Mehmet Yilmazer

Decreased total antioxidant status and increased oxidative stress in women with polycystic ovary syndrome may contribute to the risk of cardiovascular disease

OBJECTIVE To determine oxidative stress by the level of protein carbonyls and total antioxidant status (TAOS), and whether oxidative stress is associated with increased risk of cardiovascular disease in women with polycystic ovary syndrome (PCOS). DESIGN Controlled clinical study. SETTING University hospital. PATIENT(S) Thirty women with PCOS and 31 healthy control women. INTERVENTION(S) Biometric measures and blood samples collection. MAIN OUTCOME MEASURE(S) C-reactive protein (CRP), lipid fractions, glucose, protein carbonyls, insulin, and other hormone (gonadotropins, androgens) levels and TAOS were measured. The estimate of insulin resistance was calculated by homeostasis model assessment (HOMA-R). RESULT(S) The women with PCOS had significantly higher serum fasting insulin, CRP, protein carbonyl levels, HOMA-R, LH levels, and LH/FSH ratios than healthy women. However, TAOS was significantly lower in women with PCOS. TAOS was negatively correlated with fasting insulin, HOMA-R, CRP, and protein carbonyls. Fasting insulin was positively correlated with protein carbonyls. High density lipoprotein (HDL) was inversely associated with fasting insulin, HOMA-R, and protein carbonyls. CONCLUSION(S) Increased oxidative stress and decreased antioxidant capacity may contribute to the increased risk of cardiovascular disease in women with PCOS, in addition to known risk factors such as insulin resistance, hypertension, central obesity, and dyslipidemia.

Obstructive sleep apnea in pregnancy and fetal outcome

To simultaneously investigate the polysomnography (PSG) and nonstress test (NST) records of pregnant women with obstructive sleep apnea (OSA) to observe NST changes during maternal desaturation and determine maternal and fetal outcomes.

Nausea and vomiting in early pregnancy: Relationship with anxiety and depression

Objective. To investigate the association between either depression or anxiety early in pregnancy, and nausea and vomiting, in a clinical sample. Methods. Anxiety and depression scores of 230 women were investigated by using the Hospital Anxiety and Depression Scale. Nausea and vomiting of pregnancy (NVP) were scored by using the Rhodes system. These scores and demographic data were compared and P < 0.05 was considered significant. Results. A significant correlation between Rhodes score and both anxiety (r = 0.388, P < 0.001) and depression score, (r = 0.351, P < 0.001) was found. Gestational age showed an inverse correlation with anxiety scores (P = 0.019). There was no significant correlation between demographic data and anxiety/depression scores, or Rhodes scores. Conclusion. There is an association between anxiety and depression early pregnancy and severity of NVP.

Hormone replacement therapy, C-reactive protein, and fibrinogen in healthy postmenopausal women

OBJECTIVE To investigate short-term and long-term effects of combined hormone replacement therapy (HRT) on C-reactive protein (CRP) and fibrinogen plasma concentrations in healthy postmenopausal women. METHODS In this cross-sectional study 241 healthy postmenopausal women were enrolled. A total of 81 women were receiving the following treatments for 3 months; transdermal 17beta-estradiol (17beta-E2) + medroxyprogesterone acetate (MPA) (n = 21), oral 17beta-E2 + norethisterone acetate (NETA) (n = 27), and conjugated equine estrogens (CEE) + MPA (n = 33). The same combined therapies were implemented in another 58 women for 12 months; transdermal 17beta-E2 + MPA (n = 10), oral 17beta-E2 + NETA (n = 16), and CEE + MPA (n = 32). Control group included 102 healthy postmenopausal women not receiving HRT. The effect of the type and the duration of HRT regimens on plasma levels of CRP, fibrinogen and lipids were investigated. RESULTS Median CRP concentrations were significantly higher in women receiving oral 17beta-E2 + NETA (P = 0.037) and CEE + MPA (P = 0.0001) for 3 months than in women taking the same types of HRT for 12 months and of those were not on HRT. Median CRP levels were similar in women taking transdermal 17beta-E2 + MPA for 3 and 12 months, compared with controls. Fibrinogen levels were not different between nonusers and any group of HRT users. CONCLUSIONS These elevated levels of CRP, which appears very recently as a crucial marker for cardiovascular disease, may be responsible for the early increased cardiovascular risk after starting oral combined HRT. But this increased risk in the early period seems to decrease with long-term use. Transdermal 17beta-E2 + MPA had insignificant effect on CRP both in short-term or in long-term use.

Efficient and non‐invasive method for investigating Helicobacter pylori in gravida with hyperemesis gravidarum: Helicobacter pylori stool antigen test

Aim:  To investigate the relationship between Helicobacter pylori infection and severe hyperemesis gravidarum (H.Gravidarum) by using Helicobacter pylori Stool Antigen (HpSA) and other serologic test results.

Resting metabolic rate and exercise capacity in women with polycystic ovary syndrome

To assess the resting metabolic rate (RMR) and exercise capacity (or maximal oxygen consumption [VO2 max]) of women with polycystic ovary syndrome (PCOS) and central adiposity.

Oxidative stress markers in pregnant women who snore and fetal outcome: a case control study

Background. To determine the levels of oxidative stress markers in pregnant women who snore and compare with non‐snoring pregnant women. Fetal outcome of these 2 groups was also evaluated. Materials and methods. Prospective, case control study. Some 40 pregnant women who snored and 43 non‐snoring pregnant women were evaluated. The glutathione peroxidase (GSH‐Px), malondialdehyde (MDA) and myeloperoxidase (MPO) levels of the 2 groups were studied. Infant birthweight, Apgar scores, and other indicators of fetal outcome were obtained. Results. The mean level of GSH‐Px was significantly lower in the pregnant women who snored (p = 0.005), while the mean level of MDA was significantly higher in this group (p = 0.005). Levels of MPO were comparable between the groups (p > 0.05). The pregnant women who snored did not have infants with evidence of an increase in compromised outcome. Conclusion. Although the pregnant women who snored had high levels of MDA, they did not appear to be at increased risk for delivering infants with fetal compromise.

Single dose nasal 17beta-estradiol administration reduces sympathovagal balance to the heart in postmenopausal women.

Aim:  Long‐term estrogen replacement therapy has favorable results on autonomic cardiovascular functions in postmenopausal women. Although acute estrogen administration has beneficial modulations on autonomic tone in animal studies, there are still controversies about the effects of acute estrogen on autonomic modulation to the heart in humans. The aim of this double‐blind study was to investigate the acute effects of intranasal 17beta‐estradiol administration on autonomic control of heart rate.

Prevention of ovarian hyperstimulation syndrome in a rat model: efficacy comparison between cabergoline and meloxicam

Objective. To compare the efficacy of cabergoline (Cb2) and meloxicam in curbing vascular endothelial growth factor (VEGF) expression and preventing ovarian hyperstimulation syndrome (OHSS). Design. Randomized controlled, animal study. Setting. Academic facility. Sample. We used a total of 50 immature Wistar female rats randomly to create an experimental OHSS model. Methods. Ten rats each formed the control group and mild OHSS group. The remaining 30 were separated into three equal groups of severe OHSS. Mild and severe OHSS were induced through ovarian stimulation with gonadotropins. One group with severe OHSS was administered a low‐dose 100 μg/kg Cb2 therapy; another group with severe OHSS received 600 μg/kg meloxicam. Body weight, vascular permeability (VP), VEGF expression, ovary weight, and diameter were then compared. Main outcome measures. The efficacy of Cb2 and meloxicam for preventing OHSS. Results. Comparison of the severe OHSS groups with the controls and mild OHSS group revealed significant increases in VEGF expression, VP, ovary weight, and diameter. The increase in VEGF expression was demonstrated to be dependent on human chorionic gonadotropin doses. However, low‐dose Cb2 and meloxicam therapies were shown to be ineffective in decreasing VEGF expression and VP, ovary weight, and ovary diameter in severe OHSS. Conclusions. VEGF elevation played a critical part in OHSS pathogenesis, but the therapies administered failed to curb VEGF expression.

Could mean platelet volume in late first trimester of pregnancy predict intrauterine growth restriction and pre‐eclampsia?

The present study aims to determine whether mean platelet volume (MPV) specified in late first trimester of pregnancy can be used to predict pre‐eclampsia and intrauterine growth restriction (IUGR).