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The objective of this study is to assess the levels of heavy metals (cadmium, lead, antimony, mercury, and arsenic), which are also called endocrine-disrupting chemicals, and trace elements (chromium-III, chromium-VI, zinc, copper, and selenium) vs. monocyte to HDL ratio among pregnant women with gestational diabetes mellitus (GDM). A total of 112 pregnant women (60 with GDM and 52 healthy women) were included in this case-control study. Analysis of heavy metals and trace elements were performed in inductively coupled plasma mass spectrometer. Heavy metals (cadmium, lead, antimony, mercury, and arsenic), trace elements (chromium-III, chromium-VI, zinc, copper, and selenium), and metabolic parameters were assessed in both groups. It was determined that the levels of cadmium, lead, antimony, and copper were higher (p 0.05) and levels of chromium-III, zinc, and selenium were lower (p 0.05) among the GDM group compared to the control group, whereas there was a statistically insignificant difference between the two groups, regarding the levels of copper, mercury, and arsenic (p 0.05). Moreover, the monocyte to HDL ratio was higher in the GDM group (p 0.05), and the insulin resistance was significantly higher as well (p 0.05). The results of our study demonstrated that environmental factors could be effective in the etiology of GDM. Toxic heavy metals, through inducing Cu, OS, and chronic inflammation, and other trace elements, either directly by impacting insulin secretion or through weakening the body's antioxidant defense system, could play a role in the occurrence of GDM.

Intensive research has been conducted on the effects of toxic and trace elements on pregnancy. Previous studies indicated a possible relationship between placental levels of these elements and first-trimester abortion; however, their effects on the further gestational weeks are not clear. This study aimed to investigate the effect of changes in the levels of placental trace and toxic elements on second-trimester abortion.The patient group consisted of 30 women with missed abortion. The control group comprised 60 healthy term and singleton pregnant women who gave birth. Placental samples were obtained from the patients and the healthy controls, and the concentrations of placental elements were measured using inductively coupled plasma mass spectrometry.In the abortion group, placental arsenic, cadmium, mercury, lead, antimony, tin, cobalt, manganese, and selenium levels were significantly higher than those of the control group (p0.05). Antimony was determined as an independent predictor with an odds ratio of 6.1 in toxic elements (p=0.025), and selenium was determined as an independent predictor with an odds ratio of 2.3 in trace elements (p=0.015).The changes in trace element and toxic element levels, especially an increase in antimony and selenium, in placental tissue due to environmental exposure may play an important role in second-trimester abortion.Intensive research has been conducted on the effects of toxic and trace elements on pregnancy. Previous studies indicated a possible relationship between placental levels of these elements and first-trimester abortion; however, their effects on the further gestational weeks are not clear. This study aimed to investigate the effect of changes in the levels of placental trace and toxic elements on second-trimester abortion.The patient group consisted of 30 women with missed abortion. The control group comprised 60 healthy term and singleton pregnant women who gave birth. Placental samples were obtained from the patients and the healthy controls, and the concentrations of placental elements were measured using inductively coupled plasma mass spectrometry.In the abortion group, placental arsenic, cadmium, mercury, lead, antimony, tin, cobalt, manganese, and selenium levels were significantly higher than those of the control group (p0.05). Antimony was determined as an independent predictor with an odds ratio of 6.1 in toxic elements (p=0.025), and selenium was determined as an independent predictor with an odds ratio of 2.3 in trace elements (p=0.015).The changes in trace element and toxic element levels, especially an increase in antimony and selenium, in placental tissue due to environmental exposure may play an important role in second-trimester abortion.

Ovarian ischemia is a gynecological emergency case that occurs as a result of ovarian torsion. Oxidative stress plays a central role in the development of ischemia/reperfusion (IR) injuries. Lycopene (LYC) is a lipophilic, natural carotenoid well known for its antioxidant properties. This study provides information on the potential applications of lycopene. The Wistar Albino rats were distributed into six groups: Sham group (only a laparotomy was performed), Control group [laparotomy and intraperitoneal dissolvent (olive oil)], IR group, IR+olive oil group, IR+LYC 2.5 mg/kg/dose, intraperitoneal group, IR+LYC 5 mg/kg/dose intraperitoneal group. Evaluated in terms of histopathological changes, tissue malondialdehyde levels (MDA), ovarian expressions of phosphorylated nuclear factor-kappa B (p-NF-κB) and the TUNEL method was utilized to show apoptosis of ovarian tissue. There was a significant decrease in MDA, p-NF-κB values and the proportion of apoptotic cells assessed by TUNEL compared to the group that did not receive intraperitoneal LYC in rat injury with IR damage (P

Screening critical congenital heart disease in neonates with 24-48 h of age could be made by oxygen saturation determination. Perfusion index may be used as an adjunct to pulse oximetry screening to detect non-cyanotic critical congenital heart disease cases such as a left heart outflow obstruction. We evaluate the results of combined screening for oxygen saturation and peripheral perfusion index at high altitudes. The study included 501 neonates older than gestational week 35. The mean oxygen saturation was lower than at sea level, and the screening test was positive in a total of 21 (4.2%) babies. Critical congenital heart diseases were not detected in any patient. A total of 10 (2%) babies were detected with PDA, nine (1.8%) of whom recorded a positive screening test. The prevalence of PDA was significantly higher in the positive screening test group when compared with those who underwent echocardiography due to clinical findings.Conclusion: The median peripheral perfusion index at high altitude was not lower than at sea level, while the mean oxygen saturation, in contrast, was lower than at sea level. The low partial oxygen pressure found at high altitudes leads to a variation in postnatal adaptation and an increased prevalence of PDA. Accordingly, oxygen saturation screening may serve to identify babies with PDA at high altitudes. What is Known: • Oxygen saturation is known to be low at high altitudes, and thus the rates of false positivity are high when screening for critical congenital heart disease. • High altitudes are also associated with an increased prevalence of simple congenital heart disease. What is New: • The peripheral perfusion index at high altitude is not lower than at sea level. • The prevalence of PDA is significantly higher in those with false positive screening results.

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) in the PCOS group (p < 0.05). Glutamate, TNFα, IL-1β, and IL-6 values were higher whereas GABA and BDNF values were lower in pateints with moderate and severe depression (p < 0.05). There were no statistically significant relationships between these parameters and the FSFI scores (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 Ltd

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

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.

Objectives Gonadotropin-releasing hormone agonist (GnRHa) could influence the levels of sex hormones and thyroid hormones. The aim of this study was to investigate the effect of GnRHa on thyroid function. Materials and methods The data of the patients were collected from the registrations of July 2014–October 2014. A total of 41 women who underwent one-time IVF cyclus were evaluated in this cross-sectional study. The patients were categorized into two groups according to the serum T3, T4, and TSH levels before and 2 weeks’ after the administration of GnRHa. Results Mean basal TSH and mean TSH levels on hCG day were 1.98 ± 0.77 and 1.75 ± 0.70, respectively. The difference between the two groups was statistically significant (p 3 and T4 levels. Conclusions In conclusion, our results demonstrate that GnRHa led to a decrease on serum TSH level. Serum-free T3 and T4 levels were remained unchanged and this might be due to early measurement of the hormone levels (just 2 weeks later from GnRHa administration).

Amaç Preterm bebekleryenidoğan yoğun bakım ünitelerinde (YYBÜ) uzun süre takip edilirler ve bunedenle uzun süreli damar yolu ihtiyaçları olur. Uzun süreli damar yolusağlamak amacıyla umbilikal ven kateterleri, santral venöz kateterler veperiferik olarak yerleştirilmiş santral kateterler (PYSK) kullanılır. Buçalışmada PYSK uygulanan yeni doğan bebeklerin klinik özelliklerinideğerlendirmeyi amaçladık.Gereç ve YöntemlerHaziran 2016 - Haziran 2019 tarihleri arasında YYBÜ’de PYSK yerleştirilenyenidoğan bebeklerin tıbbi kayıtları retrospektif olarak incelendi. Hastalarındemografik özellikleri, PYSK yerleştirilme nedenleri, bebeklerin PYSKyerleştirme sırasındaki klinik özellikleri ve uygulama komplikasyonlarıkaydedildi.Bulgular 129 yenidoğan bebekteyerleştirilen 151 PYSK’ya ait veriler toplandı. PYSK takılan 134 (% 88,7)hastada enfeksiyon nedeniyle antibiyotik tedavisi gerekti. Sepsis bu vakaların72'sinde (% 47.6) PYSK yerleştirilmeden önce, 17'sinde (% 11.2) ise PYSK yerleştirildikten sonra tespit edildi. PYSKyerleştirilen hastalarda vücudun üst bölge damarları, alt bölge damarları vesağ taraf damarları ve sol taraf damarları arasında tıkanma, sızıntı ve / veyatromboflebit sıklığı açısından istatistiksel bir fark bulunmadı (p> 0.05).Sonuç Sonuçlarımız PYSKuygulamasının yenidoğan bebeklerde periferik damar yolu girişim sayısını önemliölçüde azalttığını, uzun süreli TPN ve antibiyotik uygulamasının mümkünolduğunu, ayrıca üst veya alt ekstremite venlerinden ve sağ veya sol taraftakivenlerden PYSK uygulanmasının komplikasyon sıklığını etkilemediğinigöstermektedir., Objective Preterm babies are followed in neonatal intensivecare units (NICU) for long times, sothey need long-term vascular access. For long-term vascular access umbilicalvein catheters, central venous catheters and peripherally inserted centralcatheters (PICC) are used. In present study we aimed to evaluate the clinicalfeatures of newborn infants in whom PICC was inserted.Materialsand Methods The medicalrecords of the newborn infants in whom PICC had been inserted from June 2016 toJune 2019 are evaluated retrospectively. Demographic features of the patients,reasons for PICC insertion, clinical features of the infants during PICCinsertion, and complications of the application are recorded.Results The data of 151 PICC that were inserted in 129newborn infants were collected. Antibiotic treatment was needed because ofinfections in 134 (88.7%) PICCs. In 72 (47.6%) of them sepsis was presentbefore PICC insertion, and in 17 (11.2%) after PICC insertion. No statistical difference was found in termsof the frequency of occlusion, leak and/or thrombophlebitis between patients inwhom PICCs were inserted via the upper body veins and lower body veins, andright veins and left veins (p>0.05).Conclusion Our results indicate thatthe PICC application significantly decreases the number of peripheral vascularaccess attempts in newborn infants, long-term total parenteral nutrition (TPN) and antibiotic administration becomes possible and insertion fromupper or lower extremity veins and right or left side veins does not affect thefrequency of complications.

The most common cause of subarachnoid hemorrhage at the period of pregnancy and during puerperium is rupture of an intracranial aneurysm. It is five times more common in pregnant women than in non-pregnant women. This pathology is more common in primiparous women and in the third trimester of pregnancy. A 37-year-old woman who was admitted to the emergency department with sudden-onset headache and loss of consciousness was diagnosed with intracranial hemorrhage due to middle cerebral artery aneurysm rupture. The patient, who gave birth with emergency cesarean delivery, underwent surgery for subarachnoid hemorrhage. The case is presented here because of its rarity.

Patent ductus arteriosus is an important problem in preterms. We aimed to investigate the relation of patent ductus arteriosus with shunt index.The preterm infants with a birth weight of ≤1500 g and/or gestational age of30 weeks and an indication for umbilical artery and venous catheterization formed the study group. Between the postnatal 24-48 hours, the first arterial and venous blood samples were obtained and the patients were evaluated by echocardiography. In patients with hemodynamically significant patent ductus arteriosus (patient group), during the first 24 hours after the competition of the first course of medical treatment, the second blood samples were obtained and echocardiography repeated. In patients without patent ductus arteriosus (control group), second blood samples were taken after the postnatal 72 hours. Also, echocardiography was performed.A total of 60 infants, (female = 29, male = 31), were included in the study. We did not find a statistically significant relation between shunt index and the presence of patent ductus arteriosus (p .05). A statistically significant positive correlation between the fraction of inspired oxygen and shunt index was found. As the postnatal ages progressed, the shunt index values tended to decrease significantly.Our results suggest that shunt index cannot be used as an indicator of hemodynamically significant patent ductus arteriosus in preterm infants. The postnatal age and fraction of inspired oxygen have a significant effect on shunt index in these patients. It was thought that the other possible factors that affect the shunt index should be investigated in preterms between certain postnatal ages.

The aim of the study was to investigate knee cartilage thickness in polycystic ovary syndrome (PCOS) patients using ultrasonography and to assess the effects of sex steroids on osteoarthritis development. A total of 90 female patients were enrolled in the study, including 47 patients diagnosed with PCOS as study group and 43 patients admitted to our hospital for any other complaints as control group. Ultrasonographic evaluation of both knees was performed in all patients. The knee cartilage thickness was measured at lateral condyle, intercondylar area and medial condyle. The measurements were averaged for each region. The mean femoral cartilage thickness was greater in the study group compared with control group in all regions, with a statistically significant difference (p, Cilj istraživanja bio je ultrazvučno procijeniti debljinu hrskavice koljena u bolesnica sa sindromom policističnih jajnika (SPCJ) i učinak spolnih hormona na razvoj osteoartritisa. U istraživanje je bilo uključeno ukupno 90 žena, tj. 47 bolesnica s dijagnozom SPCJ kao ispitna skupina i 43 bolesnice primljene na odjel zbog drugih tegoba kao kontrolna skupina. Ultrazvučna procjena obaju koljena učinjena je u svih bolesnica. Debljina hrskavice koljena mjerena je u lateralnom kondilu, interkondilarnom području i medijalnom kondilu te je izračunat prosjek mjerenja za svaku regiju. Srednja debljina koljenske hrskavice bila je veća u ispitnoj skupini u usporedbi s kontrolnom skupinom u svim regijama, a razlika je bila statistički značajna (p

Advancements in deep learning and availability of medical imaging data have led to the use of CNN-based architectures in disease diagnostic assisted systems. In spite of the abundant use of reverse transcription-polymerase chain reaction-based tests in COVID-19 diagnosis, CT images offer an applicable supplement with their high sensitivity rates. Here, we study the classification of COVID-19 pneumonia and non-COVID-19 pneumonia in chest CT scans using efficient deep learning methods to be readily implemented by any hospital. We report our deep network framework design that encompasses Convolutional Neural Networks and bidirectional Long Short Term Memory architectures. Our study achieved high specificity (COVID-19 pneumonia: 98.3%, non-COVID-19 pneumonia: 96.2% Healthy: 89.3%) and high sensitivity (COVID-19 pneumonia: 84.0%, non-COVID-19 pneumonia: 93.9% Healthy: 94.9%) in classifying COVID-19 pneumonia, non-COVID-19 pneumonia and healthy patients. Next, we provide visual explanations for the Convolutional Neural Network predictions with gradient-weighted class activation mapping (Grad-CAM). The results provided a model explainability by showing that Ground Glass Opacities, indicators of COVID-19 pneumonia disease, were captured by our convolutional neural network. Finally, we have implemented our approach in three hospitals proving its compatibility and efficiency.

We investigated the efficacy of activated cannabinoid 2 receptors for alleviating ovarian ischemia-reperfusion injury in rats. Female Wistar albino rats were divided randomly into six groups: ischemia-reperfusion (IRG); ischemia-reperfusion + 0.2 mg/kg JWH-133 (JIRG1), ischemia-reperfusion + 1 mg/kg JWH-133 (JIRG2); ischemia-reperfusion + 5 mg/kg JWH-133 (JIRG3); solvent control, and sham control. Ovarian ischemia was established for 3 h followed by reperfusion for 3 h. Ovarian tissue was investigated using histology, immunohistochemistry and biochemistry. Administration of JWH-133 synthetic cannabinoid reduced nuclear factor kappa-B immunoreactivity as well as TUNEL positivity scores and malondialdehyde levels. These reductions were significant in all cases except for the malondialdehyde levels in the 1 mg/kg JWH-133 group. Activation of cannabinoid 2 receptors by JWH-133 reduced ovarian ischemia-reperfusion injury due to its antioxidant and anti-inflammatory effects.

Objective Telomere length is used as an indicator of biological aging. It is well known that one of the most remarkable risk factors of recurrent pregnancy losses is advanced maternal age. The objective of this study was to investigate the correlation between idiopathic recurrent pregnancy loss and telomere length. Method The study group included 40 women, while the control group consisted of 41 healthy women whose age and body mass index were matched. A venous blood sample was taken from all participants into EDTA tubes in the early follicular phase, and telomere length was measured through the qPCR technique. Results When the mean TL of the groups was compared, it was determined that TL was significantly shorter among the iRPL group (7763.89±924.58 base pair) compared to the control group (8398.84±1102.95 base pair) (p Conclusion Shortened telomere length might play a role in the etiology of iRPL. We are of the opinion that patients with RPL should be screened for the presence of cardiovascular diseases and other chronic diseases, as is the case for POF.

Objective To evaluate the relationship between the maternal pulmonary function test (PFT) and the Apgar score of the newborn, umbilical cord blood (UCB) gas values and the duration of delivery. Material and Methods The present study included 41 volunteer nulliparous pregnant women who presented to our obstetrics clinic and PFTs were performed by using spirometry. Results A significant positive correlation was observed between 5th-minute Apgar scores and maternal FEV1 (forced expiratory volume in the first second) (lt), FEV1%, FVC (lt), FVC% (r=0.509, p=0.003; r=0.47, p=0.007; r=0.434, p=0.013; r=0.417, p=0.017; respectively). A significant positive correlation was observed between UCB pH value and maternal FEV1 (lt), FVC (lt) (r=0.515, p=0.003; r=0.351, p=0.049; respectively). Conclusion Our results showed that FEV1 and FVC values, which indicate maternal respiratory functions, may affect Apgar scores of the newborn and UCB gas values.

Background: This study aimed to compare the radiologic parameters of both feet in patients with unilateral accessory navicular bone (ANB) and evaluate the differences from one another. Methods: Forty-one patients with unilateral ANB volunteered to participate in this study from August 2019 to January 2020. Patient data, including age, sex, body mass index (BMI), type of ANB, and presence of symptoms were obtained. Group 1 comprised 23 patients with asymptomatic unilateral ANB, and group 2 comprised 18 patients with symptomatic unilateral ANB. Seven radiologic parameters were evaluated assessing hindfoot, midfoot, and forefoot alignment—calcaneal pitch angle, talocalcaneal angle, tibiocalcaneal angle, naviculocuboid overlap (NCO), talonavicular coverage angle (TNCA), anteroposterior talo–first metatarsal angle, and lateral talo–first metatarsal angle. Results: The mean age of patients was 40.1 years in group 1 and 42.6 years in group 2. Mean BMI was 25.2 in group 1 and 26.6 in group 2. No significant differences were noted in the radiologic parameters between the ANB and contralateral sides in all patients. The radiologic parameters of both feet in symptomatic and asymptomatic patients were not significantly different. No significant differences were noted between the affected sides of type 1 and 2 ANB and contralateral sides in terms of the radiologic parameters. BMI was significantly correlated with NCO and TNCA. Conclusion: This study demonstrated that the presence of an accessory navicular bone did not affect radiologic parameters of the foot. Radiologic parameters of both feet in symptomatic patients were not significantly different. Level of Evidence: Level III, diagnostic, comparative study.

OBJECTIVE The aim of this study was to evaluate endometrial receptivity by measuring HOXA-10, HOXA-11, and LIF gene expressions in women with polycystic ovary syndrome. METHODS A total of 48 women were included in this clinical study. Thepatients were allocated to two groups: study group consisted of 28 patients with myoma uteri and control group consisted of 20 patients without myoma uteri. Endometrial sampling was performed during the proliferative phase. The biopsies obtained from the patients with myoma uteri were taken from the place where the fibroids were localized. HOXA-10, HOXA-11, and LIF expressions were measured in the endometrial sampling material. Demographic data of the patients such as age, obstetric and gynecologic history, medical conditions, medications, surgical history, last menstrual period were recorded. Also, the number, size, localization, and type of the myoma were registered. RESULTS The mean age of the patients was 42.07 and 38.17, respectively. HOXA-11 levels in the study and control groups were 0.004 ± 0.001 and 0.010 ± 0.001, respectively ( P

OZET AMAC: Hamilelik esnasinda gecirilen asi ile onlenebilen hastaliklar sadece anne icin degil fetus icin de risklidir. Bu calismanin amaci; Turkiye’nin Yozgat ilindeki hamile kadinlarda secilmis asi ile onlenebilen hastalik etkenleri olan kizamik, kizamikcik, kabakulak, sucicegi (KKKS) ve tetanoz hastaligi antikorlarinin seroprevalansini arastirmaktir. METHOD: Kan ornekleri, hastanemiz kadin hastaliklari ve dogum poliklinigine basvuran 176 hamile kadindan alindi. KKKS virusleri ve tetanoza karsi spesifik antikor titreleri ELISA ile kantitatif olarak saptandi. Hastalik, asilama gecmisi ve demografik bilgilerinin dahil oldugu anket formu dolduruldu. SONUCLAR: Katilimcilarin yas ortalamasi 27.2±4.9 (18-45) idi. Tetanoz ,KKKS IgG seropozitifligi sirasiyla % 90.34, % 97.16, % 98.30, % 99.4, % 100 idi. Son 5 yil icerisinde tetanoz asisi olanlarda bagisiklik orani olmayanlara gore daha yuksek bulundu (93.7% ye 84.6 % , p= 0.049). Tetanoza karsi bagisik olanlarin yas ortalamasi 26.9±5, bagisik olmayanlarin yas ortalamasi 29.8±3.7 bulundu (p=0.0195). Yas ile tetanoz bagisiklik oranlari arasinda ters korelasyon tespit edildi. Yas artikca tetanoz bagisiklik oraninin azaldigi tespit edildi (p=0.002). TARTISMA: Calismamizda gebelerde yuksek oranda tetanoz ve KKKS bagisikligi bulunmustur. Ancak, hamilelik esnasinda enfeksiyonun neden oldugu riskler goz onunde bulunduruldugunda, asi ile onlenebilen hastaliklara karsi antikorlar; daha once asilanmamis ya da hastalik gecirmemis dogurganlik caginda olan kadinlarda taranmalidir ve seronegatif olanlar asilanmalidir. Anahtar kelimeler: gebelik, kizamik, kizamikcik, kabakulak, sucicegi, tetanoz, asi ile onlenebilen hastaliklar

Aim: Patent ductus arteriosus (PDA) is a frequent health problem in premature infants. Pharmacologic closure is recommended only for hemodynamically significant PDA (hsPDA) that is defined according to the clinical and echocardiographic criteria. The aim of this study was to explore the value of commonly used criteria in defining hsPDA and predicting the required number of courses of ibuprofen treatment to close PDA in premature infants. Methods: Sixty premature infants with a gestational age of ≤33 weeks were evaluated prospectively. Clinical and echocardiographic criteria [O2 requirement, ductus diameter (DD) and left atrial-to-aortic root diameter ratio (LA:Ao)] were used to define hsPDA. Clinical improvement after pharmacologic closure of PDA and association between the criteria and required number of ibuprofen courses were investigated. Results: O2 requirement decreased by PDA closure but was not different between patients with hsPDA and the others with PDA. Also, O2 requirement was not found to be associated with required number of ibuprofen courses. DD and LA:Ao were greater in patients with hsPDA. DD was found to be associated with required number of courses of ibuprofen treatment. Conclusion: Although there was an improvement in O2 requirement with PDA closure, echocardiographic criteria were found to be more valuable in defining hsPDA. DD should also be used to estimate the duration of treatment.

Objective Tonsillectomy is one of the most common surgical procedures performed at ear, nose, and throat clinics. Chronic recurrent tonsillitis, obstructive tonsillitis, and halitosis are among the most common indications for surgery. Determining whether the infection is chronic and the patient's annual number of infections are important in estimating the necessity for surgery to be performed due to infectious causes. Red blood cell distribution width (RDW) is a numerical value present in normal complete blood count that provides information about erythrocytes and their dimensions. Studies in recent years have shown that RDW increases in chronic infections, hypoxia, and oxidative stress. This study investigated the changes in RDW in patients with chronic tonsillitis and the effect tonsillectomy has on this value by comparing RDW between patients scheduled for tonsillectomy and normal population and examining preoperative and postoperative changes in RDW. Materials and Methods Sixty-three patients scheduled for tonsillectomy due to recurrent tonsillitis aged 4-14 years were included in the study. The control group consisted of 60 subjects comparable in terms of age and sex. Hemoglobin level and RDW were recorded by collecting 2 mlof blood before surgery and at 4 months postoperatively from all patients. Results Preoperative RDW was significantly higher in the patient group than in the control group. Comparison of patients' preoperative and postoperative RDW revealed a significant decrease in RDW after surgery. Conclusion As a biomarker showing chronic infection in patients with tonsillitis, RDW can provide support to the clinician in deciding on surgery. However, this has to be confirmed in further studies with greater participation.

Thrombus incidence is higher among neonates, especially in preterm infants, due to the associated additional risk factors.The medical recordings of premature infants who had been diagnosed as having intracardiac thrombus between January 2016 and January 2019 were evaluated retrospectively. We use recombinant tissue plasminogen activator when the thrombus is relatively large compared to left atrium, pedunculated, mobile, or snake shaped.A total of 13 premature patients were diagnosed as having intracardiac thrombus during the 3-year period. All were diagnosed during echocardiographic studies. Low molecular weight heparin was administered in four patients. In three, recombinant tissue plasminogen activator was started with low dose (0.01 mg/kg/h) and increased gradually to 0.06 mg/kg/h. In three, recombinant tissue plasminogen activators were started with standard dose (0.5 mg/kg/h). In one recombinant tissue, plasminogen activator was started with low dose (0.01 mg/kg/h) and increased to standard dose. Two patients died before treatment, three patients died during treatment, follow-up was not available for two patients, and thrombus completely resolved in six patients.In preterm babies with risk factors, intracardiac thrombus should be kept in mind during all echocardiographic studies. In our patients, low and standard dose regimens were used, and the treatment results were similar.

Objective: The aim of this study was to assess the awareness level of women about cervical smears, human papilloma virus (HPV), and HPV vaccine in a rural city in the central part of Anatolia. Materials and Methods: A total of 553 patients were included in the study. A 16 item questionnaire developed by our group was completed by all participants. The first part of the questionnaire collected the demographic and socioeconomic information of the participants. In the second part, it was questioned whether this information had a relationship with HPV, HPV vaccine awareness, and cervical screening tests. In the third part, the participants were asked questions related to the acceptance of an HPV vaccine for themselves and their willingness to give consent to have their children vaccinated. Results: In our study, it was found that HPV awareness significantly increased with the level of education, occupational status and total monthly family income (p

Purpose: This study aimed to investigate the feasibility and diagnostic power of unenhanced 3D turbo spin echo MR angiography sequence (a technique based on subtraction of corresponding images acquired in diastole and systole, Syngo Native Space-Siemens healthcare) to identify peripheral artery disease (PAD). Materials and methods: Thirty patients (619 arterial segments in total) suspected with PAD and who were assessed with lower extremity MDCT angiography were examined starting from the level of aortic bifurcation for both lower extremities by 3D native space MR angiography. Two readers assessed the image quality of native space MR angiography and number of lesions, their degrees of stenosis and localizations. The differences and compliance between the readers in the parameters assessed were investigated. Results: Out of 619 segments; Reader 1 considered 187 segments (30.2 %) and Reader 2 considered 177 segments (28.6 %) to have poor and inadequate MR image quality. When compared to CTA, sensitivity, specificity and diagnostic accuracy of native space MR angiography were calculated as 81.0, 83.1, 82.6 %, respectively, by Reader 1, while the same parameters were calculated as 69.9, 92.6, 84.9 %, respectively, by Reader 2. When the two readers were examined together, sensitivity, specificity, diagnostic accuracy were found to be 76.3, 88.1, 83.7 %, respectively, and the positive predictive value and negative predictive value was 70.3 and 89.9 %, respectively. A significantly better image quality was acquired with the age group below 50 years (p = 0.002). Conclusion: Native space MR angiography technique can be used as the first-step imaging technique before contrast-enhanced examinations in young and middle age patients with suspected PAD and for patients with the risk of nephrogenic systemic fibrosis in chronic renal failure. © 2016, Italian Society of Medical Radiology.

This study aimed to investigate the relationship between skinfold thickness and serum leptin, ghrelin, adiponectin, and resistin levels in infants of diabetic mothers. Biochemical parameters were also similar for the two groups (infants of diabetic mothers and controls) (p > 0.05). We confirmed that there was a negative correlation between birth weight and serum ghrelin level (p < 0.05) in the two groups. When it was evaluated for control newborns, a positive correlation between abdominal circumference and serum resistin level was found in the controls (p < 0.05). Our results indicate that gestational diabetes by appropriate diet or insulin treatment may be effective in the protection of fetuses of diabetic mothers from the negative effects of gestational diabetes. Ghrelin alone was negatively correlated with birth weight. This negative correlation could be potentially advantageous to infants, because a reduction in appetite might prevent excessive food intake and postnatal weight gain.

Objective Our aim was to determine how Ramadan fasting effects serum Human NAD-dependent deacetylase sirtuin 1 (SIRT1/SIR2L1) and visfatin levels during pregnancy. Materials and methods Thirty-six patients were included in this case-control study. The patient group consisted of 18 pregnant women who were Ramadan fasting. Another healthy 18 pregnant women with matching pregnancy weeks and ages formed the control group. Blood samples were obtained from the patients for biochemical analyses and serum adipokine level measurements. Results The mean sirtuin and visfatin levels in fasting pregnant women were 2.87 ± 0.95 and 60.18 ± 19.49 ng/mL, respectively, while the mean serum sirtuin and visfatin levels in the control group was determined to be 4.28 ± 1.45 and 23.26 ± 6.18 ng/mL, respectively. A statistically significant difference was determined between the groups (p = 0.002, p = 0.0001). A correlation analysis provided a negative correlation between number of fasting days and sirtuin levels (r = 0.45, p = 0.005) and a positive correlation with visfatin levels (r = 0.73, p = 0.0001). Conclusion As a result, while the serum sirtuin 1 level of pregnant women decreased due to fasting in Ramadan, we determined that their visfatin levels increased and this increase was in correlation with the days of fasting.

We aimed to evaluate vitamin D, apelin-36, and visfatin levels in patients with polycystic ovary syndrome (PCOS).The study was completed in six months, including a total of 110 patients who were admitted to the obstetrics and gynecology polyclinic. Patients with a diagnosis of PCOS were divided into two subgroups according to their vitamin D levels. Thirty-four patients had 10 ng/ml of vitamin D deficiency and 21 patients had 10-30 ng/ml of vitamin D insufficiency, with each being defined as a subgroup.Average apelin-36 and visfatin levels in PCOS patients were 2.52 ± 0.68 nmol/L and 72.63 ± 22:31 ng/ml, in the control group they were 0.92 ± 0.33 nmol/L, 24.66 ± 6 ng/ml, respectively. The difference found in PCOS patients was statistically significant (p = 0.0001, p = 0.0001).In conclusion, the present study shows that in PCOS patients with low levels of vitamin D, insulin resistance is greater and apelin-36 serum levels were significantly higher. Although there are different opinions in the literature on this subject, we believe that when vitamin D levels are brought to an optimal level in PCOS patient, it can prevent the negative effects of adipokines in the pathogenesis of PCOS.

Although the in vitro fertilization-intra-cytoplasmic sperm injection (IVF-ICSI) has been utilized widely, the management in patients with an autoimmune disease is still a challenge. The aim of this study was to demonstrate IVF-ICSI outcomes in infertile women with familial Mediterranean fever (FMF). Patient data were collected from the cases registered from January 2006 until January 2014. A total of 6152 assisted reproductive technology (ART) cycles were analyzed retrospectively in the Ankara Zekai Tahir Burak Women’s Health Education and Research Hospital. Ten infertile women with FMF were included in the study. Baseline clinical and laboratory characteristics were collected and perinatal outcomes evaluated. T e mean age (years), duration of infertility (years) and body mass index (kg/m2) were 29.9±5.3, 5.7±5.3 and 27.9±5.7, respectively. The mean baseline follicle-stimulating hormone (FSH; IU/L), estradiol (E2; pg/mL) and antral follicle count were 7.0±2.4, 48.1±15.8 and 7.9±2.9, respectively. The distribution of ovarian response was heterogeneous. Fourteen cycles in ten patients were evaluated. Embryo transfer could be achieved in only ten cycles. Three out of ten patients became pregnant. No adverse perinatal outcome was observed. Our findings indicate that FMF might have no impact on ART cycles.

WOS: 000456953700011, PubMed ID: 30555969, Purpose: The aim of this study was to investigate the aerobic conjunctival flora of neonates and the effects of delivery type on conjunctival flora development in neonates who were born with normal spontaneous vaginal delivery (SVD) or elective caesarean section (C/S) and who were not given prophylactic antibiotic eye drops after birth. Methods: This cross-sectional study included 95 healthy newborns. One day after the delivery, conjunctival samples were taken from newborns who were born with normal SVD or elective C/S, and not given prophylactic antibiotic eye drops after birth. Newborns with conjunctival hyperemia and discharge were excluded from study. Samples were plated in blood agar, EMB, and chocolate agar. These cultures were incubated at 37 degrees C for 24-48 h. Antibiotic sensitivity was evaluated using Kirby-Bauer disc diffusion method. Results: Staphylococcus aureus (S.aureus) growth was observed in 7 (70%) and coagulase negative staphylococcus (CNS) growth in 2 (20%) out of 10 eyes with bacterial growth in 9 culture positive newborns born with C/S. Two S. aureus strains were resistant to methicillin. On the other hand, CNS growth was observed in the conjunctival cultures of 17 out of 19 eyes with bacterial growth in 16 culture positive newborns born with SVD. In 2 eyes with CNS growth, there was also S. aureus growth. The positive cultures for S. aureus were significantly higher in the conjunctival cultures of neonates born with C/S compared to neonates born with SVD, where CNS growth was significantly lower (P = 0.002). All isolates were susceptible to vancomycin, teicoplanin, and gatifloxacin. Two isolates were resistant to methicillin. Conclusions: In deliveries with C/S, the newborn does not contact the vagina. This may result in changes of bacterial characteristic of the flora. Culture positivity for S. aureus was higher in C/S compared to SVD, which may be important in case neonatal conjunctivitis develops. Copyright (C) 2018, Iranian Society of Ophthalmology. Production and hosting by Elsevier B.V.

WOS: 000393204400005, PubMed: 27503115, Purpose: To compare unenhanced three-dimensional (3D) NATIVE (R) true fast imaging with steady-state precession (TrueFISP) magnetic resonance (MR) angiography with the more conventional MR angiography technique obtained after intravenous administration of a gadolinium chelate in the evaluation of renal arteries and their branches in patients with suspected renal artery stenosis. Materials and methods: A total of 39 patients (25 men, 14 women) with a mean age of 51.4 +/- 17.5 years (SD) (range: 10-82 years) were included in the study. All patients with suspected renal artery stenosis underwent unenhanced 3D NATIVE (R) TrueFISP MR angiography and contrast- enhanced MR angiography. The two MR angiography methods were compared by two independent readers for image quality using a four-point scale, diagnostic performance and grading of renal artery stenosis on a total of 78 renal arteries. Results: For both readers image quality of unenhanced 3D NATIVE (R) TrueFISP MR angiography(3.12 to 3.63) was greater than that of contrast-enhanced MR angiography (1.94 to 2.71) for renal artery ostium-trunk and the left renal artery segmental branches. The sensitivity of 3D NATIVE (R) TrueFISP MR angiography for the diagnosis of renal artery stenosis was 100% for both readers for the right renal artery and 66% and 80% for the left renal artery for reader 1 and reader 2, respectively. Agreement between 3D NATIVE (R) TrueFISP MR angiography and CE-MR angiography was 95% (74/78) for reader 1 and 92% (72/78) for reader 2. Conclusion: Unenhanced NATIVE (R) TrueFISP magnetic resonance angiography can play an additional role in the evaluation of renal arteries in patients with hypertension, especially in subjects at risk of nephrogenic systemic fibrosis. (C) 2016 Editions francaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

We demonstrated the IVF-ICSI results, perinatal outcomes and cost-effectivity of the patients with advanced age at a tertiary centre. A total of 456 patients categorised into two groups according to age: group 1 (n = 158) (≥39years) and group 2 (n = 298) (

To evaluate image quality of carotid computed tomography angiography (CTA) using a low voltage (80kV) and low amount of iodinated contrast material.A total of 101 patients referred for carotid CTA were randomly assigned to receive a specific protocol. In group A patients received intravenous administration of contrast material at a dose of 1mL/kg and CTA examinations were performed at 100kV. In group B, patients received intravenous administration of contrast material at a dose of 0.5mL/kg and CTA examinations were performed at 80kV. The same nonionic iodinated contrast material containing 370mg of iodine per mL was used in both groups. Attenuation values were measured from the center of specific arterial segments using regions of interest. Attenuation values above 300HU were accepted as significant. Institutional review board approval was obtained.A total of 50 patients were included in group A (38 men, 12 women; mean age, 63.56 years±13.18 [SD]) and 51 patients in group B (33 men, 18 women; mean age, 59.60 years±16.63 [SD]). A total of 1615 arterial segments (1515 common carotid artery-middle cerebral artery and 101 aortic arches) were analyzed. Venous contamination was not observed in either group. The mean attenuation values of all arterial segments in both groups were greater than 300HU. Mean arterial attenuation value in group B (499.22HU±97.25 [SD]) was significantly greater than in group A (374.36HU±73.79 [SD]) (P0.01). Hemodynamically significant stenosis (grade III stenosis or70%) was detected in 2 segments in group A and in 3 segments in group B, while grade IV stenosis (occlusion) was detected in 2 segments in group B. Distal common carotid artery dissection was detected in 1 patient and aortic dissection was detected in 1 patient in group B. Total dose-length product (DLP) value was significantly greater in group A (225.74mGy·cm±21.80 [SD]) than in group B (116.60mGy·cm±21.22 [SD]) (P0.01). The mean tube current was similar in group A (2013.11mAs±195.92 [SD]) and in group B (2096.64 mAs±309.03 [SD]) (P0.05).Carotid and cerebral CTA examinations using 128-section CT can be successfully obtained using an imaging protocol that combines low voltage and 50% reduction in the volume of iodinated contrast material. This provides good image quality with low radiation dose.

Purpose The purpose of this study was to evaluate the variations in popliteal artery branching in a large population on computed tomography angiography (CTA) using a 128-section configuration. Materials and methods A total of 652 patients (532 men, 120 women) with a mean age of 61.7 ± 18.1 (SD) years (range: 11–93 years) who had CTA of the lower limbs with a total of 1261 lower limbs (bilateral limbs in 609 patients, unilateral limb in 43 patients) were retrospectively included. CTA images were reviewed for popliteal artery branching and possible variations. Results The usual pattern of popliteal artery branching was observed in 1118 limbs (88.7%) (type IA) whereas branching variations without the usual pattern were found in 143 limbs (11.3%). Forty limbs (3.2%) were categorized as type I with non-classical patterns. Forty limbs (3.2%) showed type II high-level bifurcation and 63 limbs (4.9%) showed type III aplasia or hypoplasia. The type IIC pattern was not observed. Importantly, one single case considered as hypoplasia of the peroneal artery and another case identified with a long tibioperoneal artery were categorized into new subgroups. Conclusions Recognizing and evaluating variations in popliteal artery branches is important in terms of vascular surgery approaches and interventional vascular procedures. CTA is an effective screening method to show the vascular frame of lower extremities and variations of popliteal artery. Our study allowed identifying two new branching patterns of the popliteal artery not previously described in the literature.

Summary Background Eagle syndrome is a condition caused by an elongated styloid process. Unilateral face, neck and ear pain, stinging pain, foreign body sensation and dysphagia can be observed with this syndrome. Rarely, the elongated styloid process may cause pain by compressing the cervical segment of the internal carotid and the surrounding sympathetic plexus, and that pain spreading along the artery can cause neurological symptoms such as vertigo and syncope. Case Report In this case report we presented a very rare eagle syndrome with neurological symptoms that occurred suddenly with cervical rotation. The symptoms disappeared as suddenly as they occurred, with the release of pressure in neutral position. We also discussed CT angiographic findings of this case. Conclusions Radiological diagnosis of the Eagle syndrome that is manifested with a wide variety of symptoms and causes diagnostic difficulties when it is not considered in the differential diagnosis is easy in patients with specific findings. CT angiography is a fast and effective examination in terms of showing compression in patients with the Eagle syndrome that is considered to be atypical and causes vascular compression.

Newborns are more susceptible to infection; this makes proper wound care extremely important in them. Unfortunately, in spite of successful surgery, patients can die as a result of wound area infections. Herein, we report a case in which a combined therapy of chlorhexidine (a disinfectant) and saline (a cleansing agent used in wound care) was used effectively to treat the wound in a newborn infant with an antibiotic‐resistant, Gram‐negative, bacteria‐related surgical site infection.

Introduction To investigate the effectiveness of manual detorsion (MD) and applicability of extra-scrotal fixation for testicular torsion in a rabbit model. Material and methods Twelve New Zealand male rabbits were randomized into six groups of two rabbits each. A single-side testicular torsion (TT) model (different degrees, time and sides) was performed in all groups except the Sham group. The groups included: Group 1 (180°; 4 h), Group 2 (720°; 6 h), Group 3 (1080°; 9 h), Group 4 (540°; 1 h), Group 5 (900°; 2 h), and Group 6 (sham-only). Testes were examined by another urologist and radiologist with Color Doppler Ultrasonography (CDU). MD was performed with CDU until blood flow was observed in the affected testis. Extra-scrotal fixation was then conducted in these animals. The testes were then harvested for blinded histopathological examinations. Results TT was detected in all animals except the control group. The CDU examination detected decreased blood flow only in Group 1. An opposite rate was observed between the spermatic cord diameter and torsion degree. A wrong direction of MD in the first step was observed in two rabbits in Groups 4 and 5. Torsion signs were observed only in Group 3. Rest torsion was observed in Groups 3 and 5 after extra-scrotal fixation. Histopathological examinations showed that testicular damage increased in parallel to torsion duration. Conclusions Extra-scrotal fixation after MD along with CDU may be a simple and minimally invasive treatment option in TT therapy. However, this must be verified with further studies.

The aim of this study was to evaluate the relationship between serum sirtuin-1 (SIRT1) level and neutrophil-lymphocyte ratio (NLR) with hyperemesis gravidarum (HG).Overall, 90 patients who presented with pregnancy between August 2013 and November 2014 were included in the study. The patients were divided into two groups: patients with HG (n=45) and patients without HG (control group [C]; n=45). The patients with comorbid conditions other than pregnancy (disease or medication) were excluded. In all patients, demographic data including age, body mass index (BMI), gestational week, and smoking status were recorded. Blood samples were drawn for complete blood count and measurements of blood lipid, liver enzymes, serum SIRT1, and insulin levels. NLR was calculated from CBC.No significant differences were detected in age, BMI, or GA between groups (P>0.05). Serum SIRT1 and NLR were found to be significantly higher in patients with HG compared with those in the control group (P=0.001 and 0.006, respectively).In HG, both SIRT1 level and NLR increased. In HG, this occurred as a response to metabolic alterations and potential inflammation.