Petek Balkanlı Kaplan

Maternal serum cytokine levels in women with hyperemesis gravidarum in the first trimester of pregnancy

OBJECTIVE To compare serum cytokine levels in patients with hyperemesis gravidarum with levels in healthy pregnant and nonpregnant women. DESIGN Case-control study. SETTING Clinical and academic research center. PATIENT(S) Thirty women with hyperemesis gravidarum, 30 healthy women in the first trimester of pregnancy, and 30 healthy nonpregnant women. MAIN OUTCOME MEASURE(S) Serum levels of interleukin-1beta, interleukin-2 receptor, interleukin-6, interleukin-8, and tumor necrosis factor (TNF)-alpha. RESULT(S) Median serum levels of interleukin-2 receptor and interleukin-8 did not differ significantly among the three groups. Serum levels of interleukin-1beta and interleukin-6 were significantly higher in healthy pregnant women than in healthy nonpregnant women. Median TNF-alpha levels were significantly higher in women with hyperemesis (25.8 pg/mL [range, 4.9-140 pg/mL]) than in healthy pregnant and nonpregnant women (10.85 pg/mL [range, 4.1-35.8 pg/mL] and 12 pg/mL [4.3-68.2 pg/mL], respectively). CONCLUSION(S) Levels of TNF-alpha were significantly higher in patients with hyperemesis gravidarum than in healthy pregnant and nonpregnant women. Thus, TNF-alpha may be involved in the etiology of hyperemesis gravidarum.

Validation, cultural adaptation and responsiveness of two pelvic-floor-specific quality-of-life questionnaires, PFDI-20 and PFIQ-7, in a Turkish population

OBJECTIVES The aim of the study was cultural adaptation, validation, and test for responsiveness of the short forms of the Pelvic Floor Distress Inventory (PFDI-20) and the Pelvic Floor Impact Questionnaire (PFIQ-7) in a Turkish population. STUDY DESIGN To evaluate their validity, questionnaires were applied to 248 women. The questionnaires were compared with prolapse stage according to the Pelvic Organ Prolapse Quantification (POP-Q) system. The responsiveness of the questionnaires was assessed in 103 women with prolapse who also completed the questionnaires after reconstructive surgical treatment, with standardized response mean (SRM), effect size (ES), and the Wilcoxon signed-rank test. RESULTS Cronbach alpha coefficients of the Turkish PFDI-20 and PFIQ-7 questionnaires were 0.908 and 0.830, respectively. Significant correlations were observed between the scores of the questionnaires with the vaginal examination findings. The PFDI-20 and PFIQ-7 scores were significantly improved after vaginal reconstructive surgery. CONCLUSIONS Turkish translated versions of the PFDI-20 and PFIQ-7 are reliable, valid and responsive instruments for assessing symptom severity, impact on QoL in women with pelvic organ prolapse. They can be easily administered and self-completed by Turkish women.

Neuromuscular Morphometry of the Vaginal Wall in Women With Anterior Vaginal Wall Prolapse

The aim of this study was to compare the changes in hystomorphometry and innervation of the anterior vaginal wall in women with and without anterior vaginal wall prolapse.

Neuromuscular morphometry of the uterine ligaments and vaginal wall in women with pelvic organ prolapse

The aim of this study was to compare neuromuscular histomorphometry of the uterine ligaments and vaginal wall in women with and without pelvic organ prolapse.

The assessment of quality of life in female Turkish patients with overactive bladder

The objective of this study was to examine the quality of life in female Turkish patients with overactive bladder (OAB). The investigation was conducted as a cross-sectional study between January and April 2010. Two hundred eighty female patients responded to the Overactive Bladder Validated Eight-Question Screener, the OAB disease-specific health-related quality-of-life scale (OAB questionnaire (OAB-q)) and the general quality-of-life scale EuroQol Five-Dimensional Questionnaire (EQ-5D) for the study. Of the 280 patients, 38.9% was classified as having OAB. The mean age was 47.0 ± 8.7. All of the quality-of-life domains (coping, concern, sleep and social) and OAB-q total scores in women with OAB were significantly worse than in women without OAB (P < 0.001 for all). Similarly, the EQ-5D(index) and EQ-5D(VAS) scores for women with OAB were significantly worse than for women without OAB (P < 0.001 and P = 0.006, respectively). OAB-q and EQ-5D(index) scores in menopausal women were significantly lower than non-menopausal women (P < 0.05) in patients with OAB. In conclusion, OAB negatively affects quality of life in Turkish women. However, many womens quality of life can be improved if the patients seek medical treatment. Thus, nurses should encourage the patients to seek medical support in order to cope with health-related quality-of-life problems.

The investigation of tumoral angiogenesis with HIF-1 alpha and microvessel density in women with endometrium cancer

OBJECTIVE Hypoxia inducible factor 1 alpha (HIF-1α) is a nuclear protein upregulated in response to reduced cellular oxygen concentration which therefore acts as a marker for hypoxia. The aim of this study was to determine tumoral angiogenesis with immunohistochemical markers in endometrium cancer and its relation with stage, grade, survival rates and other prognostic factors. MATERIAL AND METHODS Using the database in our Gynecologic Oncology clinic, we selected 94 patients who were diagnosed with endometrial cancer and underwent primary surgery at our institution between 2001 and 2010. Tissue microarrays believed to demonstrate the optimum part of the tumor were reprepared from the paraffin blocks. Angiogenesis and microvessel density (MVD) were investigated with the aid of HIF-1α and CD34 antibodies. RESULTS High expression of HIF-1α was significantly more frequent in advanced grade endometrial cancers (p=0.044). HIF-1α expression was highly correlated with CD34 expression in the tumor cells (p<0.001). However lack of relation among stage, overall survival rates and histological types were analyzed with HIF-1α. When we compared HIF-1α positive and negative cases with cervical, adnexial, lymphovascular and myometrial invasion, there was no difference between these groups. MVD was evaluated with CD34 and it was remarkable and significantly different on advanced grade tumors (r=0.268; p=0.009). A similar significant difference was observed between the high expression of CD34 and type II endometrial cancer histology (p<0.001). However, there was no relationship between the MVD and stage or survival rates. CONCLUSION High expression of HIF-1α is associated with tumoral angiogenesis in endometrial adenocarcinomas. Further studies targeting HIF-1α for disrupting mechanisms essential for tumor growth in endometrium cancer will be significant investigations in the future.

Association between Beta-Sympathomimetic Tocolysis and Risk of Autistic Spectrum Disorders, Behavioural and Developmental Outcome in Toddlers

AIM: To investigate whether maternal intravenous beta-mimetic tocolytic therapy increases the risk of autistic spectrum disorders (ASD) and poorer behavioural and developmental outcomes. METHOD: Our study is a prospective case-control study among 90 children between 1.5 and three years old. Cases (n = 46) were toddlers with betamimetic tocolytic exposure; control group toddlers (n = 44) were tocolytic untreated. Treated and untreated groups were also divided into subgroups: term and preterm delivered. The gestational age of tocolytic treatment start, the dose and duration of exposure in hours were obtained from obstetric medical records. The Brief Infant-Toddler Social and Emotional Assessment (BITSEA), the Modified Checklist for Autism in Toddlers (M-CHAT) and the Denver Developmental Screening Test (DDST) tests were applied for evaluation of social, emotional problems, autism and developmental disorders. RESULTS: Term and preterm born toddlers treated tocolytically in utero didn’t demonstrate a higher risk of autistic disorders or poorer behavioural and developmental results than controls. In the preterm group, the earliest start of tocolytic treatment was correlated with toddlers lower score of the Competencies Scale (p = 0.009) and a higher score of the Problems Scale (p = 0.048). Also, we concluded that preterm membrane rupture was associated with higher ASD risk in the untreated group (p = 0.043). CONCLUSION: Exposure to betamimetics during pregnancy was not associated with an increased risk of autism, behavioural and developmental disorders.

Effect of pelvic floor muscle exercise on pelvic floor muscle activity and voiding functions during pregnancy and the postpartum period: Effect of Pregnancy and Delivery on Pelvic Floor

The aim of this study was to investigate the effects of pelvic floor muscle exercise during pregnancy and the postpartum period on pelvic floor muscle activity and voiding functions.

Quality of life in women with infertility via the FertiQoL and the Hospital Anxiety and Depression Scales: Quality of life in women with infertility

The aim of this study was to examine the relationships between quality of life, anxiety, and depression in female patients with infertility. This was a cross-sectional study with 89 women with infertility. Patients completed a questionnaire that included demographic data, the FertiQoL scale, and the Hospital Anxiety and Depression Scale. The average total FertiQoL score was 66.0 ± 14.5. There were negative correlations between the treatment and core FertiQoL scores and the Hospital Anxiety-Depression subscale scores. The attempted conception duration was negatively correlated with the total and core (emotional, mind-body, and social subscales) scores of the FertiQoL. The number of in vitro fertilizations was negatively correlated with the total, core (mind-body subscale), and treatment (tolerability subscale) scores of the FertiQoL. In conclusion, infertility significantly reduces quality of life in women by increasing their anxiety and depression levels. Thus, healthcare professionals should consider quality of life with a holistic approach when examining and treating women with infertility.

İn utero sodyum valproata maruz kalan 13-14 haftalık. omfalosel olgusu

Omfalosel 1/3200 ile 1/10 000 canli dogum arasinda gorulen nadir bir durumdur. Abdominal icerigin orta hattan herniye olmasi olarak tanimlanabilir. Vakalarin yaklasik yarisi diger malformasyonlarla iliskilidir. Ayrica multipl anomali sendromlari (Beckwith-Wiedemann ve CHARGE gibi), trizomi 13, 18, 21 ve triploidiler de eslik edebilmektedir. Valproik asid ve tuz formu sodyum valproate konvulsif hastaliklarin tedavisinde kullanilan antikonvuzanlardir. Ilac, plasentadan fetuse hizla gecmektedir. Gebelikte valproik asid ve sodyum valproate kullaniminda gorulen fetal ve neonatal sorunlar arasinda major ve minor konjenital anomaliler, intrauterin gelisme geriligi, hiperbiluribinemi, hepatotoksisite, gecici hiperglisinemi, fetal ve neonatal distres sayilabilmektedir. Makalede, gebeligi esnasinda valproik asid kullanan ve 13-14 hafialilf iken yapilan ultrasonografide omfalosel tespit edilen olgu sunularak, konu guncel literaturun isiginda tartisilmistir.