Correlation between Infantile Colic and Maternal Breastfeeding Self-Efficacy, Breastfeeding Success and Breast Milk Amount

AIM

The study was conducted to determine the correlation between infantile colic and maternal breastfeeding self-efficacy, breastfeeding success and breast milk amount.

MATERIALS AND METHODS

This descriptive study included 154 mothers, with infants of age between 3 weeks and 6 months who were diagnosed with infantile colic and who were admitted to the paediatric outpatient clinics of a hospital located in northern Turkey.

RESULT

A negative correlation was found between 'parent-infant interaction + problem infant' and 'immature gastrointestinal system' subscales of the Infantile Colic Scale (ICS) and the total mean scores of mothers on the Breastfeeding Self-Efficacy Scale. In addition, correlation analysis showed a statistically significant negative correlation between mean scores of mothers in breastfeeding success and subscale and total mean scores of ICS.

CONCLUSION

The breastfeeding self-efficacy and breastfeeding success is low in mothers of infants with infantile colic.

An examination of the attitudes of midwives and nurses towards gender roles and the influencing factorsEbe ve hemşirelerin toplumsal cinsiyet rollerine ilişkin tutumları ve etkileyen faktörlerin incelenmesi. ACTA ACUST UNITED AC 2018. [DOI: 10.14687/jhs.v15i2.5343]

AimThe study was conducted to determine the attitudes of midwives and nurses working in a university hospital in the Black Sea Region towards gender roles and influencing factors.MethodIt was a descriptive study and was carried out with 173 midwives and nurses. The sample size of the study was determined by G power analysis. The data were collected using “Introductory Information Form” and “Social Roles Attitude Scale”.FindingsThe majority of the nurses and midwives participating in the study were female (68.8%), university graduates (61.3%), nurse(92.5%) single (60.7%). Their mean age was 26.98±5.14. Social Roles Attitude Scale scores of midwives and nurses were found to be low. Gender was identified as an important factor influencing social gender attitude.In our study, the egalitarian gender role, female gender role, gender role in marriage, traditional gender role and male gender role scores were found higher in female midwives and nurses than male nurses (p<0.05). As their age increased, the mean scores of the midwives and nurses’ gender role were found to decrease (p <0.05). The single midwives and nurses were found to have more egalitarian gender roles (p <0.05).ConclisuionOne of the factors influencing the gender attitude of midwives and nurses is the education level of the mother. As the mothers’ level of education increased in the study, it was determined that the role of gender was increased in the participants. Extended English summary is in the end of Full Text PDF (TURKISH) file.ÖzetAmaçÇalışma "Karadeniz Bölgesinde  bir üniversite hastanesinde çalışan ebe ve hemşirelerin toplumsal cinsiyet rollerine ilişkin tutumlarını ve etkileyen faktörleri belirlemek amacıyla" yapılmıştır.MetotAraştırmanın tipi tanımlayıcıdır.   Çalışma  173 ebe ve hemşire ile yürütülmüştür. Çalışmanın örneklem büyüklüğü G power analizi ile belirlenmiştir.   Veriler; “Tanıtıcı Bilgi Formu” ve “Toplumsal Cinsiyet Rolleri Tutum Ölçeği” ile toplanmıştır.BulgularÇalışmaya katılan ebe ve hemşirelerin çoğunluğu;  kadın (%68.8),  üniversite mezunu (%61.3), hemşire (%92.5), ve medeni durumu bekârdır (%60.7). Katılımcıların yaş ortalaması  26.98±5.14, evlilik süresi ortalaması ise  6.07±6.29’dir. Ebe ve hemşirelerin toplumsal cinsiyet rollerine ilişkin tutum ölçeği puanları  düşük bulunmuştur. Cinsiyet, toplumsal cinsiyet tutumunu etkileyen önemli bir faktör olarak belirlenmiştir.  Çalışmamızda  "eşitlikçi cinsiyet rolü, kadın cinsiyet rolü, evlilikte cinsiyet rolü, geleneksel cinsiyet rolü ve erkek cinsiyet rolü puan ortalamaları" kadın ebe ve hemşirelerde, erkek hemşirelere göre  yüksek bulunmuştur (p<0.05). Yaş arttıkça, ebe ve hemşirelerin toplumsal cinsiyet rolü puan ortalamasının düştüğü belirlenmiştir (p<0.05). Bekar olan ebe ve hemşirelerin daha fazla eşitlikçi cinsiyet rollerine sahip olduğu belirlenmiştir (p<0.05).Çalışmada annelerin eğitimi düzeyi yükseldikçe, ebe ve hemşirelerinde toplumsal cinsiyet rolünün yükseldiği saptanmıştır.SonuçYaş, cinsiyet, ebeveynlerin eğitim durumu, medeni durum, ailede kararları alma biçimi,  para bütçesinin yönetim şekli  gibi faktörler,  toplumsal cinsiyet rolüne ilişkin tutum puanını etkileyebilmektedir (p<0.05).

INTERFERON α-2B MAY IMPAIR TESTICULAR HISTOLOGY INCLUDING SPERMATOGENESIS IN A RAT MODEL

Interferon-alpha has been used in various diseases at the reproductive ages. However, the effect of interferon-alpha on testicular histology has not been studied in literature. The aim of this study was to investigate the effects of interferon alpha-2B on testicular histology including spermatogenesis in a rat model. Seventeen adult male Wistar albino rats were divided into 3 groups: Six rats received 7.500 units (5 MIU/m2) of interferon alpha-2B (Intron), considered clinical treatment dose range. Six rats received 30.000 units (20 MIU/m2) of interferon alpha-2B (Intron), considered high treatment dose. Five rats served as a control group receiving 0.5 mL of saline injection. All injections were done intraperitoneally 3 times weekly for 3 weeks under inhalation anesthesia. All rats underwent bilateral orchiectomy 30 days after the experiment. Histological examination included the mean seminiferous tubular diameter (STD), germinal epithelial cell thickness (GECT), and testicular biopsy score (TBS). The mean STD was significantly lower in the low-dose interferon and high-dose interferon groups than in the control group (p = 0.008 and p = 0.004, respectively). The mean GECT was significantly lower in the low-dose interferon and high-dose interferon groups than in the control group (p = 0.008 and p = 0.004, respectively). The mean TBS was significantly lower in the low-dose interferon group (p = 0.05) and the high-dose interferon group (p = 0.01) than in the control group. The decreases in the mean values of the STD, GECT and TBS were not related to the interferon dose. Interferon alpha-2B may impair testicular histology even in clinical widely used treatment dose. Therefore, men at the reproductive ages should be fully informed for the use of interferon-alpha in the treatment of various diseases.

Rho-associated protein kinase II (rock II) expression in normal and preeclamptic human placentas

Rho-associated kinases are serine/threonine kinases that have several functions which might contribute to various physiological and pathological states in cells. There are two isoforms of these enzymes known as rho-associated kinase I (rock I, ROKbeta) and II (rock II, ROKalpha). It has been shown that rock II may be a potential mediator of apoptosis. In addition, rocks play a crucial role in the formation of microvilli-like structures. Increased placental apoptosis and microvilli shedding were shown in preeclampsia. We hypothesized that altered rock expression may lead to the pathologies seen in preeclampsia. Therefore in this study we compared placental rock II expression between normotensive and preeclamptic women using immunohistochemistry and Western blot. Immunohistochemistry and Western blot experiments revealed that rock II is mainly localized in syncytiotrophoblast cells of the placental villi and increased in preeclampsia. In addition to 160 kDa rock II molecule we also detected biologically relevant smaller active form of rock II in preeclamptic but not in normal placentas. We suggest that increased rock II expression in preeclamptic placentas may contribute to etiology or pathogenesis of this syndrome. However, it is considered that rock II expression may also increase to compensate for placental functions changing in preeclampsia.

Ventilatory and metabolic response to rebreathing the expired air in the snorkel

The snorkel, which allows swimmers to keep their face down in the water while breathing, is widely used by divers, spear fishermen and monofin swimmers. A snorkel adds an additional dead space of 160-170 ml and causes an increase in the concentration of CO2 in the inspired gas due to expired air trapped in the snorkel which is then re-inspired. In this study the metabolic and the ventilatory response to rebreathing the expired air in the snorkel were investigated in twelve human subjects. A 2900 C Sensor Medics gas analyzer was used in breath-by-breath mode for the measurements. Ventilation (VE), respiratory rate (RR), tidal volume (TV), oxygen consumption (.VO 2) and carbon dioxide production (.VCO 2) were measured at rest and during light exercise both with and without the snorkel dead space. We observed a significant increase in all variables except RR, when subjects rebreathed the gas in the snorkel. The increase in ventilation resulted from an increase in tidal volume rather than increasing respiratory rate. We conclude that the work of breathing is increased when CO2 concentration is high in inspired gas and re-breathing while snorkelling can be prevented by a new snorkel design with a low-resistance two-way non-rebreathing valve, which will allow the expired air flow into the water.

Steroid myopathy in a child with juvenile rheumatoid arthritis. Case report

An 8-year-old boy who had been diagnosed as systemic-onset juvenile rheumatoid arthritis were on treatment for 8 months with methotrexate and additional steroids during activation. At the end of the 8th month when the corticosteroid dose was 12.5 mg/day, he began to suffer from numbness and weakness in his hands. Physical examination, laboratory findings and electromyography results demonstrated myopathy. Steroid myopathy was considered. Corticosteroids were tapered and stopped. At follow-up clinical findings remitted and electromyography became normal at the 4th month. We present here this case to direct attention to drug-induced myopathy besides myopathy due to primary disease in connective tissue disorders whenever myopathy exists.

Hyperbaric oxygen therapy in adriamycin extravasation: an experimental animal study

Adriamycin extravasation is a serious problem that can lead to severe local necrosis and damage to underlying nerves, tendon, and muscle. There are some experimental studies in which conflicting results were reported about the beneficial effects of hyperbaric oxygen (HBO) in adriamycin-induced skin lesions. In this study the effect of HBO on the healing of adriamycin-induced wounds was investigated in the Wistar-Albino rat model. Ninety-five rats underwent injection of a 0.7-ml adriamycin solution (2 mg per milliliter) subcutaneously on the right upper hind legs. The HBO group (n = 43) received HBO treatment (at 2.5 ATA for 80 minutes) twice a day for 28 days. The control group (n = 42) did not receive any therapy. Lesion size was measured for 4 weeks. There was no significant difference in lesion size between the groups on days 7 (p = 0.1364) and 14 (p = 0.1123), but the lesion size was significantly smaller in the HBO group than in the control group on days 21 (p = 0.0251) and 28 (p = 0.0001). Of 36 animals with lesions in the HBO group, complete wound healing occurred in 16 animals by day 40. However, there was no complete wound healing in any of the 36 animals with lesions in the control group. The beneficial effect of HBO in adriamycin-induced skin lesions was observed in this experimental study.

Femoral shaft fractures in children treated by closed reduction and early spica cast with incorporated supracondylar Kirschner wires: a long-term follow-up results

38 children between 1 and 10 years of age with femoral shaft fractures were treated by closed reduction and early spica cast with incorporated supracondylar Kirschner wires and followed up prospectively. Overrides of maximum 15 mm, medial and anterior angulations less than 15 degrees and lateral angulation up to 5 degrees were considered acceptable. Posterior angulation and malrotation were not accepted. Of the 38 children examined at a mean of 65.6 months (range, 58-80 months) after fracture, none had any residual skeletal deformity and joint stiffness. At long-term follow-up, maximal shortening was 11 mm and overgrowth was 6 mm. The only factor associated with unacceptable shortening was shortening > 15 mm at the time of spica cast application. We believe that close follow-up during the first 3 weeks after cast application is important in order to achieve an acceptable final outcome. On the other hand this method of treatment is simple, safe and effective. It dramatically decreases hospital stay and cost of treatment and allows rapid return of the patients to their family environment.

Apoptosis bcl-2 and p53 expression and their relation to tumour stage in non-small cell lung carcinomas (NSCLC)

Little quantitative data exist on the extent of apoptosis (genetically mediated cell deletion) and no data are available on its relation to p53 and bcl-2 expression and on its value as a prognostic factor in NSCLCs. We examined 38 NSCLCs (26 squamous, 8 adeno, 2 adenosquamous and 2 large cell carcinomas) for the frequency of apoptotic bodies by morphometric methods using haematoxylin eosin stained sections and for the bcl-2 and mutant p53 gene product expression using immunohistochemical techniques. We also evaluated the relation of apoptosis, bcl-2 and p53 expression to tumour stage and to each other. Eleven cases were in stage I, 5 were in stage II, 13 were in stage III and 9 were in stage IV. The mean apoptotic count was 9.52 (r: 2-26); 36.8% of cases were positive for bcl-2 and 76.3% of cases were positive for p53 expression. Statistical analysis did not show any correlation between tumour stage and any of the three tested parameters. There was no statistically significant relation between apoptosis and either p53 or bcl-2 expression. There are conflicting reports on the complex relationship between bcl-2, p53 and apoptosis. bcl-2 is suggested to have a prognostic value, independent from stage in SCLCs. Though we did not find any relation between stage and bcl-2 or apoptosis, it remains to be tested whether they have any independent prognostic value in larger series with survival data.

Neuroendocrine differentiation in non-neuroendocrine thyroid carcinoma

Specimens from 40 cases of thyroid carcinomas, including 35 papillary, 2 follicular, 2 undifferentiated, and 1 Hurtle cell carcinoma were analyzed for neuroendocrine differentiation with immunohistochemical tests for synapthophysin, neuron-specific enolase (NSE), chromogranin, and calcitonin; all cases were stained for thyroglobulin. Histologically, none of the cases resembled a medullary carcinoma. Twenty-five percent (10 cases) were immunoreactive for one, 30% (12 cases) for two, and 15% (6 cases) for three markers. Three of the cases that were positive for all 3 markers (7.5% of all total) had diffuse strong immunoreactivity. These results demonstrated neuroendocrine differentiation may occur in non-neuroendocrine thyroid tumors and may support the postulation that endodermally derived ultimobronchial stem cells might give rise to C cells as well as follicular cells.

There is no relationship between concentration, motility and vacuolated cells

To determine whether there are differences between concentration and motility in the vacuolated spermatozoa of fertile donors, randomized men and infertile patients, semen samples were compared. Based on the percentages of concentration and motility, samples were divided into three groups: Group I, fertile donors, concentration > 20 x 10(6)/ml, motility > 50%; Group II, patients, concentrations < 20 x 10(6)/ml, motility < 50%; Group III, randomized men, concentration > 20 x 10(6)/ml, motility > 50%. In each group samples were assessed morphologically by the strict criteria of Kruger et al. The results showed that there was no difference between Group I and Group II, but there were differences between Group III and Group II, and Group III and Group I. We conclude that there is no relationship between concentration, motility and vacuolated cells.