The effect of increased amnion volume severity on fetal Doppler indices and perinatal outcomes in idiopathic polyhydramnios

Aim: To evaluate the relationship between polyhydramnios severity and alterations in Doppler indices and perinatal outcomes in idiopathic polyhydramnios. Methods: This prospective case control study was conducted in a tertiary hospital with 173 singleton pregnancies between 29 and 41 weeks gestational age between May 2015 and December 2016. Polyhydroamnios is classified as mild (amniotic fluid index 25–30 cm), moderate (30.1–35 cm), and severe (>35 cm) and the number of the patients in mild, moderate, and severe groups were 55, 39, and 26, respectively. The results were compared with 53 healthy controls. Fetal echocardiography and Doppler measurements of the groups were made and the perinatal outcomes from each group were noted. The relationship between the results and the severity of polyhydramnios was analyzed statistically. Results: The myocardial performance index was significantly higher in the fetuses of women with severe polyhydramnios compared to the other groups (p =.006). There were statistically significant differences among the groups in terms of first and fifth minutes according to the Apgar scores (p =.011, p =.016 respectively). In the severe polyhydramnios group compared with other groups, the middle cerebral artery pulstatility index was significantly lower (p =.002), while middle cerebral artery peak systolic velocity and umbilical artery pulstatility index values were significantly higher (p =.0001, p =.045). Conclusions: Our study showed an increase in myocardial performance index and middle cerebral artery peak systolic velocity values and a decrease in middle cerebral artery pulstatility index values, especially in the severe idiopathic polyhydramnios group. Idiopathic polyhydramnios were associated with low first and fifth minute Apgar score. Additionally, the increase in umbilical artery pulstatility index value and the decrease in middle cerebral artery pulstatility index value became more apparent with the increase in amniotic fluid volume. It should be taken into consideration that brain sparing effect may develop especially in cases with severe polyhydramnios. © 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group

Knowledge, behaviour and attitude of parents on pediatric surgical practice in our region

Objective: This study was planned to evaluate the knowledge of parents about pediatric surgery and the behaviour and attitude of bringing their children to pediatric surgeons in our city. Material and Methods: A cross-sectional descriptive study was performed on the parents of 1680 children (813 boys and 867 girls), a sampling representative of the parents of 12 years old children of our city. A questionnaire was prepared including questions about some sociodemographic parameters and knowledge of parents about pediatric surgical practice; and behaviour and attitude of taking their children to pediatric surgeons in our city. Among parents of 1680 children 1356 (80.7 %) responded the questionnaire. Results: About 31.7 % of the respondents said that they did not know a specialty called pediatric surgery. Only 1.7 % of the respondents answered the question on pediatric surgical field of practice correctly. 28.8 % of the parents answered the age group of pediatric surgical practice correctly. Statistical analyses revealed that the educational level of the parents and monthly income were positively related with their knowledge about pediatric surgery (p0.05). 26.8 % of the parents said that a pediatric surgeon treated their children. Most of the children were directed to pediatric surgery by pediatricians (42.4 %) and general practitioners (23.2 %). Twenty-one per cent of parents declared that even if there is an advanced pediatric surgical centre in their city, they prefer to transfer their children to one of the three big cities of the country for treatment. Conclusion: In this study we found out that parents in our region know little about pediatric surgery. It is necessary for the pediatric surgeons to introduce themselves to public, to explain people that pediatric surgeons are specifically and sophisticatedly trained to treat the surgical diseases of children. All children should be referred to pediatric surgeons or surgeons dealing only with children for their surgical diseases and this procedure should be supported by law and regulations. © 2019 Polish Academy of Sciences. All rights reserved

Comparison of serum maternal adiponectin concentrations in women with isolated intrauterine growth retardation and intrauterine growth retardation concomitant with pre-eclampsia

Objective: The aim of this study was to compare serum maternal adiponectin concentrations in pregnant women with isolated intrauterine growth retardation (IUGR) and in pregnant women with IUGR concomitant with pre-eclampsia (IUGRcwPE).Material and Methods: Thirty patients with isolated IUGR (group 1), 20 patients with IUGRcwPE (group 2), and 30 healthy controls (group 3) between age 18-40 were included into the study. Venous blood samples of those patients were obtained in the starving state. Adiponectin concentrations were measured by enzyme-linked immunosorbent assay in serum obtained after centrifugation. To find the differences between the groups, student t-test and one-way ANOVA statistical methods were used.Results: There were no differences between the groups in terms of age, body mass index, gestational age, and parity (p>0.05). The values of amniotic fluid index (p0.05).Conclusion: We found that IUGR increased maternal serum adiponectin concentrations; however, this rise does not occur in pregnant women with IUGRcwPE. © 2014 by the Turkish-German Gynecological Education and Research Foundation

Prediction of neonatal respiratory distress syndrome via pulmonary artery Doppler examination

PubMed ID: 29212398Objective: We aimed with this study to evaluate the role of pulmonary artery acceleration time to ejection time ratio (PATET) in the prediction of respiratory distress syndrome (RDS) in preterm neonates. Materials and methods: In this prospective cohort study, 105 singleton pregnant women with no congenital abnormalities and pregnancy complications who delivered before 37 weeks of gestational age were included. All the patients underwent ultrasound examination to obtain fetal pulmonary artery Doppler. 15 patients were excluded from the study as they did not give birth within 3 days subsequent to ultrasound examination, or inadequate Doppler measurements. After delivery the neonates were grouped according to diagnosis of RDS as RDS + and RDS-. Results: One hundred five women met the inclusion criteria. Regarding the Doppler findings; only the PATET ratio was significantly different between the groups (0.2965 ± 0.042 versus 0.386 ± 0.068 p <.001, Z = -5.206). There was an inverse correlation between the diagnosis of RDS in the neonates and the PATET values, even after adjusted for gestational age estimated fetal weight and fetal gender (r = -0.52 and p =.0017). A cut-off value of 0.327 provided optimal specificity of 77.1%, a sensitivity of 90.9%, a negative predictive value of 95.4%, and a positive predictive value 52.7%. Conclusions: In consideration of these results fetal PATET ratio is a promising noninvasive tool to predict RDS in cases of preterm deliveries. © 2017, © 2017 Informa UK Limited, trading as Taylor & Francis Group

Sağlıklı genç kadınlarda farklı quadriceps izometrik kuvvetlendirme yöntemlerinin karşılaştırılması

GİRİŞ: Kas kuvvetini arttırmak için, egzersizin ve nöromuskuler stimülasyonun birbirlerine üstünlüğünü gösterme adına literatürde net bir fikir birliğine varılmamıştır. İstemli kas kontraksiyonuna göre elektrik stimulasyonunda daha fazla motor ünitenin ateşlendiğini, hatta yüksek yoğunluklu akımların istemli kas kontraksiyonundan %10-30 arasında daha fazla kontraksiyon sağladığı önceki çalışmalarda rapor edilmiştir. AMAÇ: Bu çalışma, sağlıklı genç kadınlarda yüksek voltajlı galvanik stimülasyon, Rus akımı ve egzersizin quadriceps izometrik kas kuvveti üzerine etkinliğini karşılaştırmak amacıyla planlanmıştır. METOT: Çalışamaya 46 sağlıklı genç kadın dahil edildi (yaş ort=21.02±1.27 ). Katılımcıların quadriceps izometrik kas kuvveti İzokinetik Dinamometre (Humac Norm Testing Rehabilitation system, CSMI Medikal Solutions, USA) ile değerlendirildi. İzometrik tork ölçümleri için gövde 75° fleksiyon ve diz 60° fleksiyon açısında pozisyonlandı. Test öncesinde; gövde, bel, kalça ve ayak bileği bantlarla stabilize edildi. Test sonrası katılımcıların azami tork ve ortalama torkları kaydedildi. Tüm değerlendirmeler eğitim öncesi ve sonrası olmak üzere iki defa yapıldı. Eğitim amacıyla katılımcılar üç gruba ayrıldı. Eğitim dominant taraf quadriceps kası üzerine uygulandı. Eğitim birinci gruba (n=16) yüksek voltajlı galvanik akım (YVGS), ikinci gruba (n=15) Rus akımı ve üçüncü gruba (n=15) izometrik kuvvetlendirme olacak şekilde planlandı. Hem egzersiz hem de stimulasyon uygulamaları, gövde 75° fleksiyon, diz 60° fleksiyon açısında pozisyonlandıktan ve stabilize edildikten sonra yapıldı. Tüm uygulamalar haftada 3 gün 5 hafta boyunca toplamda 15 seans fizyoterapist gözetimi altında gerçekleştirildi. Verilerin analizinde Kruksal Wallis testi kullanıldı. SONUÇ: Quadriceps izometrik kas kuvvetindeki artış miktarını belirlemek için azami tork ve ortalama tork delta değerleri hesaplandı. Azami tork delta artış oranlarının ortalamaları Rus akım grubu için 1.55±12.97, YVGS grubu için 2.97±14.68, egzersiz grubu için 0.40±8.46 iken; ortalama tork delta artış oranlarının ortalamaları Rus akım grubu için 2.60±14.10, YVGS grubu için 5.53±18.74, egzersiz grubu için 2.65±10.60 idi. Azami tork ve ortalama tork delta değerleri karşılaştırıldığında gruplar arasında herhangi bir istatistiksel fark bulunmadı (p>0.05). TARTIŞMA: Elde ettiğimiz sonuçlara göre azami tork ve ortalama tork delta değerleri karşılaştırıldığında en fazla artış YVGS grubunda olmasına rağmen her üç uygulamanın quadriseps izometrik kas kuvvetini artırmaya yönelik birbirlerine göre herhangi bir üstünlüğü bulunmamıştır. Her üç uygulamanın da quadriseps izometrik kas kuvvetini geliştirme üzerine olumlu etki yarattığı belirlenmiştir. Quadriseps izometrik kas kuvvetini artırma açısında en yüksek değişim oranının YVGS grubuna ait olması nedeniyle, klinik uygulamalarda tercih edilmesini önermekteyiz. Uygulamaların birbirlerine göre üstünlüğünü belirlemek adına daha fazla seans sayılarına sahip çalışmaların planlanmasına ihtiyaç olduğu kanısındayız

Hemangiopericytoma of the uterus: A rare case of pelvic mass

PubMed ID: 25509980Hemangiopericytoma (HPC) is an uncommon perivascular tumor which may arise from anywhere in the body accounts for 1% of primary vascular tumors. Uterine hemangiopericytomas are usually low grade malignancies with better prognosis. The primary treatment is usually total hysterectomy and bilateral salpingo-oophorectomy. In this report, we aimed to evaluate the clinical characteristics of an 83 years of woman admitted to our clinic with pelvic mass who underwent laparotomy and underwent total hysterectomy and bilateral salpingo-ooforectomy. Postoperative pathology was hemangiopericytoma. © 2014 Old City Publishing, Inc

Diagnosis of pregnancy after conservative management for adnexal torsion due to ovarian hyperstimulation in the same cycle

We report a case of right adnexal torsion during the embryo implantation period of an IVF/ICSI cycle. A 26-yearold woman who diagnosed as primary infertility was included in an IVF/ICSI program. In the following period right adnexal torsion occurred at the sixth day of the embryo transfer. Laparoscopic detortion was successfully performed with preserving the adnexia. The patient had positive pregnancy test in the subsequent week