Are Heavy Metal Exposure and Trace Element Levels Related to Metabolic and Endocrine Problems in Polycystic Ovary Syndrome?

This study aimed to determine the relationship between the metabolic and endocrinological pathologies in polycystic ovary syndrome (PCOS) and the levels of arsenic, chromium, cadmium, lead, mercury, antimony, zinc, and copper to evaluate the relationship of these toxic metals with inflammatory/oxidative parameters. This study included a total of 154 patients (84 with PCOS, 70 healthy volunteers). Metabolic and endocrine parameters and arsenic, chromium, cadmium, lead, mercury, antimony, zinc, and copper serum levels of the patients were compared between the groups. Considering the action mechanism of toxic metals, serum malondialdehyde (MDA), superoxide dismutase (SOD), serum total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), tumor necrosis factor-alpha (TNFα), and high-sensitivity C-reactive protein (HsCRP) levels were determined. Serum TAS (p = 0.002), OSI (p = 0.006), SOD (p = 0.006), zinc (p = 0.010), and copper (p = 0.030) values were statistically lower whereas TOS (p = 0.008), MDA (p < 0.001), HsCRP (p < 0.001), TNFα (p < 0.001), antimony (p < 0.001), cadmium (p < 0.001), lead (p < 0.001), and mercury (p < 0.001) levels were significantly higher in the PCOS group than those determined in the control group. Antimony was positively correlated with fasting glucose (FG) and HOMA-IR while cadmium, in addition to FG and HOMA-IR, positively correlated with insulin and lead had a positive correlation only with FG (p < 0.05). Also, these three heavy metals correlated positively with some oxidative system and inflammatory parameters and negatively with the antioxidant system parameters (p < 0.05). In conclusion, heavy metal exposures in PCOS may be related to insulin resistance and hirsutism through oxidative and inflammatory mechanisms. This approach can be used to identify the risky patient group and to develop new treatment modalities. © 2020, Springer Science+Business Media, LLC, part of Springer Nature

Sexual function and depression in polycystic ovary syndrome: Is it associated with inflammation and neuromodulators?

Numerous studies have been carried out on depression and sexual dysfunction concomitant with polycystic ovary syndrome (PCOS). Increasing evidence has revealed the importance of inflammation in the etiology of PCOS. In addition, it has been known that some neuromodulators affect depression and sexual function. However, their effects on PCOS are not known. This study aimed to evaluate the relationship of depression and sexual function with cytokines and neuromodulators in PCOS patients. The present study included 20 fertile and 30 infertile patients diagnosed with PCOS and 30 healthy volunteers. Metabolic and endocrine parameters, interleukin (IL)-1β, IL-6, TNFα, γ-aminobutyric acid (GABA), Glutamate, Brain-derived neurotrophic factor (BDNF) serum levels, Beck Depression Index (BDI) and Female Sexual Function Index (FSFI) scores of the patients were compared between the groups. TNFα, IL-1β, IL-6, glutamate, GABA, and BDI scores were found to be significantly higher (p 0.05). Multivariate logistic regression analysis was conducted with potential factors that may affect sexual dysfunction. The results indicated that high waist-to-hip ratio (WHR) (> 0.80) with an odds ratio of 1.81 in PCOS patients, and body mass index (BMI) with an odds ratio of 2.3 and high WHR (> 0.80) with an odds ratio of 1.97 in all patients were found to be independent risk factors affecting sexual dysfunction. The results of the present study suggested that chronic low-dose inflammation seen in PCOS may interact with some neuromodulators, leading to the development of depression. However, no relationship was found between these parameters and sexual function. © 2020 Elsevier Lt

The effect of placental angiogenic and anti-angiogenic factors on pregnancy outcome in patients with early onset preeclampsia

Objective: The aim was to evaluate the possible effects of anti-angiogenic factors including soluble endoglin (sEng), placental growth factor (Pgf), and soluble fms-like tyrosine kinase 1 (sFlt-1) in both normotensive pregnant patients and preeclampsia (PE) patients. Material and Methods: The study was carried out at the Departments of Gynecology and Obstetrics and Biochemistry of Yozgat Bozok University Training and Research Hospital. Eighteen women with PE who were pregnant for at least 20 weeks comprised the study group. The control group consisted of 33 pregnant women with no complications and with similar demographic features. In the study, laboratory parameters, demographic characteristics, sEng, sFlt-1, and Pgf levels, delivery type, APGAR scores of the infants, and birthweight were determined and a comparison was made between the groups. Results: It was found that the sEng level was significantly lower in the PE group compared to the control group (p<0.05). In addition, the Pgf, birthweight, and 1st and 5th-minute APGAR scores were significantly lower in the PE group compared to the control group (p[removed

The relationship between oxidative stress and preeclampsia. The serum Ischemia-modified albumin levels and thiol/disulfide homeostasis

Objective: Preeclampsia (PE) is a dangerous complication of pregnancy and still a major cause of maternal-fetal morbidity and mortality. Its etiology remains largely unknown, but researchers have suggested oxidative stress-mediated inflammation for the same. The purpose of this study is to investigate the relationship between oxidative stress and PE as well as the usability of oxidative stress indicators such as serum ischemia-modified albumin (IMA) levels and thiol/disulfide balance in the prediction of PE. Materials and Methods: The study included 47 pregnant women with PE and 57 healthy pregnant women. We measured their serum IMA, native thiol, total thiol, and disulfide levels. Additionally, we determined the optimal cutoff values via the receiver operating characteristic curve analysis. Results: There were no differences between the two groups with respect to the maternal age, body mass index, gravida, and parity. The native and total thiol levels were found to be low when the disulfide and IMA levels were high in the patients with PE (p<0.05). When the IMA level was corrected by the albumin level (IMAR), the significant difference between the two groups disappeared. We also found that the native and total thiol concentrations were correlated with the systolic and diastolic blood pressures. The optimal cut-off values calculated for the prediction of PE were as follows: 178.45 µmol/L (with sensitivity of 72% and specificity of 83%) for native thiol, 232.55 µmol/L (with a sensitivity of 75% and specificity of 85%) for total thiol, and 29.05 µmol/L (with sensitivity of 65% and specificity of 72%) for disulfide. Conclusion: The balance of thiol/disulfide may play a role in the pathogenesis of PE and could be used as a biological marker for PE. © 2020 by Turkish Society of Obstetrics and Gynecology Turkish Journal of Obstetrics and Gynecology published by Galenos Publishing House

Hand-held echocardiography during complex electrophysiologic procedures

Introduction: Complex electrophysiologic (EP) procedures are time consuming and open to complications. Accurate and rapid recognition of cardiac pathologies is essential before, during, and immediately after such procedures. In this study, we aimed to compare hand-held echocardiography (HHE) with standard echocardiography (SE) to determine whether HHE can be used as a practical and reliable diagnostic tool during such procedures. Methods: One hundred consecutive patients undergoing complex EP procedures and catheter ablation were included in the study. All patients were evaluated with SE or HHE in terms of main cardiac pathologies at the beginning and immediately after the procedure. The diagnostic accuracy and evaluation time of both methods were compared at the beginning and after the procedure. The agreement between both methods was calculated. Results: At the beginning and after the procedure, opening and evaluation times with HHE were significantly shorter than with SE (P<0.001 for all). There was significant agreement between the two methods in the diagnosis of cardiac pathologies (Agreement was 95% for minimal mild aortic regurgitation (AR), 99% for moderate/ severe AR, 93% for minimal/ mild mitral regurgitation (MR), 95% for moderate/ severe MR, 100% for pericardial effusion, and 100% for left ventricular thrombus at the beginning of the procedure). Conclusion: With the use of HHE during complex EP procedures, cardiac pathologies can be diagnosed with similar accuracy as SE. In addition, HHE has a significant advantage over SE in terms of time to diagnosis

Smoking and Related Factors during Pregnancy

Objective: In this study, we aimed to investigate smoking habits of women during pregnancy and determine the related factors. Methods: In this cross-sectional study, a total of 1021 women were included in the first 24 h after they gave birth in the hospital between March and May 2014. The study was conducted at only one hospital. Participants were interviewed face-to-face by researchers using a questionnaire. Data were analyzed using IBM SPSS Statistics for Windows v.22.0. The relation between categorical variables was determined using chi-square test. Statistical significance was achieved when the p value was less than 0.05. Ethics committee approval from the hospital and written informed consent from the participants were obtained for the study. Results: The frequency of smoking during pregnancy was 13.0%. The majority smoked until birth (10.1%). Household smoker was significantly associated with smoking during pregnancy (p35 years) during pregnancy was associated with smoking until birth during pregnancy (p<0.05). Conclusion: The prevalence of smoking was still high among pregnant women in spite of strict measures and all efforts against smoking in Turkey. Advanced maternal age and household smoker were associated with smoking during pregnancy. Special focus is needed on the issue of smoking during pregnancy not only by pregnant women but also by their household’s members

Comparison of glucose degradation product and receptor levels in diabetic and normal pregnancy

Objective: The aim of this study was to assess the diagnostic values of new biochemical markers that may be an alternative to the oral glucose tolerance test (OGTT) and determine the differences in these markers among three groups of women with varying degrees of glucose homeostasis dysregulation. Material and Methods: This was a prospective study. All women were screened with 50 gram (g) oral glucose and a 100 g OGTT for gestational diabetes mellitus (GDM). The patients were divided into three groups depending on the result of the tests: No evidence of glucose metabolism abnormality (controls); impaired glucose tolerance (IGT); and GDM. All three groups were evaluated for serum human advanced glycation end-products (AGEs) concentrations, carboxymethyl lysine (CML) concentration and receptor for advanced glycation end-product concentrations (RAGE/AGER), body mass index (BMI), age, fasting glucose levels, obstetrical parameters and gestational age. Results: The study included 180 women divided into 59 (32.8%) GDM, 50 (27.8%) IGT and 71 (39.4%) controls. Age was similar among the three groups. Whereas fasting glucose levels and BMI in the three groups was significantly different, AGEs, CML, RAGE/AGER levels were found as significantly different between the groups (p[removed

Prenatal Diagnosis of Iniencephaly: Clues and Pitfalls

Iniencephaly is a congenital malformation consisting of occipital bone defect with enlargement of the foramen magnum, cervical dysraphism and fixed retroflection of the head due to spinal deformities. A 38-years-old woman presented to Etlik Zubeyde Hanim Maternity Hospital perinatology clinic at 18 week of gestation. Ultrasonography revealed a large occipital encephalocele and short cervicothoracic spine. Termination of pregnancy was recommended with the diagnosis of iniencephaly but the family refused it because of religious concerns. She was lost in follow-up but at 38 weeks she presented to our department with regular uterine contractions. Ultrasonography revealed extreme retroflexion of the head, a very short cervicothoracic spine, an encephalocele and marked polyhydramnios. Due to severe retroflexion of the head, a caudal sweep motion of the ultrasound probe gave an impression of a posteriorly placed bladder. Normal chin and neck relation was lacking. A cesarean section was decided due to marked flexion of the spine. A female fetus was delivered weighing 2790 g, with Apgar scores of 1 at 1 min and 1 at 5 min. Iniencephaly is a lethal abnormality which may be diagnosed prenatally with striking ultrasonographic features