Ultrasound imaging of the fetal optic nerve from a different plane

Objective In this study, we aimed to visualize the fetal optic nerve and its sheath in a lateral oblique plane by ultrasound. Methods This cross-sectional prospective study was conducted at 20–22 weeks of gestation on healthy pregnant women who applied to our perinatology clinic for anomaly screening. Optic nerve sheath diameter (ONSD) measurements were taken from the lateral orbital and the retroorbital planes twice by the same sonographer. Ultrasound durations were recorded. Intraobserver variability was calculated for both techniques. The Bland-Altman analysis was performed for the lateral orbital technique. Results A total of 45 pregnant women were evaluated in the study. The intraclass correlation coefficient value of the lateral orbital technique was 0.722 (p<0.001), suggesting that the ONSD was measured similarly by the same observer. The ONSD mean measured by the lateral orbital (LO) technique was higher than the ONSD mean measured by the retroorbital (RO) technique (2.10±0.13 vs 1.21±0.13 mm, p<0.001). The ONSD measurement with the LO technique was determined to be more time-effective than the RO technique (129.6±31.3 vs 228.2±32.7 sec, p<0.001). Conclusion It is demonstrated that by using the lateral orbital technique, the optic nerve and its sheath can be visualized separately without the shadowing artifact of the lens. This technique also takes less time than the RO technique. There is a need for more extensive research on this subject with magnetic resonance imaging (MRI) confirmation

Fenotypowe podgrupy zespołu policystycznych jajników mają różne objawy wewnątrznerkowej oporności

Objective: The polycystic ovary syndrome (PCOS) is known to be related with increased metabolic and cardiovascular risks. Various phenotypic subgroups of PCOS have been proven to have metabolic and endocrine disorders with varying degrees of severity. However, intra-renal vascular resistance, which is an indirect indication ofatherosclerosis, remains unknown in PCOS subgroups. In this study we examined whether PCOS subgroups have different intra-renal resistance symptoms. Material and Methods: 98 PCOS patients (diagnosed according to the Rotterdam criteria) 30 controls were ncluded in the study. The diagnosis of PCOS was established in the presence of at least two of the following criteria: 1- oligo and/or amenorrhea (OM); 2- clinic and/or biochemical signs of hyperandrogenism (HA); 3- polycystic ovarian morphology (PCO) detected by transvaginal ultrasonography. 37 patients (Group 1) met all three criteria (HA+OM+PCO), 29 patients (Group 2) met two of the criteria including hyperandrogenism (HA+OM or HA+PCO) and the remaining 32 patients (Group 3) had no hyperandrogenism but fulfilled the other two criteria; PCO+OM. Renal Doppler ultrasonography and hormonal/ biochemical analyses were carried out. The first outcome measure was designated as the differences in the renal resistive index (RRI) values of the groups, and the second outcome measure was designated as the relation of RRI with the insulin resistance and lipid profile. Results: In Group 1, the RRI and the homeostasis model assessment of insulin resistance (HOMA-IR) values were significantly higher than in Group 3 and controls (P < 0.031, P < 0.001, respectively, after adjusting for age and BMI). The RRI and HOMA-IR values in Group 3 were similar to those of the control group. It was determined that RRI has a positive correlation with HOMA-IR (r=0.784, PCel pracy: Zespół policystycznych jajników jest związany ze zwiększonym ryzykiem metabolicznym i sercowonaczyniowym. Fenotypowe podgrupy w obrębie zespołu PCO charakteryzują się zaburzeniami metabolicznymi i endokrynnymi o rożnym stopniu nasilenia. Jednak wewnątrznerkowa oporność naczyniowa, która jest pośrednim wykładnikiem miażdżycy, pozostaje nieznana w podgrupach zespołu PCO. W badaniu ocenialiśmy czy podgrupy zespołu PCO mają rożne objawy wewnątrznerkowej oporności. Materiał i metoda: do badania włączono 98 pacjentek z zespołem PCO (zdiagnozowanym według kryterium z Rotterdamu) oraz 30 pacjentek kontrolnych. Rozpoznanie zespołu PCO postawiono na podstawie obecności przynajmniej dwóch z poniżej wymienionych kryteriów: 1-oligo i/lub amenorrhea (OM); 2-kliniczne lub biochemiczne objawy hiperandrogenizmu (HA); 3-policystyczny obraz jajnikow (PCO) w przez pochwowym badaniu ultrasonograficznym. Grupę 1 stanowiło 37 pacjentek, które spełniły wszystkie kryteria diagnostyczne (HA+OM+PCO), grupa 2 to 29 pacjentek z dwoma kryteriami, w tym kryterium hiperandrogenizmu (HA+OM lub HA+PCO), pozostałe 32 pacjentki to grupa 3 – bez hiperandrogenizmu ale z dwoma pozostałymi kryteriami; PCO+OM. Przeprowadzono badanie dopplerowskie nerek i hormonalno-biochemiczną ocenę. Jako pierwszą zmierzono różnicę pomiędzy grupami w indeksie oporu nerkowego (RRI), następnie oceniono związek pomiędzy RRI a insulinoopornością i profilem lipidowym. Wyniki: W grupie 1, RRI i wskaźnik oceny insulinooporności (HOMA-IR) były istotnie wyższe niż w grupie 3 oraz kontrolnej (

The effect of induction duration on postabortal hemorrhage in second-trimester pregnancy termination with misoprostol

Objective: The aim was to investigate how the duration of induction affects postabortion hemorrhage in second-trimester pregnancy terminations using misoprostol. Methods: This single-center retrospective cohort study was conducted between April 2020 and April 2021 at a university hospital. Singleton pregnant women having gestational age of 13–26 weeks and being hospitalized for termination were included in the study. The misoprostol was administered 200 µg every 4 hours intravaginally to patients already diagnosed with miscarriage, and 400 µg every 3 hours to all remaining patients. Estimated blood loss volume (EBLV) was calculated using a formula previously defined by Stafford et al. A total of 117 singleton pregnant women having gestational age of 13–26 weeks and being hospitalized for pregnancy termination were included in the study. Of these, 78 patients aborted within 0–24 hours (Group 2). The remaining 39 patients aborted in more than 24 hours (Group 1). Results: The EBLV was higher in the study group (p=0.003). In addition, the rate of patients with ≥500 cc and ≥1000 cc blood loss was also significantly higher in the study group (p values 0.049 and 0.016, respectively). After adjusting for potential confounder factors, the probability of blood loss of ≥500 cc and ≥1000 cc was found to be higher in the study group (adjusted OR: 2.720, 95% CI: 1.12–6.58 and adjusted OR: 6.987, 95% CI: 1.25–38.98, respectively). Conclusion: Postabortion hemorrhage risk was found to be higher in patients whose induction period lasted longer than 24 hours in second-trimester terminations with misoprostol. However, there was no deterioration in the patient’s clinical status and no increase in transfusion rates. Care should be taken with regard to vaginal bleeding in misoprostol applications lasting longer than 24 hours

Over kanseri hücre kültüründe arsenik trioksitin topoizomeraz 2 düzeyi üzerine etkisinin western blot yöntemi ile tayini

ÖZET: Over kanseri jinekolojik kanser ölümleri arasında en yüksek mortalite oranına sahiptir. Erken tanı konamaması, tarama yönteminin olmaması, cerrahi ve kemoterapiden optimal yanıt elde edilememesi mortalite üzerinde katkıda bulunmaktadır. Over kanseri tedavisi günümüzde esas olarak cerrahi ve kemoterapiden oluşmaktadır. İnoperabl olan hastalarda palyatif ve/veya neoadjuvan kemoterapi önerilmektedir. Kür oranı bu tip tedavi rejimlerinde oldukça azdır. Bu açıdan over kanseri tedavisi için farklı modaliteler üzerinde çalışmalar yapılmaktadır. Kemoterapi uygulamaları sırasında en önemli sorun, mevcut olan ajanlara karşı direnç gelişimidir. Over kanserinde günümüzde en çok tercih edilen kemoterapi kombinasyonu piatin türevlerine (cisplatin, carboplatin) taksan türevlerinin (paklitaksel, dosetaksel) eklenmesidir. Bu kombine kemoterapi rejiminde de ilaçlara karşı direnç meydana gelmektedir. Bu çalışmada birçok hücre hattında in vitro olarak sitotoksik etkisi olduğu gösterilen arsenik trioksitin MDAH 2774 over kanseri hücre hattında Topoizomeraz 2 düzeyi üzerine etkisini araştırdık. Çalışmamızda arsenik trioksitin MDAH 2774 over kanseri hattında Topoizomeraz 2 düzeyini doza bağımlı olarak azalttığını bulduk. Bu da bize arsenik trioksitin sitotoksik etki mekanizmalarından birinin Topoizomeraz 2 enzimi üzerinden olabildiğini gösterdi. Ayrıca bu çalışma ile arsenik trioksit ile Topoizomeraz 2 enzim inhibitörü ajanlarının kombine tedavide kullanılmayacağını göstermektedir. Literatürdeki veriler ve bu çalışmanın sonuçlan bize, arsenik trioksit' in MDAH over kanseri hücre hattı üzerinde etki mekanizması ile ilgili daha fazla sayıda ve farklı çalışmalara ihtiyaç duyulduğunu göstermektedir. 2

Vesicouterina fistula: Youssef's syndrome

Vesico-uterin fistula is a rare type of fistulas and can be diagnosed frequently after surgery. First described by Youssef in 1957. Clasically findings are; cyclic haematuria without urinary incontinence and secondary amenorrhea. The patient was referred to our clinic for cyclic hematuria and she was diagnosed with vesicouterine fistula by radiological imaging methods and a cystoscopy procedure. Being a rare occurrence, this case was reported with a discussion of the relevant literature

Polycystic Ovary Syndrome: The Correlation Between Renal Doppler Ultrasound and Laboratory Parameters

Aim: To investigate whether there is alteration both right and left kidney lenght, parenchymal thickness, renal arterial, venous blood flow measurements in normotensive reproductive age women with polycystic ovary syndrome (PCOS). Material and Method: Forty women with PCOS according to Rotterdam criteria and thirty-six healthy volunteers women were included in our study. Hormonal, biochemical analysis, renal Doppler ultrasonography were performed and were investigated in terms of both left and right renal lenght, parenchymal thickness, peak systolic velocity (PSV), resistive index (RI), venous impedance index (VI), metabolic characteristics having insulin resistance, impaired glucose tolerance, serum lipid concentration. The student t test and pearson corelation test were used for statistical analysis. Results: The measurements for kidneys were not different between women with PCOS and healthy women. The peak systolic velocity of mean renal artery was lower in PCOS group. The mean renal venous impedance also was higher in PCOS group than control group. The mean renal resistive index was slightly higher in PCOS but not statistical significant. In bivariate corelation analyse including all patients, it was seen that BMI, WHR, level of serum fasting glucose, insulin, LDL, trigliserides were positively related with mean renal length and mean parenchymal thickness measurements. Discussion: We found that there was alterations kidney blood flow in normotensive reproductive age women with PCOS. This findings may indicate results of long term renal and cardiovascular complications of PCOS

Polycystic Ovary Syndrome: The Correlation Between Renal Doppler Ultrasound and Laboratory Parameters

Aim: To investigate whether there is alteration both right and left kidney lenght, parenchymal thickness, renal arterial,venous blood flow measurements in normotensive reproductive age women with polycystic ovary syndrome (PCOS). Material and Method: Forty women with PCOS according to Rotterdam criteria and thirty-six healthy volunteers women were included in our study. Hormonal, biochemical analysis, renal Doppler ultrasonography were performed and were investigated in terms of both left and right renal lenght, parenchymal thickness, peak systolic velocity (PSV), resistive index (RI), venous impedance index (VI), metabolic characteristics having insulin resistance, impaired glucose tolerance, serum lipid concentration. The student t test and pearson corelation test were used for statistical analysis.Results: The measurements for kidneys were not different between women with PCOS and healthy women. The peak systolic velocity of mean renal artery was lower in PCOS group. The mean renal venous impedance also was higher in PCOS group than control group. The mean renal resistive index was slightly higher in PCOS but not statistical significant. In bivariate corelation analyse including all patients, it was seen that BMI, WHR, level of serum fasting glucose, insulin, LDL, trigliserides were positively related with mean renal length and mean parenchymal thickness measurements. Discussion: We found that there was alterations kidney blood flow in normotensive reproductive age women with PCOS. This findings may indicate results of long term renal and cardiovascular complications of PCOS

Platelet-to-lymphocyte ratio: A new inflammatory marker for the diagnosis of preterm premature rupture of membranes

Objective: Preterm premature rupture of membranes (PPROM) is closely related with maternal and fetal complications. Therefore, early diagnosis is extremely important to provide maternal and fetal well-being. Many inflammatory markers have been evaluated for their ability to diagnose membrane rupture at early stages. We aimed to investigate the relationship between the platelet-to-lymphocyte ratio (PLR) and preterm premature membrane rupture. Material and Methods: In this study, 121 pregnant women with PPROM and 96 age-matched pregnant women with spontaneous preterm labor who were admitted to our hospital between January 2014 and December 2015 were enrolled. Demographic data, complete blood cell count results, and neonatal outcomes were recorded. Results: The neutrophil and platelet counts were higher in the PPROM group (9948.4 +/- 3393.2 vs. 7466.1 +/- 1698.5/mm(3) and 244.5 +/- 60 vs. 210.6 +/- 64.8/mm(3), respectively, p117.14 (p<0.001). Conclusion: The PLR might be a cost effective, easy to use, and practical marker for the early diagnosis of PPROM, which can help to determine the appropriate waiting time for delivery and provide maternal and fetal well-being