Effects of maternal betamethasone administration for lung maturation on birth weight and head circumference of fetuses

Amaç: 1997-2003 yıllan arasında kliniğimize başvuran preterm doğum olgularında, tek ve tekrarlayan doz antenatal kortikosteroid uygulanan ve kortikosteroid uygulanmayan bebeklerin solunum sıkıntısı, sepsis, intraventriküler hemoraji ve ölüm riski, doğum kilosu ve baş çevresi açısından karşılaştırılması. Gereç ve Yöntemler: Kliniğimizde 1997-2003 yılları arasında preterm doğan fetuslann dosyalan retrospektif olarak tarandı. Preterm doğan fetuslar steroid uygulanmayanlar (n=27), tek doz steroid uygulananlar (n=33) ve multipl doz steroid uygulananlar (n=5) olmak üzere 3 gruba aynldı. Antenatal steroid uygulaması betametazon 12 mg 2x2 12 saat arayla İM enjeksiyon şeklinde gerçekleştirilirken, multipl dozlar doğum gerçekleşmemesi durumunda 7 gün arayla tekrarlanmıştı. Gruplar, aralannda solunum sıkıntısı, sepsis, intraventriküler hemoraji ve ölüm riski açısından Fisher'in exact testi ve Pearson cross tab ile kilo ve baş çevresi açısından ise one-way Anova ile karşılaştınldı. Bulgular: Her üç grup arasında solunum depresyonu, sepsis, intraventriküler hemoraji ve ölüm oranlan açısından istatistiksel olarak anlamlı bir farklılık saptanmadı. Sadece tek doz steroid yapılan fetuslann doğum kiloları steroid uygulanmayan fetuslann doğum kilolarına göre anlamlı olarak düşüktü (p=0.018). Multipl doz steroid uygulanan fetuslann doğum kilolan uygulanmayanlara göre anlamlı olarak farklılık göstermiyordu (p>0.05). Ayrıca baş çevresi açısından da her Uç grup arasında anlamlı farklılık yoktu (p>0.05). Sonuç: Preterm doğumlarda tek doz betametazon uygulaması fetuslarda düşük doğum ağırlığına sebep olabilir. Ancak tek doz ve multipl doz steroid uygulamalannın yan etkilerini araştıracak çok merkezli, prospektif randomize çalışmalara gereksinim vardır.Objective: The aim of this study is to compare respiratory depression, sepsis, intraventricular hemorrage and mortality risk together with the delivery weight and head circumference among preterm delivery cases applied to our clinic between 1997-2003 and received either single and multiple doses of antenatal corticosteroids or no corticosteroids. Material and Methods: Files of preterm delivery fetusus at our clinic between 1997-2003 were scanned retrospectively. Fetusus delivered preterm were classified into 3 groups as receiving no steroid (n=27), receiving single dose steroid (n=33) and receiving multiple dose steroid (n=5). While antenatal steroid administration was performed as 12 mg 2x2 IM every 12 hours, multiple doses were repeated every 7 days incase the delivery was delayed. Groups were compared using Fisher's exact test and Pearson cross tab with respect to respiratory depression, sepsis, intraventicular hemorrage and morbidity risk; and with one-way Anova with respect to weight and head circumference. Results: Regarding respiratory depression, sepsis, intraventicular hemorrage and morbidity rate, there was no statistically significant difference among the three groups. Only, birth weight of fetusus injected with single dose steroid were significantly lower than the weight of those that are not injected with steroid (p=0.018). Birth weight of fetuses injected with multiple doses of steroid were not significantly different compared to the weight of those that did not receive steroid (p>0.05). Moreover, there was no difference among the groups with regard to head circumference (p>0.05)! Conclusion: Single dose betamethasone therapy in preterm delivery may cause low birth weight in fetuses. However, multiple center, prospective studies need to be carried out to investigate side effects of single and multiple doses of steroid

The relationship of pregnancy complications and AFP, HCG and estriol level detected in maternal serum

AMAÇ: Bu çalışmada Manisa ili ve çevresindeki gebe popülasyonunda maternal kanda yüksek AFP, yüksek HCG, düşük AFP ve düşük ankonjuge östriol değerleri ile intrauterin ölüm, prematürite, intrauterin gelişme geriliği, sürmatürite ve preeklampsi arasındaki ilişkiyi araştırmayı amaçladık. MATERYAL ve METOD: Celal Bayar Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Kliniği'nde 1999-2003 yılları arasında üçlü tarama testi yapılan 1020 hastanın gebelik sırasındaki in utero ölüm, prematürite, sürmatürite, intrauterin gelişme geriliği ve preeklampsi oranlarını telefonla ve hastane kayıtlarını taramak yoluyla inceledik. Maternal kanda yüksek AFP (>2 MoM), yüksek HCG (>2 MoM), düşük AFP (2 MoM), 55'inde yüksek HCG (>2 MoM), 13'ünde düşük AFP (<0.5 MoM) ve 8'inde düşük ankonjuge östriol (<0.5 MoM) değerleri bulundu. Bu hastalar tüm biyokimyasal belirteçleri normal sınırlarda olan ve kontrol grubunu oluşturan 317 gebeyle karşılaştırıldı. Düşük östriol değerleri ile prematürite arasında anlamlı bir ilişki bulunurken (p<0.05), düşük veya yüksek AFP değerleri ile gebelik komplikasyonlarından hiçbiri arasında ilişki bulunamadı. Yüksek HCG ise preeklampsi gelişimi ile ilişkiliydi (p<0.05). SONUÇ: Yüksek hCG değerleri ile preeklampsi gelişimi ve düşük östriol ile prematürite arası ilişki olması üçlü tarama testindeki biyokimyasal parametrelerde artış saptanan gebelerde obstetrik komplikasyon gelişme riskinin arttığını göstermektedir. Bu gebeler kromozom anomalisi ve malformasyon taramasının yanında obstetrik komplikasyonlar açısından da dikkatli izlenmelidir.OBJECTIVE: The aim of the study was to determine the relationship of intrauterine death, prematurity, intrauterine growth retardation, surmaturation and preeclampsia with high and low AFP, high HCG and low estriol levels detected in maternal serum. STUDY DESING: 1020 patients who had undergone tripple test during pregnancy for intrauterine death, prematurity, surmaturation, intrauterine growth retardation and preeclampsia rates between 1999-2003 at Celal Bayar University Hospital were determined. The patients with high AFP levels (&gt;2 MoM), high HCG levels (&gt;2 MoM), low AFP levels (&lt;0.5 MoM) and low estriol levels (&lt;0.5 MoM) were compared to those with normal levels. The relationship of pregnancy complications and our findings examined. Statistical analysis were done with student t test and Chi square test by using SPSS for Windows version 10.0. RESULTS: Among 428 patients of whose files were useful for inclusion criteria, 30 of 31 patients of whom tripple test results were over the critical limit ; 1/270 had undergone amniosynthesis. 4 of those 30 had Down syndrome. No other Down syndrome detected in other 26 patients who had a risky tripple test result neither with amniosynthesis nor in delivery. There were 14 patients with high AFP (&gt;2 MoM), 55 patients with high HCG (&gt;2 MoM), 13 patients with low AFP (&lt;0.5 MoM) and 8 patients with low estriol levels (&lt;0.5 MoM) among the patients those included to the study group. Those patients compared to the others with normal findings which consisted of 317 pregnants. There was statistically significant difference between low estriol levels and prematurity (p&lt;0.05), however, there was no difference between high or low AFP levels and pregnancy complications. High HCG was significantly related with preeclampsia (p&lt;0.05). CONCLUSION: Preeclampsia develoment with high HCG levels and the relation between low estriol and prematurity indicate that the patients with abnormal findings of tripple test are under the risk of obstetric complications. These patients should be consulted carefully for obstetric complications in addition to detection of cromozomal abnormality and malformation

The predictive value of middle cerebral artery peak systolic velocity in repeated intrauterine transfusion: A case report

Amaç: Orta beyin arter tepe sistolik hızı, fetal anemi tahmininde ve ilk ve ikinci kordosentezlerin zamanlamasında kullanılmaktadır. Ancak, tekrarlayan çoklu intrauterin transfüzyonlar sonrasında, orta beyin arter tepe sistolik hızının belirleyici değeri bilinmemektedir. Olgu: 31 yaşında, G5P4, 24. gebelik haftasında fetusta hidrops ile başvuran, Rh izoimmünizasyonlu gebeye 24-31. gebelik haftaları arasında dört kez intrauterine transfüzyon uygulandı. Her işlem sırasında, kordosentez ile fetal hemoglobin tayininden önce ve sonra, Doppler ultrason ile orta beyin arter tepe sistolik hızı bakıldı. Fetal hemoglobin değerleri ile orta beyin arter tepe sistolik hızı arasında ters yönde bir ilişki vardı. Sonuç: Tekrarlayan intrauterine transfüzyonlarda, transfüzyonun zamanlaması invaziv bir girişim olan kordosentez ile fetal hemoglobin tayini yapılarak belirlenmektedir. Daha önce transfüzyon yapılmamış ya da tek transfüzyon yapılmış olgularda, fetal anemi tayininde faydalı bulunan orta beyin arter tepe sistolik hızı, çoklu transfüzyonlarda intrauterin transfüzyonun zamanlanmasında invaziv olmayan uygun bir alternatif olabilir.Objective: Middle cerebral artery peak systolic velocity has been used for predicting fetal anemia and timing for first and second cordocentesis. However, predicting value of middle cerebral artery peak systolic velocity after multiple intrauterine transfusions is unknown. Case: Thirty-one-year-old woman, gravida 5, para 4, with Rh-isoimmunization who were presented with fetal hydrops at her 24th week&amp;#8217;s of gestation was undergone intrauterine transfusion four times between 24 and 31 weeks of gestation. Doppler examination of middle cerebral artery peak systolic velocity was performed before and after cordocentesis during each procedure. There was an inverse correlation between fetal hemoglobin values and Doppler measurements of middle cerebral artery. Result: The timing of intrauterine transfusion is traditionally determined by fetal hemoglobin measurement from cord blood of the fetus. Middle cerebral artery peak systolic velocity has been found useful for determining fetal hemoglobin level in the severely anemic fetuses after first and second transfusion. It may also be an appropriate non-invasive alternative in repeated transfusions for the timing of transfusion

The place of prenatal ultrasound, postmortem radiography and autopsy examination in prenatal diagnosis of osteogenesis imperfecta type 2 - A case report

Amaç: Ölümcül bir iskelet displazisi olan osteogenezis imperfektanın, diğer mineralizasyon kusuruyla giden iskelet displazilerinden ayırıcı tanısını irdelemek ve tanıda ultrasonografi ile birlikte postmortem radyografi ve otopsi bulgularının önemini vurgulamak. Olgular: 33. gebelik haftasında, G2 P1, 25 yaşında hasta, iskelet displazisi ön tanısıyla bir başka merkezden servisimize refere edildi. Yapılan ultrasonografi tüm uzun kemiklerde kısalık, kafa kemiklerinde prob baskısıyla çökme, humerusta birden çok kırık ve polihidramniyos olduğunu gösterdi. Aileye prognoz hakkında bilgi verildikten sonra gebelik sonlandırıldı. Postmortem radyografi ve otopsi bulguları ile osteogenezis imperfekta tanısı konfirme edildi. Sonuç: Osteogenezis imperfektanın diğer mineralizasyon defekti ile seyreden hastalıklardan ayırıcı tanısı önemlidir ve bu amaçla mutlaka postmortem radyografi ve otopsi incelemesi yapılmalıdır. .Background: To discuss the differential diagnosis of ostegenesis imperfecta from other skelatal dysplasias which is characterized by mineralization defect and to emphasize the importance of postmortem radiography and autopsy findings. Case: Twenty five -years- old patient gravida 2 para 1 33 weeks of pregnancy, refered to our clinic from another center with a diagnosis of skeletal dysplasia. Sonographic evaluation revealed that all long bones were short, depressed skull bones with transducer pressure, multipl fractures in?at the humerus and polyhydramnios. After consultation of the parents about diagnosis, pregnancy was terminated. The diagnosis was confirmed with postmortem radiologic findings and autopsy examination. Conclusion: It is important the differantial diagnosis of osteogenesis imperfecta from other skelatal dysplasias which characterized by mineralization defect and it should be performed postmortem radiologic and autopsy investigations

The synthesis, antimicrobial activity studies, and molecular property predictions of novel benzothiazole-2-thione derivatives

Benzothiazoles and 2-mercaptobenzothiazoles are important classes of bioactive organic scaffolds possessing antibacterial, antifungal, antitubercular, antiinflamma-tory, antidiabetic, and antimalarial properties. In recent years, prediction of drug-likeness, molecular, absorption, distribution, metabolism, and excretion (ADME) properties using in silico techniques has become a standard procedure for the evaluation of molecules in terms of their potential clinical use. In this study, compounds structured 6-benzoyl-3-substitutedmethylbenzo[d]thiazole-2(3H)-thione were synthesized using the Mannich reaction starting from 2-mercaptobenzothiazole. The antibacterial and antifungal activities of these compounds were determined against Staphylococcus aureus, Escherichia coli, Enterococcus faecalis, Pseudomonas aeruginosa, Candida albicans, Candida krusei, and Candida parapisilosis using a broth microdilution method. An additional analysis was undertaken using the in silico technique to predict the drug-likeness, molecular, and ADME properties of these molecules. Among all the compounds, respectively, Compounds 1-4 and 6-11 exhibited good minimum inhibition concentration values against Staphylococcus aureus and Candida species with promising predicted properties

A Case of Abdominal Epilepsia Partialis Continua Occurring One Year after Ischemic Stroke

Epilepsia partialis continua is characterized by continuous clonic contractions of a certain area of the body. One of the most common causes of Epilepsia partialis continua in adults is cerebrovascular events. Other causes include meningoencephalitis, Rasmussen encephalitis, diabetic nonketotic hyperosmolar coma, central nervous system malignancies, tuberculosis, cerebral venous thrombosis, or idiopathic. A 70-year-old male patient was admitted to the emergency department with abdominal muscle contractions for about an hour. Neurodiagnostic imaging revealed an encephalomalasia area secondary to the area of the previous infarction in the left frontoparietal region. Focal motor findings were controlled within 5 min after the VPA (valproic acid) treatment at a dose of 15 mg/kg admission, and then the treatment was continued with 1500 mg/day Valproic acid. Here, we aimed to emphasize that myoclonic jerks confined to the abdominal region is a rare motor phenomenon and may be a feature of Epilepsia partialis continua, the history of stroke should be questioned in the etiology, and seizures can be controlled with IV Valproic acid treatment

The impact of invasive prenatal testing on anxiety and sleep quality in pregnant women with a screen-positive result for aneuploidy

Purpose Prenatal anxiety has negative effects on pregnancy and neonate. Both screening tests and invasive diagnostic tests are associated with elevated anxiety level. But a normal fetal karyotype result could improve the anxiety level in high-risk patients. We hypothesized that patients who prefer follow-up without karyotyping may experience increased anxiety and sleep impairment until delivery. Our aim was to determine the effect of invasive diagnostic test decision on anxiety and sleep quality in women with a positive screening result. Methods 132 women were included for the study and three groups were described. The invasive group consisted of women who underwent invasive procedure after a screen-positive test result, the follow-up group consisted of women who preferred non-invasive follow-up after a screen-positive result and the control group consisted of women with screen-negative test results. Participants were evaluated with the State-Trait Anxiety Inventory (STAI) and the Pittsburgh Sleep Quality Index (PSQI) after genetic counseling. They were asked for completing the same questionnaires in the third trimester to establish the course of anxiety and sleep quality throughout pregnancy. Results STAI scores were significantly higher in both screen-positive groups than in the control group in the first evaluation (p < 0.001). STAI scores decreased in the invasive group and controls while PSQI scores did not significantly change during the course of the pregnancy. However, the anxiety level and sleep quality were worsened over time in the follow-up group. Conclusion Screen-positive women who preferred to follow up had higher anxiety level and worse sleep quality in the later stages of pregnancy. We concluded that invasive prenatal diagnostic tests could improve anxiety and sleep quality in pregnant women with a screen-positive result for aneuploidy

Two Families with SOD1 (L144F) and C9orf72 Gene Mutations and an Overview of Amyotrophic Lateral Sclerosis

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease that affects both upper and lower motor neurons and its etiology is not fully understood. The incidence of ALS is 2-3/100,000 people in the world. Although ALS occurs sporadically in most patients, 5-10% of patients are thought to have genetic inheritance. The most common gene mutations are C9orf72, superoxide dismutase 1 (SOD1), TDP43, FUS, and ubiquilin 2. In our study, within the light of the literature, we wanted to represent three patients with familial ALS who had SOD1 and C9orf72 gene mutations, who were observed in detail in our clinic in terms of clinical, electromyographic, and genetic findings

Gastrointestinal stromal tumors: A multicenter study of 1160 Turkish cases

Background/aims: The aim of this multicenter study was to determine the histopathological features and immunohistochemical profiles of gastrointestinal stromal tumors diagnosed in Turkish patients. Material and Methods: Twenty-eight participating centers registered their gastrointestinal stromal tumor cases on a nationwide database. The diagnosis of gastrointestinal stromal tumor relied upon hematoxylin & eosin features and the results of antibody panel including CD117, CD34, desmin, smooth muscle actin, S-100 protein, and Ki67. The database consisted of parameters including age, gender, location, and all other histopathological and immunohistochemical findings. Statistical analysis was performed using Pearson, Kruskal-Wallis, Mann-Whitney U, and Spearman tests. Results: From all of the gastrointestinal stromal tumors in the database, 1160 cases with a male to female ratio of 1.22 and a mean age of 56.75 years were included in the study. The most common location was the stomach (45.0%), followed by the small intestine, omentum-peritoneum, large intestine, and esophagus (32.0%, 12.6%, 9.3%, 1.1%, respectively). The risk groups were distributed as: 6.1% very low, 21.7% low, 19.3% intermediate, and 53% high-risk cases. Many histopathologic findings were correlated with risk groups. CD117 was positive in 95.3% of gastrointestinal stromal tumors, whereas CD34 was positive in 74.9%, smooth muscle actin in 45.9%, desmin in 9.2%, and S-100 in 19.1.%. Though no significant relation was found between CD117 expression and tumor location, CD34, smooth muscle actin and Ki67 expressions significantly varied in different locations (p=0.001) and risk groups. Conclusions: The results of this multicenter study demonstrated that features other than tumor size and mitosis and immune markers other than CD117 and Ki67 included in the antibody panel seem to be useful as predictive risk factors