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Prenatal distress level and its predictors according to the gestational age in pregnant women

Aim: The aim of the present study was to determine the level and predictors of prenatal distress in pregnant women according to gestational age. 

Material and Methods: This cross-sectional study was conducted in eight Family Health Centers (FHCs) in Kırklareli in Northwestern Turkey. The study included 179 pregnant women at ≥12th week of gestation, who presented to the FHCs. 

Results: The frequency of prenatal distress among the participants was 21.2% (between 12th-27th weeks: 16.5%, between 28th-41st weeks:  26.8%). It was found that level of education, age of the spouse, current pregnancy being unplanned, and social support levels were associated with the level of prenatal distress in  ≥12th week or between 12-27 weeks or between 28-41 weeks (p<0.05). In addition, perceived income level, abortion, and the number of pregnancies were associated with the level of prenatal distress in  ≥12 weeks; the age of women, perceived income levels, previous abortion experience, and the number of pregnancies were associated with the level of prenatal distress in between 12-27 weeks; the age of women, education level of a spouse, and previous delivery experience were associated with prenatal distress levels in between 28-41weeks (p<0.05).

Discussion: The level of prenatal distress according to the gestational age, the education level of the woman, the age of her spouse, unplanned pregnancies, and social support levels were predictors. In the 12-27 weeks and 28-41 weeks, the age of women was found to be a determining factor in prenatal stress levels in pregnant women. Pregnant women should be screened by healthcare professionals in terms of prenatal distress when they visit FHCs, and interventions to activate their social support mechanisms should be planned.

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Can NLR/PLR/CEA be a marker for predicting a complete pathological response in locally advanced rectal cancer?

Aim: The standard treatment for locally advanced (T3-4 and/or N +) rectal cancer (LARC) is Total Mesorectal Excision (TME) and adjuvant chemotherapy after neoadjuvant chemo-radiotherapy (n-CRT). Various clinical or pathological complete response (pCR) rates after neoadjuvant therapy have been reported in the literature. Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) or carcinoembryonic antigen (CEA) levels are used as prognostic markers for many tumors.The aim of this study is to investigate the relationship between treatment response and the above markers in patients receiving n-CRT for LARC.

Material and Methos: The pathology results of 113 patients who underwent TME after n-CRT were divided into 4 groups according to the modified ryan tumor regression grade (TRG) classification. Among these groups, NLR, PLR and CEA levels, which are considered prognostic markers in response evaluation, were compared with their changes before and after neoadjuvant treatment.

Results: While 11 (9,7%) patients had pCR (TRG 0), 41 (36,3%) patients had good response (TRG 0 and 1), 72 (63,7%) patients had a poor response (TRG 2 and 3) to n-CRT. While the initial prognostic markers were similar between the groups, post-n-CRT values were found to be significantly lower in the group with good response.

Discussion: It is not possible to predict n-CRT response in LARC patients at the time of diagnosis, but NLR, PLR or CEA values and changes in these values may be useful in predicting treatment response.

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How does the obstetric anesthesia in cesarean section affect the wellbeing of the newborn?

Aim: The well-being of newborns after a cesarean section (CS) is the main important point when choosing anesthetic methods. APGAR score, cord blood gas levels, and early feeding of the newborns after CS are indicators of the newborn’s well-being.

In this study, it was aimed to evaluate the effects of different anesthesia methods (regional and general) on Apgar score and cord blood gas, and the second aim is to evaluate the onset time of breastfeeding after CS with  different anesthesia methods.

Material and Methods: A total of 364 mothers who underwent CS in our hospital, between January 2020 and April 2020 and their newborns’ records were evaluated retrospectively.

Results: General anesthesia(GA), regional anesthesia (RA) anesthesia were applied during CS to 50% (n = 182), 50% (n = 182). There were no significant differences between the two groups (all p>0.05) in terms of APGAR score, umbilical cord arterial blood gas. The rate of breastfeeding in the first hour in the RA group was significantly higher than in the GA group (p <0.001).

Discussion: Two anesthesia (RA and GA)  methods could be preferred safely for newborns in terms of APGAR score and umbilical cord blood gas, however, the timing of breastfeeding initiation was earlier with RA than GA.

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