Pregnancy Outcome in Women of Advanced Maternal Age: A Cross-Sectional Study in a Turkish Maternity Hospital

Background: There is a current trend towards delayed childbearing around the world. This is considered to increase the risk for poor maternal and neonatal outcomes. In this study, we evaluated pregnancy outcomes in women of advanced maternal age in a single maternity hospital in Turkey.Methods: Medical records of 517 women aged 35 years and older that gave birth between 2009 and 2010 were examined retrospectively. The chi-squared, Mann-Whitney U, and Student t tests were used for statistical analyses.Results: In total, 462 (89.3%) women aged 39 years or less and 55 (10.6%) women aged 40 years and older were included in the analysis. Cesarean sections, and neonatal mortality were more common in women of advanced maternal age (p = 0.004 and p=0.002, respectively). Neonatal mortality (OR: 0.1; 95% CI 0.02–1; p = 0.032), premature birth (OR: 0.4; 95% CI 0.2–0.8; p = 0.008), and low birth weight (LBW) (OR: 0.2; 95% CI 0.1–0.5; p < 0.001) were significantly higher in women 40 years and older. Respiratory distress syndrome (RDS) developed in 26% of babies with LBWs. All patients of neonatal death were diagnosed with asphyxiation or RDS.Conclusions: At the Bolu Izzet Baysal Maternity and Children’s Hospital, advanced maternal age was associated with increased adverse fetal and neonatal outcomes

Zanimljiv slučaj bruceloze neobičnih obilježja u djeteta

Brucellosis is a zoonotic infection, which is still a major public health concern worldwide. Common clinical findings are usually nonspecific involving fever, arthralgia, myalgia, weakness and malaise. Since none of the symptoms of brucellosis is pathognomonic, it may have a similar course with various multisystemic diseases. In terms of focal involvement, sacroiliitis is the most common musculoskeletal manifestation in adult patients, while it is quite rare in pediatric patients. Blood culture is the gold standard in the diagnosis of brucellosis. In the absence of culture facilities, the diagnosis traditionally relies on serologic testing with a variety of agglutination tests such as the Rose Bengal test and the serum agglutination test. However, these agglutination tests are accompanied by frequent false negative results such as seen in prozone phenomenon, which maylead to diagnostic delays. In this article we present a rarely encountered pediatric brucellosis patient who had sacroiliitis-spondylitis, which are rarely reported in children, and exhibited prozone phenomenon in agglutination tests.Bruceloza je zoonotična infekcija koja još uvijek predstavlja znatan javnozdravstveni problem širom svijeta. Najčešći klinički nalazi obično su nespecifični, a uključuju groznicu, artralgiju, mialgiju, slabost i klonulost. Kako nijedan od simptoma bruceloze nije patognomoničan, tijek ove infekcije može biti sličan raznim multisistemskim bolestima. Prema učestalosti, sakroiliitis je najčešća koštano-mišićna manifestacija u odraslih bolesnika, ali je rijetka u pedijatrijskih bolesnika. Krvna kultura je zlatni standard u dijagnostici bruceloze. Kad oprema za kulturu nije dostupna dijagnostika se tradicionalno oslanja na serološko testiranje pomoću raznih aglutinacijskih testova, kao što su Rose Bengal test i test serumske aglutinacije. Međutim, ovi aglutinacijski testovi praćeni su čestim lažno negativnim rezultatima, primjerice u fenomenu prozone, što pak može odgoditi postavljanje dijagnoze. U ovom članku prikazujemo rijedak slučaj pedijatrijskog bolesnika s brucelozom koji je imao sakroiliitis-spondilitis, što se rijetko nalazi u djece, dok su aglutinacijski testovi pokazali fenomen prozone

Evaluation of Oncological Hyperthermia Centers and Turkey Modeling Oncological Hyperthermia Centers and Turkey Modeling

Abstract Background Hyperthermia is a radio/chemo sensitizing method effectively used in oncological treatments. These devices, which have been used effectively in many centers around the world in the treatment of cancer, are currently unavailable in our country. In this study, hyperthermia treatments that could be applied, the number of hyperthermia devices required and the potential effects in our country have been investigated in line with the applications of hyperthermia worldwide.Methods Based on the data obtained from certain reference centers the number and ratios of hyperthermia applications were determined and the data obtained was modeled according to the number of cancer cases in our country.Results According to the data obtained, an average of 375 patients are treated annually per hyperthermia device in relevant centers. When a similar projection is applied for our country, hyperthermia treatment can be applied to an average of 400 patients annually with 0,18 hyperthermia devices per one million population. According to this, considering the population and the annual cancer diagnosis rates, it is predicted that 13 deep regional hyperthermia devices are required across the country.Conclusion The presence of deep regional hyperthermia devices in comprehensive oncology centers that play an effective role in oncological treatment with modern radiotherapy devices and have enough radiation oncologists will significantly benefit the capacity to provide oncological treatment options holistically.</jats:p

Investigation of celiac disease according to Marsh classification in childhood

Background: Celiac disease (CD) is an autoimmune disorder of the small intestine related to gluten. CD is diagnosed by the evaluation of histologic findings according to the Marsh classification.Objectives: To evaluate the clinical and laboratory differences of CD according to Marsh classification.Patients and method: The records of ?Marsh 2 histologically diagnosed 132 cases were evaluated.Results: It was determined that 7(5.3%) cases were Marsh 2, 32(24.2%) were Marsh 3a, 73(55.3%) were Marsh 3b, and 20(15.1%) were Marsh 3c. Vomiting in Marsh 2 was significantly lower than Marsh 3b and Marsh 3c (respectively, 14.3% vs. 56.9%, p=0.029; and 14.3% vs. 75%, p=0.005). Hemoglobin was significantly higher in Marsh 2 than Marsh 3b and Marsh 3c (respectively, 11.9±1.7 vs. 10.5±1.6 g/dl, p=0.038 and; 11.9±1.7 vs. 9.8±1.6 g/dl, p=0.005). Positive detection ratio for tTG IgA was significantly lower in Marsh 2 than Marsh 3a, Marsh 3b and Marsh 3c (respectively, 66.7% vs. 100%, p&lt;0.001; 66.7% vs. 100%, p&lt;0.001; and 66.7% vs. 94.1%, p=0.003). After the onset of gluten free diet, the time passed for the disappearance of tTG IgA seropositivity is significantly shorter in Marsh 2 than Marsh 3c (6±3.6 vs. 9.7±2.5 months, p=0.017).Conclusions: Gastrointestinal symptoms are more frequent in patients with severe small intestinal mucosal injury. tTG IgA seropositivity is associated with more severe disease. Clinical and laboratory findings of the patients are exacerbated when histopathological findings improve in CD.Bangladesh Journal of Medical Science Vol.16(2) 2017 p.259-265</jats:p

Long COVID: rheumatologic/musculoskeletal symptoms in hospitalized COVID-19 survivors at 3 and 6 months

Objective To document the detailed characteristics including severity, type, and locations of rheumatic and musculoskeletal symptoms along with other COVID-19 persistent symptoms in hospitalized COVID-19 survivors at 3 and 6 months