Ozlem Banu Tulmac

Adrenal gland volume assessed by magnetic resonance imaging in women with polycystic ovary syndrome.

PURPOSE To determine adrenal gland volume (AGV) in women with polycystic ovary syndrome (PCOS) by comparison with healthy control subjects and to investigate the relationship between AGV and hormonal status. PATIENTS AND METHODS AGV was measured on transverse sections of T1-weighted MRI imaging data in 27 PCOS patients and 40 age-matched control subjects for this prospectively designed study. A comparative analysis of AGV in PCOS and controls was performed and possible correlations between AGV and hormonal parameters were evaluated. RESULTS PCOS patients had significantly larger AGV compared to controls ((11.7±4.4 cm(3), 7.2±1.9 cm(3), respectively, P<0.001). A significant positive correlation was found between total AGV and dehydroepiandrosterone sulfate, 17-OH progesterone, and total and free testosterone levels in the PCOS group (r=+0.51, +0.48, +0.43, +0.62, respectively; P values<0.05). In addition, AGV was significantly negatively correlated with LH and LH/FSH ratio in the PCOS group (r= -0.55, P=0.02; r=-0.51, P=0.01, respectively). CONCLUSIONS PCOS patients have significantly increased AGV as well as a positive correlation of AGV and androgens. We conclude that the assessment of AGV with MRI shows a significant correlation with the androgenic activity of the gland, and that hypertrophy of the adrenal gland may be involved in the pathogenesis of PCOS.

The evaluation of temperament and quality of life in patients with polycystic ovary syndrome

Abstract Aims: To evaluate the temperament and quality of life (QoL) of patients with PCOS. Materials and methods: Fifty-three adult patients with PCOS and 38 healthy controls were enrolled in the study. Demographic characteristics including age, education and body mass index (BMI) were recorded. Affective temperaments were assessed by the temperament evaluation of Memphis, Pisa, Paris and San Diego-autoquestionnaire version (TEMPS-A) scale. The general health-related quality of life (HRQoL) instrument used in this study was short Form 36. Hospital anxiety and depression scale (HADS) were also performed. Results: The patients with PCOS had significantly higher rates of depressive, anxious and hyperthymic scores compared to controls. The PCOS patients had significantly lower mean SF-36 health summary scores. Conclusions: TEMPS-A seems to be an easy and reliable test to evaluate temperament in PCOS patients.

Early postpartum lactation effects of cesarean and vaginal birth.

OBJECTIVES Breastfeeding has positive effects for both, the mother and the infant. The purpose of the study was to ex-amine how cesarean delivery and vaginal delivery influenced subsequent breastfeeding. The study was conducted at the Kırıkkale University Medical School. MATERIAL AND METHODS Breastfeeding outcomes after an elective cesarean delivery and after a planned vaginal delivery were compared. The study included 169 consenting mothers who gave birth to healthy infants (86 cesarean deliveries and 83 vaginal deliveries) between March and September 2001. All cesarean deliveries were performed under regional anesthesia. RESULTS Elective cesarean delivery was performed at a significantly earlier gestational age as compared to vaginal delivery (p = 0.001). Maternal age in the planned vaginal delivery group was significantly lower (p = 0.003). As for the change in prolactin levels, the results were similar but not statistically significant (p = 0.21). The frequency of breastfeeding per day did not differ significantly between the groups (p = 0.20). However, women after cesarean delivery tended to breastfeed more often than after vaginal delivery (p = 0.003). Mean number of points recorded at the first breastfeeding session, according to the LATCH charting system, was lower in the group after cesarean delivery as compared to vaginal labor. The difference between the average point scores of vaginal delivery and cesarean delivery mothers was found to be meaningful in favor of the women after vaginal delivery (p = 0.05). CONCLUSIONS Elective cesarean section has negative effects on breastfeeding. Our results indicate that cesarean section constitutes a risk factor for delayed lactogenesis.

Ocular blood flow in polycystic ovary syndrome

The aim of this study was to evaluate whether the presence of polycystic ovary syndrome (PCOS) alters ocular blood flow parameters.

HELLP Syndrome and Cerebral Venous Sinus Thrombosis Associated with Factor V Leiden Mutation during Pregnancy

Preeclampsia is a leading cause of maternal mortality and morbidity worldwide. The neurological complications of preeclampsia and eclampsia are responsible for a major proportion of the morbidity and mortality for women and their infants alike. Hormonal changes during pregnancy and the puerperium carry an increased risk of venous thromboembolism including cerebral venous sinus thrombosis (CVST). Factor 5 leiden (FVL) is a procoagulant mutation associated primarily with venous thrombosis and pregnancy complications. We report a patient with FVL mutation who presented with CVST at 24th week of pregnancy and was diagnosed as HELLP syndrome at 34th week of pregnancy.

Association of body mass index and weight gain patterns with albumin excretion in pregnancy

We examined body mass index (BMI) and gestational weight gain (GWG) patterns of pregnant women and investigated the impact of these factors on the urinary albumin‐creatinine ratio (ACR) during pregnancy.

What is the protective effect of metformin on rat ovary against ischemia‐reperfusion injury?

The aim of this study was to investigate the protective effect of metformin on the rat ovary against ischemia‐reperfusion injury.

Could erythropoietin reduce the ovarian damage of cisplatin in female rats

Abstract The aim of this study is to investigate whether erythropoietin (EPO) can reduce the ovarian damage of cisplatin or not. Thirty, female, Wistar-Albino rats were used in the study. Control group (N = 10): Intraperitoneal saline infusion, Cisplatin group (N = 10): Intraperitoneal 7 mg/kg cisplatin, Cisplatin + EPO group (N = 10): Intraperitoneal 7 mg/kg cisplatin and subcutaneous 200 IU/kg/day EPO. Serum AMH concentrations were measured by enzyme-linked immunosorbent assay kit of AMH. Follicular counts were evaluated according to mean diameter of the follicles. Ovarian damage; including follicular cell degeneration, vascular congestion, hemorrhage, and inflammation was scored histologically using a graduated scale. Posttreatment AMH levels of cisplatin group were significantly lower than control and cisplatin + EPO groups. In cisplatin group, there was a significant decrement in posttreatment AMH level compared to pretreatment AMH level. The total damage score of cisplatin group was significantly higher than scores of control and cisplatin + EPO groups. The mean primordial follicle counts of control and cisplatin + EPO groups were significantly higher than that of cisplatin group (p = .007 and p = .003). The results of this study revealed that EPO administration to cisplatin chemotherapy could ameliorate the ovarian damage. Erythropoietin administration to chemotherapeutic agents might suggest to protect ovarian failure and infertility.

Brain Diffusion Changes in Polycystic Ovary Syndrome

Department of Radiology, MD Anderson Cancer Center, University of Texas, Houston, Texas, USA Department of Radiology, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey Clinic of Obstetrics and Gynecology, Ilgin State Hospital, Konya, Turkey Department of Obstetrics and Gynecology, School of Medicine, Kirikkale University, Kirikkale, Turkey Department of Obstetrics and Gynecology, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey

Delayed diagnosis of PRES and eclampsia in a concealed pregnancy.

Pre-eclampsia and eclampsia are well-known risk factors of posterior reversible encephalopathy syndrome. Early recognition and proper treatment result in complete reversibility of this disease. Concealed pregnancy obstacles a safe prenatal care and a safe planned delivery, because of latency in the diagnosis. We present a case of unrecognized posterior reversible encephalopathy syndrome, eclampsia and premature delivery due to concealed pregnancy.