Preeclampsia (PE) has a profound effect in increasing both maternal and fetal morbidity and mortality especially in third World. Disturbances of extravillous trophoblast migration toward uterine spiral arteries is characteristic feature of PE, which, in turn, leads to increased uteroplacental vascular resistance and by vascular dysfunction resulting in reduced systemic vasodilatory properties. Underlying pathogenesis appeared to be an altered bioavailability of nitric oxide (NO•) and tissue damage caused by increased levels of reactive oxygen species (ROS) and reactive nitrogen species (RNS). The increase in ROS and RNS production or the decrease in antioxidant mechanisms generates a condition called oxidative and nitrosative stress, respectively, defined as the imbalance between pro- and antioxidants in favor of the oxidants. Additionally, ROS might trigger platelet adhesion and aggregation leading to intravascular coagulopathy. ROS-induced coagulopathy causes placental infarction and impairs the uteroplacental blood flow in PE. As a consequence of these disorders could result in deficiencies in oxygen and nutrients required for normal fetal development resulting in fetal growth restriction. On the one hand, enzymatic and nonenzymatic antioxidants scavenge ROS and protect tissues against oxidative damage. More specifically, placental antioxidant enzymes including catalase, superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) protect the vasculature from ROS, maintaining the vascular function. On the other hand, ischemia in placenta in PE reduces the antioxidant activity. Collectively, the extent of oxidative stress would increase and therefore leads to the development of the pathological findings of PE including hypertension and proteinuria. Our goal in this article is to review current literature about researches demonstrating the interplay between oxidative, nitrosative stresses and PE, about their roles in the pathophysiology of PE and also about the outcomes of current clinical trials aiming to prevent PE with antioxidant supplementation.

The aim of this study is to investigate the outpatient treatment protocol and radiation safety of a new-emerging lutetium-177 ((177)Lu) prostate specific membrane antigen (PSMA) therapy. This work analyzed the dose rate of 23 patients treated with 7400 MBq (177)Lu-PSMA at different distances (0, 0.25, 0.50, 1.0 and 2.0 m) and variable time marks (0, 1, 2, 4, 18, 24, 48 and 120 h) after the termination of infusion. Blood samples were withdrawn from 17 patients within the same group at 3, 10, 20, 40, 60 and 90 min and 2, 3, 24 h after termination of infusion. Seven different patients were asked to collect urine for 24 h and a gamma well counter was used for counting samples. Family members were invited to wear an optically stimulated luminescence dosimeter whenever they were in the proximity of the patients up to 4-5 d. The total dose of the medical team including the radiopharmacist, physicist, physician, nurse, and nuclear medicine technologist was estimated by an electronic personnel dosimeter. The finger dose was determined using a ring thermoluminescent dosimeter for the radiopharmacist and nurse. The mean dose rate at 1 m after 4 h and 6 h was 23  ±  6 μSv h(-1) and 15  ±  4 μSv h(-1) respectively. The mean total dose to 23 caregivers was 202.3  ±  42.7 μSv (range: 120-265 μSv). The radiation dose of the nurse and radiopharmacist was 6 and 4 μSv per patient, respectively, whereas the dose of the physicist and physician was 2 μSv. The effective half life of blood distribution and early elimination was 0.4  ±  0.1 h and 5  ±  1 h, respectively. Seven patients excreted a mean of 45% (range: 32%-65%) from the initial activity in 6 h. Our findings demonstrate that (177)Lu-PSMA is a safe treatment modality to be applied as an outpatient protocol, since the dose rate decreases below the determined threshold of <30 μSv h(-1) after approximately 5 h and degrades to 20 μSv h(-1) after 6 h.

Increased intestinal permeability leads to higher variation in postprandial blood glucose levels, thereby worsening metabolic control.

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The purposes of the present study are to measure the total radiation doses for the radiation workers and for the accompanying person to the patients in positron emission tomography (PET)/computed tomography (CT) imaging. Urines samples from the patients were collected at 43, 62, 87, 117, 238, 362 min after the 555-MBq (18)flour-fluorodeoxyglucose ((18)F-FDG) injection and activities were measured. Dose rates were recorded using a Geiger-Muller counter and the total radiation doses were measured with using an electronic personnel dosemeter. According to the results here, 18.4 % of (18)F-FDG was excreted in the urine in 117 min after injection. At 117th min after injection, dose rates were determined as 345, 220, 140, 50 and 15 µSv h(-1), at proposed distances. The radiation doses after 117 min were measured as 3.92 mSv at 0.1 m, 2.11 mSv at 0.25 m and 1.08 mSv at 0.5 m. In conclusion, radiation protection will be sufficient within 2 h after (18)F-FDG injection for PET/CT imaging in daily practice.

The effective half-life of iodine-131 for three patients was found to be 44 h. In conclusion, the amount of radioiodine excreted per hemodialysis session was calculated to be 51.25%.

Conventional diagnostic nuclear medicine applications have been continuously increasing in most nuclear medicine departments in Turkey, but to our knowledge no one has studied the doses to technologists who perform nuclear medicine procedures. Most nuclear medicine laboratories do not have separate control rooms for technologists, who are quite close to the patient during data acquisition. Technologists must therefore stay behind lead shields while performing their task if they are to reduce the radiation dose received. The aim of this study was to determine external radiation doses to technologists during nuclear medicine procedures with and without a lead shield. Another aim was to investigate the occupational annual external radiation doses to Turkish technologists. Methods: This study used a Geiger-Mü ller detector to measure dose rates to technologists at various distances from patients (0.25, 0.50, 1, and 2 m and behind a lead shield) and determined the average time spent by technologists at these distances. Deep-dose equivalents to technologists were obtained. The following conventional nuclear medicine procedures were considered: thyroid scintigraphy performed using 99m Tc pertechnetate, whole-body bone scanning performed using 99m Tc-methylene diphosphonate, myocardial perfusion scanning performed using 99m Tcmethoxyisobutyl isonitrile, and 201 Tl (thallous chloride) and renal scanning performed using 99m Tc-dimercaptosuccinic acid. Results: The measured deep-dose equivalent to technologists per procedure was within the range of 0.13 6 0.05 to 0.43 6 0.17 mSv using a lead shield and 0.21 6 0.07 to 1.01 6 0.46 mSv without a lead shield. Also, the annual individual dose to a technologist performing only a particular scintigraphic procedure throughout a year was estimated. Conclusion: For a total of 95 clinical cases (71 patients), effective external radiation doses to technologists were found to be within the permissible levels. This study showed that a 2-mm lead shield markedly reduced the external dose to technologists. The doses to technologists varied significantly for different diagnostic applications. Consequently, the estimated annual dose to a technologist performing only a particular scintigraphic procedure is very different from one type of procedure to another. The results of this study should help in determining the rotation time of technologists in different procedures and differences in their individual techniques.

BackgroundPrimary care providers are uniquely positioned to initiate smoking cessation. We aimed to evaluate knowledge levels about the health effects of smoking and attitudes toward smoking and tobacco control activities among primary care providers.MethodsIn the cross-sectional and primary care-based study, self-administered surveys modified from the WHO Global Health Professional Survey 5A steps of smoking cessation practice (Ask, Advise, Assess, Assist and Arrange) were provided to primary care physicians (PCPhs) and nurses (PCNs).ResultsRespondents included 1182 PCPhs and 1063 PCNs. The proportions of current and former smokers were significantly higher among PCPhs than among PCNs (34.4 vs. 30.7 % and 14.0 vs. 10.1 %, respectively; both P < 0.001). We observed that 77.2 % of PCPhs and 58.4 % of PCNs always or rarely practiced an “Ask” step about their patients’ smoking status (P < 0.001). One-third of PCPhs (33.8 %) stated that they always practiced an “Ask” step, whereas only 27.6 % of PCNs always did so in their practice (P < 0.001). A small minority of primary care providers had advised patients to quit smoking, although there was a significant difference in this between PCNs and PCPhs (8.4 vs. 15.6 %; P < 0.001). Most PCPhs considered themselves competent in advising about smoking interventions, but only a minority of PCNs did so (75.1 vs. 17.3 %; P < 0.001). Among barriers to tobacco intervention measures, lack of time was the item most commonly cited by PCPhs, whereas low patient priority was most commonly cited by PCNs (35.9 and 35.7 %; P < 0.001).ConclusionsSmoking intervention practice by primary care nurses was quite low. Lack of time and low patient priority were identified as barriers by primary care providers. Strategies by which primary care providers could improve tobacco control should be established.