Gebelerde proteinüri tanısında kullanılan yöntemlerin karşılaştırılması

Amaç Kliniğimizde preeklampsi ön tanısı ile tetkik edilen gebelerde spot idrarda dipstik, protein/kreatinin (P/K) oranı ile 24 saatlik idrarda toplam protein miktarı değerlerinin karşılaştırılması amaçlanmıştır. Gereç ve yöntem Çalışmaya, Ocak 2016–Aralık 2018 tarihleri arasında bir ünivesite hastanesinde preeklampsi ön tanısı ile spot idrarda dipstik yöntemi, P/K oranı ve 24 saatlik idrarda toplam protein analizi yapılan 317 hasta çalışmaya dahil edildi. Hastaların bu üç değeri birbiri ile mukayese edildi. Bulgular Dipstik yönteminin sensitivitesi %67,5; spesifitesi %61,5; doğruluğu %64,3 olarak hesaplandı. 24 saatlik idrarda toplam proteinüri eşik değeri 300 mg/gün olduğunda P/K oranı cut-off değeri 0,34 mg protein/mg kreatinin, sensitivite %68,9, spesifite %78,7 olarak hesaplandı. Spot idrar P/K oranı ile 24 saatlik idrardaki toplam proteinüri değerleri arasında orta düzeyde, anlamlı bir korelasyon gözlendi (R: 0,629 p<0,001). Sonuç 24 saatlik toplam idrar analizi için yeterli zamanın olmadığı acil durumlarda spot idrarda P/K oranının 24 saatlik idrarda toplam protein testine alternatif test olarak kullanılabilir

Psychosocial Loads Caused by Covid-19 Pandemic on Obstetricians and Gynecologists. A Scale Study

Introduction: The novel coronavirus infection (COVID-19) has caused a worldwide pandemic. The pandemic created a heavy psychological burden on healthcare workers. Healthcare providers in obstetrics and gynecology faced similar challenges. Aim: This study studied obstetricians' and gynecologists' psychosocial burdens and concerns due to the COVID-19 pandemic. Methods: Participants of the study consisted of obstetricians and gynecologists. They reached through social media using the snowball sampling technique. This is a survey and scale study. The researchers created the survey. The survey questioned the demographic characteristics of the participants and the problems caused by the COVID-19 pandemic. In addition, three different scales were applied to the participants: Maslach Burnout Inventory, Coronavirus Anxiety Scale, and Depression Anxiety Stress Scale-21. Results: The statistically significant difference was found for Maslach Burnout Inventory Personal Achievement and Maslach Burnout Inventory General. Maslach Burnout Inventory Depersonalization and Coronavirus Anxiety Scale scores of the participants working in pandemic hospitals were statistically significantly higher than those not working in these hospitals. According to the MANOVA results, independent variables explained 35% of the variance in the Maslach Burnout Inventory General scale, 51% in the Coronavirus Anxiety Scale, and 53% in the overall Depression Anxiety Stress Scale. Conclusion: Healthcare personnel who provide obstetric and gynecologic services have faced unique challenges during the COVID-19 pandemic, and to the difficulties experienced by other healthcare workers

Nicotinamide N-methyltransferase overexpression may be associated with poor prognosis in ovarian cancer

Ovarian cancer is the fifth leading cause of cancer-related mortality in women. Nicotinamide N-methyltransferase (NNMT) is a metabolic enzyme and there is growing evidence to suggest that it plays an important role in cancer progression. This is the first study to examine the expression of NNMT in serous ovarian cystadenomas, serous borderline tumours, low grade serous carcinomas (LGSC) and high grade serous carcinomas (HGSC) and investigate the potential independent association of NNMT expression with survival. Tissue samples were analysed immunohistochemically for NNMT expression. The stromal NNMT score was significantly higher in HGSC compared to serous cystadenomas and serous borderline tumours (p < .001, p < .043, respectively). The mean stromal NNMT score of patients with HGSC was significantly higher than patients with LGSC (p = .043). Patients with low expression of NNMT had a significantly higher mean recurrence-free survival than patients with high expression (p = .036). NNMT may support tumour progression in ovarian cancer by promoting desmoplastic stromal tumour reaction. NNMT overexpression may be associated with poor prognosis and can be a therapeutic target in ovarian cancer.IMPACT STATEMENT What is already known on this subject? Nicotinamide N-methyltransferase (NNMT) is a cytosolic enzyme that is overexpressed in many malignancies. Its overexpression was shown to lead to histone hypomethylation, which in turn can decrease and increase the expression of tumour suppressor proteins and onco-proteins, respectively. NNMT was also shown to play a role in epithelial-to-mesenchymal transition, which is critical in tumour progression and the stromal tumour reaction. The stromal tumour reaction was recently targeted with promising therapeutic results in ovarian cancer. What do the results of this study add? The expression of NNMT in various ovarian neoplasms including serous cystadenomas, borderline tumours and serous carcinomas has not been studied and independently associated with poor survival, previously. This study suggests that NNMT is progressively overexpressed in the stroma of ovarian neoplasms from benign cysts to HGSCs. NNMT overexpression appears to be independently associated with poor survival in ovarian cancer. What are the implications of these findings for clinical practice and/or further research? The implications of these findings are that NNMT may play an important role in the stromal tumour reaction, and therefore its overexpression may contribute to poor survival. NNMT overexpression may be an important target of ovarian cancer therapy