Role of Asymmetric Dimethylarginine in Psychiatric Disorders

Asymmetric dimethylarginine has been a post-translational modified form of the aminoasid arginine. Being a competitive inhibitor of nitric oxide synthase enzyme, makes asymmetric dimethylarginine important. Findings of previous studies and observations show that the accumulation of asymmetric dimethylarginine may have an important role for the regulation of signal transduction in nitric oxide system, and this accumulation may be a new mechanism for the regulation of nitric oxide production in the brain. Studies have suggested that increased asymmetric dimethylarginine levels could lead to a decrease in the level of nitric oxide production by inhibiting nitric oxide synthase enzyme. Therefore asymmetric dimethylarginine may be important in the pathophysiology of various psychiatric disorders. In this review, findings of research studies on asymmetric dimethylarginine and nitric oxide conducted with psychiatric patients so far and possible role of these molecules in the etiopathogenesis of various psychiatric disorders were discussed. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(4.000): 355-362

Can evaluation of the cervix with histogram and Bishop scoring prior to birth induction forecast the birth type for superannuated primigravidas?

Purpose: We conducted this study to research both the forecasting efficiency of the cervical histogram and Bishop scoring for birth type (vaginal birth/cesarean) for the superannuated primigravida prior to birth induction. Methods: Ninety primigravidas in week 41 and beyond were included in the present study. Exclusions for the study included prior labor, ruptured membranes, any major uterine operations, cephalopelvic discord, fetal malpresentations, fetal anomalies, multiple pregnancy, placenta previa, vaginal bleeding, a high sensitivity for oxytocin usage, and an estimated fetal weight greater than 4000 g. Histogram hyperechogenic focus and hypoechogenic focus measurements are conducted in normal spontaneous birth (NSD) and cesarean (SECTIO) groups. Findings: Thirty-six patients had a cesarean birth, while 54 of the patients had vaginal births. On logarithmical regression analysis, the Bishop score and the parameters were found statistically significant in terms of proving the cesarean indication (p=0.001). In our cervical histogram, the forecasting efficiency of the hyperechogenic focus and hypoechogenic focus measurements for determining the birth type were not been able to shown (p=0.089 ; p=0.555). Bishop scoring parameters showed statistically significant deviances between the NSD group compared to the cesarean group in terms of a 1-2 cm increase in cervical opening and for being 3-4 cm(p=0.0001), the cervical extinguishment as 40%-50% (p=0.0001), the occurrence of cervical softening (p=0.0001), and the head level at -1 and -2 (p=0.0001). When declaring the cesarean indication, the Bishop score’s AUC value was found as 0.932 and the LR(+) value as 9; while the estimation value for the Bishop score occurring below \u3c5 increased the cesarean birth risk ninefold. Conclusion: During a superannuated nulliparous pregnancy, the Bishop score and the Bishop score’s individual parameters are meaningful for vaginal birth, while a cervical histogram is not significant for forecasting the birth type

Can evaluation of the cervix with histogram and Bishop scoring prior to birth induction forecast the birth type for superannuated primigravidas?

Purpose: We conducted this study to research both the forecasting efficiency of the cervical histogram and Bishop scoring for birth type (vaginal birth/cesarean) for the superannuated primigravida prior to birth induction. Methods: Ninety primigravidas in week 41 and beyond were included in the present study. Exclusions for the study included prior labor, ruptured membranes, any major uterine operations, cephalopelvic discord, fetal malpresentations, fetal anomalies, multiple pregnancy, placenta previa, vaginal bleeding, a high sensitivity for oxytocin usage, and an estimated fetal weight greater than 4000 g. Histogram hyperechogenic focus and hypoechogenic focus measurements are conducted in normal spontaneous birth (NSD) and cesarean (SECTIO) groups. Findings: Thirty-six patients had a cesarean birth, while 54 of the patients had vaginal births. On logarithmical regression analysis, the Bishop score and the parameters were found statistically significant in terms of proving the cesarean indication (p=0.001). In our cervical histogram, the forecasting efficiency of the hyperechogenic focus and hypoechogenic focus measurements for determining the birth type were not been able to shown (p=0.089 ; p=0.555). Bishop scoring parameters showed statistically significant deviances between the NSD group compared to the cesarean group in terms of a 1-2 cm increase in cervical opening and for being 3-4 cm(p=0.0001), the cervical extinguishment as 40%-50% (p=0.0001), the occurrence of cervical softening (p=0.0001), and the head level at -1 and -2 (p=0.0001). When declaring the cesarean indication, the Bishop score’s AUC value was found as 0.932 and the LR(+) value as 9; while the estimation value for the Bishop score occurring below <5 increased the cesarean birth risk ninefold. Conclusion: During a superannuated nulliparous pregnancy, the Bishop score and the Bishop score’s individual parameters are meaningful for vaginal birth, while a cervical histogram is not significant for forecasting the birth type

Prenatal radiation exposure

Pregnant women may be exposed to nonionizing, ionizing radiation and contrast media via diagnostic or therapeutic procedures and workplace exposure. When computed tomography or magnetic resonance imaging is performed on a pregnant woman, the effects of exposure to radiation, high magnetic fields and contrast media, which can be risky for a fetus, should be considered. Nonionizing radiation that is not significantly risky for a fetus includes microwave, ultrasound, radio frequency and electromagnetic waves, while ionizing radiation that can be teratogenic, carcinogenic or mutagenic includes particles and electromagnetic radiation. The effects of radiation are associated with the level of exposure and stage of fetal development. Organogenesis (two to seven weeks after conception) and the early fetal period (eight to fifteen weeks after conception) are the most sensitive stages for a fetus. Noncancerous health effects have not been determined at any stage of gestation with less than 50 mGy (5 rad) exposure dose of ionizing radiation. Higher exposure levels may lead to spontaneous abortion, growth restriction, and mental retardation. The risk of cancer is increased regardless of the dose. Although the use of iodinated contrast media is generally thought to be safe during pregnancy, the risk of fetal hypothyroidism should be considered and it should be used only when necessary. The use of gadolinium-based contrast media during pregnancy is controversial because of the lack of clinical data. The purpose of this article is to review the existing literature regarding the prenatal radiation exposure and to discuss fetal risk of radiation

The effectiveness of extended fetal heart screening in a Tertiary Center

Our study is to evaluate the effectiveness of extended fetal heart screening in a tertiary center and research the sensitivity, specifity and the positive and negative values of echocardiography.316 patients who were diagnosed with congenital anomalies among those scanned with the extended fetal heart screening protocol in the perinatology department of our hospital were included in our study. Patients who were not diagnosed with congenital anomalies were excluded. Fetal echocardiographies were perfomed on patients who were admitted to our perinatology clinic, in accordance with the ISUOG extended fetal heart screening protocol. In our study, 55.3% of all cases with cardiac anomalies are concomitant with extracardiac anomalies. An interventional procedure was performed on 52.5% of the patients for karyotyping purposes. 19.3% was terminated early in the pregnancy, 5% and 12.5% were lost during the intrauterine and neonatal periods, respectively. In our study, upon comparison of the fetal and neonatal results, we determined that the false positive and negative rates for fetal echocardiography were 3.5% and 9.4% respectively.In our study, the sensitivity, specificity, positive predictive value and accuracy of echocardiography were determined as 91%, 99%, 98% and 99% respectively during the application of ISUOG recommendations in a tertiary center

Forgotten and fragmented ureteral j stent with stone formation: combined endoscopic management

ABSTRACTObjective : Ureteral stents are widely used in endo-urological procedures. However, ureteral stents can be forgotten and cause serious complications, including fragmentation, migration and urosepsis.There are few reports about forgotten and fragmented ureteral stents with stone formation. We aimed to present this rare case with successful combined endo-urological management.</p

Relationship between subclinical hypothyroidism and serum homocysteine concentration in premenopausal women

Objective: In our study we aimed to examine serum homocysteinelevels of patients without thyroid dysfunctionswho have high serum anti thyroid peroxidase (anti-TPO)levels and patients with subclinical hypothyroidism whohave high serum thyroid stimulating hormone (TSH) andanti-TPO levels.Methods: One hundred and seven premenopause femaleoutpatients who referred to endocrine clinic of our hospitalwere included in our study. We generated 3 groups. Firstgroup (Control) consists of 53 (50%) patients between theages of 30-40 years. Second group (Euthyroid) consistsof 31 (29%) patients between the ages of 26-49. Thirdgroup (Subclinical Hypothyroidism) consists of 23 (21%)patients between the ages of 33-53 years. Serum totalcholesterol, triglycerides, high density lipoprotein (HDL)levels were measured by Olympus 2700 autoanalyzer.Serum TSH, free T4, anti-TPO and homocysteine levelswere measured by Siemens Immulite 2000 autoanalyzer.Results: In our study, total cholesterol, triglycerides, lowdensity lipoprotein (LDL) and very low density lipoprotein(VLDL) levels were not statistically significantly differentamong the groups. Although serum homocysteine levelsof the third group were higher than the other groups it wasnot statistically significantly different among the groups.Conclusion: Serum homocysteine and lipid levels of patientswith euthyroidism and subclinical hypothyroidismwho have positive anti-TPO levels may be inadequate inassessing the risk of cardiovascular diseases. J Clin ExpInvest 2013; 4 (3): 293-297Key words: Hypothyroidsm, homocysteine, premenopaus

Does preparation for childbirth training reduce the cesarean rate?

Purpose: This study was conducted as experimental and prospective to determine the effect of birth preparation training on the birth route preparations of pregnant individuals. Methods: The study was conducted in three state hospitals which operate under Kocaeli State Hospitals Community. The study group included 110 pregnant individuals who attended the hospitals’ birth preparation training classes between 1 January – 30 June 2015 and the control group included 90 pregnant individuals from Kocaeli Maternity Hospital. The chi-squared test was used to measure the differences between groups in classified variables, and the t-test was used for parametric variables. P <0.05 was considered to be significant A survey form was used to identify individual demographic information, obstetric stories, and preferred birth route in order to collect relevant data. Findings: The survey reveals that 67% of the pregnant individuals prefer vaginal birth while 33% prefer cesarean birth. In choosing the birth route, 60% of the pregnant individuals make their own decisions, while 28.2% make the decision together with their partner, and 11.8% report the decision being made by their doctor. It is observed that—after attending the birth training—all of the individuals preferred vaginal birth. For the pregnant individuals, their birth route choices before and after the birth preparation training had been observed as highly statistically significant ( p<0, 005). However, when the choices of the pregnant individuals who participated in birth preparation training is compared to the control group’s choices, no statistical significance was found. Rates of cesarean were alike for both groups. Conclusions and Suggestions: In this study, for the individuals who participate in birth preparation training, the choice of the birth route is found to be affected by age, literacy, and former birth route experienced. However, no significant evidence was found regarding reducing the choice of cesarean. A pregnant individual’s birth route choice will be more healthy as she becomes qualified for, and receives sufficient treatment between the preconception stage to after birth, alternative birth routes, and consultancy for overcoming birth pain and relaxation methods

Seckel syndrome: a case report

Seckel sendromu boy kısalığı, mikrosefali, çıkık burun (gaga burun) ve tipik yüz görünümü ile karakterize otozomal resesif kalıtımlı bir hastalıktır (1). Ateş ve emmeme yakınmasıyla pediatri polikliniğine başvuran üç aylık erkek hasta atipik yüz görünümü nedeniyle polikliniğimize yönlendirildi. Fizik muayenesinde, vücut ağırlığı 2570 gram (<3 persentil), boyu 50 cm (<3 persentil) ve baş çevresi 29 cm (<3 persentil) idi, genel durumu iyi, bilinci açık, malnutre görünümde idi. Olguda, orantılı boy kısalığı, mikrosefali, ön fontanel küçüklüğü, yassı (geriye düşük) alın, mikrognati, düşük ve malforme kulaklar, göreceli büyük göz ve kulaklar, çıkık gaga burun, yüksek damak ve üçgen dar yüz görünümü mevcuttu. Kemik surveyde bilateral 12. kosta kemikleri yoktu. Olguya klinik olarak Seckel sendromu tanısı konuldu. Bu olgu ile mikrosefali ve tipik yüz görünümü olan hastalarda, Seckel sendromu olabileceğini hatırlatmak istedik.Seckel syndrome is an autosomal recessive disease characterized by short stature, microcephaly, prominent nose (beaked nose), and typical facial appearance (1). Three-month-old male patient was brought to pediatrics clinic with the complaints of fever and poor sucking, and referred to us because of atypical facial appearance. Physical examination revealed that he had a good general condition, was conscious, and had the appearance of malnutrition. Body weight was 2570 gr (<3rd percentile), length was 50 cm (<3rd percentile) and head circumference was 29 cm (<3rd percentile). The patient had proportionate short stature, microcephaly, the small anterior fontanelle and sloping forehead, micrognathia, low-set and malformed ears, relatively large eyes and ears, prominent nose (beaked nose), high palate, narrow triangular facial appearance. Bilateral 12th ribs were not seen with bone survey. The patient was diagnosed clinically with Seckel syndrome. We want to remind that this case, and therefore patients with microcephaly and typical facial appearance may have Seckel syndrome

Evaluation of oxidative stress in degenerative rotator cuff tears

Background: Oxidative stress occurs as a result of the disruption of the balance between the formations of reactive oxygen species and antioxidant defense mechanisms during the conversion of nutrients into energy. Increased body oxidative stress has been reported to be involved in the etiology of several degenerative and chronic diseases. We hypothesized that the body oxidative stress level is higher in patients with atraumatic degenerative rotator cuff tear than that in healthy individuals. Methods: The patients who underwent arthroscopic repair for atraumatic, degenerative rotator cuff tear were prospectively evaluated. A total of 30 patients (group 1, 19 females and 11 males; mean age: 57.33 ± 6.96 years; range: 50-77 years) and 30 healthy individuals (group 2, 18 females and 12 males; mean age: 56.77 ± 6 years; range: 51-72 years) were included in the study. The Constant and American Shoulder and Elbow Surgeons scoring systems were used to evaluate the clinical outcomes. Serum oxidative stress parameters of the patients and the control group were biochemically evaluated. Accordingly, thiol/disulfide (DS) balance (DS/native thiol [NT], DS/total thiol [TT]), Total Oxidant Status (TOS), oxidative stress index, and nuclear factor erythroid-2–associated factor-2 values were used as the biochemical parameters indicating an increase in the serum oxidative stress level. Total antioxidant status and NT/TT values served as the biochemical parameters indicating a decrease in the serum oxidative stress level. Results: The study follow-up duration was 12 months. A statistically significant increase was observed in American Shoulder and Elbow Surgeons and Constant scores of patients who underwent arthroscopic rotator cuff repair relative to that during the preoperative period (P = .01). The values of biochemical parameters (DS/NT, DS/TT, TOS, oxidative stress index, and nuclear factor erythroid-2–associated factor-2), which indicated an increase in the serum oxidative stress, were significantly higher in preoperative patients than those in postoperative patients, albeit the control group values were significantly lower than those of the postoperative patients. The biochemical parameters (NT/TT and total antioxidant status) indicating a decrease in the serum oxidative stress levels were significantly higher in the postoperative patients than those in the preoperative patients and significantly lower than those in the control group. Conclusion: High levels of markers indicating an increase in the serum oxidative stress in patients with degenerative rotator cuff rupture suggested that TOS may be involved in the etiopathogenesis of rotator cuff degeneration. Although the oxidative load decreases during the postoperative period, the fact that it is still higher than that in healthy individuals supports this claim. © 2022 Journal of Shoulder and Elbow Surgery Board of Trustee