Perinatal and neonatal outcomes of adolescent pregnancies over a 10-year period

Objectives: Poor overall neonatal outcomes, small neonatal head circumference, neonatal hypoglycemia, need for Neonatal Intensive Care Unit and late-onset neonatal sepsis are more common in adolescents. The aim of this study is to draw attention to the outcomes of adolescent pregnancies. Material and methods: This retrospective study was conducted in adolescent singleton pregnancies with maternal age < 15 years (n = 20, group 1), 16–19 years (n = 1929, group 2), and 20 years (n = 866, group 3). Age, gravidity, parity, and body mass index (BMI) measurements of mothers; mode of delivery, maternal and neonatal outcomes were evaluated and compared. Results: The rate of preterm birth, postpartum hemorrhage, asymmetrical intra-uterine growth restriction (IUGR, as 3% percentile), macrosomia, and height of newborn of Group 3 was significantly higher. The rate of asymmetrical IUGR (as 10% percentile) was significantly lower in Group 3. The rate of severe preeclampsia and cesarean section was significantly higher in Group 3. The rate of Small for Gestational Age newborn, neonatal hypoglycemia, and late-onset neonatal sepsis was significantly higher in Group 1. Conclusions: Neonatal problems with poor obstetric outcomes are common in adolescent pregnant women, so that a family planning and baby care social trainings are important in achieving good long-term maternal and neonatal outcomes

Morbidly adherent placenta and cesarean section methods. A retrospective comparative multicentric study on two different skin and uterine incision

Objectives: Morbidly adherent placenta (MAP) is one of leading causes of maternal mortality, with an increasing rate because of repeated cesarean sections (CS). The primary objective of this study is to compare two techniques of skin and uterine incisions in patients with MAP, evaluating the maternal fetal impact of the two methods. Retrospective multicentric cohort study.Material and methods: A total of 116 women with MAP diagnosis were enrolled and divided in two groups. Group one, comprised of 81 patients, abdominal entry was performed by Pfannenstiel skin incision plus an upper transverse lower uterine segment (LUS) incision (transverse-transverse), which was 2–3 cm above the MAP border, with the uterus in the abdomen. In group two, comprised of 35 patients, abdominal entry was performed by an infra-umbilical midline abdominal incision, by vertical-vertical technique, and the pregnant uterus was incised by a midline incision (vertical) from the fundus till the border of the MAP. Total surgery time, blood loss, blood product consumption, total hospital stay, cosmetic outcomes, and postoperative complications were investigated.Results: Total time of surgery was significantly shorter in group 1 (p < 0.05). Intraoperative blood loss was higher in group 2. Difference between preoperative and postoperative Hb and Htc levels were 3.30 ± 1.04 and 12.99 ± 5.07 respectively (p = 0.012; p = 0.033). The use of erythrocyte suspension (ES), fresh frozen plasma (FFP), and cryoprecipitate and thrombocyte suspension (TS) were found to be significantly lower in patients of group 1than vertical-vertical group (p = 0.008, p = 0.009, p = 0.001, p = 0.001, respectively). There was no difference in terms of total length of hospital stay between groups.Conclusions: In a subgroup of patients diagnosed for MAP, the transverse-transverse incision resulted in less bleeding, less blood and blood product use, and had better cosmetic results than vertical-vertical incision. Moreover, the total time of surgery, crucial for MAP patients, seems to be shorter also in transverse-transverse incision than in vertical-vertical incision

Screened non-bonded interactions in native proteins manipulate optimal paths for robust residue communication

A protein structure is represented as a network of residues whereby edges are determined by intra-molecular contacts. We introduce inhomogeneity into these networks by assigning each edge a weight that is determined by amino-acid pair potentials. Two methodologies are utilized to calculate the average path lengths (APLs) between pairs: To minimize (i) the maximum weight in the strong APL, and (ii) the total weight in the weak APL. We systematically screen edges that have higher than a cutoff potential and calculate the shortest APLs in these reduced networks, while keeping chain connectivity. Therefore, perturbations introduced at a selected region of the residue network propagate to remote regions only along the non-screened edges that retain their ability to disseminate the perturbation. The shortest APLs computed from the reduced homogeneous networks with only the strongest few non-bonded pairs closely reproduce the strong APLs from the weighted networks. The rate of change in the APL in the reduced residue network as compared to its randomly connected counterpart remains constant until a lower bound. Upon further link removal, this property shows an abrupt increase, towards a random coil behavior. Under different perturbation scenarios, diverse optimal paths emerge for robust residue communication.Comment: 21 pages with 6 figure

Determination of environmetal pollutants, thougt being able to take role on abortion etiology, on endometrium by using electron microscope

YÖK Tez ID: 141717ÖZET Soyer C. Abortus Etyoloj isinde Rolü Olabileceği Düşünülen Çevre Kirliliğine Yol Açan Maddelerin Elektron Mikroskop kullanımı ile Endometriyumda Tespiti, Kırıkkale Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalı, Uzmanlık Tezi, Kırıkkale, 2004. Amaç: Kırıkkale Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Bölümü Polikliniğine gebelik kayıpları nedeniyle başvuran hasta sayısı kış aylarında daha fazladır. Kırıkkale bölgesinde kış aylarında hava kirliliğinin yoğun olduğu bilinmektedir. Bu çalışmanın amacı hava kirliliğine yol açan maddelerin abortus etyolojisinde rol oynayıp oynamadığının belirlenmesidir. Yöntem: Çalışma vaka-kontrollü deneysel çalışma olarak planlanmıştır. Bu çalışmada, hava kirliliğinin başlıca bileşeni olan ağır metaller ( krom, nikel, kobalt, demir, mangan, kurşun ve çinko ) ve ağır metallere maruz kalan Wistar Albino dişi ratlar kullanılmıştır. Hayvanlar dört gruba ayrılmıştır ve her grup on adet rattan oluşmaktadır. Birinci Grup; akut ağır metallere İkinci Grup ise kronik ağır metallere maruz bırakılmıştır. Üçüncü ve Dördüncü Gruplar kontrol gruplarıdır ve sırası ile Ankara'da ve Kırıkkale'de banndınlmışlardır. Akut maruziyet grubu tek doz ağır metal inhalasyonuna, kronik maruziyet grubu ise 1 ay boyunca her gün birer saat ağır metal inhalasyonuna maruz bırakılmıştır. Son dozdan 24 saat sonra laparotomi ile uterusları alınmıştır. Metal inhalasyona maruz kalanların ve kontol gruplarındaki tüm ratlann endometriyumları Taramalı Elektron Mikroskobu ( SEM) kullanılarak incelenmiştir. Sonuç: Birinci Grup ile Üçüncü Grup arasında çalıştığımız tüm ağır metallerde endometriyumda anlamlı bir yükseklik tespit ettik ( p<0,05 ). Grup 1 ile Grup 4 arasında yalnız çinko miktarında Grup 1 lehine bir artış ( p<0,05 ) ; Grup 2 ile Grup 4 karşılaştırıldığında ise sadece krom ve kobalt miktarında Grup 2 lebine bir artış olduğunu gözledik ( p<0,05 ). Bu çalışmamızda endometriyum dokusunda havaVI kirliliğine bağlı olarak ağır metal miktarlarını kontrollere oranla göreceli yüksek bulduk. Endometriyumdaki ağır metal artışının abortus etyolojisinde rolü olabileceğini düşünmekteyiz. Anahtar Kelimeler: Abortus, çevre kirliliği, ağır metaller, SEM.vn ABSTRACT Soyer, C. Determination of environmental pollutants, thought being able to take role on abortion etiology, on endometrium by using Electron Microscope. Kırıkkale University Faculty of Medicine, Department of Obstetrics and Gynecology, Specialization Thesis, Kırıkkale, 2004. Aim: The number of patients who applied to Kırıkkale University Faculty of Medicine, Department of Obstetrics and Gynecology about pregnancy loss is higher in winter. It is also known that in Kırıkkale region air pollution is high in winter. The aim of this study was to estimate whether the environmental factors can affect abortion etiology. Method: This study was designed as experimental case-control study. We used heavy metals (chrome, nickel, cobalt, iron, manganese, lead and zinc) which are the major complements of the environmental pollution. 40 female rats (Albino Wistar type,250-300 g in weight) were randomly divided into four groups comprising 10 rats in each of them. First Group was acutely exposed to heavy metals; Second Group was chronically exposed to heavy metals. Third and Fourth Groups were control groups and were given shelter in Ankara and in Kırıkkale respectively. Acute exposure group was subjected to inhalation of heavy metals for only one dosage. Chronic exposure group was subjected to inhalation of heavy metals for one hour everyday during a month. Uterus of rats were taken out by laparotomy 24 hours after the last dosage. Endometrium from all of the groups were investigated for the heavy metals by using Scanning Electron Microscope (SEM). Result: When the amounts of all metals, studied in this research, were compared between the groups, First Group was significantly higher (p<0.05) than that of Third Group. When First Group was compared with Fourth Group, it was observed that only the amount of zinc, found in First Group, was significantly (p<0.05) higher than that of in the Fourth Group. On the other hand, amounts of chrome and cobalt, found in Second Group, were relatively higher (p<0.05) than that of in Fourth Group. In this study it was found that the amounts of heavy metals in endometrium in groups,vm exposed to heavy metals, relatively higher than that of in control groups. We think that the increase of the amounts of heavy metals in endometrium may affect abortion etiology. Keywords: Abortion, environmental pollution, heavy metals, SEM

Abortus Etyolojisinde Rolü Olabileceği Düşünülen Çevre Kirliliğine Yol Açan Maddelerin Elektron Mikroskop İle Endimetriyumda Tespiti

Tez (Tıpta Uzmanlık) -- Kırıkkale Üniversitesi48241

Analysis of heavy metals in the endometrial tissue using scanning electron microscope

ÖZET Amaç: Endometrium dokusunda çevre kirliliğine yol açan ağır metallerin tesbiti. Materyal ve Metod: 20 adet albino Wistar rat randomize olarak 2 gruba ayrıldı. Grup l'deki ratlar Ankara'da, Grup 2'deki ratlar Kırıkkale'de 1 ay süresince tutuldular. Genel anestezi altında çıkarılan uteruslar scanning electron mikroskopta incelenerek metal tayinleri yapıldı. Bulgular: Her iki grup karşılaştırıldığında Grup 2'deNikel anlamlı olarak yüksek tesbit edildi (p0.05). Sonuçlar: endometrium dokusundaki yüksek nikel düzeyi endometrial kompozisyonu etkileyerek düşük sebebi olabilir.Objective: Determination of the heavy metals in endometrial tissue, which cause environmental pollution. Materials and Methods: 20 albino Wistar rats are divided into 2 groups at random. During one month, the rats of Group 1 were held in Ankara, the rats of Group 2 were held in Kirikkale. The uteruses were taken out under general anesthesia and were examined in scanning electron microscope, so their determinations of metal were done. Results: In a comparison between the groups, the quantity of Nickel was determined significantly at high level in Group 2. Conclusions: The etTect of the high level of Nickel in endometrial tissue on endometrial composition may be accepted as the reason ofabortion

Predictive value of early second trimester maternal serum cyclophilin A concentrations in women complicated with preeclampsia: a preliminary case–control study

Objective To investigate cyclophilin A in early second trimester of pregnancy before the onset of preeclampsia. Methods In this prospective case-control study, 51 pregnant women whose serum were collected and stored and who developed preeclampsia in later follow-up and 41 pregnant women as control group were included. Results Maternal serum cyclophilin A levels in the study group who developed preeclampsia in later follow-up were significantly higher than those of normal healthy pregnant women. Conclusion Cyclophilin A may be a valuable predictor for pregnant women who subsequently develop preeclampsia in their pregnancies

The etiopathogenetic factors which figure in the development of polycystic ovary syndrome

Amaç: Polikistik Over Sendromunun farklı kriterlere göre tanımlanması ve bu sendromun gelişiminde rol alan etyopatogenetik faktörlerdeki çeşitliliğin araştırılmasıdır. Method: Polikistik Over Sendromu ilk olarak 1935'de Stein ve Leventhal tarafından tanımlanmıştır. Geçmiş yıllarda klinik tanı amenore, hirsutizm, obesite triadından oluşmaktaydı. Ancak son zamanlarda yapılan çalışmalar ise PKOS'nun geniş, heterojen bir klinik tabloya ve multifaktöriyel bir etyolojiye sahip olduğunu göstermiştir. PKOS'da görülen hiperandrojenizm ve anovulasyon endokrinolojik olarak 4 kompartmanda görülen anormallikler sonucu ortaya çıkar; over, adrenal bez, cilt ve yağ dokusu, hipotalamo-hipofizer aks. PKOS'nda etyopatogenez.de hipotalamo-ptuiter-overyen akstaki değişiklikler, intrinsik over patolojisi, peripubertal ekzajere adrenarş ve fizyolojik insülin rezistansının birlikteliği, obezite, patolojik insülin rezistansı ve pankreasla beta hücre disfonksiyonu ve genetik etyolojiye işaret eden ailesel birikimin rolü kesin olarak gösterilmekle beraber bu konuda halen çalışmalar devam etmektedir. Bu derlemede 'PKOS'nun farklı kriterlere göre tanımlanması ve sendromun gelişiminde rol alan çeşitli etyopatogenetik faktörler anlatılmaktadır. Sonuç: PKOS'da etyopatogenetik faktörlerin tam olarak bilinmesi; hastalığın tanısı, izlemi, tedavisi ve uzun dönem komplikasyonların gelişiminin engellenmesi açısından çok büyük bir önem kazanmaktadır.Objective: To define the polycystic ovary syndrome according to different criteria and to investigate the diversity of the etiopathogenetic factors which figure in the development of polycystic ovary syndrome. Method: Polycystic ovary syndrome was first described by Stein and Leventhal in 1935. The clinical diagnosis was based on the triad of amenorrhea, hirsutism and obesity in past years. On the other hand recent studies have shown that PCOS has an extensive, heterogen clinical view and multifactorial etiology. Hyperandrogenism and anovulation seen in PCOS are arised endocrinogically as a consequence of the anomalies of 4 compartments: over, adrenal gland, skin and fat tissue, hypothalamic-pituitary axis. However the alterations of hypothalamic-pituitary-ovarian axis, intrinsic ovary pathology, synergy of peripubertal exagere ad-renarge and physiological insulin resistance, obesity, pathologic insulin resistance and beta cell disfunction of pancreas and the role of familial aggregation indicating the genetic etiology have been definitely revealed in the etiopatho genesis of PCOS, studies are currently carried on this subject. In this review the definition of PCOS according to different criteria and the variable etiopatho genetic factors that figure in the development of this syndrome are explained. Conclusion: Assuming the etiopatho genetic factors entirely become very important for the diagnosis, trial, treatment of the disease and also for the prevention of complications

Assessment of DNA damage in postmenopausal women under osteoporosis therapy

Sardas, Semra/0000-0001-5456-8636WOS: 000240483600013PubMed: 16504368Objective: The following study was designed to examine possible DNA damage levels in peripheral blood leukocytes, using the alkaline Comet assay, isolated from postmenopausal women undergoing osteoporosis treatment. Study Design: Thirty-two postmenopausal women were randomized into two groups of 16. A dosage of 2.5 mg/day of tibolone (Livial) and 10 mg/day of alendronate sodium (Fosamax) were administered to Group 1 over a 12-month period while Group 2 took 10 mg/day of alendronate alone over the same period. The control group consisted of 16 postmenopausal women who did not receive any treatment. Genotoxicity was assessed by the standard method of alkaline Comet assay. Results: When the results of the study groups were compared with those of the control group, significant differences in terms of DNA damage levels were found (p 0.05). Conclusion: Although, no statistical difference in terms of DNA damage levels between tibolone plus alendronate as opposed to alendronate alone was found, an increase in DNA damage levels was observed in Groups 1 and 2 compared with the control group. Consequently, it can be asserted that the frequency of DNA damage in postmenopausal women with osteoporosis increases under alendronate treatment with or without tibolone. (C) 2006 Elsevier Ireland Ltd. All rights reserved

Gestational diabetes mellitus: Screen all of them?

Amaç: Gestasyonel diabetes mellitus taramasında 50 g oral glukoz testinin gerekliliğinin araştırılması. Çalışmanın Yapıldığı Yer: Kırıkkale Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalı. Materyal ve Method: Çalışmaya 425 gebe dahil edildi. Bunların 274'Une 50 g oral glukoz tarama testi (OGL), riskli olan 149'una ise 100 g oral glukoz tolerans testi (OGTT) uygulandı. Bulgular: Taranan 274 gebenin 30'unda ( % 10,9) OGL sonucu 140 mg/dl ve üzerinde bulundu. Bunlardan hiç birine uygulanan OGTT'ler ile GDM tanısı konmadı. Risk taşıyan 149 gebeye, OGTT uygulandı. Bu gebelerin 9 (%6) tanesine GDM tanısı kondu. Bizim popülasyonumuzdaGDMinsidansı% 2 olarak tespit edildi. Sonuçlar: Bu çalışma GDM için tüm gebelerin taranmasının gerekli olmadığını göstermektedir. Biz tam saha taraması yerine seçilmiş vakaların taranmasını öneriyoruz.Objective: To evaluate the necessitate of the 50-g glucose challenge test as a screening test for gestational diabetes mellitus. Institution: Department of Obstetrics and Gynecology, Kırıkkale University Faculty of Medicine. Material and Methods: Four hundred and twenty five adult pregnant women were included in the study. Two hundered and seventy four of them screened with a 1 -hour, 50 g oral glucose challenge test (GCT). Three-hour, 100 g oral glucose tolerance tests (OGTT) were performed on risk positive 149 pregnant women. Results : Of the 274 pregnancies screened, 30 (10.9%) had an initial oral GCT result of > or 140 mg/dl. Of those tested, none of them were diagnosed with GDM on the basis of greater > or 2 criteria. One hundered and fourty nine risk positive pregnant women had initially tested with OGTT . Nine (6 %) of them were diagnosed with GDM. The incidence of GDM in our population was 2%. Conclusions: . This study demonstrates that the universal screening for GDM is not necessary in all pregnant population. We recommend selective screening instead of universal screening