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Objectives: To evaluate the perinatal outcomes of antenatally diagnosed omphalocele cases. Material and methods: This was a retrospective study conducted between July 2014 and February 2020 at the prenatal diagnosis center of a university clinic. Gestational week of diagnosis, associated anomalies, karyotype analysis results, complications during pregnancy, termination/delivery characteristics, and postnatal results were evaluated. Results: The analysis was performed on 58 patients. The median diagnosis time was 14.5 weeks of gestation. Thirty-three cases (57%) were defined in the first trimester. 33 (57%) of 58 patients had one or more concomitant anomalies, while 25 patients (43%) had isolated omphalocele. The most common associated anomaly was a cardiac anomaly which was observed in 17 fetuses (30% of all omphalocele cases). Karyotype analysis was performed in forty-five patients (41 in the prenatal period, 4 in the postnatal period). A normal karyotype was detected in 27 cases (60%). Trisomy 18 was the most common chromosomal anomaly (n = 15, 33.3%). Thirty of 58 patients (52%) requested termination of pregnancy (TOP) in the early pregnancy period. Thirteen of the cases died in-utero (22%). Fifteen pregnancies resulted in live births (26%), of those eight were lost in the first year of life (six of them had additional anomalies, while two of them had isolated omphalocele but the omphalocele pouch was containing the liver in those two babies). Conclusions: Most of the cases with an omphalocele can be diagnosed in the first trimester. Cardiac anomalies were the most common associated anomalies, while trisomy 18 is the most common chromosomal anomaly. Thus, earlier and effective counseling can be made about the prognosis of pregnancy.

OBJECTIVE To evaluate perinatal survival rates and predictors in severely anemic fetuses that underwent intrauterine transfusion (IUT). METHOD This was a retrospective study of both Turkish and Syrian patients who underwent IUT for fetal anemia due to Rh alloimmunization between 2015 and 2019. The association between pretransfusion factors and perinatal survival was evaluated by multivariate logistic regression. Receiver operating characteristics (ROC) curves were used to identify the level of fetal hemoglobin deficits that predict perinatal survival. RESULTS Eighty-seven IUTs were performed in 42 pregnancies. Approximately 75% of fetuses were severely anemic and the overall perinatal survival rate was 50%. The survival rate was better in Syrian refugees compared to Turkish patients (71.4% vs. 39.3%, p

OBJECTIVE To characterize stillbirths associated with pregestational diabetes and gestational diabetes mellitus (GDM) in a large, prospective, U.S. case-control study. METHODS A secondary analysis of stillbirths among patients enrolled in a prospective; multisite; geographically, racially, and ethnically diverse case-control study in the United States was performed. Singleton gestations with complete information regarding diabetes status and with a complete postmortem evaluation were included. A standard evaluation protocol for stillbirth cases included postmortem evaluation, placental pathology, clinical testing as performed at the discretion of the health care professional, and a recommended panel of tests. A potential cause of death was assigned to stillbirth cases using a standardized classification tool. Demographic and delivery characteristics among women with pregestational diabetes and GDM were compared with characteristics of women with no diabetes in pairwise comparisons using χ or two-sample t tests as appropriate. Sensitivity analysis was performed excluding pregnancies with genetic conditions or major fetal malformations. RESULTS Of 455 stillbirth cases included in the primary analysis, women with stillbirth and diabetes were more likely to be older than 35 years and have a higher body mass index. They were also more likely to have a gestational hypertensive disorder than women without diabetes (28% vs 9.1%; P

Objective To evaluate sacrococcygeal teratoma (SCT) cases according to associated cardiac, extracardiac, and chromosomal anomalies in the prenatal period, and to review their outcomes. Materials and methods Data of pregnancies with a prenatal diagnosis of SCT between 2009 and 2019 were retrospectively reviewed. Results One ongoing pregnancy was excluded. There were five medically terminated cases, three due to severe heart failure and the remaining two due to additional congenital defects. Two infants who had heart failure due to hyperdynamic flow died in the neonatal period. Nine infants are well and alive at the time of writing. Conclusion When a lesion is detected in the sacrococcygeal region during fetal sonography, the differential diagnosis should be made with an appropriate evaluation with emphasis on a possible diagnosis of fetal SCT. Tumor growth and heart failure should be monitored with serial scans when SCT has been diagnosed prenatally.

Purpose: The aim of this study was to investigate the mRNA expression level of p16, CDK4, CDK6, Cyclin D, RB1, and E2F genes in preterm premature rupture of membrane (PPROM) cases and their roles in etiopathogenesis of PPROM. Materials and Methods: Twenty-one pregnancies with PPROM before 34th gestational weeks (study group) were compared with twenty pregnancies with no complication, who gave birth after 37th gestational-week (control group). Both groups chorioamniotic membranes were compared for mRNA expression of p16, cyclin D, CDK4, CDK6, RB1 and E2F genes.Results: The mRNA expression levels of p16, cyclin D, CDK4, CDK6, RB1and E2F genes decreased in the PPROM group compared to control group at a statistically significant level.Conclusion: Our findings have shown that oxidative stress may not act on the p16 pathway in these cases. In order to understand the molecular mechanism of PPROM, biomarkers of oxidative stress and aging should be evaluated together with other pathways related to aging and oxidative stress in future studies., Amaç: Bu çalışmanın amacı, preterm erken membran rüptürü (PEMR) vakalarında, p16 ile CDK4, CDK6, siklin D, RB1, E2F genlerinin mRNA ekspresyon seviyelerini ve bu genlerin etiyopatogenezdeki rollerini saptamaktır.Gereç ve Yöntem: Çalışmamızda 34. gebelik haftasından önce membran rüptürü olan 21 gebe (çalışma grubu) ile herhangi bir durumla komplike olmamış ve 37. gebelik haftasından sonra doğum yapmış 20 gebenin (kontrol) doğum sonu koryoamniyotik membranları incelendi ve bu iki grubun koryoamniyotik membran örnekleri p16, siklin D, CDK4, CDK6, RB1 ve E2F genlerinin mRNA ekspresyon seviyeleri açısından karşılaştırıldı.Bulgular: Çalışmamızda, kontrol grubu ile kıyaslandığında p16, siklin D, CDK4, CDK6, RB1 ve E2F genlerinin ekspresyon seviyelerinin PEMR grubunda anlamlı derecede azaldığı saptandı.Sonuç: Bulgularımız bu vakalarda oksidatif stresin p16 yolağı üzerinden etki etmeyebileceğini göstermiştir. PEMR’nin moleküler mekanizmasını anlamak için, gelecekteki çalışmalarda oksidatif stres ve yaşlanma biyobelirteçleri ile yaşlanma ve oksidatif streste görevli diğer yolaklar birlikte değerlendirilmelidir.

OBJECTIVE This study aimed to evaluate the "off-hour effect" on maternal and neonatal adverse events in a large cohort representing U.S. POPULATION STUDY DESIGN A secondary analysis of the Consortium on Safe Labor (CSL) dataset with 208,695 women and 229,385 deliveries was performed. The study included the deliveries of ≥23 gestational weeks from 19 hospitals in the United States from 2002 to 2008. Babies with congenital anomalies were excluded from neonatal outcomes. We compared maternal and neonatal outcomes of patients delivered during weekdays versus off hours (nights and weekends). The primary outcomes of the study were composite maternal and composite neonatal adverse events. The secondary outcomes were delivery type and individual maternal and neonatal adverse events including maternal death and perinatal mortality rate. Associations between off hours and all the outcomes were analyzed in bivariable and multivariable analyses. The same analyses were performed in strata by indication for admission (spontaneous labor or induction of labor). RESULTS Composite maternal adverse events (6.19 vs. 6.06%, p = 0.41) and maternal death (0.01 vs. 0.01%, p = 0.19) were not significantly different between off hours and weekday groups. In contrast, composite neonatal adverse events (6.91 vs. 5.84%, p

Purpose: The aim of this study was to evaluate the relationship between patient temperament and preference for invasive prenatal tests.Materials and Methods: This was a prospective study of 337 pregnant women who had increased risk of having a fetus with Down syndrome. Their temperament profile was determined by using the temperament evaluation of TEMPS-A. Women were grouped as accepting (study) or declining (control) to perform an invasive test. Results: 284 pregnancies were included in the final analyzes. The study group had more likely employed and had a higher level of education level. There was no predominant temperament in 247 (87%) women. Hyperthymic temperament had the highest scores (11.2 ± 4.1) among other four temperament types. Study group patients had lower scores for anxious and depressive temperaments compared with control groups. Conclusion: Women who had a less anxious or depressive personality were more likely to prefer an invasive prenatal test. In addition, employment and higher educational status were correlated with undergoing invasive prenatal testing., Amaç: Bu çalışmanın amacı gebelerin mizaç özellikleri ile invaziv testi tercih etmeleri arasındaki ilişkinin değerlendirilmesi. amaçlanmıştır. Gereç ve Yöntem: Mevcut çalışma fetüste Down sendromu açısından artmış riske sahip 337 gebeliğin prospektif değerlendirilmesini içermektedir. Hastaların mizaç özellikleri TEMPS-A skalası aracılığıyla belirlenmeye çalışılmıştır. Gebeler invaziv test yapılmasını kabul edenler (çalışma) ve etmeyenler (kontrol) şeklinde iki gruba ayrılmıştır. Bulgular: Nihai analizler 284 gebe üzerinden yapılmıştır. Çalışma grubundaki hastalarda düzenli bir işte çalışma oranı ve eğitim seviyesi kontrol grubuna göre daha yüksek bulunmuştur. Hastaların 247'sinde (%87) baskın bir mizaç saptanmadı. Bununla birlikte en yüksek skor hipertimik mizaca (11.2 ± 4.1) ait olarak bulundu. Çalışma grubundaki hastalar daha düşük anksiyetik (ve depresif (mizaç skorlarına sahiplerdi. Sonuç: Daha düşük anksiyöz ya da depresif mizaç özelliklerine sahip hastalar invaziv tanı testlerini daha yüksek oranda tercih etmektedirler. Buna ek olarak düzenli bir işte çalışma ve daha yüksek eğitim durumu da invaziv prenatal testi yaptırmayla ilişkilidir.

OBJECTIVE To evaluate the association between maternal fructosamine levels at the time of delivery and stillbirth. DESIGN Secondary analysis of a case-control study. SETTING Multicentre study of five geographic catchment areas in the USA. POPULATION All singleton stillbirths with known diabetes status and fructosamine measurement, and representative live birth controls. MAIN OUTCOME MEASURES Fructosamine levels in stillbirths and live births among groups were adjusted for potential confounding factors, including diabetes. Optimal thresholds of fructosamine to discriminate stillbirth and live birth. RESULTS A total of 529 women with a stillbirth and 1499 women with a live birth were included in the analysis. Mean fructosamine levels were significantly higher in women with a stillbirth than in women with a live birth after adjustment (177 ± 3.05 versus 165 ± 2.89 μmol/L, P

Amac: Bu calismamin amaci kadinlarin depresyon ve anksiyete skorlariyla en fazla iliskili faktorlerin ortaya konmasi ve aciklanamayan infertiliteye sahip primer ve sekonder infertil kadinlar arasindaki olasi farklarin bulunmasidir. Gerec ve Yontem: Bu calisma 166 primer ve 60 sekonder infertil kadini iceren kontrollu prospektif bir calismadir. Bunlar hormonal ya da uterin patholojisi olmayip aciklanamayan infertilite grubundaydi. Hastalar Beck depresyon envanteri ve Hamilton anksiyete skorlamasini iceren bir anket formunu doldurdular. Bulgular: Iki grup arasinda anksiyete ve depresyon skorlari arasinda fark bulunamadi. Alt grup analizileri arasinda da sadece siddetli depresyon sekonder infertil grupta anlamli derecede daha yuksekti (11/60 ile 10/166,). Hastalarin yasi ile anksiyete skorlari ve tedavi deneme sayisi ile depresyon skorlari arasinda korelasyon oldugu goruldu. Sonuc: Infertilite tedavisinin kadin sagligi uzerine fiziksel yan etkileri oldugu kadar onlara psikolojik bir yuk de getirmektedir.Belli kulturlerde cocuk sahibi olmak oldukca onemli olsa da yine de infertilite tedavisine baslamis ve daha fazla cocuk isteyen sekonder infertillerde stresi azaltmayabilmektedir. Primer ya da sekonder infertil olmasina bakilmaksizin infertilite tedavisine baslayacak hastalarin desteklenmesi onlarin mizacini olumlu yonde etkilyecegi gibi tedavi basarisini arttirmasi bakimindan da onemlidir.

WOS: 000462504300004 PubMed ID: 31019836 Objective: To evaluate persistent left superior vena cava (PLSVC) cases according to associated cardiac, extracardiac, and chromosomal anomalies in the prenatal period and to review their outcomes. Materials and Methods: The data of patients with a prenatal diagnosis of PLSVC between January 2013 and December 2017 were reviewed retrospectively. Results: Data of 32 cases were reviewed. Nineteen (60%) cases were associated with cardiac defects, 5 (15%) were associated with both cardiac and extracardiac defects, and 8 (25%) had no associated anomalies. Two fetuses had karyotype anomalies. All patients with isolated PLSVC survived. Among the cases associated with extracardiac anomalies, cardiac anomalies, and with both extracardiac and cardiac anomalies, the survival rate was 40%, 40%, and 25%, respectively. Outcome was more favorable in cases with isolated PLSVC (100% vs. 40%). Conclusion: Prenatally diagnosed PLSVC is associated with cardiac and extracardiac anomalies in the majority of cases. The prognosis is good in isolated cases, but worsens when accompanied by cardiac or extracardiac anomalies.

Objectives: We hoped to reveal the frequency of Aberrant Right Subclavian Artery (ARSA) and to find the relationship of isolated/non-isolated ARSA with chromosomal defects and other fetal congenital heart diseases (FCHD) in a heterogeneous population. Material and methods: This was a retrospective cohort study conducted between December 2015 to September 2018. Women admitted for routine ultrasound examination or referred to our hospital for a suspected fetal anomaly were underwent detailed fetal anomaly ultrasonography scan and tested for the presence of ARSA. Results: ARSA was detected in 27 patients and an isolated finding in 13 (48%) cases. Among 13 cases with isolated ARSA, trisomy 21 was diagnosed in 1 case. In the non-isolated group (n: 14, 52%), five cases presented with trisomy 21. There was no significant difference of trisomy 21 frequency between isolated and non-isolated groups (7.6% vs 35.7%, p = 0.08). In 3 patients, FCHD was diagnosed and 2 of them had trisomy 21. Conclusions: Our study shows that ARSA can be the only marker in trisomy 21. The examination of the subclavian artery must be a part of the fetal anomaly ultrasonography. Detecting an ARSA should increase the attentiveness of the sonographer to investigate for the other markers of trisomy 21. In the existence of other findings, invasive diagnostic procedures should be offered to the patients, whereas in cases that arsa is the only finding, other risk factors should be investigated to offer karyotyping or cell-free DNA analysis.

OBJECTIVE: Our aim is to elucidate the relationship between mediolateral episiotomy (MLE) angle and postpartum perineal pain. METHODS: This study was designed prospectively. Primiparous women with MLE in the postpartum period were included in the study and divided into three groups according to episiotomy angle ranges (Group 1: 60 degrees). Postpartum perineal pain was quantified with the short-form McGill Pain questionnaire (SF-MPQ) consisting of the following three parts: Sensory-affective-verbal descriptions, visual pain scale (VPS), and present pain intensity scale (PPI). Postpartum perineal pain scores on days 1 and 7 were compared among the angle group. RESULTS: Overall, 86 eligible women were enrolled in this study. Seventy-three women (85%) scored the perineal pain between 0 and 3 on the VPS and 13 women (15%) rated the pain from 4 to 6 on the 1st postpartum day. No significant differences were noted among the three groups regarding the total pain scores on SF-MPQ and on the each part of form at the 1st postpartum day. At 7 days postpartum, total pain score was found significantly high in Group 1 [Med; IQR (min-max)=0; 4 (0-5)] compared with Group 2 [Med; IQR (min-max)=0; 0(0-5)]. The pain scores obtained from the sensory, affective, VPS, and PPI parts of the questionnaire were [Med; IQR (min-max)=0; 1 (0-2)], [Med; IQR (min-max)=0; 1 (0-1)], [Med; IQR (min-max)=0; 2 (0-2)], and [Med; IQR (min-max)=0; 0.25 (0-1)], respectively, in Group 1. For Group 2, pain scores obtained from the sensory, affective, and PPI were [Med; IQR (min-max)=0; 0(0-1)]; and VPS was [Med; IQR (min-max)=0; 0(0-2)]. No significant differences were observed between Groups 1 and 2 for each part of the questionnaire on day 7. Percentage of need for analgesics on day 7 was found significantly higher in Group 1 (42.9%) than Group 2 (31.2%) CONCLUSION: MLE at an angle

Antiphospholipid syndrome (APS) is a rare condition clinically characterized by thrombotic events or pregnancy complications and confirmed by one or more repeatedly positive antiphospholipid antibodies on two or more occasions at least 12 weeks apart. Several factors are thought to have roles in the pathogenesis of adverse obstetric events related to APS, including platelet and endothelial cell activation, complement activation, and ultimate activation of the thrombotic pathway. Despite standard treatment with a heparin agent and low-dose aspirin, 30% of women with definite APS cannot achieve a successful pregnancy outcome. Additional treatment options are still controversial, and prospective trials with appropriate controls are needed to investigate the efficiency of alternative treatments. In this chapter, we discuss diagnostic, clinical, and therapeutic approaches in the treatment of APS syndrome in pregnancy.

Purpose: The aim of the study is examine the effect of oral contraceptives on the serum levels of adhesion molecules and identify if the synthetic oestrogens provide protection against atherosclerosis.Materials and Methods: The interleukin 6 (IL-6), Tumor necrosis factor alfa (TNF Alfa), Vascular cell adhesion molecule 1 (VCAM-1), Intercellular Adhesion Molecule (ICAM-1), E selectin, P selectin, C selectin, C Reactive Protein (CRP) levels and erythrocyte sedimentation rate (ESH) of patients between 18-45, without additional illness, using oral contraceptives for contraception at least for three years were compared to healthy volunteers, aged between 18-45, having regular menstruation and without any additional diseases.Results: There has been no meaningful difference between the VCAM-1, ICAM-1, E selectin, P selectin, TNF alfa, IL 6, ESH levels of the two groups. Serum CRP levels are meaningfully higher in the group using oral contraceptives.Conclusion: Oral contraceptives change the serum levels of adhesion molecules. The change in the serum CRP levels might be due to the liver first pass effect., Amaç: Bu çalışmanın amacı, oral kontraseptiflerin adezyon moleküllerinin serum seviyelerine olan etkisini araştırarak, sentetik östrojenlerin ateroskleroza karşı koruyucu etkisi olup olmadığı saptamaktır.Gereç ve Yöntem: Ek hastalığı bulunmayan, kontrasepsiyon amaçlı en az 3 aydır oral kontraseptif kullanan, 18-45 yaş aralığında olan hastaların serum interlökin 6 (İL-6), tümör nekrozis faktör alfa (TNF alfa), damarsal hücre yapışma molekülü 1 (VCAM-1), hücreler arası adezyon molekülü (ICAM-1), E selektin, P selektin, c reaktif protein (CRP) seviyeleri ve eritrosit sedimentasyon hızları (ESH); ek hastalığı bulunmayan, düzenli adet gören, 18-45 yaş aralığında olan sağlıklı gönüllülerle karşılaştırıldı.Bulgular: Her iki grubun VCAM-1, ICAM-1, E selektin, P selektin, TNF alfa, İL 6, ESH seviyeleri arasında anlamlı fark saptanmadı. Oral kontraseptif kullanan grupta serum CRP seviyeleri anlamlı olarak daha yüksek saptandı.Sonuç: Oral kontraseptiflerin adezyon moleküllerinin serum seviyelerini değiştirdiği gösterilemiştir. Serum crp seviyelerinin değişimleri ise karaciğer ilk geçiş etkisine bağlanmaktadır.

Objective Because of the ongoing and recurring inflammatory state in familial Mediterranean fever (FMF), patients may experience a high risk of cardiovascular events. Our aim was to investigate the arterial stiffness and associated factors in patients with FMF. Methods Sixty-nine consecutive FMF patients (including 11 females) and 35 controls (including 5 females) were enrolled in the study. The demographical, clinical, and laboratory data and genetic mutations of the patients were recorded. In the study, FMF patients according to the Tel-Hashomer criteria were included, whereas patients with other known inflammatory rheumatologic disease, atherosclerotic cardiovascular disease, hypertension, diabetes, those under the age of 18 years, or those refusing to participate in the study were excluded. Arterial stiffness measurements were performed using the TensioMed device (TensoMed Ltd, Budapest, Hungary). Results The patient and control groups were similar in terms of the mean ages, BMIs, gender, systolic blood pressures, and smoking. FMF patients had a higher pulse wave velocity (PWV) (7.73±1.3 and 7.18±1.1 m/s; p=0.03) and lower brachial and aortic augmentation indexes (-64.6±14.6% and -54.6±25.9%, p=0.041 and 4.9±7.4% and 14.0±11.5%, p=0.025, respectively) compared with the controls. Thirty-one (45%) patients were in the "during-attack" state and had higher PWV (8.17±1.6 and 7.38±0.9 m/s; p=0.027) compared with the asymptomatic patients. PWV was correlated to serum CRP, WBC, ESR, fibrinogen, and neutrophil/lymphocyte ratios (r=0.666, 0.429, 0.441, 0.388, and 0.460, respectively). The genetic mutation and predominant attack type had no effect on arterial stiffness. Conclusion FMF patients have increased arterial stiffness during attacks compared with asymptomatic patients and controls. The impaired arterial stiffness is correlated to the severity of the inflammatory state rather than to the attack type or genetic mutations.

Amaç: Bu çalışmamın amacı kadınların depresyon ve anksiyete skorlarıyla en fazla ilişkili faktörlerin ortaya konması ve açıklanamayan infertiliteye sahip primer ve sekonder infertil kadınlar arasındaki olası farkların bulunmasıdır.Gereç ve Yöntem: Bu çalışma 166 primer ve 60 sekonder infertil kadını içeren kontrollü prospektif bir çalışmadır. Bunlar hormonal ya da uterin patholojisi olmayıp açıklanamayan infertilite grubundaydı. Hastalar Beck depresyon envanteri ve Hamilton anksiyete skorlamasını içeren bir anket formunu doldurdular. Bulgular: İki grup arasında anksiyete ve depresyon skorları arasında fark bulunamadı. Alt grup analizileri arasında da sadece şiddetli depresyon sekonder infertil grupta anlamlı derecede daha yüksekti (11/60 ile 10/166,). Hastaların yaşı ile anksiyete skorları ve tedavi deneme sayısı ile depresyon skorları arasında korelasyon olduğu görüldü.Sonuç: İnfertilite tedavisinin kadın sağlığı üzerine fiziksel yan etkileri olduğu kadar onlara psikolojik bir yük de getirmektedir.Belli kültürlerde çocuk sahibi olmak oldukça önemli olsa da yine de infertilite tedavisine başlamış ve daha fazla çocuk isteyen sekonder infertillerde stresi azaltmayabilmektedir. Primer ya da sekonder infertil olmasına bakılmaksızın infertilite tedavisine başlayacak hastaların desteklenmesi onların mizacını olumlu yönde etkilyeceği gibi tedavi başarısını arttırması bakımından da önemlidir., Purpose: In this study, we aimed to show the most related factors with women's anxiety and depression levels as well find out the differences between primary and secondary infertile women with unexplained reason. Materials and Methods: This was a prospective controlled study of 166 primary and 60 secondary infertile women. They had unexplained infertility and had not any hormonal or uterine pathology. Beck Depression Inventory and Hamilton Anxiety Rating Scale were used for questionnaire. Results: While there were not any differences between two groups for anxiety and depression scores as well for subgroups, secondary infertile women showed a higher rate of severe depression than primary infertile women (11/60 vs. 10/166). While patients' age was correlated with anxiety score, number of treatment attempts was correlated with depression score.Conclusion: Infertility treatment does not have only physical side effects but it has also a psychological burden for women. While having a child is very important for some cultures it may not decrease the stress of women who started infertility treatment and wanted to have more. It is important to support the women who undergo infertility treatment whether is primary or secondary infertile, while this affects the patient's mood positively as well may increase the success of treatment.

INTRODUCTION[|]Cervical cancer contributes to a significant global health burden with room for improvement of primary prevention methods. This study aimed to determine the prevalence of Turkish women with abnormal cytology and their management by comparing results from repeat cytological analysis with close follow-up and colposcopy.[¤]METHODS[|]A retrospective evaluation of 8738 women who underwent Pap smears at a single institution during 2011 was performed. Either repeat cytological analysis or colposcopic biopsy was used for follow-up evaluation of women who had abnormal index cytology.[¤]RESULTS[|]From the 8670 women, 8259 of had normal cytology results (95.3%) and 411 women had abnormal cytology (4.7%) in the index Pap smear. The frequency of initial abnormal cytology was 65% (n=267), 27% (n=111), 3.4% (n=14), 2.4% (n=10), 1.9% (n=8), and 0.3% (n=1) for atypical squamous cell of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LSIL), ASC cannot exclude high-grade intraepithelial lesion (ASC-H), high-grade SIL (HSIL), atypical glandular cells (AGC), and invasive cancer, respectively. Of the 267 women with initial ASCUS, 108 (40.4%) underwent repeat cytology analysis, 84 (31.5%) underwent colposcopic biopsy, and 75 (28.1%) were lost to follow-up. On histopathology, 8.3% (n=7) of patients had cervical intraepithelial neoplasm 2 (CIN2) on colposcopy. Of 60 women with LSIL that underwent colposcopic biopsy, 13.3% (n=8) had CIN2/3.[¤]DISCUSSION AND CONCLUSION[|]The results of the study suggest that routine cytological follow-up may be an appropriate method in the management of ASCUS instead of immediate colposcopy while immediate colposcopy cannot place repeat cytology for LSIL in developing countries.[¤]

Objective: Fetal structural malformations affect approximately 2-3% of all pregnancies. Only focusing on trisomy screening in first trimester and deferring the anatomic screening to second trimester may result with late detection of major anomalies that can be diagnosed earlier with careful examination. Material and Methods: This was a descriptive study of retrospective data that were obtained from all terminated single pregnancies due to ultrasonographic findings of major anomalies from 2011 to 2016 in our department. The study was based on a chart review and only abnormalities that were diagnosed before the 16th week were included. Results: Two hundred forty-four first trimester pregnancy terminations were performed. In total, 273 anomalies were detected in the 244 patients. Cranial NTD comprised 32% of all anomalies (n=89). Fifteen percent of anomalies (n=41) needed detailed anatomic scanning for early diagnosis. Conclusion: In this study, we presented the number and percentage of our early diagnosed anomalies by years, as well showed our diagnostic performance for specific anomalies such as atrioventricular septal defect during a 5-year period. The study provides valuable information for future studies in Turkey and shows the need for an anatomic scan protocol while performing aneuploidy screening during early gestation. © 2018 by the Turkish-German Gynecological Education and Research Foundation.

WOS: 000435647500014 Aim: To investigate whether complete blood count parameters of early pregnancy or biochemical markers of first-trimester trisomy screening were related to the prediction of early onset preeclampsia. Material and Method: Group 1 (n-214) was composed of patients between 18-40 years old with a single pregnancy who was diagnosed with preeclampsia at = 37 weeks of gestation. Group 2 (n=240) was a control. Women who became pregnant by assisted reproductive technologies or had a body mass index (BMI) >30kg/m2, had a history of delivery complicated by chromosomal anomalies, current or previous medical problems, or multiple pregnancies and patients who had vaginal bleeding in the antenatal period or a history of preterm delivery were excluded. Preeclampsia for pregnancy is defined as having a systolic blood pressure >= 140 and diastolic blood pressure >= 90 as well proteinuria after the 20th gestational week Blood samples for complete blood count, PAPP-A, and free beta-HCG were collected between 11+0 to 13+6 gestational weeks. Results: The mean gestational weeks at delivery and birth weight were significantly lower in Group 1 (preeclampsia) than in Group 2 (control). NRL and PDW were found significantly higher in Group 1. Lymphocyte count was significantly lower in Group 1. PAPP-A was lower in Group 1. Discussion: We found a strong relation between high levels of NLR and PDW. as well as low levels of lymphocyte count and PAPP-A, with early onset preeclampsia development during the current pregnancy. Giriş: Bu çalışmanın amacı; erken gebelik dönemindeki tam kan sayımı parametrelerinin ve ilk trimester trizomi taraması sırasında bakılan biyokimyasal parametrelerin erken başlangıçlı preeklampsiyi tespit edip etmeyeceğinin araştırılmasıdır. Gereç ve Yöntem: Çalışmadaki 1. Grup, 18-40 yaşındaki tekil gebeliği olan ve 34. gebelik haftasından önce preeklampsi tanısı alıp 37. hafta ve sonrasında doğum yapan 214 hastadan oluşmaktaydı. Kontrol grubunu 2. grup oluşturdu. Yardımcı üreme teknikleriyle gebe kalanlar, vücut kitle indeksi >30kg/m2 olanlar, kromozomal anomalili gebeliğe sahip olanlar, medikal problemi ya da öyküsü olanlar, çoğul gebelikler, antenatal dönemde vajinal kanaması olanlar ve erken doğum öyküsü olanlar çalışma dışı bırakıldı. Preeklampsi, sistolik kan basıncı 140 mmHg ve üstü, diyastolik kan basıncı 90 mmHg ve üstü hesaplanan ve 20. gebelik haftasından sonra proteinürisi olan gebelikleri tanımlamaktaydı. Tam kan sayımı, PAPP-A ve serbest beta-HCG için kan örnekleri 11+0 ile 13+6 gebelik haftaları arasında alındı. Bulgular: Doğumdaki gebelik haftası ve doğum ağırlıkları 1. grupta anlamlı olarak daha düşük bulundu. Nötrofil lenfosit oranı ve trombosit dağılım genişliği preeklamsi grubunda daha yüksek bulundu. Buna karşın lenfosit sayısı ve PAPP-A düzeyi preeklampsi grubunda daha düşüktü. Tartışma: Mevcut gebelikteki, nötrofil lenfosit oranı ve trombosit dağılım genişliğinin yüksek seviyeleri ve lenfosit sayısı ve PAPP-A’nın düşük seviyeleri ile erken başlangıçlı peeklampsi arasında güçlü bir bağlantı olduğu sonucuna ulaştık.

Vitamin B12 eksikliği olan olgular hematolojik, nöropsikiyatrik ve kardiyovasküler semptomlar ile başvurabilir. Akut psikoz tablosu nadiren de olsa görülebilmekte ve vitamin B12 eksikliği giderilmediğinde kalıcı hasar bırakabilir. Akut psikoz ve anemi semptomları ile kliniğimize başvuran altmış yaşında erkek hasta değerlendirildi. Terminal ileite bağlı vitamin B12 eksikliği saptandı. Yerine koyma tedavisiyle kalıcı hasar gelişmeden hasta iyileşti.Tanı ve tedavisi oldukça basit olan vitamin B12 eksikliğinin, kalıcı psikiyatrik sorunlara yol açmaması için psikiyatrik yakınmalarla başvuran hastalarda anemi olsun yada olmasın mutlaka vitamin B12kan düzeyinin kontrol edilmesi uygun olacaktır.

A large number of predisposing factors (obesity, nasal obstruction, adenoid hypertrophy, macroglossia, etc.) are reported to be associated with obstructive sleep apnea syndrome (OUAS). In addition to these factors, the large goiter and hypothyroidism were reported to be associated with OSAS as well. However, this relationship could not yet be fully demonstrated. In our case related to plonjon goiter, we wanted to show the effect of hyroidectomy to OSAS and #8211;if there is- and the relationship between pressure and OSAS. Two years ago, a 72-year-old female with BMI: 26.8 kg/m2 patient was admitted to our clinic with complaints of respiratory standstill during sleep, snoring, morning headaches and drowsiness during daylight. In the chest X-ray, chest computed tomography and ultrasonography applied to the patient, it was detected that the trachea was deviated to the left due to euthyroid plonjon goiter and severe OSAS and polisomnografisi (PSG) was diagnosed for the patient. The patients apnea-hypopnea index (AHI) was measured 63.1/h. With the aim of treatment, in 7cm H2O pressure, nasal continuous positive airway pressure (nCPAP) was applied to the patient and AHI decreased to the level of 11.4/h. Thyroidectomy was performed one month after the diagnosis. AHI was found 34.8 /h on the PSG applied for the purpose of 8 week-postoperative control. There were recovery on the levels of total sleep time, AHI, obstructive apnea index, hypopnea index, average desaturation index, stage 3 and REM as 16%, 44.8%, 84.7%, 19%, 38.3%, 52.4% and 28% respectively when compared the preoperative term with and postoperative term. It was demonstrated that there was no change of the in the degree of OSAS after thyroidectomy but only some partial improvement in the OSAS. The conclusion that there may be some improvements in nCPAP pressures after thyroidectomy and nCPAP treatment should not be stopped was reached. Also, it should be kept in mind that patients who apply to the primary care centers with the complaints of drowsiness, snorring and fatigue may be diagnosed as OSAS. [TAF Prev Med Bull 2014; 13(4.000): 353-356]

Objective: The aim of this pilot study was to determine clinical and laboratory factors that predict amputation surgery and to evaluate the predictive value of soluble CD14 (sCD14), interleukin-6 (IL-6), and procalcitonin (PCT) in patients with diabetic foot ulcers (DFUs). Methods: Twenty-seven (20 males, 7 females) Diabetic Foot Ulcers (DFU) patients admitted to our department were consecutively enrolled. The patients’ demographics and wound characteristics were noted. IL-6, PCT, and sCD14 were measured at admission. Results: Six of the 27 patients (22%) eventually underwent lower extremity amputation. Compared to the non-amputation group, a previous history of amputation (p=0.017), the presence of gangrene (p=0.044), the Wagner grade (p=0.011), the IL-6 concentration (p=0.018), the white blood cell count (WBC) (p=0.036), and the erythrocyte sedimentation rate (ESR) (p=0.042) were significantly high in the amputation group. However, the sCD14 and PCT concentration were not significantly different. Conclusion: We have shown for the first time that IL-6 may have predictive value for lower extremity amputation in patients with DFU. Further studies are needed to confirm its predictive value in this patient group.

We read with interest the article “Cystatin C and neutrophilgelatinase-associated lipocalin: biomarkers for acute kid-ney injury after congenital heart surgery” written by Ste-fanie Seitz et al. [1]. They concluded that, after congenitalheart surgery, urine neutrophil gelatinase-associated lipo-calin (NGAL) indicated the damaging effects of cardiopul-monary bypass and that serum cystatin C was a valuablepredictive biomarker for the resulting acute kidney injury(AKI) [1].In current practice, the standard method for renal functionmonitoring remains serum creatinine (SCr) measurement,although it is late and insensitive as there is a 24- to48-hour delay between renal insult and SCr changes [2].Furthermore, creatinine starts increasing only when morethan 50% of the glomerular filtration rate (GFR) is lost,cannot reflect GFR trends and may be diluted after aggress-ive fluid resuscitation [3]. NGAL has emerged as one of themost promising biomarkers for the early diagnosis of AKI,and a significant correlation has been found between acuterenal injury and serum NGAL concentration 2 hours aftercardiopulmonary bypass [4]. Recent investigations havevalidated the reliability of NGAL as a specific, sensitiveand early predictor of AKI after cardiac surgery, contrastadministration, septic shock and even renal transplantation[5]. Plasma NGAL (pNGAL) is less specific than its ur-inary counterpart [2]. In fact, pNGAL is already increasedin patients with chronic kidney disease or systemic ill-nesses, and increases six times less than urinary NGAL incases of renal injury [2]. Urinary NGAL was evident evenafter very mild “subclinical” renal ischaemia, despite nor-mal serum creatinine levels [3]. In intensive care settings,plasma cystatin C (pCysC) was able to detect AKI earlierand was more sensitive than SCr in detecting minor GFRreductions [2]. Unfortunately, pCysC levels may also be in-fluenced by several nonrenal factors including corticoster-oid administration, thyroid dysfunction, systemic inflam-mation, neoplasia, age and muscular mass [2]. There is anurgent need for tools allowing an early and accurate detec-tion of AKI [2]. In this regard, urinary NGAL and pCysCseem to be the most promising [2]. These early biomarkerswill also help to develop new preventive and/or therapeuticmethods for the management of AKI [2].We think that such early, rapid and simple detection of ur-inary NGAL and pCysC in patients with subtle, subclinic-al ischaemic renal injury or subclinical nephrotoxic dam-age will alert the clinician to introduce manoeuvres aimedat preventing progression to overt acute renal failure.Note from the publisher: The authors of the original articledo not wish to comment on this contribution.

INTRODUCTION Fetuin‑A is a glycoprotein secreted from hepatocytes, which affects diabetes and peripheral arterial disease. However, there has been no studies regarding the relation between diabetic foot and fetuin‑A levels. OBJECTIVES We aimed to analyze the association between diabetic foot development and serum fetuin‑A levels. PATIENTS AND METHODS Following the approval of the local ethical board, 137 patients were included in the study. Patients were divided into 3 groups: diabetes group (n = 49), diabetic foot group (n = 57), and control group (n = 31). In all patients, serum fetuin‑A, C‑reactive protein, magnesium, and hemoglobin A1c (HbA1c) levels were measured. Diabetic foot wounds were classified according to the Wagner classification and lower extremity arteries were evaluated by ultrasonography. RESULTS Median fetuin‑A levels in patients with diabetic foot were significantly higher than in those with diabetes. However, the differences in HbA1c levels between both groups were not statistically significant. A positive correlation was found between the Wagner classification and ultrasound evaluation of the peripheral arteries (degree of atherosclerosis) in patients with diabetic foot. In the diabetic foot group, fetuin‑A levels were also found to be positively correlated with ultrasound evaluation. CONCLUSIONS We observed a positive correlation between serum fetuin‑A levels and the development of diabetic foot.

A 40 nm CMOS digital-to-analog converter (DAC) based multimode transmitter (MMTX) is presented. The transmitter can be operated in either narrow- or wideband applications. It has a maximum 2.2 GHz signal bandwidth and exhibits an in-band IM3 of less than - 58 dBc. The MMTX consists of a current-steering DAC with digital sinc equalization and rolloff compensation. By implementing high-speed, feed-forward pipelined digital logic and a distributed decoder, the DAC sampling rate extends to 5 GHz. A distributed regulator approach ensures preservation of the achieved wideband linearity in noisy embedded SoC environments. The MMTX can deliver up to +11 dBm of output power and exhibits 20 dB of analog power backoff with 1 dB steps and a precision better than ±0.1 dB. The MMTX consumes only 375 mW and occupies 1.65 mm2.

Microalbuminuria (MA) is common in hypertensive population and is a marker for endothelial dysfunction and a predictor of increased cardiovascular risk. A great body of data shows the importance of MA as a strong predictor of renal and cardiovascular disease (CVD) risk in hypertensive population.In this study, we aimed to compare the anti-albuminuric effects of an angiotensin II receptor antagonist, valsartan, with a calcium channel blocker, amlodipine, in newly diagnosed hypertensive patients.Totally, 20 patients were recruited into the study. Patients were randomized to one of the following intervention protocols: An (a) angiotensin II receptor blocker (valsartan, 80-320 mg/day) or (b) calcium channel blocker (amlodipine, 5-10 mg/day), for 12 weeks immediately after baseline measurements. Ten patients were randomized into valsartan group and 10 patients into the amlodipine group. Twenty-four-hour urinary albumin excretion (UAE) levels of the patient groups were measured before treatment and on the 12th week.Patients of the two groups were matched for age and body mass index. In the amlodipine group, baseline urine microalbumin levels were higher compared to valsartan group, although the difference was not statistically significant (p = 0.082). At the 12th week, there was a significant decrease in urine microalbumin levels in the amlodipine group, but no significant change was observed in the valsartan group.Amlodipine seems to be superior to valsartan in decreasing UAE. To reduce cardiovascular risks, endothelial dysfunction, and microinflammation, these factors are taken into consideration while prescribing antihypertensive drugs in hypertensive patients.

Tuberculosis is still an important disease all over the world. Despite lungs being the most frequently affected organ from tuberculosis, other sites of infection are also reported. Inguinal tuberculosis lymphadenitis is an extremely rare form of extrapulmonary tuberculous lymphadenitis. In this case, a 25 years old male with isolated unilateral tuberculous lymphadenitis and its treatment is presented. The diagnosis was made with histological examination following excisional biopsy.

Ovarian and testicular tissue cryopreservation are the only fertility preservation options for sexually immature individuals. Because of their experimental nature, it is important to determine safety and possible bundling with other medicallyindicated procedures.Prospective observational.Cryopreservation indications included cancer in 75 % of females and 50 % of males, while non-cancer indications included various hematological conditions. Similar numbers of females (12/28) and males (3/9) underwent prior chemotherapy. Females underwent laparoscopic (27/28) or robotic (1/28) approaches while incisional biopsy was used in males. Bundling of ovarian and testicular harvesting with other medicallyindicated procedures was performed in 42 % and 22 %, respectively. The operative time inclusive of bundled procedures was similar (1.6 ± 0.1 vs. 0.9 ± 0.3 h) but the discharge time was significantly longer for females than males (10.4 ± 0.6 vs. 4.6 ± 0.6 h, p0.05) due to frequent bundling of medically-indicated procedures in females. All procedures were successfully completed without complications or significant blood loss.Pediatric gonadal tissue cryopreservation can be combined with other medically-indicated procedures to minimize the potential inconvenience, additional anesthetic risks, and costs.