Prediction of the preeclampsia: a view of biochemical markers

Preeclampsia is a diverse, multiorgan group of related disease processes that occurs in up to 5%-8% of pregnancies after 20 weeks’ gestation and it is one of the leading causes of maternal and fetal morbidity and mortality. Many molecular mechanisms are contributed to the pathogenesis of preeclampsia. Although it is unknown whether the mechanisms act independently or have synergistic effects. This review describes review of primary papers investigating blood based biomarker such as PAP-A, Inhibin A, sFlt1, and PP13 in general and first trimester biochemical markers and combinations of them specifically for preeclampsia

Vitamin D levels in pregnancies and neonatal outcomes

Objective: We aimed to evaluate the differences in obstetrics and neonatal outcomes, such as mode of delivery, gestational diabetes mellitus, preeclampsia, and infant birth weight between pregnancies with normal and insufficient vitamin D levels. Methods: The study was designed as a retrospective study. One hundred and seventy-nine pregnant women who were followed up at our clinic and whose vitamin D levels were evaluated in each trimester were included. All patients were administered 1200 IU/day beginning from the 12 weeks of gestation in accordance with the national guidelines. Vitamin D levels above 20 ng/ml were defined as sufficient, and those below 20 ng/ml were defined as insufficient. Results: The median vitamin D level in the third trimester was significantly higher than that in the first and second trimesters (p<0.001). There was a moderate positive correlation between vitamin D levels in infant cord blood at the time of birth and vitamin D levels in the third trimester (p<0.001, R=0.496). Birth weights of the patients with insufficient vitamin D levels in the first trimester but with sufficient neonatal cord blood levels as a result of treatment were significantly higher compared to those in patients with insufficient cord blood vitamin D levels (3327 g vs. 3133 g, p=0.030). Conclusion: This study observed that neonatal cord blood vitamin D level is a better indicator than antenatal vitamin D levels. Regardless of first-trimester vitamin D levels, infant birth weights were significantly higher in the group with sufficient neonatal cord blood levels

Symplastic leiomyoma that mimic adnexial mass and magnetic resonans imaging: A case report

Amaç: Simplastik leiomyom terimi, orta dereceden ciddi dereceye kadar sitolojik atipi kriterlerini karşılayan hücreleri içeren leiomyomları ifade etmektedir. Simplastik leiomyomlar sarkomla karıştırılabileceğinden tanınması önemlidir. Klinik davranışları sıradan leiomyomlarla benzerdir. Şüphede kalınan pelvik kitlelerin ayırıcı tanısında MRI kullanımı yararlı olabilir. Adneksiyal kitleyi taklit eden simplastik leiomyom olgusu sunuldu ve literatür eşliğinde tartışıldı.Objective: The term symplastic leiomyoma denotes those leiomyomas that contain cells meeting the criteria of moderate to severe cytologic atypia. Symplastic leiomyomas, are important to recognize, as they can be misinterpreted as sarcoma. Clinical features are similar to those of usual leiomyomas. Magnetic Resonans Imaging (MRI) can be useful for the diagnosis of some indeterminate pelvic mass. Symplastic Leiomyoma that mimic adnexal mass is presented, and discussed according to the review of the literature

Analysis of heavy metals in the endometrial tissue using scanning electron microscope

ÖZET Amaç: Endometrium dokusunda çevre kirliliğine yol açan ağır metallerin tesbiti. Materyal ve Metod: 20 adet albino Wistar rat randomize olarak 2 gruba ayrıldı. Grup l'deki ratlar Ankara'da, Grup 2'deki ratlar Kırıkkale'de 1 ay süresince tutuldular. Genel anestezi altında çıkarılan uteruslar scanning electron mikroskopta incelenerek metal tayinleri yapıldı. Bulgular: Her iki grup karşılaştırıldığında Grup 2'deNikel anlamlı olarak yüksek tesbit edildi (p0.05). Sonuçlar: endometrium dokusundaki yüksek nikel düzeyi endometrial kompozisyonu etkileyerek düşük sebebi olabilir.Objective: Determination of the heavy metals in endometrial tissue, which cause environmental pollution. Materials and Methods: 20 albino Wistar rats are divided into 2 groups at random. During one month, the rats of Group 1 were held in Ankara, the rats of Group 2 were held in Kirikkale. The uteruses were taken out under general anesthesia and were examined in scanning electron microscope, so their determinations of metal were done. Results: In a comparison between the groups, the quantity of Nickel was determined significantly at high level in Group 2. Conclusions: The etTect of the high level of Nickel in endometrial tissue on endometrial composition may be accepted as the reason ofabortion

Intraocular pressure changes in healthy pregnant women and women with preeclampsia

Amaç: Sağlıklı ve preeklampsili gebelerde göziçi basıncı (GİB) farklılıklarının incelenmesi ve bunun yanısıra, hipertansiyonun GİB üzerindeki etkilerinin değerlendirilmesi Gereç ve Yöntem: Antenatal izlemleri yapılan benzer yaşta ve 3. gebelik trimesterindeki 18 preeklampsili gebe ve 20 sağlıklı gebe ile yaş uyumlu gebe olmayan 20 fertil kadın çalışma kapsamına alındı. Tüm olgularda tam oftalmolojik muayene ve applanasyon tonometri ile GİB ölçümü uygulandı. Bulgular: Preeklampsili gebelerin ortalama GİB değeri (16.71.9 mm-Hg) ile gebe olmayan kadınların ortalama GİB değerleri (16.21.2 mm-Hg) arasında anlamlı farklılık gözlenmezken; normal gebelerde GİB (14.31.5 mm-Hg) preeklampsili gebelere (P0.001) ve gebe olmayan kadınlara (P0.01) kıyasla anlamlı düzeyde düşük bulundu Sonuç: Preeklampsili gebelerde GİB, sağlıklı gebelerden farklı bir süreç izlemektedir. Preeklamsili gebelerde GİB'de azalma olmaması, sistemik hipertansiyonun bir sonucu olabilir.Purpose: To investigate the changes of the intraocular pressure (IOP) in healthy pregnant women and women with preeclampsia and to evaluate the effects of hypertension on IOP. Methods: We studied IOP in 20 healthy 3rd trimester pregnant women,18 preeclamptic women and 20 non-pregnant fertile women. All participants were underwent complete ophthalmological examination and IOP measurement with applanation tonometry. Results: Between the non-pregnant women and preeclamptic women, there was no statistical significant difference in IOP (P>0.05). IOP in healthy pregnant women was lower than that of preeclamptic women and non-pregnant women (P<0.05) Conclusions: The fact that IOP in preeclamptic women was higher than that of 3rd trimester normotensive pregnant women, may result from hypertension

Menopozda endometrial kalınlık ve vücut kitle indeksinin değerlendirilmesi

Bu çalışmanın amacı endometrium kalınlığının ölçümü ile menopozda vücût kitle indeksi arasında ilişki olup olmadığını incelemektir. Kırıkkale Üniversitesi Tıp Fakültesi Kadın-Doğum polikliniğimize başvuran en az bir yıllık amenore döneminden sonra gelen klinik ve hormonal olarak menopoz tanısı konan ve hormon replasmanı almayan 50 hasta çalışma kapsamına alındı. Endometrium kalınlığı çift tabaka kalınlık olarak ölçüldü. Hastalar endometrium kalınlığı, 5 mm. ve 5 mm olanlar olarak iki gruba ayrıldı, istatistiki testlerden, ortalama ve lineer regrasyon analizleri kullanıldı, p 0,05 istatistiki olarak anlamlı kabul edildi. Hastalarımızın yaş ortalaması 50,0 4,4 yıl olup ortalama menopoz süresi 3,1 2,3 yıl idi. Asemptomatik hastalarda endometrium kalınlığı ile vücut kitle indeksi arasında istatistiki olarak anlamlı ilişki tesbit ettik (r 0,124, p 0,01). Bu da vücut kitle indeksinin önemini vurgulamaktadır.OBJECTIVE: Investigation of a possible relationship between body mass index and endometrial thickness, which is an important marker of endometrial pathologies during menopause. STUDY DESIGN: We included 50 patients who have an amenorrhea period of at least 1-year and have a clinical and hormonal diagnosis of menopause. We classified the patients into two groups. The first group was consisted of the patients whose endometrial thickness was lower than 5 mm and the second group was consisted of the patients whose endometrial thickness was more or equal to 5 mm. Mann-Whitney U test and linear regression analysis were used as statistical test. In our study group, the mean age was 50.0 ± 4.4, menopausal age was 3.1 ± 2.3 years. RESULTS: In our study group, the mean age was 50.0 ± 4.4, menopausal age was 3.1 ± 2.3 years. We found a statistically meaningful correlation between endometrial thickness and body mass index (r 0.124, p 0.01). CONCLUSION: We found a statistically significant correlation between the endometrial thickness and body mass index in asymptomatic postmenopausal women. This emphasizes the importance of body mass index. (Gynecol Obstet Reprod Med 2000; 6: 120-123)/.

Uterus anomalisi ile birlikte endosalpingiosis: Bir olgu sunumu

Endosalpinjiosis fallop tüpüne ait glandüler epitelin ektopik lokalizasyonda bulunmasıdır. Endosalpingiosisin semptom, bulgu ve tedavisi net olarak belirlenmemiştir. Bikornuat uterusla birlikte tespit edilen endosalpinjiosis olgusu sunuldu ve literatür eşliğinde tartışıldı.Endosalpingiosis is the presence of glandular epithelium of the fallopian tube in an ectopic location. The symptoms, sings and treatment of the endosalpingiosis are not clear. Endosalpingiosis in association with bicornuate uterus is presented and discussed according to the review of the literature

The etiopathogenetic factors which figure in the development of polycystic ovary syndrome

Amaç: Polikistik Over Sendromunun farklı kriterlere göre tanımlanması ve bu sendromun gelişiminde rol alan etyopatogenetik faktörlerdeki çeşitliliğin araştırılmasıdır. Method: Polikistik Over Sendromu ilk olarak 1935'de Stein ve Leventhal tarafından tanımlanmıştır. Geçmiş yıllarda klinik tanı amenore, hirsutizm, obesite triadından oluşmaktaydı. Ancak son zamanlarda yapılan çalışmalar ise PKOS'nun geniş, heterojen bir klinik tabloya ve multifaktöriyel bir etyolojiye sahip olduğunu göstermiştir. PKOS'da görülen hiperandrojenizm ve anovulasyon endokrinolojik olarak 4 kompartmanda görülen anormallikler sonucu ortaya çıkar; over, adrenal bez, cilt ve yağ dokusu, hipotalamo-hipofizer aks. PKOS'nda etyopatogenez.de hipotalamo-ptuiter-overyen akstaki değişiklikler, intrinsik over patolojisi, peripubertal ekzajere adrenarş ve fizyolojik insülin rezistansının birlikteliği, obezite, patolojik insülin rezistansı ve pankreasla beta hücre disfonksiyonu ve genetik etyolojiye işaret eden ailesel birikimin rolü kesin olarak gösterilmekle beraber bu konuda halen çalışmalar devam etmektedir. Bu derlemede 'PKOS'nun farklı kriterlere göre tanımlanması ve sendromun gelişiminde rol alan çeşitli etyopatogenetik faktörler anlatılmaktadır. Sonuç: PKOS'da etyopatogenetik faktörlerin tam olarak bilinmesi; hastalığın tanısı, izlemi, tedavisi ve uzun dönem komplikasyonların gelişiminin engellenmesi açısından çok büyük bir önem kazanmaktadır.Objective: To define the polycystic ovary syndrome according to different criteria and to investigate the diversity of the etiopathogenetic factors which figure in the development of polycystic ovary syndrome. Method: Polycystic ovary syndrome was first described by Stein and Leventhal in 1935. The clinical diagnosis was based on the triad of amenorrhea, hirsutism and obesity in past years. On the other hand recent studies have shown that PCOS has an extensive, heterogen clinical view and multifactorial etiology. Hyperandrogenism and anovulation seen in PCOS are arised endocrinogically as a consequence of the anomalies of 4 compartments: over, adrenal gland, skin and fat tissue, hypothalamic-pituitary axis. However the alterations of hypothalamic-pituitary-ovarian axis, intrinsic ovary pathology, synergy of peripubertal exagere ad-renarge and physiological insulin resistance, obesity, pathologic insulin resistance and beta cell disfunction of pancreas and the role of familial aggregation indicating the genetic etiology have been definitely revealed in the etiopatho genesis of PCOS, studies are currently carried on this subject. In this review the definition of PCOS according to different criteria and the variable etiopatho genetic factors that figure in the development of this syndrome are explained. Conclusion: Assuming the etiopatho genetic factors entirely become very important for the diagnosis, trial, treatment of the disease and also for the prevention of complications

Assessment of DNA damage in postmenopausal women under osteoporosis therapy

Sardas, Semra/0000-0001-5456-8636WOS: 000240483600013PubMed: 16504368Objective: The following study was designed to examine possible DNA damage levels in peripheral blood leukocytes, using the alkaline Comet assay, isolated from postmenopausal women undergoing osteoporosis treatment. Study Design: Thirty-two postmenopausal women were randomized into two groups of 16. A dosage of 2.5 mg/day of tibolone (Livial) and 10 mg/day of alendronate sodium (Fosamax) were administered to Group 1 over a 12-month period while Group 2 took 10 mg/day of alendronate alone over the same period. The control group consisted of 16 postmenopausal women who did not receive any treatment. Genotoxicity was assessed by the standard method of alkaline Comet assay. Results: When the results of the study groups were compared with those of the control group, significant differences in terms of DNA damage levels were found (p 0.05). Conclusion: Although, no statistical difference in terms of DNA damage levels between tibolone plus alendronate as opposed to alendronate alone was found, an increase in DNA damage levels was observed in Groups 1 and 2 compared with the control group. Consequently, it can be asserted that the frequency of DNA damage in postmenopausal women with osteoporosis increases under alendronate treatment with or without tibolone. (C) 2006 Elsevier Ireland Ltd. All rights reserved

Evaluation of hormone replacement therapy which may have an adrenomedullin-mediated protective effect on cardiovascular disorders

WOS: 000249820100010PubMed: 17607091Background and aims: This study aimed to determine whether there is an adrenomedullin (AM)-mediated protective effect of postmenopausal estroger/progestin therapy (HRT) against cardiovascular disorders. Methods: A total of 22 post-menopausal women without hysterectomy undergoing postmenopausal symptoms (aged 43-52) were treated with conjugated equine estrogen (0.625 mg/die) plus medroxyprogesterone acetate (2.5 mg/die) for six months. The flow velocity of the right middle cerebral artery [measured as resistance index (RI) and pulsatility index (PI)], plasma levels of adrenomedullin and endothelin-1 (ET-1), mean baseline ratio of AM to ET-1, and lipid profiles were assessed before and after HRT. Results: A statistically significant difference was found for triglycerides, total cholesterol, AM/ET-1 ratio and right middle cerebral artery PI (p 0.05) between pre- and post-HRT. Conclusions: Adrenomedullin may be added to other vasoactive peptides as a new potential candidate for HRT-mediated vascular protection. The ratio of AM/ET-1 vs AM or ET-1 alone may be a useful biological marker of this protection