Gestational trophoblastic neoplasia after miscarriage with dilatation and curettage with normal histological findings

Gestational trophoblastic neoplasia may develop after a molar, term, ectopic pregnancy, or an abortion. The diagnosis of gestational trophoblastic neoplasia can be made solely based on changes in human chorionic gonadotropin levels without pathologic confirmation. It is important to distinguish molar pregnancy from that disease, as treatment for these entities differs. However, gestational trophoblastic neoplasia developing after a term or ectopic pregnancy, or an abortion may be difficult to diagnose, because there is no tissue confirmation. In such cases, the time between a previous pregnancy event and the current event, and an inconsistency between very high levels of human chorionic gonadotropin and the size of lesions in the uterine cavity may be warning signs of gestational trophoblastic neoplasia. The role of curettage in the treatment of the disease is limited. We present a case of gestational trophoblastic neoplasia that developed after an abortion, serving as a reminder illustration that gestational trophoblastic neoplasia can develop not only after molar pregnancies, but also after other pregnancy events

Recurrent hydatidiform moles: detection of a new mutation in the NLRP7 gene in the family

Hydatidiform moles are the most common type of gestational trophoblastic neoplasia. Hyperproliferative vesicular trophoblasts and imperfect fetal development are abnormal pregnancies, and recurrent hydatidiform moles are rare. Mutations in NLRP7 are responsible for recurrent hydatidiform mole. Genetic heterogeneity has been demonstrated in patients with the NLRP7 mutation. This study presents our case with gravida 11, parity 0, histopathologically diagnosed with six hydatidiform moles and five missed abortion histories at age 35. Karyotype analyses of the unrelated couple were normal. A genetic examination revealed a novel mutation of the NLRP7 gene in the patient, his brother, and his parents. Detecting a new NLRP7 mutation in recurrent hydatidiform moles cases provides further evidence for the predetermined role of NLRP7 mutations in the pathophysiology of recurrent moles hydatidiform. Based on our findings, we hope to contribute to the literature by expanding the spectrum of recurrent pregnancy loss associated with NLRP7 mutations in patients

Effects of Preoperative Anxiety and General Anesthetic Administration on Intraoperative Awareness in Patients Undergoing Cesarean Section

Aim:The aim was to investigate the effects of preoperative anxiety and general anesthetic administrations on intraoperative awareness among patients undergoing cesarean section.Methods:This prospective randomized study included 90 pregnant subjects. Preoperative anxiety was assessed using the Beck Anxiety Inventory. The patients were divided into three groups: group P received propofol 2.5 mg/kg, group T thiopental 5 mg/kg and group K received ketamine 1 mg/kg. Data on intraoperative hemodynamics, isolated forearm (IFA) responses and time to first pain and to first analgesic requirement evaluated using postoperative numerical rating scale were recorded. The Modified Brice Scale (MBS) was used to assess awareness.Results:The preoperative anxiety levels in the groups were low and demographic data were similar (p>0.05). There was no statistically significant difference in IFA response between the groups (p>0.05). Group T had higher MAP at all times and NRS values at hour 0 compared to the other groups (p<0.05), and had shorter time to first analgesic requirement (p<0.05). MBS responses were evaluated as recall in 12 cases in group K, four in group P and three in group T.Conclusion:As the anxiety levels in pregnants were low, the superiority of agents used in induction over each other regarding awareness could not be shown

Diaspora Turizmi

Bu bölümde, diaspora ve diaspora turizmi kavramları tanımlanmakta, diaspora turizmi talebi ve arzının özellikleri, dünyada ve Türkiye’deki diaspora turizminin mevcut durumu aktarılmaktadır

Ciążowa neoplazja trofoblastu w następstwie poronienia u pacjentki z prawidłowymi wynikami badania histopatologicznego po zabiegu łyżeczkowania jamy macicy

Gestational trophoblastic neoplasia may develop after a molar, term, ectopic pregnancy, or an abortion. The diagnosis of gestational trophoblastic neoplasia can be made solely based on changes in human chorionic gonadotropin levels without pathologic confirmation. It is important to distinguish molar pregnancy from that disease, as treatment for these entities differs. However, gestational trophoblastic neoplasia developing after a term or ectopic pregnancy, or an abortion may be difficult to diagnose, because there is no tissue confirmation. In such cases, the time between a previous pregnancy event and the current event, and an inconsistency between very high levels of human chorionic gonadotropin and the size of lesions in the uterine cavity may be warning signs of gestational trophoblastic neoplasia. The role of curettage in the treatment of the disease is limited. We present a case of gestational trophoblastic neoplasia that developed after an abortion, serving as a reminder illustration that gestational trophoblastic neoplasia can develop not only after molar pregnancies, but also after other pregnancy events

NRS-2002 and mNUTRIC score: Could we predict mortality of hematological malignancy patients in the ICU?

Background Malnutrition is a problem that greatly affects patients with hematological malignancy (HM) throughout the course of illness. Intensity of the malignancy treatment, inadequate energy intake, complex procedures such as hematopoietic stem cell transplantation, and treatment side effects are contributing factors for malnutrition in HM patients. The aim of this study was to compare the accuracy of the modified Nutrition Risk in Critically Ill (mNUTRIC) score and Nutrition Risk Screening 2002 (NRS-2002) in predicting hospital and long-term mortality of HM patients in the intensive care unit (ICU) and to identify effects of malnutrition on ICU mortality. Methods This prospective observational cohort study was conducted in a university teaching hospital tertiary ICU service. During the study period, 112 HM patients who were >18 years old were admitted to the ICU. We excluded the patients who were discharged or died within 24 h from the statistical analysis. The patients were followed for 3 years after discharge for long-term mortality. Results Twenty-nine patients died within 24 h of admission and were excluded from the study; therefore, statistical analysis was done for 81 patients. Logistic regression analysis demonstrated that high malnutrition risk, according to the NRS-2002 score, was associated with greater odds of ICU mortality (P = 0.002, odds ratio = 19.16). Conclusion In this study, we showed that NRS-2002 is superior to mNUTRIC score in predicting ICU mortality in patients with HMs. mNUTRIC score and NRS-2002 were not superior to each other in predicting long-term mortality

Cystectomy in a patient with immature teratoma of the ovary: Re-staging, chemotherapy or follow-up?

We presented a 15-year-old girl with grade 2 immature ovarian teratoma, who had undergone cystectomy with a presumed diagnosis of mature cystic teratoma in frozen section examination. There is limited information regarding the subsequent management of patients with ovarian immature teratomas who had initially managed with conservative surgery, particularly in patients who desire to preserve their reproductive functions. The multi-disciplinary tumor council at our instution, agreed on giving adjuvant chemotherapy to the patient however, the present data for patients with immature ovarian teratoma managed by only cyctectomy is inconclusive concerning the subsequent management strategies such as re-operation for staging, applying adjuvant chemotherapy, or just to follow - up without chemotherapy. Our aim was to present a patient with an immature ovarian teratoma who had initially managed only by cystectomy. We tried to discuss above-mentioned, subsequent management options under the guidiance of literature

The effects of propolis on gill, liver, muscle tissues of rainbow trout (Oncorhynchus mykiss) exposed to various concentrations of cypermethrin

The aim of this study was to investigate the therapeutic effects of propolis for the toxicity of cypermethrin (CYP) on histopathological changes in tissues of rainbow trout (Oncorhynchus mykiss). CYP is one of the most toxic pyrethroids highly for the aquatic organisms. The fish were exposed to three sublethal concentrations of CYP (0.0041, 0.0082 and 0.0123 ppm). In addition, different concentrations of propolis (10, 20 and 30 ppm) were used in the investigation for the period of 96 h. Propolis was collected by honeybees from different plants to prevent oxidative damages as an antioxidant. The therapeutic concentration of propolis was determined at 10 ppm. 10 ppm propolis was added to three cypermethrin concentrations. Shorting the secondary lamellae , fusion of secondary lamellae, oedema, necrosis, vacuolization and cartilage damage in gill tissue of fish exposed to CYP were observed by histopatological analyses. Hepatic lesions in liver tissue of fish exposed to CYP were characterized as hydropic degeneration, necrosis, mononuclear cell infiltration and narrowing of sinusoids. The most common changes in muscle tissues at all concentrations of CYP were nuclear proliferation and congestion. Besides, 10 ppm propolis on gill, liver, muscle tissues of rainbow trouts showed significant therapeutic effects. Histological analysis revealed that propolis may serve as an antitoxic agent against pesticide toxicity

Effects of propolis on some blood parameters and enzymes in carp exposed to arsenic

The purpose of this study was to investigate the therapeutic effects of natural products like propolis on biochemical and hematologic parameters in carp (Cyprinus carpio, Linnaeus 1758) exposed to arsenic. In this study fish were exposed to 0.01 mg/L arsenic and 10 mg/L propolis for seven days. Our results indicated that triglyceride, urea, total cholesterol, cobalt, ALT (alanine amino transferase), AST (aspartate amino transferase), LDH (lactate dehydrogenase) values increased when exposed to arsenic (P<0.05) but reduced by combination of arsenic and propolis (P<0.05). Granulocyte, erythrocyte, hemoglobin, hematocrit values were decreased by use of arsenic in comparison to control group. These parameters increased in arsenic+propolis group (P<0.05). In addition levels of leucocyte, agranulocyte, MCV (mean corpuscular volume), MCH (mean corpuscular hemoglobin) and MCHC (mean corpuscular hemoglobin concentration) increased in the arsenic group (P<0.05) and decreased in arsenic+propolis group (P<0.05). We can say that propolis can improve biochemical and hematologic functions of common carp blood, after being exposed to arsenic