Hilal Uslu Yuvacı

Smoking, alcohol, and substance use and rates of quitting during pregnancy: is it hard to quit?

Background Alcohol and substance use is a major health challenge in Turkey, as it is worldwide. Recently, there has been a rapid increase in the number of females using substances and although usage tends to reduce during pregnancy, it is of critical importance to determine its exact level as substance use negatively impacts on the health of both the mother and infant. Aim The aim of the present study was to investigate the frequency of smoking, alcohol, and substance use, and quitting rates during pregnancy. Method This study was conducted on pregnant females in Sakarya, Turkey. A total of 1,082 consecutively presenting females who agreed to participate in the study were evaluated. The study team prepared a sociodemographic data form and adapted the “Introduction” section, derived from the Addiction Profile Index, to cover substance use during pregnancy. Results The substances most frequently used by pregnant females in their previous pregnancies and current pregnancies were cigarettes/tobacco products (11% and 11.8%, respectively), alcohol (0.6% and 0.4%, respectively), and rarely, synthetic cannabinoids (0.3% and 0.2%, respectively). Daily tobacco smokers continued to smoke during pregnancy, with a rate of 42.5%. Based on research into predictors of smoking (cigarettes) in pregnancy, a correlation was found between lifetime smoking and smoking during a previous pregnancy. A similar link was found with respect to alcohol. Conclusion Cigarettes are the most frequently used substance in pregnancy, and to a lesser extent, alcohol and synthetic cannabinoids, also considered to be risky substances. A high incidence of smoking regularly during pregnancy was found in daily smokers. It is recommended that physicians should sensitively ask pregnant females presenting at clinics about all forms of substance use, including alcohol and synthetic cannabinoids, and to include such questions in their routine enquiries.

Evaluation of the level of thiol-disulphide homeostasis in patients with mild and severe preeclampsia

• We assessed thiol-disulphide balance with a new colorimetric method recently developed by Erel & Neselioglu.

Neutrophil‐to‐lymphocyte ratio and platelet distribution in patients with endometrial cancer

We read the article entitled ‘Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in patients with endometrial hyperplasia and endometrial cancer’ by Mete Ural et al. with great interest. The authors reported that neutrophil-to-lymphocyte ratio (NLR) is an inexpensive and easily measurable laboratory variable, and that it was elevated in patients with endometrial cancer as compared to those without endometrial cancer. Interestingly, platelet distribution width (PDW) was negatively correlated with endometrial cancer. Their study is interesting; however, we have some questions. First, in table 1, there seems to be an error. The PDW of the endometrial cancer group is given as 18.5 ± 1.6 mg/dL, whereas in group 3, PDW is given as 19.4 ± 1.4. In the Results section, the authors reported that PDWwas increased in group 1 compared to group 3 (P < 0.001). We think that one of these two is wrong. There is an error either in table 1 or in the Results section. Age may affect NLR. Recently it was reported that NLR was positively correlated with age. According to this study, elderly patients had higher NLR values. Mete Ural et al. divided the patients into three groups according to endometrial biopsy results. In their study, the patients in the endometrial cancer group were older than those in the endometrial hyperplasia group and the normal endometriumgroup. They did not adjust for this potential confounder. Age can influence NLR and platelet parameters. Our other concern is about exclusion criteria. The authors did not mention chronic inflammatory diseases and coronary artery disease (CAD) as exclusion criteria. These diseases may affect hematologic parameters, such asNLR, platelet-to-lymphocyte ratio, and PDW. It iswell known that NLR is significantly associated with chronic

Perinatal Anxiety Screening Scale validiy and reliability study in Turkish (PASS-TR validity and reliability)

ABSTRACT BACKGROUND: Anxiety disorders are common in women. This sensitivity extends into the perinatal period as well. Thus, screening for anxiety disorders during the aforementioned period is important for the proper management and treatment of conditions. This study was conducted to assess the validity and reliability of the Perinatal Anxiety Screening Scale, which was determined to be beneficial for the purposes listed above. METHOD: For this study, the “Perinatal Anxiety Screening Scale” (PASS) was translated into Turkish and relabelled “Perinatal Anksiyete Tarama Ölçeği” (PASS-TR). 312 perinatal women were then evaluated with: the ICD 10 diagnosis system, SCID-1, the Hamilton Anxiety Scale, Hamilton Depression Scale, Beck Anxiety Scale, and PASS-TR. The resulting data was examined using Pearson Correlation analysis, Reliability tests, ROC analysis, and Factor analysis. The generated sub-dimensions were re-examined again by confirmatory factor analysis and Root Mean Square Error of Approximation (RMSEA), Root Mean Square Residual (RMR), Standardized Root Mean Square Residual (SRMR) χ2/sd, the Goodness of Fit Index (GFI), Adjusted Goodness of Fit Index (AGFI), Comparative Fit Index (CFI), Akaikes Information Criterion (AIC), and the Bayesian Information Criterion (BIC). RESULTS: In this assessment, Cronbachs Alpha value for the scale is = 0.95, and the sub-dimensions obtained by explanatory factor analysis are: (1) general anxiety and specific fear, (2) perfectionism and control, (3) social anxiety and adjustment disorder, (4) acute anxiety and trauma. The cut-off score for the scale is 16. As a result, it was determined that PASS-TR is an accurate method for the scanning of anxiety disorders in the perinatal period. CONCLUSION: PASS-TR can be validly and reliably used to scan for anxiety disorders amongst perinatal women.

Affective temperaments during pregnancy and postpartum period: a click to hyperthymic temperament

Abstract Background: Pregnancy and postpartum periods are the main reproductive periods during which women experience mood disorders. Affective temperaments are known antecedents of mood disorders and their importance is increasing in time for early diagnosis and determining risky groups. But data about affective temperaments during perinatal period is limited. Methods: Women during pregnancy and perinatal period and healthy controls who are not in perinatal period are included in the study. 83 pregnant women in 1st trimester, 94 pregnant women in 2nd trimester and 115 pregnant women in 3rd trimester; 32 women in 1st month postpartum and 89 women in 2nd month postpartum; and 88 healthy non-pregnant women with similar ages were evaluated regarding their temperament evaluation of Memphis, Pisa, Paris and San Diego auto-questionnaire (TEMPS-A) scores. Results: Women in perinatal period had higher scores of hyperthymic temperaments than the control group. Women in the 2nd month of postpartum period had also higher anxious temperament scores. And women in the second trimester had the highest hyperthymic temperament scores. Conclusion: Pregnancy and postpartum periods correlate with hyperthymic temperament characteristics in women without active psychiatric diagnosis. Future studies will help to understand if this is a mental quietness or increased risk for bipolarity.

Unperceived Pregnancies: A Review

Nazan Aydýn1, Oðuz Omay2, Esra Yazýcý3, Melike Dönmez4, Yüksel Kývrak5, Hazal Yavuzlar Cývan6, Özgür Çaðla Cenker7, Hilal Uslu Yuvacý8 1Prof. Dr., 6Dr., Bakýrköy Ruh ve Sinir Hastalýklarý Hastanesi, Ýstanbul 2Uzm.Dr., La Teppe Psikiyatri Kliniði,Fransa 3Doç.Dr., Sakarya Üniversitesi Týp Fakültesi Psikiyatri A.D., Sakarya 4Dr., Marmara Üniversitesi Týp Fakültesi Psikiyatri A.D., Ýstanbul 5Doç.Dr., Kafkas Üniveristesi Týp Fakültesi Psikiyatri A.D., Kars 7Uzm.Dr., Kaçkar Devlet Hastanesi, Psikiyatri Kliniði,Rize 8Yard.Doç.Dr., Sakarya Üniversitesi Týp Fak. Kadýn Hastalýklarý ve Doðum A.D., Sakarya