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Forensic veterinary toxicology has become a popular branch of toxicology, dealing with animal cruelty (e.g., malicious poisoning), regulatory issues (e.g., contamination of the feed supply chain), insurance litigation or wildlife poisoning. The current study highlights the importance of the toxicological aspects of animal health-related disagreements in a pet custody case following a divorce. In this study, the custody case of three dogs and a cat was concluded with the aid of toxicological test results that were obtained from the pets’ blood samples for the first time in Turkey. The results confirmed the presence of benzoylecgonine in one of the blood samples, as alleged by one of the owners. The study also aims to raise the veterinarians’, as well as the judicial system members’, awareness of drug abuse in pets.

This study aimed to determine cavum septum pellucidum (CSP) nomogram values between 15-28 weeks of gestation. Routine biometric measurements and CSP width were measured by transabdominal ultrasonography in 6042 structurally normal foetuses between 15-28 weeks of gestation. Distribution of CSP width by the week of pregnancy and percentile values were calculated. The mean week of gestation (GW) was 21 ± 1.7, and the mean biparietal diameter (BPD) was 50.2 ± 5.8 mm. The CSP width range was 1.6-7.7 mm at 15-28 weeks, and the mean CSP width was 4.1 ± 0.8 mm. CSP width was found to have a significant correlation between a gestational week (CSP = GW X 0.2705-1.6121; R = 0.62

Bu çalışmada, İstanbul ilinin yapım yılları farklı iki otoyolu olan, E80 Tem Otoyolu ve Kuzey Marmara Otoyolu’nun farklı bölgelerinden alınan 36 adet toprak numunesinin kapsamlı inorganik profillerinin belirlenmesi, ayrıca kirlilik faktörü (CF) ve jeo-birikim (Igeo) indeksi hesaplamaları yapılarak çevre toksikolojisi çerçevesinde değerlendirilmesi amaçlanmıştır. Indüktif eşleşmiş plazma-kütle spektrometresi kullanılarak 24 inorganik element aranmış ve iki otoyol arasında Li, Mg, K, Ca, Cr, Ni, As, Sr ve Ba elementleri için anlamlı fark bulunmuştur (p

Objective: The management of multiple pregnancies is still a challenge. The aim of this study was to compare the outcome of triplet pregnancies managed expectantly or by multifetal pregnancy reduction to twins. Study design: For this retrospective, comparative and monocentric study, the medical files of all women with triplets who admitted to our institution over a 13-year period were examined. Women requesting multifetal pregnancy reduction to have twins formed the study group, and women with triplets who wished to continue their pregnancies formed the control group. Main outcome measures were durations of pregnancies presented as number of weeks gestation, abortion rates, term and preterm birth rates, fetal loss and live birth rates. Results: During the study period, 171 women with triplets admitted to our institution. One hundred fifty one patients are included in this study. Forty-five women carrying triplets wished to continue their pregnancies and 106 women requested multifetal pregnancy reduction to have twins. Fetal reduction of triplets to twins was associated with a significantly lower incidence of birth before 34th gestational week and higher incidence of late preterm and term birth rates without changing live birth rates. Conclusion: Multifetal pregnancy reduction of triplet pregnancies to twins resulted in a later gestational age at birth compared with the triplet gestations managed expectantly. © 2021 2-s2.0-85119275656

n this review, we reviewed current literature on COVID-19 infection during pregnancy and provided up-to-date information and community/society recommendations. Although it has previous examples such as SARS and MERS and the infection findings appeared at an earlier period and have become known in China, the infection could not be limited and spread worldwide. Until June 8, 2020, a total of 6.8 million cases were reported and 397,000 cases died. As of the same date, the total case number in Turkey is 171,000 and total number of death is 4711. COVID-19 virus spread by droplets and its incubation period varies between 2 and 14 days. The rate of asymptomatic cases is 42% in non-pregnant patients while it is 44–89% in pregnant women. The disease progresses with mild-medium severity in about 80% of the patients, and it recovers by itself. A total of 17 maternal death cases has been reported. Although vertical transmission risk is very low according to a study investigating 265 pregnant women, there are cases showing fetal vertical transmission and we reviewed such cases in detail in this review.

Nickel (Ni) is a frequently used metal in the production of many products, and Ni exposure occurs in humans through food, inhalation, and skin. Studies reported Ni as the most common allergen diagnosed in the serial patch test. The main purpose of our study was to determine the concentration of Ni and other elements in the urine samples of individuals with Ni-sensitivity and to determine the effect of lifestyle habits on these variables. This study was conducted with 388 participants; additionally, both Ni patch test and inorganic analysis (for 24 elements) method in urine with inductively coupled plasma-mass spectrometry (ICP-MS) were applied to all participants. Ninety-two (23.7%) of the participants were found to have nickel sensitivity with a mean urine concentration of 4.475 mu g/g creatinine (median=4.260; SD=2.527). The urine nickel concentration was significantly different between female and male participants (p =0.001). We found a significant correlation between Ni and other metals alongside various element pairs. The mean urine Ni concentration of the individuals with a positive Ni sensitivity test result was not different from that of the participants without Ni sensitivity (4.475 vs 4.256 mu g/g creatinine, respectively; p = 0.068). The high accuracy, recovery, and repeatability data obtained from the analyses indicate that this study is efficient and appropriate for the quantitative determination of nickel and other elements in urine samples. Ni-containing objects and Ni-rich foods should be of concern for individuals with hypersensitivity reactions to the element.

Objectives This study aimed to evaluate the effect size of each parameter used in the first trimester Down syndrome (DS) risk analyses by using multiple regression analysis techniques. Methods This data mining study included data of 44,260 pregnant women screened at the Acibadem Labmed laboratories from 2010 to 2019. In this study, risk was calculated using the PRISCA software on the basis of nuchal translucency (NT), crown-rump length measurement, in vitro fertilization application, diabetes mellitus, Down syndrome story, smoking, maternal age, and the level of maternal serum biochemistry markers including pregnancy-associated plasma protein-A (PAPP-A) and free beta-human chorionic gonadotropin (hCGβ). Results Forty-four thousand two hundred sixty risk analysis patients result data were re-investigate, and 851 (1.93%) risk analysis results were found as positive. PAPP-A 747 (CI%, 476–1,170) times, NT value 512 (CI%, 343–764) times, DS story 21 times (CI%, 6.7–63.2) and hCGβ value 7.01 (CI%, 6.31–7.79) times affect the combined first-trimester risk analysis results. Conclusions We have suggested that those accurate PAPP-A levels and NT levels evaluation are the most critical point of combined risk analysis and that the risk of free hCGβ levels after PAPP-A is essential as a biochemical test.

Amaç: Son yıllarda fetal anomalilerin prenatal tanı ve takibinde önemli ilerlemeler olmuştur . Çalışmamızda, fetal anomalilerin tanı ve takibinde ultrasonografi ve serum beta-2 mikroglobulin düzeyinin rolünü araştırdık.Yöntemler: Fetal anomali nedeniyle hastanemizde takip edilen 29 olgu çalışmaya alındı. Gebelere önce ultrasonografi yapıldı. Daha sonra, kordosentez ile fetal kan alınarak beta-2 mikroglobulin düzeyi ölçüldü. Karyotip tayini yapıldı. Postnatal fizik muayene ve ultrasonografi sonuçları ve bazı olgularda postnatal beta-2 mikroglobulin düzeyleri olguların antenatal tanıları ve serum beta-2 mikroglobulin düzeyleri ile karşılaştırıldı.Bulgular : Fetal anomalisi olan toplam 29 olgu prospektif olarak değerlendirildi. En çok multisistem anomalisi ve daha az sıklıkta üriner sistem, santral sinir sistemi ve gastrointestinal sistem anomalileri gözlendi. Fetal serum beta-2 mikroglobulin düzeyi olguların %76,5'inde 3 mg/dl'nin üzerinde tespit edildi. Postnatal ultrasonografi ve fizik muayenede olguların 8'inde herhangi bir anomaliye rastlanmadı. Kordosentez yöntemi ile alınan fetal kanda bakılan karyotiplemede 4 (%14) fetusta kromozomal anomali saptandı. Kromozomal anomalili fetusların %50'sinin anne yaşı 35 yılın üzerinde idi.Sonuçlar: Çalışmamızda, antenatal ultrasonografinin fetal anomalileri saptamadaki duyarlılığı %72 idi. Fetal serum beta-2 düzeyi fetal anomalili olguların %76'sında yüksek saptandı. Sonuç olarak, gebelikte belirli aralıklarla prenatal ultrasonografik incelemenin ve anomalili veya anomali şüphesi olan olgularda serum fetal beta-2 mikroglobulin düzeyinin ölçümü prenatal tanı ve takipte faydalı olabilir. Ancak, serum beta-2 mikroglobulin düzeyinin daha homojen bir anomali grubunda çalışılması daha objektif sonuçlar verecektir.&nbsp

A national wastewater-based epidemiology (WBE) monitoring campaign has been initiated to determine the trends in drug consumption in Turkey since 2019. This study aimed to present the wastewater monitoring results for four periods in 2019 for six major cities with 17 wastewater treatment plants. The study investigated heroin (HER), amphetamine (AMP), methamphetamine (METH), cocaine (COC), 3,4-methylenedioxymethamphetamine (MDMA), cannabis, alcohol, and tobacco to understand the temporal and geographical drug consumption trends. The results indicated a trend of regular cannabis use in all the cities. Considering geographical variations, the drug usage trends were not homogeneous within the country for any of the investigated drugs, except cannabis. HER consumption was predominant in Denizli (1042.48 mg/1000 inh/day), while Izmir and Antalya (154.10 and 79.56 mg/1000 inh/day, respectively) topped for COC consumption. Aydin had the highest consumption levels of AMP (90.03 mg/1000 inh/day) and METH (358.13 mg/1000 inh/day), while MDMA consumption was the highest in Samsun (157.64 mg/1000 inh/day). Tobacco consumption was high in Aydin (8791.69 mg/1000 inh/day) and Antalya (5375.17 mg/1000 inh/day), whereas alcohol consumption was higher in Bursa than in the other cities (53434.61 mL/1000 inh/day). There were no statistically significant differences in the weekend consumption levels of the investigated drugs among these six cities. Although this study included the results of 1 year of consumption monitoring, the data confirms internationally published information on the drug trafficking routes of conventional drugs in this region, especially the Heroin-Balkan route. Results from further sampling will enable accurate evaluation of global drug consumption and trafficking, in addition to alcohol and tobacco use.

These guidelines follow the mission of the World Association of Perinatal Medicine, which brings together groups and individuals throughout the world with the goal of improving outcomes of maternal, fetal and neonatal (perinatal) patients. Guidelines for auditing, evaluation, and clinical care in perinatal medicine enable physicians diagnose, treat and follow-up of COVID-19-exposed pregnant women. These guidelines are based on quality evidence in the peer review literature as well as the experience of perinatal expert throughout the world. Physicians are advised to apply these guidelines to the local realities which they face. We plan to update these guidelines as new evidence become available.

Background:Behçet’s Syndrome (BS) is a vasculitis of unknown origin. Vascular involvement, so-called vascular Behçet’s syndrome (VBS), may involve blood vessels of all sizes belonging to both venous and arterial system, with pulmonary artery involvement (PAI) being the most frequent form of arterial involvement. PAI in BS occurs in the form of aneurysms or thrombosis, and results in significant mortality.Objectives:To report the clinical characteristics of PAI in patients with BS and to define the predictors of relapses.Methods:We performed a retrospective analysis of BS patients with PAI who fulfilled international study group criteria. Among 460 patients with VBS, 66 were diagnosed with PAI. For final analyses, 61 patients with PAI, who had at least 2 follow-up visits (72.1% male, mean age at BS diagnosis 29.34 (SD 10.1) years), were included. The data of the patients were recorded. Relapse was defined as the reoccurrence of vascular event at any vascular structure. Factors associated with relapse were assessed by logistic regression analysis.Results:There were not any differences considering demographic and clinical features of the patients with and without PAI in VBS group except for that intracardiac thrombosis was more common in the patients with PAI than the patients without (19.7% vs 0.3%, respectively) (Figure 1). Among 61 patients with PAI, 50 (82.0%) had isolated pulmonary artery thrombosis (PAT), whereas 11 (18.0%) had pulmonary artery aneurysm (PAA) with or without PAT. The characteristics of 61 patients with PAI were shown in Table 1. A total of 37 relapses occurred in 24 (39.3%) patients during follow-up a median of 65.9 (IQR 20.1-109.0) months. To define the factors associated with relapses, the patients with isolated PAT were analysed. In multivariable logistic regression analysis, older age at BS diagnosis and anticoagulation usage seemed to be protective, even though they could not reach statistical significance (OR: 0.92 95% CI 0.86-1.02, OR: 0.34 95% CI 0.09-1.33, respectively).Table 1.Characteristics of the patients with pulmonary artery involvementAlln= 61Isolated PATn= 50PAAn= 11Sex (male), n (%)44 (72.1)35 (70.0)9 (81.8)Age at diagnosis of BS, years (SD)29.3 (10.1)28.8 (10.4)31.9 (8.0)Age at diagnosis of PAI, years (SD)36.3 (12.83)36.7 (13.8)34.7 (6.7)Symptoms, n (%)Dyspnea28 (45.9)23 (46.0)5 (45.5)Hemoptysis26 (42.6)19 (38.0)7 (63.6)Vascular event before PAI, n (%)21 (34.4)20 (40.0)1 (9.1)Other vascular events at PAI, n (%)33 (54.1)28 (56.0)5 (45.5)Thrombophlebitis, n (%)7 (21.2)6 (21.4)1 (20.0)Upper and/or lower extremity DVT, n (%)20 (60.6)16 (57.1)4 (80.0)SVCS, n (%)1 (3.0)1 (3.6)0 (0)IVCS, n (%)3 (9.1)1 (3.6)2 (40.0)Intracranial thrombosis, n (%)4 (12.1)4 (14.3)0 (0)Intracardiac thrombosis, n (%)8 (24.2)7 (25.0)1 (20.0)Arterial event other than PAI, n (%)4 (12.1)3 (10.7)1 (20.0)Relapse, n (%)24 (39.3)20 (40.0)4 (36.4)Time to the first relapse, median (IQR), month49.8 (13.2-102.6)54.1 (24.4-117.9)3.9 (1.7-67.9)Death, n (%)2 (3.3)0 (0)2 (18.2)BS= Behçet Syndrome, PAI= pulmonary artery involvement, PAT= pulmonary artery thrombosis, PAA= pulmonary artery aneurysm, DVT= deep vein thrombosis, SVCS= superior vena cava syndrome, IVCS= inferior vena cava syndromeFigure 1.A) Axial CT image shows thrombus formation in the left upper lobe pulmonary artery branch. B) Giant thrombus is seen in the right ventricle (black arrow). Note the thrombus formation in the left lower lobe pulmonary artery branches (white arrows).Conclusion:Our results indicate that there is a higher frequency of intracardiac thrombosis in BS patients with PAI and an increasing current trend of PAT in patients with PAI. In addition, there might be a possible efficacy of anticoagulation usage in preventing relapses, which needs confirmation with further studies.Disclosure of Interests:None declared

Wastewater-based drug monitoring is a complementary tool that has been used worldwide in recent years, and many cities have periodically reported monitoring results. However, this study is the first to analyze drugs in wastewater in a single city with a high population during four periods simultaneously from 14 treatment plants. The aim was to estimate the consumption of conventional illicit drugs [amphetamine (AMP), methamphetamine (METH), 3,4-methylenedioxymethamphetamine (MDMA), cannabis, cocaine, and heroin], tobacco, and alcohol in 2019 for quarterly periods in Istanbul city, which has a population of almost 20 million, to aid in implementing evidence-based measures. Additionally, the seasonal variations among the 14 wastewater treatment plants and their weekday/weekend comparison of drug use patterns and consumption per substance were examined. Solid phase extraction was followed by liquid chromatography-tandem mass spectrometry and a previously validated method was enhanced by adding new parameters (morphine, cotinine, and ethyl sulfate), and satisfactory results were obtained. In this study, alcohol, nicotine, and cannabis had the highest estimated per capita consumption with mean values of 29655.3 mL/1000 inh/day, 5507.6 mg/1000 inh/day and 3607.0 mg/1000 inh/day, respectively. These results were followed by heroin and cocaine consumption with mean values of 557.0 and 200.9 mg/1000 inh/day, respectively, whereas AMP-type stimulants had the lowest values among the targeted substances. METH and cannabis were also highly consumed drugs when compared with the results of other metropolitan cities, whereas heroin consumption was remarkably high owing to Turkey's location on a possible heroin trafficking route. Because Istanbul is the business center of the country and has the potential to attract tourists in all four seasons, meaningful seasonal consumption differences were not observed for all substances.

Advances in technology and wide used of obstetric ultrasound have allowed an increase in the antenatal identification of fetal problems, such as fetal lung lesions. Technological advances in transducer and software technology have remarkably improved visualization of structures in the fetus. Additionally, newer understanding of the natural course of several malformations and new methods of in utero treatment, the evolution of fetal surgical techniques and anesthesia have made fetal surgery possible and have changed the course of evolution of lung defects before and after birth. Therefore, there is now an increasing demand for an accurate and timely diagnosis, counseling, and planning of appropriate management of the cases whether expectant management or in utero therapy at perinatal care centers with timely perinatal transfer. How to cite this article Sen C, Yayla M, Api O, Goynumer G. Fetal Lung Surgery. Donald School J Ultrasound Obstet Gynecol 2016;10(3):271-296.

Prenatal screening for fetal aneuploidies has been focused on mainly Down syndrome in the last 40 years. The method of screening has changed from maternal age in the 1970s, with a detection rate of 30 and 5% false positive rate (FPR), to a combination of maternal age and second-trimester serum biochemical markers (triple test and quadruple test) in the 1980s and 1990s, with 60 to 75% detection rate and 5% false positive rate (FPR). Following this, the era of first trimester screening for Down syndrome has started with the clinical implementation of fetal nuchal translucency screening. The combination of maternal age, NT thickness and serum free beta-human chorionic gonadotropin (â-hCG) and pregnancy-associated plasma protein A (PAPP-A) in the first trimester has yielded a 90% detection rate with a 5% FPR. Starting from the year 2008, studies have shown that the performance of screening may be improved by analysis of cell-free deoxyribonucleic acid (DNA) (cfDNA) in maternal blood. Several studies in the last few years have reported the clinical validation of cell free fetal DNA test in the maternal serum in screening for trisomies 21, 18, and 13 and sex chromosome aneuploidies.Its widespread use is limited by the relatively high cost of the test and the lack of consensus about the optimal way for its clinical implementation. Until the optimal way of incorporating cfDNA into the clinical practice gets identified, it would be wise not to substitute cfDNA testing in place of first-trimester screening for fetal defects and other major complications of pregnancy. Furthermore, it would be preferable for clinicians managing individual patients not to counsel them for their result as positive or negative, rather the clinicians should use the risk estimate from the first-line method of screening as the prior risk and modify this by the appropriate positive or negative likelihood ratio from the cfDNA test.How to cite this articleSen C, Api O, Yayla M, Goynumer G. Cell-free DNA Testing: Where are We now? Donald School J Ultrasound Obstet Gynecol 2016;10(2):172-177.

In Islamic religion, daytime fasting during the month called Ramadan is an annual practice. In this study, we aimed to investigate the effect of Ramadan fasting and maternal hypoalbuminaemia on neonatal growth parameters. A prospective case-control study was conducted in Diyarbakir and Istanbul, Turkey. The sample size of fasting group was 168 and that of non-fasting group was 170. Demographic characteristics, obstetrics ultrasonographic findings and laboratory parameters of the participants were recorded. Neonatal anthropometric parameters and placental weight were noted. The mean placental weight was significantly higher in the fasting group (p = 0.037). Also, in the fasting group, pregnant women with hypoalbuminaemia had significantly higher placental weight (p = 0.009). In conclusion, the mean placental weight in the fasting group was significantly higher. Also a significant correlation between placental weight and maternal serum albumin level was observed in the fasting group.

Objective: The purpose of this study is to show distribution of risk in pregnancies which underwent first trimester combined tests, and investigate general demographic and clinical characteristics of patients, underwent invasive diagnostic tests after screening tests. Methods: Combined test data of first trimester screening in 20082011 were evaluated retrospectively and cross-sectional. After the measurement of nuchal translucency (NT), double test was applied to complete combined test within the same day. Invasive diagnostic procedures were compared in terms of rate, indications, karyotype and postnatal outcomes. Results: A total of 1109 pregnant women were included. Their mean age was 31.07±3.73 years. Free-βhCG was 1.26±0.94 MoM and PAPPA was 1.16±0.65 MoM. Mean NT value was 1.60±0.67 mm. With threshold of 1/250, screening test was positive in 3.1% of the cases. Additional 22 cases due to first trimester screening and 19 cases due to second trimester screening had invasive procedures (6.4% in total). Invasive procedures revealed karyotype anomaly in 11.3%. Karyotype anomalies were more frequent in group (20%) with positive combined test compared to ones performed for other reasons like maternal anxiety. Conclusion: Although false positive rate is 3.1% in first trimester combined test, rate of total invasive procedures is more than double (6.4%). Number of invasive diagnostic procedures increased due to maternal anxiety of age and physicians evaluating only NT or double tests. With diagnostic procedures, chromosome anomalies reaches 11% and termination need reaches 10%. Invasive procedures performed due to anxiety of mother or physician revealed no chromosomal anomaly requiring termination.

Lead is a hazardous compound that affects the central nervous system in people, particularly children, and may cause some reversible and irreversible diseases. Legal regulations try to prevent the exposure from products especially produced for children such as coating paints, jewelry, toys, bed linen, textile, etc. The aim of this study was to determine the lead levels of coating paints on children׳s outwear selling in district bazaar by laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS) and to specify the percent of non-complying samples. Here we described the solid matrix calibration method and confirmed the results with the microwave-assisted acid digestion method. Both comparative methods were validated by analysis of the certified reference materials (NIST SRM-612 glass matrix, NIST SRM-2582 powdered paint and ERM-EC681k) and bias% for accuracy and RSD% for precision were calculated lower than 6.8% and 7.3%, respectively. The recovery ranges of laser ablation and microwave-assisted acid digestion method for Pb were found to be between 88.2–98.1% and 95.3–101.3%, respectively. The limits of detection values were determined as 0.162 mg kg−1 for direct sampling in the ablation chamber and 0.002 ng mL−1 for aqueous solutions. Correlation result of 16 samples (r=0.99) examined in both methods was satisfactory. In coating paint samples, 14.65% of 198 (n=29) did not comply with the 90 mg kg−1 lead limit according to regulation. Validated quantitative laser ablation method may be preferred to quickly and reliably determine the Pb levels in other solid samples as well as coating paints.

Objective: Our aim was to determine the distribution of chorion and amnion sac types in twin pregnancies during the routine screening procedures during the first trimester, and to investigate their relevance with pregnancy being natural or by assisted reproductive technology. Methods: Twin pregnancies analyzed during routine first trimester screening were evaluated retrospectively. The twins were grouped according to their conception types which are natural birth and by assisted reproductive technologies (ART). The cases which have missing or suspicious information about chorion-amnion types and with unknown conditions for pregnancies whether they were by ART or naturally were excluded from the study. In the sonographic chorionicity distinction, the presence of classic lambda and T signs was considered. The unavailability of amniotic membrane among fetuses was defined as monoamniotic twin. Results: During 14 years, 286 twin pregnancies were considered as appropriate cases to analyze. Mean maternal age was 30.47±5.07 years, and mean week of gestation during sonography was 12.23±0.70. Double placentas were found in 83.2% of all pregnant women, and single placenta in 16.7% of all pregnant women. While 54.5% (n=156) of twin pregnancies were ART pregnancies, 45.5% of them were natural pregnancies. It was determined that 67.7% of natural twins were diamniotic dichorionic, 27.7% of them were diamniotic monochorionic and 4.6% of them were monoamniotic monochorionic while 96.2% of ART pregnancies were diamniotic dichorionic, 3.2% of them were diamniotic monochorionic and 0.6% of them were monoamniotic monochorionic. There was statistically significant difference between ART twins and natural twins in terms of chorionicity distributions (p

To establish a reference range for the intracranial translucency (IT). In this prospective study, we examined 596 singleton fetuses at 11–14 weeks of gestation using transabdominal ultrasonography. The distribution curves of the anterior–posterior diameter of the IT were established according to the gestational weeks, and the percentiles for 11–14 weeks of gestation were calculated. Regression analysis was performed to estimate the relationship between the anterior–posterior diameter of the IT and other fetal biometric parameters. The mean anterior–posterior diameter of the IT was 1.8 ± 0.4 mm. From 11 to 14 weeks of gestation, the IT diameter increased linearly with advancing gestation. The linear regression equation for the IT × crown–rump length (CRL) was IT = CRL × 0.0184 + 0.575 (R = 0.385, p

A prospective study was conducted to determine the cut-off values of nuchal skin-fold thickness (NFT) with false-positive rates for each gestational week (GW) for chromosomal abnormalities during the 2nd trimester of pregnancy. A total of 2,313 women with normal singleton pregnancies were included in the study. Cases of multiple gestations, aneuploidy and major congenital malformations were excluded. The distribution of NFT between the 15th and 24th GW and the cut-off values of NFT with false-positive rates for chromosomal abnormalities were determined. A significant positive correlation was noted between NFT and GW. Statistically significant differences were observed in NFT for the each GW. The 95th percentile values of NFT between 15 and 24 weeks' gestation were 4.7, 4.77, 5.0, 5.5, 5.76, 5.9, 6.0, 6.1, 6.5 and 6.8 mm, respectively. In all fetuses, if the cut-off value of NFT was considered as 6 mm, the false-positive rate ranged from 1.8% to 37% in 15-24 weeks' gestation. Evaluation of NFT according to cut-off values determined by population-based percentiles for each GW might be a more appropriate screening method for chromosomal abnormalities than accepting NFT ≥ 6 mm for all fetuses as abnormal, regardless of gestational age.

Aims: In the Islamic religion, Ramadan is a month in the year that is passed by fasting. Healthy adult individuals are prohibited to eat, drink, and smoke from sunrise to sunset. In the present study, our aim was to assess the relation of Ramadan fasting with fetal development and maternal-fetal Doppler indices in pregnant women. Methods: This is a prospective case-control study carried out in the month of Ramadan in 2013 (9 July–7 August). One hundred and six pregnant women at the second and third trimesters of pregnancy were enrolled into the study. The sample size of the fasting group was 83 and the non-fasting group sample size was also 83. Fetal biometric measurements, such as biparietal diameter, head circumference, abdominal circumference, femur length, estimated fetal weight, amniotic fluid index, and Doppler indices of both uterine and umbilical arteries were evaluated by gray scala and color Doppler ultrasound at the beginning and end of Ramadan. Results: At the end of the Ramadan, increase in biparietal diameter, head circumference, and femur length showed a statistically significant difference from initial measurements (P Conclusion: We demonstrated some adverse effects of Ramadan fasting on fetal development. In the Islamic religion, pregnant individuals have the privilege of not fasting; therefore, they should consider postponing fasting to the postpartum period, especially in the summer season. If they are willing to do so, an appropriate nutritional program should be recommended.

Objective: It was aimed to compare the consistency according to genders between clinical weeks of gestation and weeks of gestation calculated based on crown-rump length (CRL) found ultrasonographically at 11 0/7

Objective: Trisomy 8 mosaicism (MT8) is characterized by intracranial, genitourinary and skeletal system anomalies, congenital cardiovascular disorders, deep palmar and plantar creases, and neoplastic and hematological disorders. In the literature, there are only a few antenatal ultrasound (US) and fetal magnetic resonance imaging (MRI) findings reported for MT8. Case: The fetus whose gestational age was 26 weeks and 4 days was referred for fetal MRI due to corpus callosum agenesis suspected in routine US screening. We are presenting the major and minor MRI findings of the fetus in this case report. Conclusion: Fetal MRI can be used in addition to the antenatal ultrasound to evaluate genetic syndromes such as trisomy 8 mosaicism and to identify additional anomalies which cannot be found in the ultrasound screening.

Background: We aimed to compare the second trimester uterine artery Pulsatility Index (PI) measurement in twin pregnancies according to the chorionicity and determine its effect on twin pregnancy outcome in terms of fetal and birth weight. Methods: All medical records of twin pregnancies, whose fetal screening was done between May 1999 and January 2012, were evaluated retrospectively. All twin pregnancies without detected/suspicious anatomical or genetic fetal anomalies, biochemical abnormalities, and familial genetic diseases were included in the data analyses. Ones with missing PI measurements and ones with undetermined chorion types were excluded from the data analyses. Results: A total of 149 twin pregnancies were evaluated. The percentages of chorion types were diamniotic dichorionic in 89.9% (n=134) and diamniotic monochorionic 10.1% (n=15). Mean age of the mothers was 31.56 ± 4.9 years. Mean gestational week of PI measurement was 20.30 ± 2.23 weeks. Mean birth week was 35.5 ± 2.50 weeks. Mean birth weight was 2405 ±437 grams. Correlation analyses related to PI values and second trimester weight and birth weight parameters didn’t show any statistically significant correlation. Mean maternal age, mean gestational week of PI measurements, mean birth week, mean fetal weights and birth weights were indifferent between chorionicity groups. Comparisons of second trimester PI, second trimester weight and birth weight and related parameters showed no statistically significant between groups. Conclusions: Second trimester uterine artery pulsatility index measurements do not differ between chorionicity types. It has no effect on twin pregnancy outcome in terms of fetal weight and birth weight.

Although titanium is a highly inert material, it may corrode when in contact with the oral cavity. This study aimed to examine the titanium presence and levels in gingiva samples that had been in contact with a dental implant cover screw for 3 months. Twenty two-staged dental implants were included in the study as a test group. Gingiva samples were taken over the implant sites. Ten control samples were obtained from oral mucosa during gingivoplasty. All samples were analyzed by Laser Ablation-Inductively Coupled Plasma-Mass Spectrometry. The results showed that the average semi-quantitative titanium levels were higher in the test group (50.4 µg/g ± 23.5 µg/g) than in the control group (37.1 µg/g ± 1.0 µg/g). This difference was found to be statistically insignificant (p = 0.075). The presented study showed that titanium may corrode in a relatively short time. Long-term studies are needed with a higher number of patients and varying conditions to evaluate the titanium levels in the soft tissues around implants.

Measurement of intracranial translucency (IT), which is a recent earlier recognizable sonographic marker, has been suggested for detection of spina bifida. In this prospective study we aimed to determine normative values of IT in the population of Turkish singleton pregnant women during the first trimester of pregnancy.Between January 2011 and July 2011, all consecutive singleton pregnant women were screened for intracranial translucency. Pregnancies were followed until birth. Pregnancies with any detected/suspicious anatomical or genetic fetal anomalies, biochemical abnormalities, increased nuchal translucency measurements, pregnancies of artificial reproduction techniques and anomaly detected at birth were set to be excluded from the data analyses. Mean±standard deviation, median and percentile values of intracranial translucency were calculated. Linear regression analyses were done between the length of intracranial translucency and gestational week and CRL.Data analyses included 201 fetuses. Median maternal age was 31 years. Median CRL was 62 mm. Median gestational week was 12.57 weeks. Median IT value for the first trimester was 1.7 mm (range 1.00-2.40). Calculated formulae are; IT (mm)=[0.237×Gestational Week)]-1.27, R(2)=0.302; p0.001 and IT (mm)=[0.020×CRL (mm)]+0.44, R(2)=0.381; p0.001). IT measurements increased with increasing CRL and advancing gestational weeks. During follow up none of the fetuses was found to have any anatomical abnormality or anomaly.This study presents normative values of intracranial translucency in the first trimester screening of normal singleton pregnancies of the Turkish population. In accordance with previous reports, intracranial translucency increases linearly with advancing CRL.Yeni erken saptanabilen sonografik bir marker olan intrakraniyel translüsensi ölçümü sipina bifida varlığının saptanması için önerilmektedir. Prospektif olan çalışmamızda Türk popülasyonundaki tekil gebeliklerde birinci trimester fetal intrakraniyel translüsensi (IT) ölçümlerinin normal dağılımının saptanması amaçlandı.Ocak 2011 ve Temmuz 2011 tarihleri arasında tüm ardışık tekil gebelerde intrakraniyel translüsensi ölçümleri bakıldı. Gebeler doğuma kadar takip edildi. Şüpheli veya gösterilen anatomik/genetik fetal anomalileri, biyokimyasal değer anormalliği, artmış nukal kalınlığı yada doğumda anomali saptanan fetuslar ve yardımcı üreme teknikleri uygulanmış fetuslar değerlendirme dışında tutuldu. İntrakraniyel translüsensi için ortalama±standart deviasyon, medyan ve persentil değerleri hesaplandı. Lineer regresyon analizleri ile intrakraniyel translüsensi ve gebelik haftası ve CRL arasındaki ilişki saptandı.Veri analizlerine 201 fetus dahil edildi. Medyan anne yaşı 31 yıl, medyan CRL 62 mm ve medyan gebelik haftası 12.57 hafta saptandı. Birinci trimester için medyan IT değeri 1.7 mm (aralık 1.00–2.40) bulundu. Hesaplanan formüller; IT (mm)=[0.237×Gebelik Haftası]−1.27, R2=0.302; p0.001 ve IT (mm)=[0.020×CRL (mm)]+0.44, R2=0.381; p0.001. IT ölçümleri artan CRL ve ilerleyen gebelik haftası ile birlikte artıyor olarak saptandı. Takip esnasında hiçbir fetusta anomali saptanmadı.Mevcut çalışmada Türk popülasyonundaki tekil gebeliklerde birinci trimester fetal intrakraniyel translüsensi normal dağılımları gösterilmektedir. Literatür ile uyumlu olarak, intrakraniyel translüsensi ilerleyen gebelik haftası ve CRL ile lineer olarak artmaktadır.

Evaluation of nasal bone improves the performance of first-trimester screening for trisomy 21. In this retrospective study we aimed to determine normative values related to the measurement of nasal bone length of the Turkish population during the first trimester ultrasonographic fetal screening.Medical records of singleton pregnancies, whose first trimester fetal screening was performed between 2004 and 2010, were evaluated retrospectively. Pregnancies with any detected/suspicious anatomical or genetic fetal anomalies, biochemical abnormalities, increased nuchal translucency measurements, and pregnancies of artificial reproduction techniques were excluded from data analyses. Mean±standard deviation, median and percentile values of the length of nasal bone were calculated separately for 11(0-6), 12(0-6) and 13(0-6) gestational weeks.Nasal bone could be visualized in 99.6% of the included 1762 singleton pregnancies. In 16.5% of the cases nasal bones were only noted as present or absent. Mean maternal age was 29.67±4.50 years and mean gestational age was 12.54±0.61 weeks. Median values of nasal bone lengths were 1.7, 1.9, and 2.2 mm for 11(0-6), 12(0-6) and 13(0-6) gestational weeks respectively. Nasal bone length (NBL) increased linearly with advancing gestational age and CRL. NBL (mm)=[0.298xGestational Age (week)]-1.779, R(2)=0.318; p0.001; NBL (mm)= [0.023 × CRL (mm)] + 0.520, R(2)=0.331; p0.001.The present study presents normative values of nasal bone in the first trimester screening of normal singleton pregnancies of Turkish population. Nasal bone length increases with advancing gestational age and CRL.Birinci tirmester trizomi 21 taramasında nazal kemik değerlendirmesi performansı arttırmaktadır. Bu retrospektif çalışmada Türk popülasyonundaki tekil gebeliklerde birinci trimester fetal nazal kemik ölçümlerinin gebelik haftalarına göre persentil dağılımlarının saptanması amaçlandı.Retrospektif olarak 2004 ve 2010 tarihleri arasında taraması yapılmış olan anatomik anomali, biyokimyasal değer anormalliği, aile öyküsünde genetik hastalığı olmayan, nukal kalınlığı normal olan spontan tekil gebelikler değerlendirmeye alındı. 11Dahil edilen 1762 tekil gebeliğin %99.6’sında nazal kemik görüntülenmişti; bunların %16.5’inde nazal kemik sadece var ya da yok olarak not edilmiştir. Ortalama anne yaşı 29.67±4.50 yıl ve ortalama gebelik haftası 12.54±0.61 idi. Nazal kemik ölçümlerinin medyan değerleri 11

To determine the distribution of fetal nasal bone length (NBL) according to gestational age during the second trimester of pregnancy in a Turkish population.Fetal NBL and other routine biometric measurements were evaluated retrospectively in 2327 fetuses between 15 and 24 weeks of gestation. The measurements were obtained via transabdominal ultrasound. The distribution of fetal NBL between 15 and 24 weeks of gestation was established, and percentiles were calculated. Relationships between fetal NBL and other parameters were assessed using regression analysis.Mean (±standard deviation) fetal NBL ranged from 2.95±0.52 at 15 weeks of gestation to 6.26±0.77mm at 24 weeks of gestation. The fifth percentile for fetal NBL was 2.1mm at 15 weeks of gestation and 5.0mm at 24 weeks of gestation. A significant positive correlation was noted between fetal NBL and gestational age (NBL=gestational age×0.37-2.55; R(2)=0.59; p0.01) and between fetal NBL and biparietal diameter (BPD) (NBL=BPD×0.11-0.33; R(2)=0.61; p0.01).Fetal NBL is less in Turkish subjects compared with non-Turkish subjects.

Purpose: This study was planned to answer the management of cases with translocated intrauterine devices (IUDs) into the abdomen or into the wall of the uterus. Materials and Methods: This study was a retrospective analysis of patients' records at the training and research hospital during the years 2001–2005, which required an admission to the hospital for the removal of an IUD that had translocated to the outside of the uterus. Thirteen (13) cases that were diagnosed and treated as migrated IUDs in our clinic were evaluated retrospectively. IUDs were inserted in 1788 patients at the hospital in which the study was performed during the study interval. Results: In 10 patients, removal of the IUDs at laparoscopy succeeded, whereas, in 1 case, laparotomy proved necessary, and 2 IUDs were removed via hysteroscopy. Three (3) IUDs were in the Douglas space, 7 of them were embedded in the omentum, 1 was inside the broad ligament, and 2 had perforated the wall of the uterus. In 6 cases, mild adhesion, an...

Jarcho-Levin syndrome (JLS) causes severe vertebral and thoracic deformity and has an autosomal-recessive mode of inheritance. Prenatal diagnosis may be difficult in some cases without the history of an affected baby. We present 4 cases of JLS with neural tube defects as the prominent finding. In 2 of them the deformity of the thorax was minimal and was not detected by ultrasonography. Rib anomalies were revealed with radiological and pathological examinations after the termination. The location of the vertebral defect may be the determinant factor for the severity of the thoracic deformity. The real recurrence risk could only be found out after postnatal examinations in cases with neural tube defects.

The concentration of twenty-seven elements (Li, Be, B, Mg, Al, P, K, Ca, Cr, Mn, Co, Ni, Cu, Zn, As, Se, Sr, Mo, Cd, Sn, Sb, Ba, Hg, Pb, Bi, Th, and U) in green coffee samples and their infusions were determined by using inductively coupled plasma-mass spectrometry (ICP-MS). Prior to analysis, green coffee samples were prepared by microwave digestion, while infusions were analyzed without any pre-treatment. The accuracy and precision of the proposed methods were verified by recovery experiments. Considering samples; K, Cu, and Al had the highest mean concentrations with 6714.5 μg g−1, 12.1 μg g−1, and 25.9 μg g−1 among major, trace and toxic elements, respectively. The impact of brewing type on leachability of elements was also studied and the results outlined that mean leachability of elements to Turkish coffee were greater than to mud coffee. Furthermore, dietary element intakes through green coffee consumption were also estimated. This is the first study presenting wide range of elements in green coffee brews and calculating dietary intakes.

Objectives To determine the severity and, accordingly, the treatment of genital trauma in a pediatric population. Methods A total of 116 children with genital trauma and anorectal injury were retrospectively reviewed. The severity of trauma was graded according to the genital injury score (GIS), which we developed as a genital trauma scoring system. Results The median age was 8 years. Of the 116 children, 80 were girls and 36 were boys. The etiology of the trauma was traffic road accident (53 patients), fall, sexual abuse, and gunshot wound. Sixty-one patients had additional organ injuries. The GIS was I for 25 children, II for 19, III for 32, IV for 23, and V for 17. In addition to the primary repair, colostomy was performed in 22 patients. The most frequent postoperative complication was wound infection. The postoperative complication rate was significantly greater in patients with an injury severity score greater than 15, severe contamination, prolonged delay (longer than 8 hours), and a GIS of IV or V. Conclusions The clarification of the mechanism and severity of the genital injury and associated organ injuries under general anesthesia may help in the appropriate classification. Primary repair should be the standard approach in genital trauma patients with a GIS of IV or less. Those with a GIS of V associated with severe contamination and prolonged delay require colostomy for improved outcome.

Objective To describe a new surgical technique to treat prophylactic gonadectomy in patients with androgen insensitivity syndrome. Design Prospective study. Setting University hospital. Patient(s) Six patients with androgen insensitivity syndrome. Intervention(s) Laparoscopy-assisted transinguinal or suprapubic extracorporeal gonadectomy. Main outcome measure(s) Accessibility, operation time, and cost-effectiveness. Result(s) Laparoscopy-assisted transinguinal extracorporeal gonadectomy under general anesthesia was performed successfully, with no complications, in all patients as a one-day procedure. The operation times were 12 to 22 minutes (average, 16 minutes). Histopathologic examination revealed testicles in all cases. The cost of each operation was approximately $500 to $1,000. Conclusion(s) Laparoscopy-assisted transinguinal or suprapubic and extracorporeal gonadectomy has several advantages over laparotomy and operative laparoscopy, including short operating time, safety, simplicity, and cost-effectiveness.