Irish journal of medical science
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The incidence of breast cancer (BC) has been on the rise over the last decades in the USA, and it is most frequently diagnosed among women aged 65-74 years. ⋯ Turkish BC patients are diagnosed at younger ages than BC patients in developed countries, and this portends a significant health problem. Therefore, it is important and vital that society be educated about the disease without any further delay and screening programs should be instated effectively and extensively from the age of forties.
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Butyrylcholinesterase (BChE), an important biomarker of exposure to anticholinesterases, varies its activity according to the intensity and duration of exposure to these agents. Their normal values may vary in different populations. It is important to determine the reference values for the local population, mostly black/brown. ⋯ Despite the high miscegenation and predominance of the black race in Salvador, contrary to what was expected, the sample did not show statistically significant intra-racial differences in BChE activity, being able to use the same reference values currently used, observing factors such as sex, use of contraceptives, and drinking alcohol.
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Observational Study
Non-diabetic fetal macrosomia: outcomes of elective delivery versus expectant management.
Macrosomia in the absence of diabetes can be associated with increased neonatal and maternal morbidity. Management is usually undertaken on a case-by-case basis. ⋯ Overall, there was no difference in major maternal or neonatal outcomes between management options for fetal macrosomia. However, inducing nulliparas with an unfavorable cervix for non-diabetic macrosomia was associated with obstetric anal sphincter injury and postpartum hemorrhage.
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Myocardial infarction with nonobstructive coronary arteries (MINOCA) is now being recognized as an important clinical entity with prognostic implications. There are limited data in relation to MINOCA in our local Australian settings. ⋯ The clinical prevalence rate of MINOCA at Peninsula Health is 10.9% with a MACE of 5.2%. MINOCA is recognized and the low rate of additional testing could be improved given the female predominance and prognostic implications.
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Vitamin B12 deficiency is common in Ireland, The Irish Longitudinal Study on Aging (TILDA) survey indicates 12% of over 50s in Ireland are low or deficient. The condition is commonly managed exclusively in general practice. ⋯ This closed loop audit demonstrated that there was over treatment and under investigation of patients with B12 deficiency in general practice and that auditing of this process could both reduce risk for patients and save money and time.