Electrocardiographic Findings at Initial Diagnosis in Children with Isolated Left Ventricular Noncompaction

Background: The aim of this study was to comprehensively evaluate electrocardiographic (ECG) findings of isolated left ventricular noncompaction (IVNC) patients at initial diagnosis and to explore the correlation between them and the clinical, echocardiographic, and magnetic resonance imaging (MRI) findings. Methods: Twenty‐three patients diagnosed with IVNC by echocardiography and cardiac MRI between January 2006 and June 2010 were enrolled in this study. The patients were examined with standard ECG and 24‐hour Holter ECG. For comparison purpose, ECGs of 50 healthy children of similar ages and demographic characteristics were taken. Results: In 87% of patients, ECG abnormalities were found. The most frequently seen ECG findings were left ventricular hypertrophy, ST‐segment depression, and negative T wave related to abnormal repolarization particularly in DII, DIII, and V_4–6 leads, as well as prolonged PR and QTc intervals. No ECG features or patterns were found that were specific to the disease. In contrast to adult patients, while no intraventricular conduction defects (particularly in the left bundle brach) were found in any of our patients, 13% had considerable bradycardia and one required a pacemaker. The Holter ECG recordings showed supraventricular tachycardia attacks in two patients and a short ventricular tachycardia attack in one. Patients whose echocardiograms and MRI showed left ventricular systolic dysfunction and left ventricular dilatation had signs of left ventricular hypertrophy and repolarization abnormality on their ECGs, but there was no significant difference in PR, QRS, and QTc intervals. Conclusion: Regardless of how frequently left ventricular hypertrophy and repolarization abnormalities are found on IVNC patients’ initial ECGs, we think that they are not unique to the disease but are related to the severity of the cardiomyopathy. Ann Noninvasive Electrocardiol 2011;16(2):184–191     

Determinants of choosing withdrawal over modern contraceptive methods in Turkey

Objectives The determinants of the use of withdrawal in Turkey are examined using a multinomial logistic model.

Methods Data were drawn from a nation-wide population-based cross-sectional study, the Turkish Demographic Health Surveys that took place in 1998 and 2003. Detailed interviews were conducted with 8576 women aged 15–49 and analysed using SPSS.

Results Contextual, cultural and demographic characteristics define women's choice of withdrawal over modern methods. Socio-economic status, education, employment status, and past fertility behaviour are among key determinants. First-ever used contraception method has a very strong impact on later choices. Urban women, the more educated, those with better socioeconomic status, and those living in less crowded households resort less to withdrawal. Experience and empowerment positively linked to modern contraceptive use among women in Turkey.

Conclusions The use of contraceptive methods in Turkey differs greatly. Empowerment of women in terms of better socioeconomic status, better education, modern and liberal attitudes towards women and family planning seem to reduce withdrawal use as the main method of contraception. The results suggest the need for education (particularly targeting young women and couples), information and provision of modern contraceptive services particularly for disadvantaged groups.     

Age estimation from fetus and infant tooth and head measurements

Forensic identification comprises legal, social, ethical, and religious aspects where age detection is an important factor. When the case is a fetus or infant, recording various measurements of the body, head, and teeth is essential. The aim of this research is to evaluate the effects of different tooth and body measurements and their implications on the age estimation of fetuses and infants. This research was performed on 96 fetus and infant incisor teeth taken from 24 autopsy cases (54 % males and 46 % females) where age of the subjects were within the range of prenatal 16 weeks to postnatal 72 weeks. The data were statistically processed by regression analysis via curve estimations. According to the results, growing patterns of the head circumference (HC) and the upper central tooth measurements indicate a strong relationship, where there is no significant difference for both sexes. The growth patterns of all variables showed a linear function to a certain age (approximately 56 weeks pre–plus postnatal); the tooth height (TH) slightly increases until the closure of the root apex, and the HC gradually stabilizes in time, therefore a log-linear relation was found considerable. The results revealed eight age estimation formulas, including the combination of HC with the labiolingual, mesiodistal (MD), crown height, and TH measurements. Among these, only MD can be applied to a living. In conclusion, tooth and head measurements are found to be the main factors of age estimation formulas.     

Over 14 years of experience with cardiac myxomas

Atrial myxomas are the most commonly encountered tumours of the heart and can present at different ages with different clinical symptoms.They are one of the curable tumours of the heart. Appropriate surgical treatment and surgery must be performed with great precautions in order to prevent fatal systemic embolizations. In this retrospective study we will present our experience of 14 years, between 1990 and 2004, in 27 patients who had been operated for cardiac myxomas. Diagnosis of the myxomas were made by echocardiography in all cases. Surgical approach to the tumour was biatrial in nine, left atrial in II, and transseptal in seven patients. Associated procedures included coronary artery bypass grafting in one, mitral valve repair with tricuspid annuloplasty in two patients, mitral valve replacement in one and bilateral femoral embolectomy in one patient. One hospital mortality occurred as a result of multiorgan failure in a patient with peripheral embolization. None of the patients required recurrent operation, however, mitral valve insufficiency was surgically corrected in one patient.     

Randomized controlled trial on lifestyle modification in hypertensive patients

The authors examined the effects of a comprehensive lifestyle modification intervention on blood pressure (BP) and other cardiovascular risk factors in hypertensive patients. A total of 70 participants were randomly placed into either a lifestyle intervention or a control group. Four education classes and individual counseling sessions were held for the intervention group. Participants in the control group were provided with routine outpatient services and were asked to maintain their usual lifestyle. Data were gathered at baseline and at the end of 6 months. At the end of 6 months, BP, body weight, body mass index, waist circumference, and fasting lipids, apart from high-density lipoprotein cholesterol, significantly declined in the intervention group. Healthpromoting lifestyle scores of the intervention group had increased significantly compared to those of the control group. In conclusion, the results demonstrate the feasibility of comprehensive lifestyle modification and show its beneficial effects.     

Validity and reliability of Turkish Caregiver Burden Scale among family caregivers of haemodialysis patients

Aims and objectives. To investigate the validity and reliability of the Caregiver Burden Scale in family members who provide primary care for haemodialysis patients. Background. In Turkey, there is a need for a multi‐dimensional instrument to evaluate the caregiver burden in people who provide care for patients with chronic diseases. Design. A methodological study. Methods. The study sample consisted of 161 family members who provide primary care for haemodialysis patients. The forward‐backward translation method was used to develop the Turkish Caregiver Burden Scale. The reliability was based on internal consistency investigated by Cronbach’s alpha and item–total correlation. The factorial construct validity of the scale was tested with confirmatory factor analysis. By means of convergent and divergent validity, correlation between Caregiver Burden Scale and 36‐Item Short Form Health Survey (SF‐36) and correlation between Caregiver Burden Scale and the Maslach Burnout Scale were investigated. Results. Cronbach’s alpha and item–total correlations results suggested that there was good internal reliability. We found five underlying factors similar to original Scale’s five‐factor solution. The confirmatory factor analysis five‐factor model represented an acceptable fit. Factor loadings were significant, with standardised loadings ranging from 0·43–0·81. By means of divergent validity, all sub‐dimension scores and the total score of the Caregiver Burden Scale were negatively correlated with the SF‐36, whereas there was a positive correlation with the emotional exhaustion and depersonalisation subscales of the Maslach Burnout Scale as expected. Conclusion. These results suggest that the Caregiver Burden Scale is a reliable and valid instrument which can be used with confidence in Turkish caregivers for haemodialysis patients to screen caregiver burden. Relevance to clinical practice. The burden experienced by people who provide care for patients with chronic diseases can be evaluated with the Caregiver Burden Scale. Additionally, the Caregiver Burden Scale can be used in the evaluation of the effectiveness of attempts to decrease caregiver burden.     

The effect of anxiety and depression scores of couples who underwent assisted reproductive techniques on the pregnancy outcomes

ObjectiveThe aim of this study was to determine the effect of anxiety and depression scores of couples who underwent Assisted Reproductive Techniques (ART) on pregnancy outcomes.MethodThis study was conducted as a prospective and comparative study with 217 couples. The study data was collected by using a semi-structured questionnaire and the Turkish version of the State-Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI). The questionnaire, STAI and BDI were applied to couples who initiated ART treatment. Couples'' state anxiety scores were re-evaluated after embryo transfer (ET).ResultsA significant relationship was found between the depression score of women and pregnancy outcome (p < 0.05). It was determined that anxiety scores for both men and women were higher before the ART procedure, but their anxiety scores decreased after ET (p < 0.05). Spouses of women with a negative pregnancy outcome had higher trait and state anxiety mean scores (p > 0.05) and lower depression scores (p <0.05) than spouses of women with a positive pregnancy outcome.ConclusionStudy results indicated that the anxiety and depression scores of couples who had achieved a positive pregnancy result were lower than for couples with a negative result. The results of this study will contribute to the health professionals especially to the nurses who spend the most time with couples in providing consulting services and supporting psychological status of couples during ART process in Turkey.